Ibrahim Nergiz

Influence of various surface-conditioning methods on the bond strength of metal brackets to ceramic surfaces

With the increase in adult orthodontic treatment comes the need to find a reliable method for bonding orthodontic brackets onto metal or ceramic crowns and fixed partial dentures. In this study, shear bond strength and surface roughness tests were used to examine the effect of 4 different surface conditioning methods: fine diamond bur, sandblasting, 5% hydrofluoric acid, and silica coating for bonding metal brackets to ceramic surfaces of feldspathic porcelain. Sandblasting and hydrofluoric acid were further tested after silane application. A total of 120 ceramic disc samples were produced, and 50 were used for surface roughness measurements. The glazed ceramic surfaces were used as controls. Metal brackets were bonded to the ceramic substrates with a self-curing composite. The samples were stored in 0.9% NaCl solution for 24 hours and then thermocycled (5000 times, 5 degrees C to 55 degrees C, 30 seconds). Shear bond tests were performed with a universal testing device, and the results were statistically analyzed. Chemical surface conditioning with either hydrofluoric acid (4.3 microm) or silicatization (4.4 microm) resulted in significantly lower surface roughness than mechanical conditioning (9.3 microm, diamond bur; 9.7 microm, sandblasting) (P <.001). The surface roughness values reflect the mean peak-and-valley distances. The bond strengths of the brackets bonded to the ceramic surfaces treated by hydrofluoric acid with and without silane (12.2 and 14.7 MPa, respectively), silicatization (14.9 MPa), and sandblasting with silane (15.8 MPa) were significantly higher (P <.001) than those treated by mechanical roughening with fine diamond burs (1.6 MPa) or sandblasting (2.8 MPa). The highest bond strength values were obtained with sandblasting and silicatization with silane or hydrofluoric acid without silane; these fulfilled the required threshold. The use of silane after hydrofluoric acid etching did not increase the bond strength. Diamond roughening and sandblasting showed the highest surface roughness; they can damage the ceramic surface. Acid etching gave acceptable results for clinical use, but the health risks should be considered. The silicatization technique has the potential to replace the other methods; yet cohesive failures were observed in the ceramic during removal of the brackets.

Effect of different surface textures on retentive strength of tapered posts

STATEMENT OF PROBLEM Tapered posts allow for the preservation of tooth substance in the fragile apical area and are advantageous in clinical situations where they conform to the root and canal configuration of endodontically treated teeth. However, their lower retention compared with passive parallel-sided or active threaded posts is a disadvantage. PURPOSE This study determined the retentive strength of tapered titanium posts with different surface textures and examined the effect of roughening dentinal walls of the prepared post space. MATERIAL AND METHODS Posts with four surface configurations (smooth, with and without grooves, and sandblasted, with and without grooves) were examined when cemented in extracted anterior teeth. RESULTS The smooth post showed the lowest retentive strength. Sandblasting the smooth post more than doubled its retentive strength. The retentive strength of both smooth and sandblasted posts could be further increased by the addition of circumferential grooves. Roughening the dentinal walls of the prepared post space increased the retentive strength of sandblasted posts with and without grooves even more. CONCLUSIONS These findings indicated that, when a tapered post is used, roughening the dentin canal wall, as well as sandblasting and grooving the post, can provide statistically significant additional resistance to dislodgment.

Effect of alloy type and surface conditioning on roughness and bond strength of metal brackets

The effect of 5 different surface conditioning methods on bonding of metal brackets to cast dental alloys was examined. The surface conditioning methods were fine (30-microm) or rough (125-microm) diamond bur, sandblasting (50-microm or 110-microm aluminum oxide [Al2O3]), and silica coating (30-microm silica). Fifty disc-shaped specimens of 5 different alloys (gold-silver, palladium-silver, nickel-chromium, cobalt-chromium, and titanium) were ground with 1200-grit silicone carbide abrasive and polished before being reused for each conditioning method. Polished surfaces were used as negative controls. After measuring surface roughness (RZ), metal brackets were bonded to the conditioned alloys with a self-curing resin composite. Specimens were thermocycled (5000 times, 5 degrees-55 degrees C, 30 seconds), and shear bond tests were performed. Significantly higher (P<.001) surface roughnesses were observed with use of the rough diamond bur (RZ approximately 33 microm), 110-microm Al2O3 (RZ approximately 14 microm), and fine diamond bur (RZ approximately 10 microm), compared with the controls (RZ approximately 1 microm). Silica coating (RZ approximately 4 microm) and 50-microm Al2O3 (RZ approximately 4 microm) demonstrated no significant difference (P>.001) in roughness when compared with the controls. The control group showed no resistance to shear forces (0 MPa). Bond values were greater (19 MPa) when silica coating was used, compared with 50-microm Al2O3 (7 MPa) and 110-microm Al2O3 (8 MPa) for all alloys tested. However, interaction between alloys and conditioning methods exhibited significant differences (P<.0001).

