Surface treatments for repair of feldspathic, leucite - and lithium disilicate-reinforced glass ceramics using composite resin

How the repair bonding strength of hybrid ceramic CAD/CAM blocks is influenced by the use of surface treatments and universal adhesives

We examined how different methods of surface treatment and different universal adhesives with or without extra silane affected the repair bonding strength of hybrid ceramic CAD/CAM restorations. Cerasmart specimens (n=320) were subjected to thermocycling and assigned to the following surface pretreatment protocols: control, diamond bur (DB), hydrofluoric acid (HF), and tribochemical silica coating (TSC). Half the specimens received a coating of silane, followed by application of the universal adhesives Futurabond M+ (FMU), Tokuyama Universal Bond (TUB), Single Bond Universal (SBU), or Clearfil Universal Bond Quick (CUQ) (n=10). A hybrid composite resin was used to simulate repair; then the specimens underwent further thermocycling. Shear bond strength (SBS) was determined and modes of failure were examined. The TSC-CUQ silane (-) group showed the highest SBS values. The best repairs were obtained when the surface was treated with TSC, with the exception of the DB-TUB silane (-) group. TUB increased SBS more than the other adhesives. Additional silane decreased SBS in the HF-TUB and TSC-CUQ groups, while increasing it in the TSC-TUB and DB-FMU groups (p<0.05).

Do different protocols affect the success rate or bond strength of glass-ceramics repaired with composite resin? A systematic review and meta-analysis

STATEMENT OF PROBLEM

Intraoral repair techniques prevent unnecessary replacement of ceramic restorations, thereby increasing the survival rate. However, adhesion between ceramics and the composite resin is challenging and how different protocols influence adhesion is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to analyze the influence of different protocols on repairing glass-ceramic surfaces with composite resins.

MATERIAL AND METHODS

PubMed, Scopus, ISI Web of Science, and Embase electronic databases were searched to select studies comparing bond strength values or survival rates of glass-ceramic repaired with composite resins using different surface treatment protocols. No publication year or language restriction was applied. Data sets were extracted from all included studies, and the mean differences calculated. A 95% confidence interval was calculated by using the random effect model (Rev Man 5.4).

RESULTS

The search identified 5037 studies, and 165 were assessed for eligibility. Finally, 123 in vitro studies were included in the systematic review and 48 in the meta-analysis. Considering different glass-ceramics, bond strength tests, and aged or not aged specimens, 37 meta-analyses found the effect of repair protocols: only adhesive, silane plus adhesive alone or preceded by hydrofluoric (HF) acid, airborne-particle abrasion (APA) with Al2O3 particles, silica-coated APA (SCAPA), diamond rotary instrument (DRI), and laser irradiation (LI).

CONCLUSIONS

For feldspathic porcelain, HF acid, APA, SCAPA, or DRI improved the repair micromechanical retention; applying silane is essential to HF-conditioned surfaces but the use of adhesive is optional when silane is applied. Results for leucite and lithium disilicate were inconclusive in terms of suggesting a treatment other than HF acid plus silane and adhesive applications.

Chemical Surface Modification Methods of Resin Composite Repaired with Resin-Modified Glass-Ionomer Cement

OBJECTIVE

 This study examined the chemical surface modification methods of resin composite repaired with resin-modified glass-ionomer cement (RMGIC).

MATERIALS AND METHODS

 Ninety aged resin composite rods were produced and sorted into 9 groups of 10 specimens and surface modified with silane agent and/or bonding agent as follows: group 1, no surface modified; group 2, etch + single bond 2 (SB2); group 3, SB2; group 4, etch + RelyX ceramic primer (RXP) + SB2; group 5, RXP + SB2; group 6, etch + single bond universal (SU); group 7, SU; group 8, etch + RXP + SU; and group 9, RXP + SU. A clear silicone mold was placed on the top of specimen center, and then filled with RMGIC. The specimens' shear bond strengths (SBSs) were examined in mechanical testing equipment. To determine failure types, the fractured specimen surfaces were inspected using a stereomicroscope.

STATISTICAL ANALYSIS

 The data collected were analyzed using one-way analysis of variance, and significance level was operated using Tukey's test (p < 0.05).

RESULTS

 Group 8 had the greatest SBS, but it was statistically indistinguishable from groups 4, 5, and 9. The most frequent fracture mode was adhesive failure. High SBS was commonly associated with mixed failure.

