Mine Dündar

Bond Strengths of All-Ceramics: Acid vs Laser Etching

Various applications of dental lasers on dental materials have been proposed for surface modifications. This study evaluated whether laser etching could be an alternative to hydrofluoric acid (HF) etching. One hundred and ten lithia-based all-ceramic specimens (Empress 2) (R: 4 mm, h: 4 mm) were prepared and divided into five groups (n = 22/group). The untreated specimens served as the control, while one of the experimental groups was treated with 9.5% HF for 30 seconds. Three remaining test groups were treated with different laser (Er:YAG laser wavelength:2940 nm, OpusDent) power settings: 300 mJ, 600 mJ and 900 mJ. Ten specimens in each group were luted to the other 10 specimens by a dual-curing cement (Variolink II), and shear-bond strength (SBS) tests were performed (Autograph, crosshead speed: 0.5 mm/minute). The results were statistically analyzed (Kruskal Wallis and Mann Whitney-U, alpha = .05). Mean SBS (MPa) were 31.9 +/- 4.0, 41.4 +/- 4.3, 42.8 +/- 6.2, 29.2 +/- 4.5 and 27.4 +/- 3.8 for the control and HF, 300, 600 and 900 mJ groups, respectively. SEM evaluations revealed different surface morphologies depending on the laser parameters. The differences between HF acid and 300 mJ, when compared with the control, 600 and 900 mJ groups, were significant (p < .05). The 300 mJ laser group exhibited the highest shear-bond strength values, indicating that laser etching could also be used for surface treatments.

Possible hazardous effects of hydrofluoric acid and recommendations for treatment approach: a review

Hydrofluoric acid (HF) is commonly used for conditioning the glass ceramics either prior to cementation or for intraoral repair in prosthetic and restorative dentistry. The present study offers a review of chemical properties of HF used, highlight the possible hazardous effects of this agent, and to recommend the treatment approach for potential risks. Available published information documented in PubMed, Medline, and Picarta literature databases was reviewed. Additional information was derived from scientific reports, medical and chemical textbooks, handbooks, product information, manufacturers’ instructions, Internet web sites of the HF manufacturers. No report was found on the incidence of the hazardous effects of HF in dentistry. Reports from other fields presented incidences of acute and chronic symptoms in exposure to HF. While acute symptoms include skin or nail burns, chronic ones involve systemic toxicity, eye injuries, inhalation and ingestion-related symptoms that can be even fatal. HF can be harmful and particularly aggressive to soft tissues, but symptoms may not be apparent immediately after exposure. The hazardous effects are not based on the pH value, but on the toxicity of HF. Potential hazards of HF known from other applications than dentistry should be considered also in dental applications. Especially the clinicians, who often deal with adhesive cementation or repair of glass ceramics, should take necessary precautions for possible hazards of HF.

Influence of cervical finish line type on the marginal adaptation of zirconia ceramic crowns

The current study evaluated the effect of different cervical finish line designs on the marginal adaptation of a zirconia ceramic. Four different marginal finish lines (c: chamfer, mc: mini-chamfer, fe: feather-edge and s: rounded shoulder) were prepared on phantom incisors. Die models for each preparation group (N = 28, n = 7 per finish line design group) were made of epoxy resin. Y-TZP (ICE Zirkon) frameworks were manufactured by a copy-milling system (Zirconzahn) using prefabricated blanks and tried on the master models for initial adaptation of the framework; they were then sintered, followed by veneering (Zirconzahn). The finished crowns were cemented with a polycarboxylate cement (Poly F) under 300 g load and ultrasonically cleaned. The specimens were sliced and the marginal gap was measured, considering absolute marginal opening (AMO) and marginal opening (MO) for each coping under a stereomicroscope with image processing software (Lucia). The measurements were statistically analyzed using the Kruskal Wallis, Mann Whitney and Wilcoxon Signed Ranks tests at a significance level of alpha = 0.01. Means of AMO measurement (microm) for the feather-edge finish line (87 +/- 10) was significantly lower than that of the chamfer (144 +/- 14), shoulder (114 +/- 16) and mini-chamfer finish line types (114 +/- 11) (p < 0.01). Means of MO measurements was the lowest for feather-edge finish line (68 +/- 9) (p < 0.01) and then, in ascending order, shoulder (95 +/- 9), mini-chamfer (97 +/- 12) and chamfer (128 +/- 10). The cervical finish line type had an influence on the marginal adaptation of the tested zirconia ceramic. Although the feather-edge finish line resulted in lower AMO and MO values, with its proven mechanical disadvantage, it cannot be recommended in clinical applications of zirconia crowns. This type of finish line has acted solely as a control group to test the null hypothesis in the current study. For better marginal adaptation, both shoulder and mini-chamfer finish line types could be suggested for zirconia crowns.

Nanoleakage inhibition within hybrid layer using new protective chemicals and their effect on adhesion.