Effect of surface conditioning on the retentive bond strengths of fiberreinforced composite posts

STATEMENT OF PROBLEM Debonding is a common cause of failure encountered with fiber-reinforced composite (FRC) posts, and usually occurs along the post space-dentin adhesive interface. Surface conditioning of posts is expected to increase the chemical and mechanical bond between the luting composite resin and the post, but the best method has not been definitively determined. PURPOSE The purpose of this in vitro study was to compare the effects of 3 surface-conditioning methods on the retentive bond strengths of FRC posts using 5 composite resin materials, and compare results to those of unconditioned FRC posts as well. MATERIAL AND METHODS Post space preparations (DentinPost ER root post system, length of 12 mm) were performed on 200 human anterior teeth. Groups of 50 FRC posts (ISO size 90) each were treated using 1 of the following conditioning methods: silanization, etching with 5% hydrofluoric acid, tribochemical coating (CoJet system), or were left untreated (control group). FRC posts (n=10) in each group were placed using 1 of 5 composite resin materials (Calibra or RelyX Unicem resin cements or Build-It, MultiCore Flow, or Rebilda DC foundation composite resins). Following water storage (37 degrees C, 24 hours) and thermal cycling (5000 cycles, 5 degrees -55 degrees C, 30-second dwell time), tensile strength testing was performed. Fracture modes were assessed using a light microscope. Data were analyzed statistically (1-way and 2-way ANOVA, Bonferroni-Dunn correction, alpha=.05). RESULTS Retentive bond strengths of FRC posts luted with MultiCore Flow in combination with the CoJet system, and of posts inserted with Rebilda DC in combination with hydrofluoric acid (HF) etching as well as with the CoJet system, were significantly higher than those of the corresponding unconditioned FRC posts (P<.001). No significant differences were noted between the bond strength values of RelyX Unicem with CoJet, MultiCore Flow with CoJet, and Rebilda DC with either CoJet or HF etching (P>.05). Retentive bond strengths were significantly lower for HF etching (Calibra, RelyX Unicem, Build-It), and for the treatment with the CoJet system in combination with Build-It compared to the corresponding control groups (P<.001). Fracture modes were primarily adhesive at the post surface or cohesive within the composite resin layer or within the FRC post. CONCLUSIONS The retentive bond strengths differed significantly with respect to the tested combinations of conditioning method and luting composite resin.

Wear and hardness of different core build-up materials

Before crown preparation, teeth with extensive coronal destructions are built up with core materials. Sometimes, these build ups are exposed to the oral environment without the protection of crowns. Therefore, this in vitro investigation was aimed at evaluating the wear, surface roughness, Vickers hardness, and surface structure of 10 core composites, two glass ionomer cements (GICs), and four posterior restoration composites. The three-body wear was tested after water storage and 2,00,000 cycles. We measured both surface roughness and Vickers hardness (DIN 50133) and evaluated the surface structures by scanning electron microscopy. Results were statistically analyzed by use of the Mann-Whitney U test (alpha = 0.05). Lowest wear was found for the restorative composites (20 microm Grandio; others about 40 microm). A comparison of the composites Build-It, Chroma Core, Rebilda LC, and Rebilda DC to Quixfil showed similar wear values for each material (43-50 microm). Wear values of GICs and all others core composites ranged between 58 and 75 microm. Only Ti-Core showed significantly higher wear than all other materials (p < 0.05). All core materials except Ti-Core (35 HV) showed Vickers hardness values between 42 and 61 HV. Most core composites, particularly Build-It, Multicore Flow, Rebilda LC, Ecusit, and Tetric Evo Ceram, showed more homogenous surface structures compared to GICs and restorative composites. Therefore, wear values of core build-up materials not only differed widely but were higher than those of conventional restorative materials; yet, core build-up materials showed advantageous surface structures.

