Effect of temporary cements and their removal methods on the bond strength of indirect restoration: a systematic review and meta-analysis

OBJECTIVES

For a conventional indirect restoration, temporary cementation inevitably contaminated collapsed dentin collagen. The purpose of this review was to evaluate the optimal strategy for minimizing its negative effects.

MATERIAL AND METHODS

Databases such as PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for in vitro studies, involving the influence of immediate dentin sealing (IDS), different temporary cements, and their removal strategies on dentin bond strength. The meta-analysis used the inverse variance method with effect method of the standardized mean difference and statistical significance at p ≤ 0.05. The I² value and the Q-test were used to assess the heterogeneity.

RESULTS

A total of 14 in vitro trials were subjected to the meta-analysis. Within the study's limitations, we assumed that IDS eliminated the negative effects of temporary bonding, achieving the comparable immediate bond strength with the control (p = 0.46). In contrast, under delayed dentin sealing (DDS), temporary cementation statistically decreased bond strength (p = 0.002). Compared with resin-based and non-eugenol zinc oxide cements, polycarboxylate and calcium hydroxide cements performed better on bond strength with no statistical difference from the control group (p > 0.05). Among the removal methods of temporary cements, the Al₂O₃ abrasion restored the decreased bond strength (p = 0.07) and performed better than hand instruments alone (p = 0.04), while pumice removal slightly reduced the bond strength in contrast with the control group (p = 0.05, 95% CI =  - 1.62 to 0).

CONCLUSIONS

The choices of IDS, polycarboxylate and calcium hydroxide temporary cements, Al₂O₃ abrasion removal method were feasible and efficient to enhance the bond strength.

CLINICAL RELEVANCE

It is worthwhile applying IDS technique, polycarboxylate and calcium hydroxide temporary cements during indirect restoration. The Al₂O₃ abrasion of cleaning dentin can minimize the negative effects of temporary cement.

The effect of mechanical and chemo-mechanical temporary cement cleaning methods on shear bond strength with self-adhesive resin cement (an in-vitro study)

BACKGROUND

Adhesive tooth-colored restorations are strongly dependent on the substrate surface cleanliness to allow intimate contact between resin cement and dentin surface, so several methods were adopted for the total cleaning of temporary cement residues. This study aimed to assess the effect of mechanical and chemo-mechanical cleaning methods of temporary cement on the immediate shear bond strength of self-adhesive resin cement to dentin surface.

METHODS

Forty freshly extracted lower first premolars were cut to expose a flat dentin surface. Discs of temporary crown composite resin material were constructed and cemented to the flat dentin surface using resin-based and non-eugenol temporary cement then stored at room temperature in distilled water. Dividing of samples into two groups according to the method of temporary cement cleaning. Group I (n = 20) mechanical cleaning using the rotary instrument, and group II (n = 20) chemo-mechanical cleaning using chlorhexidine-containing scrub. CAD/CAM reinforced Composite discs were bonded to the dentin surface using self-adhesive composite resin cement, then measurement of shear bond strength was done using a universal testing machine. Further analysis of failure mode after debonding was performed by Scanning electron microscope.

RESULTS

No statistically significant difference was found between the mean shear bond strength of the two cleaning methods (P-value = 0.636). Regardless of the cleaning method, the group cemented with resin-based temporary cement showed statistically significantly higher mean shear bond strength than non-eugenol temporary cement (P-value = 0.048).

CONCLUSION

Both cleaning methods (mechanical and chemo-mechanical) applied in this study were effective in cleaning temporary cement remnants from the dentin substrate surface with statistically significant differences between results of shear bond strength with significantly higher values recorded with resin-based temporary cement.

Evaluation and Comparison of Two Different Cleaning Procedures on Mechanical Properties for Recemented Restoration Using Two Conventional Glass Ionomer Cement Types: An In Vitro Study

Background In modern dentistry, fixed dental prostheses are often the preferred and the most complex treatment procedures. However, the success of these procedures depends to a great extent on the durability and consistency of the ongoing reconstruction. This paper aimed to compare the shear bond characteristics of conventional glass ionomer cement types, namely, Vivaglass luting cement and GC fuji 1 cement, after being subjected to two different dentin-cleaning techniques: the tungsten carbide bur and the prophy jet. This would help determine whether the castings that have been cleaned and recemented are just as tenacious as when they were initially placed. Methodology A total of 60 human teeth extracted due to periodontal disease were collected for this study. The teeth were cleaned and stored in a thymol arrangement after carefully removing any leftover fragile tissue. They were randomly grouped as follows: luted with Vivaglass cement (N = 30) in group A and GC fuji 1 cement (N = 30) in group B. Each group's debonded surfaces were arbitrarily split into three subgroups, with each containing 10 samples. This was done to comply with dentin-cleaning techniques for recementation. Results The intergroup bond strengths calculated were compared among the subgroups. The mean strength for subgroup IA was 2.78 ± 0.24 MPa, subgroup IB was 2.60 ± 0.30 MPa, subgroup IIA was 4.39 ± 0.19 MPa, subgroup IIB was 3.80 ± 0.23 MPa, subgroup III A was 4.52 ± 0.22 MPa, and subgroup IIIB was 3.63 ± 0.17 MPa. An analysis of variance test showed there was a significant difference between the subgroups (F = 117.60; P = 0.001). The results revealed that there was a significant difference between the subgroups. Shear bond strength testing was performed using common testing equipment. The results indicated that there was not any significant difference between the mean increases in the shear bond strength of the two luting cement types. However, the GC fuji 1 cement showed greater initial shear bond strength than the Vivaglass cement. Additionally, when the tungsten carbide bur was used as a cleaning technique before recementing, it showed greater shear bond strength compared to the prophy jet. Conclusions The initial shear bond strength of GC fuji 1 (Group B) luting cement was slightly higher than that of Vivaglass (Group A), and the bond strength achieved after recementation with GC fuji 1 and surface cleaning with the carbide bur was the highest among the other three groups.