CONCLUSION

 The use of bonding agents enhances the resin composite's wettability and allows it to bond to RMGIC. Moreover, the use of the silane coupling agent before applying bonding agent showed significantly higher bonding ability of resin composite and RMGIC interface.

Construction of Nanostructured Glass-Zirconia to Improve the Interface Stability of Dental Bilayer Zirconia

Bilayer zirconia restoration is one of the most commonly used restorations in dental practice, but the high frequency of the cohesive/adhesive fracture of veneered porcelain is still a problem. This paper focuses on the development of nanostructured glass-zirconia to improve the interface stability of dental zirconia substrate and veneered porcelain. A novel SiO₂-Li₂O-Al₂O₃ (SLA) glass was prepared and infiltrated into the surface of fully sintered dental zirconia to obtain nanostructured glass-zirconia structure. The prepared glass-zirconia was analyzed with scanning electron microscopes (SEM), energy dispersive spectroscopy (EDS) and X-ray diffraction spectroscopy (XRD). The wettability, roughness and 3D morphology of zirconia were altered, and shear bonding strength (SBS) test demonstrated almost double increase in SBS values of the nanostructured glass-zirconia structure. The failure modes and microstructure characteristics also verified the improved interfacial stability. This investigation provides a promising method for enhancing the structural stability of bilayer zirconia restorations.

Indirect restorative systems-A narrative review

OBJECTIVE

The background and clinical understanding of the properties of currently available indirect restorative systems and fabrication methods is, along with manufacturer and evidence-based literature, an important starting point to guide the clinical selection of materials for tooth and/or implant supported reconstructions. Therefore, this review explores most indirect restorative systems available in the market, especially all-ceramic, along with aspects of manufacturing process, clinical survival rates, and esthetic outcomes.

OVERVIEW

Progressive incorporation of new technologies in the dental field and advancements in materials science have enabled the development/improvement of indirect restorative systems and treatment concepts in oral rehabilitation, resulting in reliable and predictable workflows and successful esthetic and functional outcomes. Indirect restorative systems have evolved from metal ceramics and polymers to glass ceramics, polycrystalline ceramics, and resin-matrix ceramics, aiming to improve not only biological and mechanical properties, but especially the optical properties and esthetic quality of the reconstructions, in attempt to mimic natural teeth.

CONCLUSIONS

Based on several clinical research, materials, and patient-related parameters, a decision tree for the selection of indirect restorative materials was suggested to guide clinicians in the rehabilitation process.

CLINICAL SIGNIFICANCE

The pace of materials development is faster than that of clinical research aimed to support their use. Since no single material provides an ideal solution to every case, professionals must continuously seek information from well designed, long-term clinical trials in order to incorporate or not new materials and technological advancements.

Overview of Several Typical Ceramic Materials for Restorative Dentistry

With the development of ceramic technology, prosthodontic ceramics are becoming a useful option for improving esthetic outcomes in dentistry. In this paper, various ceramic materials were reviewed and evaluated, and their advantages and disadvantages and indications in oral prosthodontics were analyzed objectively. The properties of resin-based ceramics, polycrystalline ceramics, and silicate ceramics were compared and analyzed. Resin-based ceramics may replace other ceramic materials in the CAD/CAM field.

Grinding and polishing of the inner surface of monolithic simplified restorations made of zirconia polycrystals and lithium disilicate glass-ceramic: Effects on the load-bearing capacity under fatigue of the bonded restorations