Shear bond strength of repair resin using an intraoral tribochemical coating on ceramometal, ceramic, and resin surfaces

Many attempts have been made to develop a simple, efficient, and inexpensive method for the intraoral repair of fractured esthetic veneers of crowns or pontics. However, the results are not predictable, especially when alloy surfaces are exposed to the oral environment. The aim of this in vitro study was to evaluate a new method for repairing fractured veneers intraorally by blasting the surfaces with 30 μm aluminum oxide grains coated with SiO 2 (Co-Jet®) using an intraoral alumina blaster before bonding with the repair resin. Sample surfaces of three different alloys and an alloy with resin or ceramic veneer layers were blasted with Co-Jet® particles, using an intraoral alumina blaster (Microetcher®). Samples were treated with specific silane solutions, opaquers (alloy samples), or bonding agents (veneered samples) and then bonded to two bisphenol-A glycidyl methacrylate repair resins. Shear bond strengths were determined after storage in water and after thermocycling resins. The results indicated that coating by the Co-Jet®/Microetcher® system increased the bond strength compared with surfaces abraded with aluminum oxide (control group). The highest mean bond strengths were recorded for repaired resin veneered samples (17.7 MPa) and Co/Cr and ceramic substrate samples (13 MPa). The results of this study suggest that coating with an intraoral alumina blaster offers the dentist the opportunity of a direct, chair-side repair of fractured porcelain and resin veneers with silica coating.

Penetration of moxifloxacin into rat mandibular bone and soft tissue

Objective. Based on its in vitro activity and spectrum of activity, the new 8-methoxyquinolone antibiotic moxifloxacin (MXF) seems suited for the antibiotic therapy of odontogenic infections. Penetration into the relevant tissue is another prerequisite for clinical efficacy. For this reason, the levels of MXF in plasma, soft tissue, and mandibular bone were determined in an animal model with Wistar rats. Material and methods. Samples of 49 rats were analyzed. Tissue samples were homogenized and proteins were precipitated. The pharmacokinetic evaluation was conducted based on non-compartmental analysis. Results. The concentration-time courses of tissues show a more plateau-shaped curve compared to plasma. Calculated AUC (area under the curve) ratios tissue:plasma were M. masseter:plasma = 2.64 and mandibles:plasma = 1.13. Conclusions. Administration of antibiotics is considered an important part of therapy during and/or after surgical procedures in the maxillofacial area. Because of the good penetration into bone and muscle tissues demonstrated in Wistar rats, MXF might be an option for clinical application in this indication.

Cleaning Effectiveness of Implant Prophylaxis Instruments

PURPOSE The aim of this study was to evaluate the cleaning effectiveness of implant prophylaxis instruments on polished and acid-etched implant surfaces. MATERIALS AND METHODS Biofilm layers of Streptococcus mutans were grown on a total of 80 titanium disks; 40 disks were polished and 40 were acid-etched. Five disks of each surface were cleaned using each of seven implant prophylaxis instruments: (1) manual plastic curette, (2) manual carbon fiber-reinforced plastic (CFRP) curette, (3) sonic-driven prophylaxis brush, (4) rotating rubber cup with prophylaxis paste, (5) sonic-driven polyether ether ketone (PEEK) plastic tip, (6) ultrasonic-driven PEEK plastic tip, and (7) air polishing with amino acid (glycine) powder. Ten disks (five of each surface type) served as controls. After cleaning, the surfaces with remaining bacteria were assessed by light microscopy. Statistical analyses of the results were performed with one-way and two-way analyses of variance with Bonferroni-Dunn multiple comparisons post hoc analysis (α = .05). RESULTS The cleaning effectiveness of the plastic curette was significantly lower than those of all machine-driven instruments on the polished surface. Significantly lower cleaning effectiveness occurred with the CFRP curette compared to the prophylaxis brush and to both oscillating PEEK plastic tips on the polished surface. The rubber cup provided less cleaning effectiveness compared to the ultrasonic PEEK plastic tip and air polishing on the acid-etched surface. Superior results, with less than 4% of the biofilm remaining, were obtained for both oscillating PEEK plastic tips and air polishing on both implant surfaces. The cleaning ability of the prophylaxis brush, rubber cup, and ultrasonic PEEK plastic tip differed significantly between both surface structures. CONCLUSIONS Cleaning effectiveness, ie, less than 4% of the biofilm remaining, was not observed with all tested implant prophylaxis instruments. The cleaning ability of the devices depended on the implant surface structure.