A randomized, controlled clinical evaluation of two resin cement systems in the adhesion of CAD/CAM-fabricated resin nanoceramic restorations: 18-month preliminary results

OBJECTIVE

The purpose of this clinical study was to evaluate the performance of two different adhesive resin cement systems in the cementation of inlay/onlay restorations produced from resin nanoceramic blocks using the CAD/CAM system.

MATERIALS AND METHODS

A total of 70 inlay/onlay restorations made from Cerasmart (GC, Tokyo, Japan) resin nanoceramic blocks using CEREC Omnicam (Sirona Dental, Bensheim, Germany) were placed in 53 patients. The restorations were cemented with RelyX U200 Automix (3M ESPE, Seefeld, Germany) self-adhesive resin cement (RXU) after selective enamel etching or with G-CEM LinkForce (GC, Tokyo, Japan) adhesive resin cement (GCL) in combination with a universal adhesive (G-Premio Bond) in selective etch mode. At baseline and after 6, 12, and 18 months, restorations were examined by two calibrated clinicians according to modified USPHS criteria. The data were analyzed using Chi-square (χ² ) test and Friedman test (p < 0.05).

RESULTS

After 18 months, two teeth at RXU group were endodontically treated due to hypersensitivities. At GCL group, three restorations were lost due to debondings (2) and ceramic fracture (1). The survival rates of RXU (94.3%) and GCL group (91.4%) exhibited no statistically significant difference (p = 0.661). No significant differences were detected for surface texture, secondary caries, anatomic form, color match, marginal discoloration, marginal integrity, interproximal contacts, and patient satisfaction (p > 0.05).

CONCLUSIONS

The two resin cement systems showed acceptable clinical performance for the cementation of resin nanoceramic CEREC Omnicam inlay/onlay restorations.

CLINICAL SIGNIFICANCE

Resin nanoceramic restorations fabricated using CEREC Omnicam and cemented with either a self-adhesive or a universal adhesive/resin cement system demonstrated clinically acceptable results for posterior teeth in a single visit.

Influence of resin removal treatments on the surface topography and strength of de-bonded lithium disilicate ceramic

AIM

This study aims to assess the influence of resin removal treatment regimes on the surface topography and compressive strength of de-bonded ceramic surfaces.

MATERIAL AND METHODS

Sixty-five lithium disilicate ceramic (LDC) discs were prepared, cleaned, and polished with carbide paper. All samples were etched using 9.6% hydrofluoric acid (HFA). Fifteen samples were taken as positive controls; the remaining 50 samples were subjected to the process of silanization. Resin build-up using dual-cure cement was performed incrementally and light cured. Based on different methods of resin cleaning from de-bonded LDC, the samples were divided into five groups, n=10 each: group 1 (no treatment), group 2 (slow-speed diamond bur), group 3 (1 min heat treatment), Group 4 (6 min heat treatment), and group 5 (sandblasting with Al₂O₃). Following resin removal, LDC samples were tested under compressive failure load in a universal testing machine. Five disc specimens from each group were sputter coated with gold for scanning electron microscopy (SEM). Analysis of variance (ANOVA) and Tukey's post hoc test was used for descriptive statistics. Level of significance was established at p<0.05.

RESULTS

The highest compressive strength with significant difference among all experimental groups was found in group 5 (321.54 ± 13.25 MPa) (p<0.05). The lowest compressive strength values, presenting significant difference compared with all other groups, were displayed in group 1 (158.57 ± 5.22 MPa) (p<0.05). Compressive strength among group 2 (231.54 ± 15.55 MPa), group 3 (237.81 ± 10.81 MPa), and group 4 (255.53 ± 8.95 MPa) specimens was statistically comparable (p>0.05). On SEM, heat-treated specimens confirmed coarser granules, with mild porosities and roughening, whereas sandblasted specimens exhibited consistent evenness with moderate porosity and loss of glazed surface.

CONCLUSION

De-bonded LDC surface, treated with heat treatment and sandblasting procedures, exhibited removal of residual resin and significantly high compressive strength compared with non-cleansed ceramic surface.

Effects of Desensitizers, Temporary Cements, and Dentin Cleaning Methods on the Bond Strength of Self-Etch/ Adhesive Resin Cements to Dentin: An In Vitro Study

Aim:

The aim of this study was to evaluate the effect of desensitizer, temporary cements, dentin cleaning methods on shear bond strength (SBS) of self-etch and self-adhesive resin cements to dentin.

Materials and Methods:

Four hundred eighty buccal or lingual/palatine coronal portions of human molar teeth were mounted in the acrylic blocks. Teeth surfaces were prepared until the dentin was exposed. Specimens were divided into four groups. One group separated as control and three groups of teeth were treated with a desensitizing agent containing calcium-phosphate desensitizer (Teethmate Desensitizer, TMD), resin-based self-reinforcing monomer (Shield Force Plus, SFP) and 2-hydroxyethyl methacrylate and glutaraldehyde (Gluma Desensitizer). Two different temporary cement containing calcium hydroxide (Dycall) and zinc oxide based (Rely X Temp NE) temporary cement were applied to the dentin surfaces. Temporary cement was removed with one of three cleansing techniques: 2% chlorhexidine digluconate and glass particles containing agent (Consepsis Scrub), cleansing bur (OptiClean), and ıntra/extracoronal rotary brush (Starbrush). All groups were further divided into two cementation subgroups (Panavia V5 and Panavia SA). The SBS (MPa) was measured using a universal testing machine at 0.5 mm/min crosshead speed. The data were analyzed statistically with a four-way analysis of variance and Tukey’s Honest Significant Difference test ( α = 0.05).

