Deniz Sen

Shear bond strength of resin luting cement to glass-infiltrated porous aluminum oxide cores

STATEMENT OF PROBLEM Resin bonding surface treatment methods for conventional silica-based dental ceramics are not reliable for glass infiltrated high alumina content In-Ceram ceramics. PURPOSE This study developed an alternative surface treatment to improve resin bonding of glass-infiltrated aluminum oxide ceramic blasting with diamond particles and then observed the efficiency of this treatment. Material and methods. In-Ceram test specimens were prepared and divided into 2 groups. All specimens were sandblasted with Al(2)O(3), and blasted with diamond particles and 2 adhesive resins were applied. After bonding and storage in humid conditions, shear bond strength values were measured with a universal testing machine. Surface roughness and fracture interfaces were determined with a perthometer and a SEM. RESULTS The highest bond strength was obtained on the samples blasted with diamond particles (group II). The differences between the 2 groups and the 2 adhesive resin cements were both statistically significant. CONCLUSION Panavia-Ex cement exhibited higher bond strength than Super-Bond cement. This higher bond strength was attributed to ceramic oxide and ester bond and the mechanical properties of Panavia-Ex cement.

Evaluation of air-particle abrasion of Y-TZP with different particles using microstructural analysis

BACKGROUND This study evaluated the effect of air-particle abrasion with different particle sizes on the surface roughness and phase transformation of yttria-stabilized tetragonal zirconia ceramics (Y-TZP). METHODS Eighty-four Y-TZP discs of 15 mm diameter and 1.0 mm thickness were fabricated. The samples were divided into four groups (n = 21): (1) air-particle abrasion with 30 μm CoJet sand blast coating agent (CoJet, 3M ESPE); (2) 50 μm Al2O3 particles; (3) 110 μm Al2O3 particles; and (4) 250 μm Al2O3 particles. Each group was further divided into three subgroups each (n = 7) and treated for 5 seconds, 15 seconds and 30 seconds. Mean surface roughness was determined using a profilometer. The surfaces were analysed with a scanning electron microscope. XRD analysis was employed and the relative amount of the monoclinic phase was calculated. The results were statistically analysed by two-way analysis of variance (ANOVA, p < 0.05). RESULTS Air-particle abrasion with 250 μm Al2O3 particles for 30 seconds had the highest surface roughness (p < 0.001) and a significantly higher amount of monoclinic phase compared to air-particle abrasion with 30 μm, 50 μm and 110 μm particles (p < 0.001). CONCLUSIONS Duration and particle size of air-particle abrasion affects the roughness and phase transformation of Y-TZP. Longer treatment times with larger particles may result in degradation of material.

Influence of zirconia base and shade difference on polymerization efficiency of dual-cure resin cement.

PURPOSE The aim of this study was to investigate the polymerization efficiency of dual-cured resin cement beneath different shades of zirconia-based feldsphathic ceramic restorations. MATERIALS AND METHODS Five translucent zirconia (Zirkonzahn) discs (4.0-mm diameter, 1.2-mm height) were prepared. Feldsphathic ceramic (1.2 mm) (Noritake Cerabien Zr) in 5 shades (1M2, 2M2, 3M2, 4M2, 5M2) was applied on the zirconia discs. Twelve dual-cure resin cement specimens were prepared for each shade, using Panavia F 2.0 (Kuraray) in Teflon molds (4.0-mm diameter, 6.0-mm height), following the manufacturers instructions. Light activation was performed through the zirconia-based ceramic discs for 20 seconds, using a quartz tungsten halogen curing device (Hilux 200) with irradiance of 600 mW/cm(2) . Immediately following light curing, specimens were stored for 24 hours in dry, light-proof containers. Vickers hardness measurements were conducted using a microhardness tester with a 50-g load applied for 15 seconds. The indentations were made in the cross sectional area at four depths, and the mean values were recorded as Vickers hardness number (VHN). Results were statistically analyzed with one-way ANOVA and Tukey HSD test (p < 0.05). RESULTS A statistically significant decrease in VHN of the resin cement was noted with increasing depth and darkness of the shade (p < 0.05). CONCLUSION Curing efficiency of dual-cure resin cement is mainly influenced by the lightness of the shades selected.