Hybrid-layer degradation occurs because of acidic properties of currently used adhesive systems. Titanium tetrafluoride couples with tooth surface, and titanium compounds are not substituted. Caffeic acid phenethyl esther inhibits endogenous matrix metalloproteinases that cause hybrid-layer degradation. It was hypothesized that titanium tetrafluoride and caffeic acid phenethyl esther application on exposed dentine surfaces before adhesive applications would inhibit nanoleakage and hybrid-layer degradation without compromising the bond strength of the adhesives. In ultracut thin sections, human dentine–chemical agent–adhesive composite interfaces were observed under transmission electron microscope with complementary scanning electron microscopy. Microtensile bond strength tests were also accomplished. Titanium tetrafluoride and titanium tetrafluoride + caffeic acid phenethyl esther applications decreased bond strength values. Caffeic acid phenethyl esther showed decreased silver nitrate penetration for cements based on Bisphenol glycydilmethacrylate and methyl methacrylate, whereas cement based on 4-methacryloyloxyethyl trimellitate anhydride methyl methacrylate showed almost no infiltration. Caffeic acid phenethyl esther application before cementation could inhibit nanoleakage and biodegradation of the hybrid layer.

Bond Strength Comparison of Amalgam Repair Protocols Using Resin Composite in Situations With and Without Dentin Exposure

The replacement of defective amalgam restorations leads to loss of tooth material and weakens the tooth, creating an increased risk of cusp fracture. The repair of such defects is a minimal intervention technique. The current study compared the repair bond strengths of a resin composite to amalgam and an amalgam-dentin complex after various surface conditioning methods. The specimens (N = 50) consisted of sound human canines with cylindrical preparations (diameter: 2.3 mm, depth: 3 mm) with amalgam-dentin complex (N = 30, n = 10/per group) and two groups with amalgam only (N = 20, n = 10/per group). The teeth were embedded in auto-polymerized polymethylmethacrylate (PMMA). The preparations were filled with non-Gamma 2 amalgam. The enamel was removed to expose dentin. The specimens with the amalgam-dentin complex were randomly assigned to one of the following conditioning methods: Group 1: Silicacoating amalgam, etching dentin, silane application on amalgam, primer/bonding on dentin, opaquer on amalgam, resin composite on both; Group 2: Etching dentin, silicacoating amalgam, silane application on amalgam, primer/bonding on dentin, opaquer on amalgam, resin composite on both and Group 3: Etching dentin, primer/bonding on dentin, opaquer, resin composite. The specimens with only amalgam were assigned to one of the following conditioning methods: Group 4: Silicacoating, silane application, opaquer, resin composite and Group 5: Opaquer, resin composite. For the two control groups, where no dentin was involved (Groups 4 and 5), bonding was achieved only on amalgam and Group 5 had no conditioning. The specimens were kept in water at 37 degrees C for five weeks before bond strength (MPa +/- SD) testing (Universal Testing Machine). After debonding, the failure types were analyzed. The results were significantly affected by the surface conditioning method (ANOVA). Only dentin conditioning (Group 3) showed the highest bond strength (39.9 +/- 14). The unconditioned control group (Group 5) showed the least favorable results (1.4 +/- 0.5). Multiple comparisons (Tukey-Kramer adjustment) showed that the mean values of Group 1 (34.1 +/- 11.4), 3 (39.9 +/- 14) and 4 (35.5 +/- 4) were not significantly different (p > 0.05), but between Groups 2 (22.8 +/- 6.6) and 3 (39.9 +/- 14), significant differences were observed (p = 0.0027). For reliable repair of amalgam restorations, including dentin fractures, the amalgam surface should first be silica coated, then the dentin/enamel should be etched, washed and rinsed thoroughly. Finally, the amalgam should be silanized and primer/bonding applied onto the dentin.

Adhesion concepts in dentistry: tooth and material aspects

Adhesion concepts require understanding of substrate material properties, surface conditioning methods and chemical interactions, formation of interfaces/interphases between different material combinations, changes at interfaces with time, failure mechanisms and failure modes of the interfaces as a consequence of aging phenomenon. In dentistry, different methods are being used to test adhesion of resin-based materials to various biological and artificial substrates that require individual conditioning protocols. Variations among specimen configurations, material properties and chemical compositions of adhesives, test methods and test conditions all have effect on adhesion of similar or dissimilar substrates. Selection of the test, its proper execution, as well as the interpretation of the data through chemistry of the materials involved is of importance. Although adhesion to enamel is not a major concern today, effective adhesion to dentin requires several steps where failure in any of these consecutive events might result in failure of the whole system after long-term clinical use. Test methodologies used for assessment of mechanical behavior of materials in engineering may not directly apply to tooth–material combinations in dentistry. The objective of this review on adhesion in dentistry is to summarize current materials and methods used in dental materials testing and to summarize the current state-of-the-art in adhesion durability and quality with respect to the material type.