Results:

Although SFP showed higher SBS, there was no statistically significant difference between other groups ( P > .05). There were no significant differences between temporary cements ( P > .05). OptiClean rotary bur showed higher mean SBS values in all groups. The dual-polymerized Panavia V5 showed the highest SBS values in all groups ( P <.05).

Conclusion:

Cleaning of dentin surface from temporary cement remnants with a silicon bur and dual-cure resin cement showed the highest bond strength values.

Effectiveness of dentin pre-treatment on bond strength of two self-adhesive resin cements compared to an etch-and-rinse system: an in vitro study

Statement of problem

It has been shown that selective etching improves the bond strength of some self-adhesive resin cements to enamel. The same has yet to be determined with dentin pre-treatment.

Purpose

To evaluate the tensile bond strength of two self-adhesive resin cements after two dentin surface pre-treatments, and also to analyze the cement/dentin interface.

Material and Methods

One hundred and twelve human third molars were extracted. The teeth were distributed into seven groups (n = 16). Maxcem Elite Chroma (MAX) (Kerr, Scafati, Italy) and Relyx U200 (RLX) (3M ESPE, Neuss, Germany) were used without pre-treatment or with two dentin pre-treatments (polyacrylic acid or phosphoric acid). A conventional etch-and-rinse (EAR) luting cement, NX3 Nexus (NX3) (Kerr, Scafati, Italy), was used as an external control group. Before testing, all specimens were stored in distilled water for 24 hours. Three specimens from each group were prepared for scanning electron microscopy observation (SEM). A tensile bond strength test (TBS) was performed for the remaining samples. The data were statistically analyzed using the Kruskal–Wallis test and Pairwise comparisons using the Wilcoxon rank sum test.

Results

MAX without pre-treatment and with phosphoric acid etching attained statistically similar bond strengths to NX3 (P > 0.05). There was a statistical difference (P = 0.00488) between RLX without pre-treatment (5.62 MPa) and NX3 (10.88 MPa). Phosphoric acid pre-treatment increases the bond strength values of RLX to a strength that is comparable to NX3 (P > 0.05). The lowest tensile bond strength (TBS) was attained after the application of polyacrylic acid with MAX (1.98 MPa). No statistical differences were found between the RLX bond strength values after polyacrylic acid treatment and RLX without pre-treatment or NX3 (P > 0.05). SEM observations disclosed an enhanced potential of the self-adhesive cements to infiltrate into dentin tubules and form resin tags when applied after phosphoric acid pre-treatment. The failure mode was dominantly adhesive.

Conclusions

On dentin, the self-adhesive resin cement MAX might be an effective alternative to conventional resin cement. Etching the dentin with phosphoric acid does not have a negative effect on the bond strength of MAX to dentin. On the other hand, phosphoric acid improved the bond strength of RLX when compared to EAR cement.

Status of decontamination methods after using dentin adhesion inhibitors on indirect restorations: An integrative review of 19 publications

The purpose of this review was to assess the literature regarding the decontamination of resin cement before the luting procedure in order to provide clinicians with a comparative overview of decontamination effects. A total of 19 articles were selected for inclusion in this review. The results indicated that bonding effectiveness is reduced due to residual adhesion inhibitors such as saliva, blood, hemostatic agents, and temporary/provisional cement. Self-etching and self-adhesive systems tend to be more negatively affected by adhesion inhibitors than do etch and rinse systems. Cleaning with an ultrasonic scaler or rotating brush have demonstrated conflicting effects in several studies. Some studies have reported that phosphoric acid has negative effects and recommend mild acid for decontamination. The application of phosphoric acid followed by sodium hypochlorite has been shown to help avoid negative effects. Alumina blasting has been investigated as a mechanical cleaning method in a relatively large number of experiments, most of which have confirmed its effectiveness. An intraoral cleaner containing functional monomers that has become commercially available in recent years is a promising method in clinical practice because it can easily and effectively remove temporary adhesive material. In addition, adhesion inhibitors can be easily removed from resin-coated dentin surfaces.

Airborne-particle Abrasion and Dentin Bonding: Systematic Review and Meta-analysis

CLINICAL RELEVANCE

The literature reviewed suggests that airborne particle abrasion has no negative effects on the bond strength of resin-based materials to dentin and that a positive influence on dentin bond strength was only achieved in specific air-abrasion conditions.

SUMMARY

In this systematic review the authors investigated how airborne-particle abrasion (APA) using aluminum oxide affects the bond strength of resin-based materials to dentin. The search was performed in three databases. In vitro studies (Type of study) comparing the bond strength of resin-based materials (Outcome) to air-abraded (Intervention) compared with non-air-abraded (Comparison) human dentin (Population) were included (the PICOT elements are given parenthetically). From 5437 unique articles, 65 were read in full, 33 were included in the qualitative synthesis, and 32 were included in the meta-analysis. Methodologic quality and risk of bias were assessed. Comparisons were performed between air-abraded and control dentin groups by adopting a random-effects model (α=0.05). Additional analyses were carried out for the different parameters used in APA: type of surface treatment in the control group, particle size, air pressure, and APA duration. The bond strength to air-abraded dentin was favored only when the control surface was treated with a hand excavator. For particle size, APA was favored when the particle size was >30 μm and the controls were no treatment or hand excavator or when the particle size was ≤30 μm and the control was bur. In addition, the results favored air-abraded groups only when the pressure was > 5 bar and bur was used in the control group. No significant differences were observed for duration of APA. No comparison on bond strength considering the presence of aging conditions was possible in the included studies due to the low number of studies that aged the specimens. In conclusion, APA had no negative effects on the bond strength of resin-based materials to dentin and was able to improve the dentin bond strength only when the particle size was > 30 μm and air pressure was > 5 bar. PROSPERO registration protocol: CRD42018096128.