This study evaluated the effect of grinding and polishing the inner surface of monolithic discs made of zirconia polycrystals (ZR) and lithium disilicate glass-ceramic (LD) on the load-bearing capacity under fatigue of the restorations bonded onto a dentin analogue material (epoxy resin). ZR and LD ceramic discs (10 mm in diameter, 1 mm in thickness) were produced and randomly allocated into 10 groups considering the internal adjustment approach: Ctrl - No adjustment; F - Grinding with fine diamond bur (46 μm); F + Pol - Grinding with fine diamond bur followed by polishing with 2 tips (finisher and polisher); FF - Grinding with extrafine diamond bur (30 μm); FF + Pol - Grinding with extrafine diamond bur followed by polishing. In addition, discs (10 mm in diameter, 2.5 mm in thickness) of fiber reinforced epoxy resin were produced. Afterwards, the intaglio surface of the ZR discs were air-abraded with 45 μm alumina particles for 10 s, the LD and resin epoxy discs were etched with hydrofluoric acid (5%/20 s and 10%/60 s, respectively), and the treated discs were primed as recommended. Each ceramic disc was luted onto the epoxy resin disc with resin cement. Then, the samples were tested under a step-stress fatigue test (20 Hz, 10,000 cycles/step, step-size of 100 N starting at 200 N, and proceeding until failure detection). Fractographic, topographic and surface roughness analysis were also performed. The adjustments (grinding with or without polishing) (ZR: 733-880 N; LD: 1040-1106 N) triggered a detrimental effect on the fatigue behavior in both ceramics compared with the absence of treatment (control group; ZR: 973 N; LD: 1406 N). The polishing step had no effect on fatigue findings. Thus, grinding the inner surface of the tested ceramics should be avoided wherever possible to prevent introducing damage and its detrimental effects on the fatigue behavior.

Evaluation of Efficacy of Various Surface Conditioning Methods on the Repair Bond Strength of Composite to Different Fracture Types of Zirconia Ceramics

The aim of this study was to investigate the effects of different surface treatment methods on shear bond strength between composite resin and different levels of zirconia ceramic. Laser surface-conditioning procedures have been reported as effective method to increase repair bond strength of composite to zirconia ceramics. Detailed information of effects of Er,Cr:YSGG laser treatment with different pulse rates on the zirconia ceramics is lacking in the literature. 120 disc-shaped specimens were prepared including zirconia, veneering ceramic, and 50% veneering ceramic-50% zirconia surfaces. Four different surface treatments were applied to the specimens. These were grinding with diamond bur, sandblasting, and short and long pulse rates of Er,Cr:YSGG laser irradiation. An intraoral ceramic repair kit was used to repair specimens, and shear bond strength was performed on the composite resin to each specimen. The highest mean bond strength was seen in the veneering ceramic surface that was ground using a diamond bur, and the lowest mean bond strength value was observed in the same surface that was treated with long pulse laser irradiation. The sandblasting with alumina particles exhibited lower mean repairing bond strength among the rest of used methods in this study for the group which contained half of the veneering ceramic and half of the zirconia. Sandblasting and Er,Cr:YSGG laser using surface treatment procedures obtained appropriate bond strength for the group that included 50% veneering ceramic-50% zirconia, because of no significant differences observed among the applied surface conditioning methods in this group.

Clinical performance of two different adhesive strategies for metal-ceramic cracks repairing and related in vitro study

To evaluate the bonding reliability of a universal adhesive compared to a commercial ceramic repair system for metal-ceramic cracks. In vitro part: sixty specimens with porcelain, metal and porcelain-metal substrate were fabricated. Half specimens were bonded by Singlebond Universal adhesive and Filtek Z350 resin composite. The other were processed by Ceramic Repair N. Shear bond strength was tested. In vivo part: forty patients with sixty ceramic fractured porcelain-fused-metal restorations were involved. Half were repaired by Singlebond Universal and Filtek Z350. The other were restored by Ceramic Repair N. The mean observation period was 65 weeks. Results showed the bond strength ranged from 13.97 MPa to 15.85 MPa using two different repair system on different substrate with no statistical difference. There was no statistical difference between the two adhesive system in survival rate according to Kaplan-Meier analysis. The universal adhesive had a similar repair performance compared to commercial ceramic repair system.

Evaluation of bond strength of dual resin cements to CAD/CAM-created lithium disilicate ceramic

BACKGROUND

The objective was to examine the microshear bond strength values of different dual resin cements to computer-aided design (CAD)/computer-aided manufacturing (CAM)-created ceramics containing lithium disilicate, which underwent different surface treatments.

METHODS

Two dual resin cements (RelyX ARC and RelyX Ultimate) and three surface treatments of lithium disilicate ceramic blocks (Ceramic Primer (CP; containing silane) plus Adper Scotchbond Multipurpose (ASM) adhesive; CP plus Single Bond Universal (SBU) adhesive; and SBU adhesive alone) were tested. The SBU adhesive includes silane in its formulation. Each sample underwent a microshear test and bond strength values were subjected to analysis of variance (ANOVA) followed by Tukey's test (α=0.05). Fracture patterns were also observed with light microscopy.

