Effect of a Home Bleaching Agent on the Ion Elution of Different Esthetic Materials

PURPOSE

To investigate the effect of a 16% carbamide peroxide home bleaching agent on the ion elution of different esthetic restorative materials and to determine if the released ions exceed the minimal risk levels.

MATERIALS AND METHODS

Ceramic materials comprising a low-fusing porcelain (Vita VM7), lithium disilicate glass-ceramics (IPS e.max Press and IPS e.max CAD), zirconium substructure materials (IPS e.max ZirCAD and Vita In-Ceram YZ for InLab), and ceromers (Estenia and Tescera ATL) were chosen. Thirty disk-shaped specimens (2 mm thickness and 10 mm diameter) were fabricated from each material and then were divided into 3 experimental groups to receive one of the following solutions: acetic acid (positive control), a bleaching agent and distilled water (negative control) (n = 10/group). For the bleaching agent, the specimens were subjected to a 16% carbamide peroxide solution (VOCO Perfect Bleach) for 2 hours per day for 14 days. A 4% acetic acid solution was applied at 80°C for 16 hours according to the ISO 6872:2015 protocol and specimens of negative control group were immersed in distilled water for 16 hours. Ion elution measurements were conducted with inductively coupled plasma atomic emission spectroscopy (ICP-AES) after immersion in the solutions, and the weight loss of the materials was measured with a precision scale. Changes in the surface topography were investigated by a scanning electron microscopy (SEM).The results were evaluated using multivariate analysis of variance (MANOVA).

RESULTS

Among the specimens tested, the most ion elution was observed in the Tescera ATL group, and the least ion elution was observed in the e.max ZirCAD group in all solutions. Ion elution was found to be greater in the bleaching agent than in the acetic acid and distilled water groups. Sodium was the most released ion, and zinc and lithium were the least released among the elements tested.

CONCLUSIONS

It should be noted that the bleaching-related ion release may exceed toxic doses even if restorative materials meet ISO 6872 standards, and the materials should be protected before home bleaching to prevent ion elution.

Mechanical and Tribological Characterization of a Dental Ceromer

BACKGROUND

Indirect restorations using composites with ceramic fillings can be an alternative to ceramic veneering and direct composite restorations for the treatment of posterior teeth. The aim of this study was the evaluation of the mechanical and tribological properties of a ceromer.

MATERIALS AND METHODS

Sixty specimens were produced and divided into two groups: one control group not submitted to thermocycling (n = 20) and one test group submitted to 5000 cycles of thermocycling (n = 40). The studied parameters were microhardness, surface roughness and the coefficient of friction (scratch test).

RESULTS

The ceromer exhibits a reduction of polymerization shrinkage, higher wear, and fracture resistance than the composite resins. The studied ceromer presented good mechanical properties, even after being submitted to thermocycling. Roughness was the property most affected, increasing 25.8%, microhardness decreased by 10.5% and the coefficient of friction increased by 4.2%.

CONCLUSIONS

In certain situations, ceromers can be an alternative to composite resins and ceramics, providing an aesthetic, conservative and longevity option.

Shear Bond Strength of Composite and Ceromer Superstructures to Direct Laser Sintered and Ni-Cr-Based Infrastructures Treated with KTP, Nd:YAG, and Er:YAG Lasers: An Experimental Study

OBJECTIVE

The aim of this study was to examine the shear bond strength (SBS) of ceromer and nanohybrid composite to direct laser sintered (DLS) Cr-Co and Ni-Cr-based metal infrastructures treated with erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser modalities in in vitro settings.

METHODS

Experimental specimens had four sets (n = 32) including two DLS infrastructures with ceromer and nanohybrid composite superstructures and two Ni-Cr-based infrastructures with ceromer and nanohybrid composite superstructures. Of each infrastructure set, the specimens randomized into four treatment modalities (n = 8): no treatment (controls) and Er:YAG, Nd:YAG, and KTP lasers. The infrastructures were prepared in the final dimensions of 7 × 3 mm. Ceromer and nanohybrid composite was applied to the infrastructures after their surface treatments according to randomization. The SBS of specimens was measured to test the efficacy of surface treatments. Representative scanning electron microscopy (SEM) images after laser treatments were obtained.