Repair Surface Conditioning Measures Affect Enamel and Dentin Bond Strength

CLINICAL RELEVANCE

Contamination of enamel and dentin with repair surface conditioning measures should be avoided.

SUMMARY

Objectives: To analyze whether the contamination with different repair conditioning measures impairs the adhesive performance of a universal adhesive applied in etch-and-rinse mode (ER) or self-etch mode (SE).Methods and Materials: Bovine enamel and dentin surfaces (each subgroup n=16) were bonded with a universal adhesive in ER or SE after contamination with different repair conditioning measures (sandblasting, silica coating, hydrofluoric acid etching, self-etching ceramic primer). In half of the groups, sand-blasting, silica coating, and hydrofluoric acid etching was followed by the use of a universal primer. If the universal adhesive was applied in ER, contamination was performed either before or after phosphoric acid etching. If the universal adhesive was applied in SE, bonding was performed after contamination. In the control groups, no contamination was simulated. Shear bond strength (SBS) and failure modes of composite buildups were determined after thermal cycling (10,000 cycles, 5°C-55°C). Statistical analysis was performed using analyses of variance, Weibull statistics, and χ2 tests (p<0.05).Results: In ER, sandblasting and silica coating significantly reduced SBS (control: enamel =25.7±4.2 MPa; dentin = 22.0±5.3 MPa) only when performed after phosphoric acid etching. Contamination with hydrofluoric acid impaired SBS on enamel but not on dentin. The self-etching ceramic primer reduced SBS, but not significantly. The contamination with the universal primer had no significant effect. In SE, all repair conditioning measures except the universal primer reduced SBS (control: enamel = 20.3±5.5 MPa; dentin = 23.0±4.0 MPa).Conclusion: Contamination of enamel and dentin by repair conditioning measures potentially affects bond strength.

Influence of Dentine Pre-Treatment by Sandblasting with Aluminum Oxide in Adhesive Restorations. An In Vitro Study

Dentine pretreatment through sandblasting procedures has been widely studied but no curve test results are currently available. Thus, the aim herein was to in vitro compare the adhesive strength in sandblasted or not samples using a universal testing machine. Thirty -two bovine teeth were divided into two groups, namely test (n = 16 bars), sandblasting with aluminum oxide particles (50 µm) was performed before the adhesion procedures), and control (n = 16 bars), where no sandblasting procedure was performed. A bi-material curve test was used to evaluate the characteristics of the dentine pretreatment in terms of tensile stress and fracture strength. A scanning electron microscope (SEM) was used to analyze the fracture topography in the composite, bonding, dentin, and at the relative interfaces. The results demonstrated a statistically significant difference between the two groups in terms of tensile stress at maximum load showing values of 84.300 ± 51.342 MPa and 35.071 ± 16.609 MPa, respectively for test and control groups (p = 0.033). Moreover, a fracture strength test showed values of 18.543 ± 8.145 MPa for test and 8.186 ± 2.833 MPa for control group (p = 0.008). In conclusion, the sandblasting treatment of the dentine significantly influenced the mechanical resistance of the adhesion in this in vitro study.

Effect of Etching Procedures on the Adhesion of Biofilm-Coated Dentin

Oral biofilms coat all surfaces in the oral cavity including the exposed dentin surface. This study aimed to investigate biofilm removal by acid etching procedures and the effects of the residual biofilm on dentin surfaces on composite-dentin adhesion. Dentin discs were assigned to five groups: no biofilm formation (C); biofilm formation and no surface treatment (BF); biofilm formation and acid etching (BF-E); biofilm formation and acid etching followed by chlorhexidine soaking (BF-EC); and biofilm formation and rubbing with pumice, followed by acid etching (BF-RE). Biofilms were formed on saliva-precoated dentin discs by soaking the discs in Streptococcus mutans (S. mutans) suspension. Biofilm removal from the dentin surface was evaluated quantitatively and qualitatively by confocal laser scanning microscopy and scanning electron microscopy, respectively. To compare the bond strength of the biofilm-coated dentin discs with the surface treatments, specimens were assigned to four groups: no biofilm formation and acid etching (C-E); BF-E; BF-EC; and BF-RE. Assessments of the micro-shear bond strength and subsequent failure modes were performed. BF-E and BF-EC did not remove the biofilm, whereas BF-RE partially removed the biofilm attached to the dentin (p < 0.05). The bond strength of BF-RE was significantly higher than those of BF-E and BF-EC, but lower than that of C-E (p < 0.05). In conclusion, mechanical biofilm removal is recommended before etching procedures to enhance adhesion to the biofilm-coated dentin.

Effect of Pretreatment and Activation Mode on the Interfacial Adaptation of Nanoceramic Resin Inlay and Self-adhesive Resin Cement

OBJECTIVES

The first objective of this study was to determine if the luting material used for resin nanoceramic inlay affects interfacial adaptation. The second was to investigate whether pretreatment and the adhesive curing method before cementation affects interfacial adaptation. The final objective was to compare activation modes of luting material.

METHODS

Class I cavities were prepared on extracted human third molars. Resin nanoceramic inlays were fabricated using Lava Ultimate CAD/CAM block (3 M). For the control groups, inlays were cemented using Panavia V5 (Kuraray Noritake). For the experimental groups, teeth were randomly divided into five experimental groups with four subgroups using different self-adhesive cements (SACs). Cement in Group I was dual-cured without pretreatment. In Group II, the cement was dual-cured after polyacrylic acid treatment of the tooth cavity. In Groups III and IV, the cement was dual-cured after universal dentin adhesive treatment with pre-cure and co-cure methods. In Group V, the inlay was cemented in self-cure mode. After thermocycling, interfacial adaptation at the inlay-tooth interface was measured using swept-source optical coherence tomography (SS-OCT) imaging. Finally, polymerization shrinkage strain of the luting material was measured and compared.