RESULTS

RelyX ARC treated with CP+ASM or CP+SBU presented resistance values that were significantly higher than the same treatments for RelyX Ultimate. Conversely, for the blocks treated with SBU alone, the mean resistance value for RelyX Ultimate was higher than that of RelyX ARC. Regarding the different types of treatment for each resin, the mean resistance value of RelyX ARC treated with CP+ASM was significantly highest, followed by treatment with CP+SBU and SBU treatment alone. Meanwhile, RelyX Ultimate treated with CP+ASM or CP+SBU presented resistance values that were significantly higher than SBU treatment alone. In all of the groups, an adhesive fracture pattern was predominantly observed.

CONCLUSIONS

The present results indicate that silanization is important for ASM and SBU adhesives to be effective.

Effect of surface treatments and universal adhesive application on the microshear bond strength of CAD/CAM materials

PURPOSE

The aim of this study was to evaluate the microshear bond strength (µSBS) of four computer-aided design/computer-aided manufacturing (CAD/CAM) blocks repaired with composite resin using three different surface treatment protocols.

MATERIALS AND METHODS

Four different CAD/CAM blocks were used in this study: (1) flexible hybrid ceramic (FHC), (2) resin nanoceramic (RNC), (c) polymer infiltrated ceramic network (PICN) and (4) feldspar ceramic (FC). All groups were further divided into four subgroups according to surface treatment: control, hydrofluoric acid etching (HF), air-borne particle abrasion with aluminum oxide (AlO), and tribochemical silica coating (TSC). After surface treatments, silane was applied to half of the specimens. Then, a silane-containing universal adhesive was applied, and specimens were repaired with a composite, Next, μSBS test was performed. Additional specimens were examined with a contact profilometer and scanning electron microscopy. The data were analyzed with ANOVA and Tukey tests.

RESULTS

The findings revealed that silane application yielded higher µSBS values (P<.05). All surface treatments were showed a significant increase in µSBS values compared to the control (P<.05). For FHC and RNC, the most influential treatments were AlO and TSC (P<.05).

CONCLUSION

Surface treatment is mandatory when the silane is not preferred, but the best bond strength values were obtained with the combination of surface treatment and silane application. HF provides improved bond strength when the ceramic content of material increases, whereas AlO and TSC gives improved bond strength when the composite content of material increases.

Interaction of a universal adhesive with different surface treatments with feldespathic ceramics

Introduction

Universal adhesives provide the possibility of simplified protocols for using ceramics; however, determining the synergy of these adhesives with silanes and the possibility of replacing silanes requires extensive research.

Objective

To evaluate the influence of a universal adhesive, associated with airborne-particle abrasion, acid etching, and silane, on the bond strength of a feldspathic ceramic CAD-CAM to composite resin.

Materials and methods

CAD-CAM feldspathic ceramic blocks were cut into 2-mm slices and were randomly divided into six groups (n = 10): A1, Single Bond Universal (SBU); A2, Adper Single Bond 2 (SB2); B1, silane + SBU; B2, silane + SB2; C1, acid etching + silane + SBU; C2, and acid etching + silane + SB2. Tygon tubes were placed and filled with composite resin. All samples were stored in distilled water at 37 °C for 24 h and then subjected to micro-shear tests. The type of failure was analyzed using a stereomicroscope.

Results

SBU demonstrated slightly higher adhesion values compared with SB2 in all groups; however, no significant differences were observed between the adhesives (p < 0.05).

Conclusion

SBU was not statistically superior to the control adhesive. The use of silane prior to a universal adhesive should not yet be eliminated.

Current status on lithium disilicate and zirconia: a narrative review

Background

The introduction of the new generation of particle-filled and high strength ceramics, hybrid composites and technopolymers in the last decade has offered an extensive palette of dental materials broadening the clinical indications in fixed prosthodontics, in the light of minimally invasive dentistry dictates. Moreover, last years have seen a dramatic increase in the patients’ demand for non-metallic materials, sometimes induced by metal-phobia or alleged allergies. Therefore, the attention of scientific research has been progressively focusing on such materials, particularly on lithium disilicate and zirconia, in order to shed light on properties, indications and limitations of the new protagonists of the prosthetic scene.

Methods

This article is aimed at providing a narrative review regarding the state-of-the-art in the field of these popular ceramic materials, as to their physical-chemical, mechanical and optical properties, as well as to the proper dental applications, by means of scientific literature analysis and with reference to the authors’ clinical experience.