Shear bond strengths of five intraoral porcelain repair systems

In fixed prosthodontics, fracture of the porcelain veneer is not an uncommon problem under clinical conditions due to, e.g., malfunction, trauma or technical failures. To avoid time-consuming and cost-intensive renewal of the entire restoration, repair of the chipped veneer is desirable. The aim of this in vitro study was to evaluate the shear bond strengths of five intraoral porcelain repair kits based on different chemical bonding systems. 45 metal plates veneered with feldspathic porcelain were fabricated. The surface treatment was performed using five porcelain repair systems based on tribochemical silica coating (Cojet), mechanical roughening (Silistor, Cimara, Ceramic Repair) or etching (Clearfil Repair) followed by application of silane coupling agents (five specimens each). Cylinders of composite resin of Charisma and Pertac Hybrid were bonded using Cojet, Silistor, Cimara and Ceramic Repair, and of Clearfil AP-X with Clearfil Repair onto the porcelain specimens. After thermocycling (5000 cycles, 5–55°C) shear bond strength was measured according to ISO 10477 followed by assessment of the failure mode. Statistical analysis was carried out with one-way ANOVA and Bonferroni–Dunns multiple comparisons post-hoc analysis for test groups (α = 0.05). Shear bond strengths higher than 10 MPa were found for all test groups except for Ceramic Repair with Pertac Hybrid (8.1 ±1.3 MPa), which was significantly lower than all other groups (P < 0.05). Highest shear bond strength was found for Silistor with Charisma (23.1 ± 5.8 MPa), which was significantly higher (P < 0.05) than all other groups except Cojet with Charisma (17.8 ± 3.6 MPa) and Clearfil Repair (20.3 ± 5.0 MPa). Cojet and Silistor with Charisma, Cimara, as well as with Clearfil mainly showed cohesive or mixed failure modes (cohesive and interfacial). Bond strengths of the combinations Silistor-Charisma, Clearfil Repair-Clearfil AP-X and Cojet-Charisma were superior to all other combinations used in the present tests.

Untersuchungen zur Haftfestigkeit von Brackets mit und ohne Silanisierung

ZusammenfassungZiel der Untersuchung war es, einen neuen Retentionsmechanismus beim Verbund zwischen Adhäsiv und herkömmlichen Bracket-Basistypen zu evaluieren. Für die Untersuchungen wurden fünf verschiedene Metallbracket-Typen ausgewählt, die unterschiedliche Basen aufwiesen. Die glatten Metallbrackets wurden als Kontrollgruppe herangezogen. Je zehn beschichtete und unbeschichtete Prüfkörper von jeder Gruppe wurden mit Concise Enamel Bond auf die Zähne geklebt und nach 28 Tagen die Scherkräfte mit einer Zugprüfmaschine gemessen. Die silanbeschichteten Basen zeigten ein höheres Retentionspotential als die herkömmlichen Basen. Die silanisierten glatten Bracketbasen ließen eine ähnlich gute Haftung zum Adhäsiv erkennen wie die mit zusätzlichen mechanischen Retentionen versehenen, nicht silanisierten Brackets.SummaryThis study was undertaken to show that a silane treated bracket base can provide a better bonding to the enamel than conventional bonding bases commercially available. Five different types of metal brackets, each with different retentive properties, were tested. 20 brackets of each type were used, half of them silanated with a special silicoater treatment. The brackets were bonded to the surface of the teeth with Concise Enamel Bond and were then tested to failure in an Instron testing machine after 28 days. The following conclusions can be drawn from the study: 1. Silane-coated bracket bases demonstrated a higher bonding strength than the conventional bases, 2. silane treatment of plain bases is an effective method for the bonding of brackets to teeth, similiar to non-silane-boated brackets with additional mechanical retentive devices.