RESULTS

Interfacial adaptation differed depending on the luting material. After application of a universal adhesive, some subgroups showed improved interfacial adaptation. Interfacial adaptation and polymerization shrinkage strain differed significantly depending on activation mode.

SIGNIFICANCE

Interfacial adaptation for a resin nanoceramic inlay can differ according to the type of SAC and activation mode. For some SACs, application of a universal adhesive before cementation improves interfacial adaptation.

Improved mechanical performance of self-adhesive resin cement filled with hybrid nanofibers-embedded with niobium pentoxide

OBJECTIVES

In this study hybrid nanofibers embedded with niobium pentoxide (Nb₂O₅) were synthesized, incorporated in self-adhesive resin cement, and their influence on physical-properties was evaluated.

METHODS

Poly(D,L-lactide), PDLLA cotton-wool-like nanofibers with and without silica-based sol-gel precursors were formulated and spun into submicron fibers via solution blow spinning, a rapid fiber forming technology. The morphology, chemical composition and thermal properties of the spun fibers were characterized by field emission scanning electron microscopy (FE-SEM), energy dispersive X-ray spectroscopy (EDS) and Fourier-transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC), respectively. Produced fibers were combined with a self-adhesive resin cement (RelyX U200, 3M ESPE) in four formulations: (1) U200 resin cement (control); (2) U200+1wt.% PDLLA fibers; (3) U200+1wt.% Nb₂O₅-filled PDLLA composite fibers and (4) U200+1wt.% Nb₂O₅/SiO₂-filled PDLLA inorganic-organic hybrid fibers. Physical properties were assessed in flexure by 3-point bending (n=10), Knoop microhardness (n=5) and degree of conversion (n=3). Data were analyzed with One-way ANOVA and Tukey's HSD (α=5%).

RESULTS

Composite fibers formed of PDLLA-Nb₂O₅ exhibited an average diameter of ∼250nm, and hybrid PDLLA+Nb₂O₅/SiO₂ fibers were slightly larger, ∼300nm in diameter. There were significant differences among formulations for hardness and flexural strength (p<0.05). Degree of conversion of resin cement was not affected for all groups, except for Group 4 (p<0.05).

SIGNIFICANCE

Hybrid reinforcement nanofibers are promising as fillers for dental materials. The self-adhesive resin cement with PDLLA+Nb₂O₅ and PDLLA+Nb₂O₅/SiO₂ presented superior mechanical performance than the control group.

Analysis of the bond interface between self-adhesive resin cement to eroded dentin in vitro

The purpose of this study was to evaluate the bonding interface between a self-adhesive resin cement to in vitro eroded dentin. Seventy-two third molars were used and divided into two groups: sound dentin and in vitro eroded dentin. The in vitro erosion was performed following a demineralization protocol, in which the specimens were immersed in a demineralizing solution for 2 minutes per cycle and remineralizing solution for 10 minutes per cycle for 9 days. Both groups were submitted to four dentin surface treatments: control group (without any treatment), 2% chlorhexidine, 20% polyacrylic acid, and 0.1 M EDTA (n = 9). Blocks of resin-based composite were bonded with RelyX U200 self-adhesive resin cement applied on the pretreated dentin surfaces. The teeth were sectioned into beams (1mm²) and submitted to microtensile bond strength testing to evaluate the bond strength of self-adhesive resin cement to dentin after 24 hours and 8 months of immersion in artificial saliva. Three specimens of each group were longitudinally cut and evaluated using confocal laser scanning microscopy to analyze the dentin/cement interface. Eroded dentin showed higher bond strength values when compared to sound dentin for the 2% chlorhexidine group (p = 0.03), 24 hours after adhesion. When considering eroded dentin, the 0.1M EDTA group showed higher bond strength values with a statistically significant difference only for the control group (p = 0.002). After 8 months of storage, the present results showed that there was no statistically significant difference between the two substrates for all experimental groups (p>0.05). Analysis of the microscopy confocal showed different types of treatments performed on dentin generally increased tags formation when compared to the control group. The eroded dentin showed a significant increase in density and depth of resinous tags when compared to sound dentin. The storage of samples for 8 months seems to have not caused significant degradation of the adhesive interface.

Dental Cements for Luting and Bonding Restorations: Self-Adhesive Resin Cements

Self-adhesive resin cements combine easy application of conventional luting materials with improved mechanical properties and bonding capability of resin cements. The presence of functional acidic monomers, dual cure setting mechanism, and fillers capable of neutralizing the initial low pH of the cement are essential elements of the material and should be understood when selecting the ideal luting material for each clinical situation. This article addresses the most relevant aspects of self-adhesive resin cements and their potential impact on clinical performance. Although few clinical studies are available to establish solid clinical evidence, the information presented provides clinical guidance in the dynamic environment of material development.

Comparison between shear forces applied on the overlay-dental tissue interface using different bonding techniques: An in vitro study

Aim:

The aim of this study was to compare the adhesion of glass-ceramic overlays to tooth structure, under the effect of shear forces, using different bonding systems.

Materials and Methods:

Thirty healthy lower third molars were selected and randomly allocated into three groups (n = 10). Group 1: overlays bonded to tooth structure using Panavia V5 with immediate dentin sealing (IDS); Group 2: overlays bonded using Panavia V5 without IDS; and Group 3: overlays bonded using heated composite combined with a bonding agent with IDS. All the restorations were made of glass-ceramic (Suprinity, Vita). The restored teeth were then stored in distilled water for 7 days and at room temperature. Shear forces were applied using a universal testing machine. Load and displacement were recorded at intervals of 0.1 s. A statistical analysis was used to compare the groups.