Results

A huge amount of data, sometimes conflicting, is available today. Both in vitro and in vivo studies pointed out the outstanding peculiarities of lithium disilicate and zirconia: unparalleled optical and esthetic properties, together with high biocompatibility, high mechanical resistance, reduced thickness and favorable wear behavior have been increasingly orientating the clinicians’ choice toward such ceramics.

Conclusions

The noticeable properties and versatility make lithium disilicate and zirconia materials of choice for modern prosthetic dentistry, requiring high esthetic and mechanical performances combined with a minimal invasive approach, so that the utilization of such metal-free ceramics has become more and more widespread over time.

Shear bond strength of metal brackets to ceramic surfaces using a universal bonding resin

Background

Assure Plus is a recently introduced universal adhesive with the ability to bond to various restorations. This study compared the shear bond strength of brackets bonded to two types of ceramics using conventional bonding agent and Assure Plus. Surface damage caused by debonding was also evaluated.

Material and Methods

In this in vitro study, 40 feldspathic and lithium disilicate ceramic discs were sandblasted, etched with 9.6% hydrofluoric acid and divided into two groups. In group 1, silane was applied and air-dried followed by application of Transbond XT primer, which was light-cured. In group 2, Assure Plus was applied and air-dried. In both groups, maxillary central incisor brackets were bonded. After incubation in distilled water at 37°C for 24 hours and 2000 thermal cycles, bond strength was measured using a universal testing machine, and the adhesive remnant index (ARI) and failure modes were determined. ANOVA and LSD tests were used to compare bond strength values; chi-squared test was used to compare ARI scores.

Results

Bracket bond to lithium disilicate by Assure Plus was significantly stronger than that to Feldspathic porcelain (P=0.041). Only in the Assure Plus/lithium disilicate group did some adhesive remain on the surface following debonding (40% of samples, P<0.05). Cohesive porcelain fracture had the lowest frequency in the lithium disilicate/Assure Plus group.

Conclusions

Assure Plus provided high bond strength between ceramic and brackets and minimized damage to lithium disilicate ceramic during debonding. Assure Plus is recommended for use in orthodontic treatment of adults with ceramic restorations.

Key words:Adhesives, ceramics, dental bonding, shear bond strength.

Fatigue failure load of an adhesively-cemented lithium disilicate glass-ceramic: Conventional ceramic etching vs etch & prime one-step primer

OBJECTIVES

To evaluate the effect of different glass-ceramic surface treatments and aging on the fatigue failure load of a lithium disilicate glass-ceramic adhesively cemented to a dentin analogue material.

METHODS

One hundred and twenty (120) disc-shaped lithium disilicate specimens (Ø=10mm, thickness=1.5mm) were produced and randomly allocated (n=20) into 6 groups, considering 2 study factors: "surface treatment" in 3 levels (SIL-silane application only; HF5+SIL-5% hydrofluoric acid etching and silane application; ME&P-etching with an one-step ceramic primer), and "storage" in 2 levels (baseline-storage for 7 days; aging-storage for 90 days+12,000 thermal cycles). Ceramic discs were adhesively cemented to discs of a dentin analogue material (Ø=10mm, thickness=2.0mm) following the manufacturers' instructions. The fatigue failure load was determined by the staircase approach (250,000 cycles; 20Hz; initial load=1050N [∼70% of mean load-to-failure]; step size=52.5N [5% of initial load]). Micro-morphologic, fractographic, and atomic force microscope analysis were also performed. Fatigue failure load data were evaluated by one-way ANOVA, Bonferroni and t-tests for independent samples.

RESULTS

HF5+SIL presented higher fatigue failure load in both conditions (baseline and aging); ME&P presented intermediary mean values, while the SIL group presented the worst performance. All groups had a statistically significant decrease in the fatigue performance after aging.

SIGNIFICANCE

Hydrofluoric acid followed by silane application showed the best fatigue performance for an adhesively-cemented lithium disilicate ceramic. Aging negatively influenced the fatigue performance for all tested groups.