Adhesion of 10-MDP containing resin cements to dentin with and without the etch-and-rinse technique

PURPOSE This study evaluated the adhesion of 10-MDP containing self-etch and self-adhesive resin cements to dentin with and without the use of etch-and-rinse technique. MATERIALS AND METHODS Human third molars (N=180) were randomly divided into 6 groups (n=30 per group). Conventional (Panavia F2.0, Kuraray-PAN) and self-adhesive resin cements (Clearfil SA, Kuraray-CSA) were bonded to dentin surfaces either after application of 3-step etch-and-rinse (35% H3PO4 + ED Primer) or two-step self-etch adhesive resin (Clearfil SE Bond). Specimens were subjected to shear bond strength test using the universal testing machine (0.5 mm/min). The failure types were analyzed using a stereomicroscope and quality of hybrid layer was observed under a scanning electron microscope. The data (MPa) were analyzed using two-way ANOVA and Tukeys tests (α=.05). RESULTS Overall, PAN adhesive cement showed significantly higher mean bond strength (12.5 ± 2.3 - 14.1 ± 2.4 MPa) than CSA cement (9.3 ± 1.4 - 13.9 ± 1.9 MPa) (P<.001). Adhesive failures were more frequent in CSA cement groups when used in conjunction with two-step self-adhesive (68%) or no adhesive at all (66%). Hybrid layer quality was inferior in CSA compared to PAN cement in all conditions. CONCLUSION In clinical situations where bonding to dentin substrate is crucial, both conventional and self-adhesive resin cements based on 10-MDP can benefit from etch-and-rinse technique to achieve better quality of adhesion in the early clinical period.

Effect of thickness and surface modifications on flexural strength of monolithic zirconia

Statement of problem. A recommended minimum thickness for monolithic zirconia restorations has not been reported. Assessing a proper thickness that has the necessary load‐bearing capacity but also conserves dental hard tissues is essential. Purpose. The purpose of this in vitro study was to evaluate the effect of thickness and surface modifications on monolithic zirconia after simulated masticatory stresses. Material and methods. Monolithic zirconia disks (10 mm in diameter) were fabricated with 1.3 mm and 0.8 mm thicknesses. For each thickness, 21 disks were fabricated. The specimens of each group were further divided into 3 subgroups (n=7) according to the surface treatments applied: untreated (control), airborne‐particle abrasion with 50‐&mgr;m Al2O3 particles at a pressure of 400 kPa at 10 mm, and grinding with a diamond rotary instrument followed by polishing. The biaxial flexure strength was determined by using a piston‐on‐3‐balls technique in a universal testing machine. Flexural loading was applied with a 1.4‐mm diameter steel cylinder, centered on the disk, at a crosshead speed of 0.5 mm/min until fracture occurred. X‐ray diffraction (XRD) and scanning electron microscopy (SEM) analyses were performed. The data were statistically analyzed with 2‐way ANOVA, Tamhane T2, 1‐way ANOVA, and Student t tests (&agr;=.05). Results. The 1.3‐mm specimens had significantly higher flexural strength than the 0.8‐mm specimens (P<.05). Airborne‐particle abrasion significantly increased the flexural strength (P<.05). Grinding and polishing did not affect the flexural strength of the specimens (P>.05). Conclusions. The mean flexural strength of 0.8‐mm and 1.3‐mm thick monolithic zirconia was greater than reported masticatory forces. Airborne‐particle abrasion increased the flexural strength of monolithic zirconia. Grinding did not affect flexural strength if subsequently polished.

Effectiveness of different surface cleaning methods on the shear bond strength of resin cement to contaminated zirconia: an in vitro study

Abstract The purpose of this in vitro study was to evaluate and compare the effectiveness of different surface cleaning methods on the shear bond strength (SBS) of zirconia ceramic surfaces. Seventy polished and cleaned zirconia disk specimens of 8 mm in diameter and 3.4 mm in thickness were immersed in fresh saliva. They were then pressed into a freshly mixed silicone disclosing medium. Six different cleaning methods were applied to the tested groups; they were airborne-particle abraded (AA), covered with a cleaning paste (Ivoclean®) (IV), etched with orthophosphoric acid (PA), immersed in alcohol (AL), rinsed with tap water only (WA), or cleaned with steam (SC). No surface cleaning was done after saliva immersion and silicone disclosing medium contamination to the control group (CC). The specimens were then bonded to an adhesive resin cement using polyethylene tubes. SBS was determined using a universal testing machine at a crosshead speed of 1 mm/min. The specimens were also examined with a scanning electron microscope and a stereomicroscope. Group AA yielded the highest SBS value (7.01 ± 1.4 MPa) among the groups, while Group WA had the lowest SBS value (3.03 ± 0.8 MPa). The SBS values of Group AA (7.01 ± 1.4 MPa) and IV (6.2 ± 1.7 MPa) were also significantly higher than those of the remaining four groups (p < 0.05). Within the limitations of this in vitro study, it was concluded that among the various cleaning methods tested, airborne-particle abrasion and Ivoclean® paste were effective in cleaning the zirconia surface.

