Alessio Casucci

Influence of different surface treatments on surface zirconia frameworks.

OBJECTIVES To evaluate the effect of different chemo-mechanical surface treatments of zirconia ceramic in the attempt to improve its bonding potential. METHODS Sintered zirconium oxide ceramic discs (Lava Ø10mm x 1mm height) were treated with (n=4): (1) airborne particle abrasion with 125microm Al(2)O(3) particles; (2) 9.5% HF acid etching; (3) selective infiltration etching (SIE); (4) experimental hot etching solution applied for 10, 30 and 60min; (5) no treatment. Ceramic discs surfaces were analyzed by atomic force microscopy (AFM) recording average surface roughness measurements of the substrate. Data were statistically analyzed by Kruskall-Wallis analysis of variance and Mann-Whitney tests (alpha=0.05). The same discs were used for bi-dimensional zirconia ceramic surface characterization with scanning electron microscope (SEM). RESULTS Ceramic surface treatments significantly influenced surface topography and roughness (p<0.001). Bi-dimensional changes in ceramic surface morphology were assessed on a nanometric scale. The experimental hot etching solution improved surface roughness, independently from the application time. CONCLUSION Zirconia conditioning with the experimental hot etching solution may enhance ceramic roughness and improve the surface area available for adhesion allowing the formation of micromechanical retention. The influence of this surface treatment with regard to bond strength of zirconia needs to be addressed.

Effect of simulated pulpal pressure on self-adhesive cements bonding to dentin.

OBJECTIVES To evaluate the bonding effectiveness of self-adhesive luting cements to dentin in the presence of simulated hydrostatic intrapulpal pressure (PP). METHODS Thirty composite overlays (Aelite All Purpose Body) were luted to deep-coronal dentin surfaces using four self-adhesive resin cements (Rely X Unicem, G-Cem, Multilink Sprint, Bis-Cem) and one total-etch system (Calibra). Half of the specimens resin cements were applied under a PP of 15 cm H2O. After storage in a moist condition for 1 month (37 degrees C, 100% relative humidity), specimens were sectioned into microtensile beams (1mm2) and stressed to failure with the microtensile bond strength test (microTBS). Data were statistically analyzed with Kruskal-Wallis ranking (p<0.05) and Mann-Whitney tests (p<0.001). The fracture pattern was evaluated under SEM. RESULTS Bond strength of Calibra fell significantly when PP was applied during bonding (p<0.05). Rely X Unicem and Bis-Cem performed better under PP. No significant differences for Multilink Sprint and G-Cem bonded specimens were recorded with or without PP. SIGNIFICANCE Simulated PP influences the adhesive performance of resinous cements. The predominance of acid-base reactions or radical polymerization may explain the different behavior of self-adhesive cements when changing substrate wetness. The application of constant intrapulpal perfusion should be considered when simulating luting procedures in vitro.

Effect of surface pre-treatments on the zirconia ceramic–resin cement microtensile bond strength

OBJECTIVE To evaluate the influence of different surface treatments on the microtensile bond strength of resin cement to zirconia ceramic. MATERIALS AND METHODS Twelve cylinder-shaped (∅ 12×5.25 mm high) blocks of a commercial zirconium-oxide ceramic (Cercon® Zirconia, DENTSPLY) were randomly divided into 4 groups (n=3), based on the surface treatment to be performed: (1) airborne particle abrasion with 125 μm Al₂O₃ particles (S); (2) selective infiltration etching (SIE); (3) experimental hot etching solution applied for 30 min (ST) and (4) no treatment (C). Paradigm MZ100 blocks (3M ESPE) were cut into twelve cylinders of 4mm in thickness. Composite cylinders were bonded to conditioned ceramics using a resin cement (Calibra®, DENTSPLY), in combination with the proprietary adhesive system. After 24h bonded specimens were cut into microtensile sticks and loaded in tension until failure. Bond strength data were analyzed with Kruskall-Wallis and Dunns Multiple Range test for multiple comparisons (p < 0.05). Failure mode distribution was recorded and the interfacial morphology of debonded specimens was analyzed using a scanning electron microscope (SEM). RESULTS Bond strength values achieved after SIE and ST treatment were significantly higher than after S treatment and without any treatment (p < 0.05). Premature failures were mostly recorded in the S group. SIGNIFICANCE Conditioning the high-strength ceramic surface with SIE and ST treatments yielded higher bond strengths of the resin cement than when zirconia ceramic was treated with airborne particle abrasion or left untreated.

Morphological analysis of three zirconium oxide ceramics: Effect of surface treatments

OBJECTIVE To evaluate the effect of different chemo-mechanical surface treatments on the morphology of three recently marketed dental zirconia ceramics. MATERIALS AND METHODS Ceramic discs (Ø 10 mm x 1 mm height) were obtained from three sintered zirconia ceramics (Lava, Cercon, and Aadva Zr) and treated with: (1) airborne particle abrasion with 125 microm Al(2)O(3) particles (S); (2) selective infiltration etching (SIE); (3) experimental hot etching solution applied for 30 min (ST); (4) no treatment (C). Five discs per group were used for surface roughness analysis using an atomic force microscope (AFM). Data were statistically analyzed by Kruskall-Wallis analysis of variance and Mann-Whitney tests (alpha<0.05). The same discs were evaluated under SEM for surface topography analysis. Three discs per group were cemented to a composite overlay (Paradigm MZ100) with a total-etch resin luting agent (Calibra) and cross-section interfacial analysis was performed under SEM. RESULTS AND SIGNIFICANCE Airborne particle abrasion improved the average surface roughness of Cercon and Lava (p<0.05) while SIE induced significant changes on Lava and Adava Zr. Statistical differences in surface roughness were recorded after selective infiltration etching when compared to no treated group, independently from the zirconia type. SEM and AFM analyses revealed changes in surface topography for all the tested ceramics and intergrain spaces opening, especially after ST. The effectiveness of the tested chemo-mechanical surface treatments depends on the zirconia type. The hot experimental etching solution increased the surface roughness of all the tested ceramics creating retentive micro-spaces that may potentially improve zirconia/resin cement interfacial strengths.

Interfacial nanoleakage and internal cement thickness of three esthetic crown systems

OBJECTIVES To evaluate interfacial nanoleakage expression of the combination of different cementation procedures and different crown systems. METHODS Forty-five human premolars prepared to receive single crowns were randomly divided into three groups (n=15) based on the materials to be used for crown fabrication and cementation: group 1: Zirc (Ivoclar-Vivadent) cemented with Multilink Automix; group 2: Ivoclar disilicate IPS Empress 2 luted with Excite DSC in combination with Variolink II; group 3: AAdva Zirconia (GC) cemented with G-Cem Automix. The specimens were then assessed for interfacial nanoleakage expression and the amount of silver deposits along the interface was quantified. The thickness of the cement was assessed at 5 different levels: cervical margins, midway between the cervical margin and the occlusal wall along the axial walls and at the occlusal wall. The nanoleakage scores and the cement thickness were analyzed with Kruskall-Wallis non-parametric Analysis of Variance and Dunns Multiple-range post hoc test. RESULTS Group 2 showed significantly less nanoleakage expression than group 1 (p<0.05). The groups can be ranked in the following order 3<1<2 with regard to the cement thickness. CONCLUSIONS There was no correlation among combination of different cementation procedures and different crown systems and interfacial nanoleakage. Also the cement thickness and the degree of nanoleakage cannot be related. The amount of cement found at the cervical margins of all groups showed discrepancies within a clinical acceptable range.