Effect of Hydrofluoric Acid Concentration and Etching Time on Bond Strength to Lithium Disilicate Glass Ceramic

The aim of this study was to evaluate the influence of different concentrations of hydrofluoric acid (HF) associated with varied etching times on the microshear bond strength (μSBS) of a resin cement to a lithium disilicate glass ceramic. Two hundred seventy-five ceramic blocks (IPS e.max Press [EMX], Ivoclar Vivadent), measuring 8 mm × 3 mm thickness, were randomly distributed into five groups according to the HF concentrations (n=50): 1%, 2.5%, 5%, 7.5%, and 10%. Further random distribution into subgroups was performed according to the following etching times (n=10): 20, 40, 60, 120, and 20 + 20 seconds. After etching, all blocks were treated with a silane coupling agent followed by a thin layer of an unfilled resin. Three resin cement cylinders (∅=1 mm) were made on each EMX surface, which was then stored in deionized water at 37°C for 24 hours before testing. The μSBS was in a universal testing machine at a crosshead speed of 1 mm/min until failure. Data were submitted to two-way analysis of variance, and multiple comparisons were performed using the Tukey post hoc test (α=0.05). One representative EMX sample was etched according to the description of each subgroup and evaluated using scanning electron microscopy for surface characterization. The HF concentrations of 5%, 7.5%, and 10% provided significantly higher μSBS values than 1% and 2.5% (p<0.05), regardless of the etching times. For 1% and 2.5% HF, the etching times from 40 to 120 seconds increased the μSBS values compared with 20 seconds (p<0.05), but etching periods did not differ within the 5%, 7.5%, and 10% HF groups (p>0.05). The effect of re-etching was more evident for 1% and 2.5% HF (p<0.05). Different HF concentrations/etching times directly influenced the bond strength and surface morphology of EMX.

The effect of surface treatment with a fractional carbon dioxide laser on shear bond strength of resin cement to a lithium disilicate-based ceramic

BACKGROUND

This study investigated the impact of different surface treatments, including fractional carbon dioxide (CO₂) laser on shear bond strength (SBS) of resin cement to lithium disilicate ceramic.

MATERIALS AND METHODS

In this in vitro study, 72 blocks of IPS e.max CAD ceramic were randomly divided into six groups in terms of treatment (n = 12). Group 1 underwent etching with 9.6% hydrofluoric (HF) acid, whereas group 2 was subjected to air abrasion with aluminum oxide particles. Groups 3 and 4 were treated with a fractional CO₂ laser for 10 s using 10 W/14 mJ (group 3) or 20 W/10 mJ (group 4). In groups 5 and 6, the CO₂ laser was applied similar to that in groups 3 and 4, respectively; then, the specimens were etched by HF acid. After silane application, luting cement was bonded to the specimens. The SBS was assessed with a universal testing machine, and the type of bond failure was determined. Data were analyzed by ANOVA, Duncan, and Fisher's exact tests.

RESULTS

Surface conditioning with fractional CO₂ laser alone resulted in significantly lower SBS than HF acid treatment (P < 0.05). Bond strengths of the specimens treated with a combination of laser irradiation and acid etching were significantly greater than all the other groups (P < 0.05). No significant difference was found in the distribution of failure modes among the groups (P = 0.337).

CONCLUSION

The combination of fractional CO₂ laser irradiation and HF acid etching could be recommended when extra retention is required for lithium disilicate-based restorations, whereas laser treatment alone cannot produce sufficient SBS.

Influence of Surface Treatments and Adhesive Systems on Lithium Disilicate Microshear Bond Strength

The purpose of this study was to evaluate the microshear bond strength of ceramic prosthetic structures reinforced by lithium disilicate cemented with resin cement under conditions of different surface treatments and adhesive systems. Seventy-two rectangular blocks of lithium disilicate (6.5 mm long × 5 mm wide × 1 mm thick) were fabricated, air abraded with 50-μm Al2O3 particles and divided into six groups (n=12) depending on the surface pretreatments. The groups were as follows: 10HF/S/SBM: 10% hydrofluoric acid etched for 20 s (10HF) + silane (S) + Adper Scotchbond Multi-Purpose (SBM); 10HF/S/SB: 10HF + S + Single Bond Universal (SB); 10HF/SBM; 10HF/SB; S/SBM and S/SB. Two 1-mm-long plastic tubes were placed on the specimens, filled with RelyX ARC resin cement and cured for 20 s per tube. The plastic tube was removed, and the microshear bond strength was tested. Data were submitted to analysis of variance and Tukey's tests (α=0.05). Fractured specimens were observed under optical microscopy. For both adhesives, the bond strengths (MPa) of groups treated with acid-etching and silane (10HF/S/SB: 24.82, 10HF/S/SBM: 24.90) were higher (p<0.001) than those of groups treated with acid-etching (10HF/SB: 16.47, 10HF/SBM: 19.94) only or only silane (S/SB: 18.42, S/SBM: 13.24). All groups showed a predominance of failure adhesive. The silanization should be a clinical step in cementing ceramic structures reinforced by lithium disilicate, even with the application of universal adhesive that contains silane in its formulation.