Simultaneous Replacement of Maxillary Central Incisors with CEREC Biogeneric Reference Technique: A Case Report.

Biogeneric Reference Technique (BRT) of the CEREC 3D v.3.8 software is an effective technique for single anterior ceramic crowns because it provides computer-controlled match of the tooth form to the contralateral tooth. BRT also enables the fabrication of two or more anterior all-ceramic crowns simultaneously. This clinical report demonstrates the clinical application of BRT for designing and milling two central incisors in one appointment using a single optical impression. After completing the virtual design of the first central incisor, it was copied and a mirror image was created. The second central incisor was designed using this replicated image and therefore a computer-controlled symmetry was obtained. The crowns were milled from monolithic feldspathic ceramic blocks and adhesively luted with dual-cured resin cement following dentin conditioning. At the two-year follow-up appointment, the restorations were intact, no adverse effects were noted, and the resultant appearance was highly satisfactory for the patient. A step-by-step protocol is described from design to cementation of these restorations.Background and aims. An ideal root canal filling material should completely seal the entire root canal space and block communication between the root canal system and its surrounding tissues; it should also be nontoxic, noncarcinogenic, non-genotoxic, biocompatible, insoluble in tissue fluids and dimensionally stable. Bonding to dentin is a promising property, which can prevent leakage and improve the sealing ability of root canal filling materials. Resilon was developed and rec-ommended initially because the existing rootcanal filling materials did not bond to root canal dentin. Since its introduction in 2004, numerous reports have been published regarding various aspects of this material. The aim of this literature review is to present investigations regarding Resilons physical and chemical properties and leakage studies. Materials and methods. A review of the literature was performed by using electronic and hand searching methods for Resilon from May 2004 to April 2012. Results. There are many published reports regarding Resilon. The searchshowed that Resilon is composed of a parent polymer, polycaprolactone or Tone, which is a biodegradable aliphatic polyester, with filler particles consisting of bioactive glass, bismuth oxychloride and barium sulfate. It possesses some antibacterial and antifungal properties. It is a promising material for root canal filling. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies on clinical applications of this material. Resilon has some drawbacks such as high cost. Conclusion. Resilon seals well and is a biocompatible material. However, more clinical studies are needed to confirm its efficacy compared with other materials.

Shear bond strength of luting cements to fixed superstructure metal surfaces under various seating forces

PURPOSE In this study, the shear bond strengths (SBS) of luting cements to fixed superstructure metal surfaces under various seating forces were investigated. MATERIALS AND METHODS Seven different cements [Polycarboxylate (PCC), Glass-Ionomer (GIC), Zinc phospahate (ZPC), Self-adhesive resin (RXU), Resin (C&B), and Temporary cements ((RXT) and (TCS))] were bonded to a total number of 224 square blocks (5×5×3 mm) made of one pure metal [Titanium (CP Ti) and two metal alloys [Gold-Platinum (Au-Pt) and Cobalt-Chrome (Co-Cr)] under 10 N and 50 N seating forces. SBS values were determined and data were analyzed with 3-way ANOVA. Pairwise comparisons and interactions among groups were analyzed with Tukeys simultaneous confidence intervals. RESULTS Overall mean scores indicated that Co-Cr showed the highest SBS values (1.96±0.4) (P<.00), while Au-Pt showed the lowest among all metals tested (1.57±0.4) (P<.00). Except for PCC/CP Ti, RXU/CP Ti, and GIC/Au-Pt factor level combinations (P<.00), the cements tested under 10 N seating force showed no significantly higher SBS values when compared to the values of those tested under 50 N seating force (P>.05). The PCC cement showed the highest mean SBS score (3.59±0.07) among all cements tested (P<.00), while the resin-based temporary luting cement RXT showed the lowest (0.39±0.07) (P<.00). CONCLUSION Polycarboxylate cement provides reliable bonding performance to metal surfaces. Resin-based temporary luting cements can be used when retrievability is needed. GIC is not suitable for permanent cementation of fixed dental prostheses consisting of CP Ti or Au-Pt substructures.