Results:

The mean resistance to fractures ± standard deviation obtained for the Groups 1, 2, and 3 was, respectively, 15.7440 ± 2.13, 12.0750 ± 1.41, and 8.33364 ± 2.85 MPa. The analysis of variance was highly significant (P < 0.001) allowing us to reject the null hypothesis of equality between the three groups. Comparisons between pairs also provided significant results.

Conclusion:

Bonding using Panavia V5 with IDS showed a better resistance to shear forces when compared to other bonding techniques. The application of IDS increased the adhesion.

Effect of Airborne Particle Abrasion on Microtensile Bond Strength of Total-Etch Adhesives to Human Dentin

Aim of this study was to investigate a specific airborne particle abrasion pretreatment on dentin and its effects on microtensile bond strengths of four commercial total-etch adhesives. Midcoronal occlusal dentin of extracted human molars was used. Teeth were randomly assigned to 4 groups according to the adhesive system used: OptiBond FL (FL), OptiBond Solo Plus (SO), Prime & Bond (PB), and Riva Bond LC (RB). Specimens from each group were further divided into two subgroups: control specimens were treated with adhesive procedures; abraded specimens were pretreated with airborne particle abrasion using 50 μm Al₂O₃ before adhesion. After bonding procedures, composite crowns were incrementally built up. Specimens were sectioned perpendicular to adhesive interface to produce multiple beams, which were tested under tension until failure. Data were statistically analysed. Failure mode analysis was performed. Overall comparison showed significant increase in bond strength (p < 0.001) between abraded and no-abraded specimens, independently of brand. Intrabrand comparison showed statistical increase when abraded specimens were tested compared to no-abraded ones, with the exception of PB that did not show such difference. Distribution of failure mode was relatively uniform among all subgroups. Surface treatment by airborne particle abrasion with Al₂O₃ particles can increase the bond strength of total-etch adhesives.

The effect of resin cement type and cleaning method on the shear bond strength of resin cements for recementing restorations

PURPOSE

This laboratory study assessed the effect of different dentin cleaning procedures on shear bond strength of resin cements for recementing prosthesis.

MATERIALS AND METHODS

4 × 4 flat surface was prepared on the labial surface of 52 maxillary central incisors. Metal frames (4 × 4 × 1.5 mm) were cast with nickel-chromium alloy. All specimens were randomly divided into 2 groups to be cemented with either Panavia F2.0 (P) or RelyX Ultimate (U) cement. The initial shear bond strength was recorded by Universal Testing Machine at a crosshead speed of 0.5 mm/min. Debonded specimens were randomly allocated into 2 subgroups (n = 13) according to the dentin cleaning procedures for recementation. The residual cement on bonded dentin surfaces was eliminated with either pumice slurry (p) or tungsten carbide bur (c). The restorations were rebonded with the same cement and were subjected to shear test. Data failed the normality test (P < .05), thus were analyzed with Mann Whitney U-test, Wilcoxon signed rank test, and two-way ANOVA after logarithmic transformation (α = .05).

RESULTS

The initial shear bond strength of group P was significantly higher than group U (P = .001). Pc and Uc groups presented higher bond strength after recementation compared to the initial bond strength. However, it was significant only in Pc group (P = .034).

CONCLUSION

The specimens recemented with Panavia F2.0 provided higher bond strength than RelyX Ultimate cement. Moreover, a tungsten carbide bur was a more efficient method in removing the residual resin cement and increased the bond strength of Panavia F2.0 cement after recementation.

Effect of Enamel and Dentin Surface Treatment on the Self-Adhesive Resin Cement Bond Strength

Abstract The aim of this study was to evaluate the effect of enamel and dentin surface treatment on the micro-shear bond strength of self-adhesive cement. Seventy-two extracted third molars had their crowns embedded in acrylic resin and worn to obtain a flat enamel or dentin surface. The enamel and dentin specimens were randomly assigned to 8 groups (n=12) that were based on surface treatment (11.5% polyacrylic acid solution or no treatment), substrate condition (wet or dry) and storage period (1 day or 90 days), and treated accordingly. Cylinders (1 × 1 mm) were fabricated using self-adhesive resin cement (RelyX U200) following the manufacturer's instructions. The specimens were stored in distilled water at 37 °C for either 1 day or 90 days and subjected to micro-shear bond strength test (EMIC DL 2000 at 0.5 mm/min). After this, the failure type of the specimens was determined. Data were subjected to statistical analysis (a=0.05). According to the results, the 11.5% polyacrylic acid application decreased the bond strength in both enamel and dentin samples. The moist groups showed higher bond strength than the dry ones, regardless of the substrate and surface treatment. Storage period did not influence bond strength. In conclusion, surface treatment with 11.5% polyacrylic acid and absence of moisture decreased the bond strength of the resin-cement (RelyU200), regardless of the storage period.

Effect of Curing Mode on Shear Bond Strength of Self-Adhesive Cement to Composite Blocks

To overcome the disadvantages of computer-aided design/computer-aided manufacturing (CAD/CAM) processed indirect restorations using glass-ceramics and other ceramics, resin nano ceramic, which has high strength and wear resistance with improved polish retention and optical properties, was introduced. The purpose of this study was to evaluate the shear bond strength and fracture pattern of indirect CAD/CAM composite blocks cemented with two self-etch adhesive cements with different curing modes. Sand-blasted CAD/CAM composite blocks were cemented using conventional resin cement, Rely X Ultimate Clicker (RXC, 3M ESPE, St. Paul, MN, USA) with Single Bond Universal (SB, 3M ESPE, St. Paul, MN, USA) for the control group or two self-adhesive resin cements: Rely X U200 (RXU, 3M ESPE, St. Paul, MN, USA) and G-CEM Cerasmart (GC, GC corporation, Tokyo, Japan). RXU and GC groups included different curing modes (light-curing (L) and auto-curing (A)). Shear bond strength (SBS) analyses were performed on all the specimens. The RXC group revealed the highest SBS and the GC A group revealed the lowest SBS. According to Tukey's post hoc test, the RXC group showed a significant difference compared to the GC A group (p < 0.05). For the curing mode, RXU A and RXU L did not show any significant difference between groups and GC A and GC L did not show any significant difference either. Most of the groups except RXC and RXU L revealed adhesive failure patterns predominantly. The RXC group showed a predominant cohesive failure pattern in their CAD/CAM composite, Lava^TM Ultimate (LU, 3M ESPE, St. Paul, MN, USA). Within the limitations of this study, no significant difference was found regarding curing modes but more mixed fracture patterns were showed when using the light-curing mode than when using the self-curing mode.