"Digitally Oriented Materials": Focus on Lithium Disilicate Ceramics

The present paper was aimed at reporting the state of the art about lithium disilicate ceramics. The physical, mechanical, and optical properties of this material were reviewed as well as the manufacturing processes, the results of in vitro and in vivo investigations related to survival and success rates over time, and hints for the clinical indications in the light of the latest literature data. Due to excellent optical properties, high mechanical resistance, restorative versatility, and different manufacturing techniques, lithium disilicate can be considered to date one of the most promising dental materials in Digital Dentistry.

Effect of surface treatments on shear bond strength of resin composite bonded to CAD/CAM resin-ceramic hybrid materials

PURPOSE

The purpose of this study was to assess the effect of surface treatments on shear bond strength of resin composite bonded to thermocycled and non-thermocycled CAD/CAM resin-ceramic hybrid materials.

MATERIALS AND METHODS

120 specimens (10×10×2 mm) from each material were divided into 12 groups according to different surface treatments in combination with thermal aging procedures. Surface treatment methods were airborne-particle abrasion (abraded with 50 micron alumina particles), dry grinding (grinded with 125 µm grain size bur), and hydrofluoric acid (9%) and silane application. According to the thermocycling procedure, the groups were assigned as non-thermocycled, thermocycled after packing composites, and thermocycled before packing composites. The average surface roughness of the non-thermocycled specimens were measured after surface treatments. After packing composites and thermocycling procedures, shear bond strength (SBS) of the specimens were tested. The results of surface roughness were statistically analyzed by 2-way Analysis of Variance (ANOVA), and SBS results were statistically analyzed by 3-way ANOVA.

RESULTS

Surface roughness of GC were significantly lower than that of LU and VE (P<.05). The highest surface roughness was observed for dry grinding group, followed by airborne particle abraded group (P<.05). Comparing the materials within the same surface treatment method revealed that untreated surfaces generally showed lower SBS values. The values of untreated LU specimens showed significantly different SBS values compared to those of other surface treatment groups (P<.05).

CONCLUSION

SBS was affected by surface treatments. Thermocycling did not have any effect on the SBS of the materials except acid and silane applied GC specimens, which were subjected to thermocycling before packing of the composite resin.

Effects of mechanical and chemical surface treatments on the resin-glass ceramic adhesion properties

AIM

Intraoral repair of fractured ceramic restorations using resin composite is practical for dental treatment. In the present study, we investigated whether differences in surface treatments for glass ceramic would affect resin adhesion.

METHODS

Leucite-reinforced glass ceramic plates (IPS Empress Esthetic) were ground with 320-grit silicon carbide paper, cleaned using phosphoric acid, and then etched with hydrofluoric acid (IPS Ceramic Etching Gel) or left unetched, and silanized using silane coupling agent (RelyX Ceramic Primer) or kept unsilanized. Either conventional (Adper Scotchbond Multi-Purpose) or universal (Scotchbond Universal) adhesive was used to bond the resin composite to ceramic surfaces. Specimens were subjected to microshear test after 37°C water storage for 24 h, and fractured surfaces were examined. Ceramic surface hydrophobicity after treatments was verified with contact angle measurements. Data were analyzed using anova and Tukey's tests.

RESULTS

Regardless of the adhesive tested, hydrofluoric acid-etched ceramics showed higher bond strengths. Ceramic primer application improved resin bonding, even in non-etched groups, and also influenced fractography (P < 0.001). Contact angles on ceramics treated with ceramic primer were higher than those treated with silane-containing universal adhesive (P < 0.001).

CONCLUSIONS

Mechanical and chemical retentions contribute to resin adhesion to glass ceramic. Universal adhesive seems to not function in the same manner as a silane coupling agent.