Influence of monolithic lithium disilicate and zirconia thickness on polymerization efficiency of dual-cure resin cements

OBJECTIVE To evaluate the influence of anterior monolithic zirconia and lithium disilicate thickness on polymerization efficiency of dual-cure resin cements. MATERIALS AND METHODS Twelve ceramic disks (4.0-mm diameter) with thicknesses of 0.5, 1, 1.5, 2, 2.5, and 3 mm were prepared from monolithic zirconia (Prettau® Anterior; n = 6) and lithium disilicate (IPS e.max® CAD HT; n = 6). Three dual-cure resin cements (Panavia F 2.0, DuoLink Universal™, and RelyX™ U200) were used for polymerization beneath ceramic disks. For each resin cement, 10 specimens were prepared by light curing under monolithic zirconia and lithium disilicate disks of each thickness. Vickers hardness measurements were conducted at four different measurement depths. Data were statistically analyzed using univariate four-, three-, two-, and one-way analysis of variance and independent samples t-tests. RESULTS Microhardness of resin cements decreased significantly with increasing measurement depth and thickness of monolithic zirconia or lithium disilicate (P < .001). Cements polymerized under lithium disilicate showed higher microhardness values than did those polymerized under zirconia (P < .001). For both ceramics, Panavia F 2.0 exhibited the greatest microhardness, followed by DouLink Universal and RelyX™ U200 (P < .001). CONCLUSIONS Different dual-cure resin cements may have different polymerization efficiencies, and the type and thickness of the overlying ceramic can influence polymerization. CLINICAL SIGNIFICANCE The findings of this study suggest that an increase in the thickness of monolithic lithium disilicate or anterior monolithic zirconia restorations can significantly decrease the microhardness of the dual-cure resin cement polymerized beneath the restoration. Dual-cure resin cements can be used for the cementation of anterior monolithic zirconia restorations up to 2 mm thickness and for monolithic lithium disilicate restorations up to 2.5 mm thickness. However, for lithium disilicate restorations with a ≥2.5 mm thickness and zirconia restorations with a ≥2-mm thickness, different cementation approaches must be further studied, such as: extended light curing; the use of dual-cure resin cement with a higher self-curing component than the ones used in this study; or a self-cure resin cement.

The effect of MDP-based primer on shear bond strength of various cements to two different ceramic materials

Abstract The aim of this study was to determine the effect of 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based primer on the shear bond strengths of thermally aged self-adhesive and conventional adhesive resin cements and zinc phosphate cement to zirconia and lithium disilicate substructures. Sixty zirconia (Z) and 60 lithium disilicate (L) disk specimens were cut from ceramic blocks. Each group was divided into six subgroups (n = 10). Half of the specimens of each ceramic group were treated with primer (P) and the other half was remained untreated. Three types of cement were applied: zinc phosphate cement [(ZPC) (Hoffmann Harmonic Shades)]; self-adhesive resin cement [(SAC) (RelyX U200)]; conventional adhesive resin cement [(CAC) (C&B)]. The specimens were subjected to thermal aging procedure for 1 week under 37 °C water bath. Shear bond strength (SBS) was determined using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with three-way (ANOVA). Pairwise comparisons and interactions between groups were analyzed by using Tukey’s simultaneous confidence intervals. There was no significant difference between the SBS values of SAC-Z (11,47 ± 0,47) and SAC-ZP (11,39 ± 0,42) (p > 0.05). However, the SBS values of SAC-L (12.34 ± 0,55) and SAC-LP (12,50 ± 0,49) were significantly higher than those of SAC-Z and SAC-ZP (p < 0.00). The use of primer significantly increased the SBS value of CAC-ZP (8,05 ± 0,55) when compared to the SBS value of CAC-Z (3,53 ± 0,41) (p < 0.00). Resin cement that contains methacrylate monomers with phosphoric ester functional groups exhibited reliable bond to zirconia. However, the use of an MDP-based primer may not further improve its bond strength.