Effect of dentin pretreatment and curing mode on the microtensile bond strength of self-adhesive resin cements

PURPOSE

The aim was to evaluate the effect of curing mode and different dentin surface pretreatment on microtensile bond strength (µTBS) of self-adhesive resin cements.

MATERIALS AND METHODS

Thirty-six extracted human permanent molars were sectioned horizontally exposing flat dentin surface. The teeth were divided into 12 groups (3 teeth/group) according to the dentin surface pretreatment methods (control, 18% EDTA, 10% Polyacrylic acid) and curing mode (self-curing vs. light-curing) of cement. After pretreatment, composite resin blocks were cemented with the following: (a) G-CEM LinkAce; (b) RelyX U200, followed by either self-curing or light-curing. After storage, the teeth were sectioned and µTBS test was performed using a microtensile testing machine. The data was statistically analyzed using one-way ANOVA, Student T-test and Scheffe's post-hoc test at P<.05 level.

RESULTS

For G-CEM LinkAce cement groups, polyacrylic acid pretreatment showed the highest µTBS in the self-cured group. In the light-cured group, no significant improvements were observed according to the dentin surface pretreatment. There were no significant differences between curing modes. Both dentin surface pretreatment methods helped to increase the µTBS of RelyX U200 resin cement significantly and degree of pretreatment effect was similar. No significant differences were found regarding curing modes except control groups. In the comparisons of two self-adhesive resin cements, all groups within the same pretreatment and curing mode were significantly different excluding self-cured control groups.

CONCLUSION

Selecting RelyX U200 used in this study and application of dentin surface pretreatment with EDTA and polyacrylic acid might be recommended to enhance the bond strength of cement to dentin.

Effect of different surface-cleaning techniques on the bond strength of composite resin restorations

STATEMENT OF PROBLEM

Different techniques have been suggested for cleaning dentin surfaces after the removal of an interim prosthesis and before the application of a bonding agent. How different surface-cleaning techniques affect the bond strength of the composite resin restorations is not clear.

PURPOSE

The purpose of this study was to investigate the effects of different surface-cleaning techniques on the bond strength of composite resin restorations and the surface topography of the prepared tooth surfaces.

MATERIAL AND METHODS

The occlusal surfaces of 25 molars were ground until the dentin was exposed. A bonding agent and interim cement were applied on the teeth. The teeth were divided into 5 groups (n=5) according to the method used for surface-cleaning (microairborne-particle abrasion, alcohol, rubber-rotary instrument, desiccating agent, and control). Once the surfaces of the teeth had been cleaned, the same bonding material was applied to the teeth. A 5-mm-thick composite resin layer was built up. Each specimen was sectioned to microbars, and 6 centrally located beams were selected for microtensile testing (n=30) (1.10 ±0.10 mm). The data were statistically analyzed with 1-way ANOVA (1-sample Kolmogorov-Smirnov test). The Bonferroni test was used for significantly different groups (α=.05). One specimen from each group was observed under a scanning electron microscope and an atomic force microscope. Energy dispersive x-ray analysis also was performed.

RESULTS

Bond strength values were in the following descending order: microairborne-particle abrasion, desiccating agent, alcohol, rubber-rotary instrument, control. Differences between the microairborne-particle abrasion group and the remainder of the groups, desiccating agent--rubber-rotary instrument, desiccating agent-control, alcohol--rubber-rotary instrument, and alcohol-control groups, were statistically significant (P<.05). The microairborne-particle abrasion group displayed the roughest surface and a different surface topography from the remainder of the groups. Increased aluminum was observed in the microairborne-particle abrasion group.

CONCLUSIONS

Surface-cleaning techniques, except for the rubber-rotary instrument, increased the bond strength of composite resin. The roughest dentin surfaces and highest bond strength were achieved with the microairborne-particle abrasion technique.

WITHDRAWN: Effect of different dentin cleaning techniques on bond strength and the micromorphology of dentin/self-adhesive resin cement interface

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Influence of different conditioning methods on immediate and delayed dentin sealing

STATEMENT OF PROBLEM

Data are needed to evaluate the effect of various conditioning methods on immediate and delayed dentin sealing.

PURPOSE

The purpose of this study was to test bond strength and surface configuration of immediate and delayed dentin sealing surfaces after applying different surface conditioning methods.

MATERIAL AND METHODS

A total of 96 premolars were allocated to the immediate and delayed groups. The groups differed in the timing of dentin sealing. The immediate-group specimens were sealed with a self-etching adhesive immediately after preparation. The delayed-group specimens were sealed before the final ceramic restoration bonding. Provisional restorations were cemented on immediate-group and delayed-group specimens for 1 week. Four conditioning methods were used: polishing with fluoride-free pumice paste, airborne-particle abrasion with silicoated aluminum oxide, glycin, or calcium carbonate. After 24-hour storage, the shear bond strength was tested. The fractured specimens were optically inspected with a stereomicroscope. An optical 3-dimensional surface analysis was performed for quantitative and qualitative evaluation. A 2-way ANOVA with post hoc Tukey honestly significant difference tests for significant effects was performed to investigate effects of the 2 factors, sealing and conditioning, and their interaction (α=.05).