RESULTS

Overall, in current experimental settings, Nd:YAG, KTP, and Er:YAG lasers, in order of efficacy, are effective to improve the bonding of ceromer and nanohybrid composite to the DLS and Ni-Cr-based infrastructures (p < 0.05). Nd:YAG laser is more effective in the DLS/ceromer infrastructures (p < 0.05). KTP laser, as second more effective preparation, is more effective in the DLS/ceromer infrastructures (p < 0.05). SEM findings presented moderate accordance with these findings.

CONCLUSIONS

The results of this study supported the bonding of ceromer and nanohybrid composite superstructures to the DLS and Ni-Cr-based infrastructures suggesting that laser modalities, in order of success, Nd:YAG, KTP, and Er:YAG, are effective to increase bonding of these structures.

[Color stability of ceromer of different thicknesses and resin adhesive materials of different types after accelerated aging]

OBJECTIVE

This study aims to investigate the color stability of ceromer with different thicknesses and different types of resin adhesive materials after accelerated aging and provide references for clinical application and selections.

METHODS

Nine groups of experimental samples were used, and each group contained five samples. We made joint samples with ceromer having three different thicknesses (1.00, 0.75, 0.50 mm) combined with three different resin adhesive materials (RelyX Veneer, RelyX Unicem, Filtek Z350 Flow), respectively. All samples were placed into Xenon Lamp Aging Instrument to implement accelerated aging. Spectrophotometer was used to measure the lightness (L*), red green color value (a*), and blue yellow color value (b*) of all samples before and after accelerated aging. The change of lightness (ΔL), red green color value (Δa), blue yellow color value (Δb), and color variation (ΔE) were also calculated. We investigated the influence of ceromer veneer thicknesses and resin adhesive material types on color variation by two-factor analysis of variance.

RESULTS

The thickness and type factors showed significant influence on ΔE values, and exhibited interactions (P < 0.05). The ΔE values of all experimental groups were lower than 3.3. After the accelerated aging process, all L*, a*, and b* values of the experimental groups decreased and the ΔL values were lower than 2.0.

CONCLUSION

Ceromer veneer thickness and resin adhesive material types could affect the color stability of ceromer veneer and resin adhesive materials. The changes in lightness and color in ceromer veneer and resin adhesive materials are considered clinically acceptable after accelerated aging.

Effect of in-office bleaching agents on the color changes of stained ceromers and direct composite resins

PURPOSE

To evaluate the effect of two in-office bleaching agents on the color changes of two ceromers (Ceramage and Adoro SR) and one direct composite resin (Gradia Direct Anterior) after staining by tea and coffee.

MATERIALS AND METHODS

Twenty-four disk-shaped specimens were fabricated for each resin material and randomly divided into three groups (n = 8). The specimens were immersed in tea, coffee or deionized water, respectively, for 7 days. Each group was then equally divided into two sub-groups (n = 4), which were subjected to two in-office bleaching agents (BEYOND and Opalescence Boost), respectively. The color of the specimens was measured by a spectrophotometer at baseline, after staining and after bleaching. The color differences (ΔE values) between baseline and after treatments were calculated.

RESULTS

Statistical analysis indicated that the staining solution had significant influence on the color change of resin composites tested (p < 0.001). The discolorations of resin composites were perceptible after immersing in tea or coffee solutions (ΔE>2.0). There was no statistically significant difference between BEYOND and Opalescence Boost in stains removal from discolored resins (p = 0.550). The color changes in ΔE value between baseline and after bleaching were less than 2.0 for all resin composite groups.

CONCLUSIONS

Tea solution produces severe discoloration of three resin composites tested. The two in-office bleaching agents can effectively remove the stains from two ceromers and one direct composite resin tested in this study.