RESULTS

Two-way ANOVA found significant differences between the sealing and conditioning groups. The immediate group had significantly lower bond strengths than the delayed group. In all groups, surface polishing produced the highest bond strengths, and airborne-particle abrasion with calcium carbonate produced the lowest. Fracture analysis found more failures in the adhesive layers in the immediate groups and a prevalence of mixed failures in the delayed groups. The surface analysis found significant abrasion and roughness when airborne-particle abrasion with silicoated aluminum oxide was used for immediate and delayed dentin sealing surfaces.

CONCLUSIONS

Polishing and airborne-particle abrasion with silicoated aluminum oxide or glycin are efficient methods in conditioning immediate and delayed dentin sealing surfaces. Airborne-particle abrasion with silicoated aluminum oxide leaves significant surface alterations on both types of surfaces.

Microshear bond strength according to dentin cleansing methods before recementation

PURPOSE

The aim of this study was to determine the efficiency of Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet laser in different output powers for removing permanent resin cement residues and therefore its influence on microshear bond strength compared to other cleaning methods.

MATERIALS AND METHODS

90 extracted human molars were sectioned in 1 mm thickness. Resin cement was applied to surface of sliced teeth. After the removal of initial cement, 6 test groups were prepared by various dentin surface treatment methods as follows: no treatment (Group 1), ethylene diamine tetra acetic acid application (Group 2), Endosolv R application (Group 3), 1.25 W Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet laser irradiation (Group 4), 2 W Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet laser irradiation (Group 5) and 3.5 W Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet laser irradiation (Group 6). The topography and morphology of the treated dentin surfaces were investigated by scanning electron microscopy (n=2 for each group). Following the repetitive cementation, microshear bond strength between dentin and cement (n=26 in per group) were measured with universal testing machine and the data were analyzed by Kruskal Wallis H Test with Bonferroni correction (P<.05). Fracture patterns were investigated by light microscope.

RESULTS

Mean microshear bond strength ± SD (MPa) for each group was 34.9 ± 17.7, 32.1 ± 15.8, 37.8 ± 19.3, 31.3 ± 12.7, 44.4 ± 13.6, 40.2 ± 13.2 respectively. Group 5 showed significantly difference from Group 1, Group 2 and Group 4. Also, Group 6 was found statistically different from Group 4.

CONCLUSION

2 W and 3.5 W Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet laser application were found efficient in removing resin residues.

The effect of dentin desensitizers and Nd:YAG laser pre-treatment on microtensile bond strength of self-adhesive resin cement to dentin

PURPOSE

The purpose of this study is to evaluate if pre-treatment with desensitizers have a negative effect on microtensile bond strength before cementing a restoration using recently introduced self-adhesive resin cement to dentin.

MATERIALS AND METHODS

Thirty-five human molars' occlusal surfaces were ground to expose dentin; and were randomly grouped as (n=5); 1) Gluma-(Glutaraldehyde/HEMA) 2) Aqua-Prep F-(Fluoride), 3) Bisblock-(Oxalate), 4) Cervitec Plus-(Clorhexidine), 5) Smart protect-(Triclosan), 6) Nd:YAG laser, 7) No treatment (control). After applying the selected agent, RelyX U200 self-adhesive resin cement was used to bond composite resin blocks to dentin. All groups were subjected to thermocycling for 1000 cycles between 5-55℃. Each bonded specimen was sectioned to microbars (6 mm × 1 mm × 1 mm) (n=20). Specimens were submitted to microtensile bond strength test at a crosshead speed of 0.5 mm/min. Kolmogorov-Smirnov, Levene's test, Kruskal-Wallis One-way Analysis of Variance, and Conover's nonparametric statistical analysis were used (P<.05).

RESULTS

Gluma, Smart Protect and Nd:YAG laser treatments showed comparable microtensile bond strengths compared with the control group (P>.05). The microtensile bond strengths of Aqua-Prep F, and Cervitec Plus were similar to each other but significantly lower than the control group (P<.05). Bisblock showed the lowest microtensile bond strength among all groups (P<.001). Most groups showed adhesive failure.

CONCLUSION

Within the limitation of this study, it is not recommended to use Aqua-prep F, Cervitec Plus and Bisblock on dentin when used with a self-adhesive resin cement due to the decrease they cause in bond strength. Beside, pre-treatment of dentin with Gluma, Smart protect, and Nd:YAG laser do not have a negative effect.

Does inhibition of proteolytic activity improve adhesive luting?

Endogenous enzymes may be involved in the biodegradation of adhesive restoration-tooth interfaces. Inhibitors of matrix metalloproteinases (MMPs) have been suggested to retard the bond-degradation process. Limited data are available on whether composite cements may also benefit from MMP inhibitors. Therefore, the aim of this study was to determine the effect of two MMP inhibitors--chlorhexidine digluconate (CHX) and galardin--on the microtensile bond strength (μTBS) of two self-adhesive composite cements to dentin. Ceramic specimens were cemented to bur-cut dentin surfaces using the self-adhesive composite cements RelyX Unicem 2 (3M ESPE) or Clearfil SA (Kuraray), or the etch-and-rinse composite cement Nexus 3 (Kerr) that served as the control. The surfaces were left untreated or were pretreated with MMP inhibitors (2% CHX or 0.2 mM galardin). The μTBS was determined 'immediately' and upon ageing (water storage for 6 months). Statistical analysis revealed a significant effect of the factors 'composite cement' and 'storage', as well as all interactions, but no effect of the MMP inhibitors. After 6 months of ageing, the μTBS decreased for all cements, except for the multistep etch-and-rinse luting composite when it was applied without MMP inhibitors. The MMP inhibitors could not prevent the decrease in μTBS upon ageing and therefore do not improve the luting durability of the composite cements tested.