Effects of Different Surface Conditioning Methods on the Bond Strength of Composite Resin to Amalgam

Repairing amalgam restorations with composite resins using surface conditioning methods is a conservative treatment approach. This study investigated the effects of different conditioning methods that could be used for repair of amalgam fractures. Amalgam (N=96) was condensed into cavities within autopolymerizing polymethylmethacrylate (PMMA), and the exposed surface of each specimen (diameter, 6 mm; thickness, 2 mm) was ground finished. The specimens were randomly divided into nine experimental groups (n=12 per group), depending on the conditioning method used. The control group had natural central incisors with amalgam (n=12). The combination of the following conditioning methods was tested: silicacoating (Sc), sandblasting (Sb), metal primers, coupling agents, fiber (Fb) application, and opaquers (O). Five types of silanes, metal primers, or adhesives (Visiobond [V], Porcelain Photobond [PP], Alloy Primer [AP], Unibond sealer [Us], ESPE-Sil [ES]), and four opaquers, namely, Clearfil St Opaquer (CstO), Sinfony (S), Miris (M), and an experimental Opaquer (EO-Cavex), were used. The groups were as follows: group 1, Sc+ES+S+V; group 2, Sc+ES+CstO+V; group 3, Sc+ES+M+V; group 4, Sc+ES+EO+V; group 5, Sb+AP+S; group 6, Sb+AP+PP+CstO; group 7, Sc+ES+S+Fb+V+Fb; group 8-control, SC+ES+V; and group 9, Etch+Sc+ES+S+Us. One repair composite was used for all groups (Clearfil Photo Bond Posterior, Kuraray, Tokyo, Japan). Shear bond strengths (SBSs) (MPa ± SD) were evaluated after 5 weeks of water storage (analysis of variance [ANOVA], Tukey honestly significant differences [HSD], α=0.05). Group 1 exhibited significantly higher values (35.5 ± 4.1) than were seen in group 4 (19.4 ± 8.9), group 6 (19.1 ± 7.8), and group 8 (20.1 ± 4.1) (p<0.05). Group 9 exhibited significantly lower values (8.3 ± 3.4) than were noted in groups 1 to 3 (35.5 ± 4.1; 27 ± 12.5; 24.4 ± 5.1, respectively) (p<0.05). Group 7 (16.4 ± 5.9) showed significantly lower values than were observed in group 1 (35.5 ± 4.1) (p<0.05). Surface conditioning techniques affected the bond strengths of composite adhesion to amalgam. Experimental opaquer exhibited lower values. Leaving a small border of enamel around the restoration decreased the bond strength.

Effects of soldering and laser welding on bond strength of ceramic to metal.

STATEMENT OF PROBLEM Welding or soldering of metal frameworks negatively affects the overall bond strength between the veneering ceramic and metal. PURPOSE The purpose of this study was to evaluate the effect of soldering and laser-welding procedures on the bond strength between ceramic and metal. MATERIAL AND METHODS Thirty Ni-based metal specimens (Wiron 99) (8 × 4 × 4 mm) were fabricated and divided into 3 groups; soldered (S), laser welded (L), and control (untreated cast alloy) (n=10). In S and L specimens, a notch (1 × 1.5 mm) was prepared longitudinally on the surface of each specimen and filled with compatible alloy (Wiron soldering rods and Wiroweld NC, respectively). Vickers hardness measurements were made after polishing the surfaces with a metallographic polishing kit. A veneering ceramic (VITA VMK 95) was vibrated, condensed in a mold, and fired on the metal frameworks. The specimens were sectioned in 2 axes to obtain nontrimmed bar specimens with a bonding area of approximately 1 mm². Forty bars per block were obtained. Each bar was subjected to microtensile bond strength (μTBS) testing with a crosshead speed of 1 mm/min. The μTBS data (MPa) were recorded, and SEM was used for failure analysis of the tested bars. The measurements were statistically analyzed using a 1-way ANOVA and Tamhane tests (α=.05). RESULTS The mean differences in μTBS of veneering ceramic to soldered (10.4 ±2.4 MPa) and laser-welded (11.7 ±1.3 MPa) metal surfaces were not significantly different and were significantly lower than that of the cast alloy (25.4 ±3.6 MPa) (P<.05). The mean Vickers hardness of cast alloy was significantly higher (236 ±17 HV) than soldered (114 ±9 HV) and laser-welded groups (129 ±11 HV) (P<.05). CONCLUSIONS Soldering and laser welding significantly decreased the μTBS of a veneering ceramic to a base metal alloy.

Preliminary evaluation of titanium tetrafluoride as an alternative ceramic etchant to hydrofluoric acid.

PURPOSE The etching of dental ceramics with a glassy matrix by means of hydrofluoric acid (HF) is highly effective and after the application of a silane coupling agent, a strong link between the adhesive and the ceramic is achieved. The purpose of this study was to investigate whether aqueous titanium tetrafluoride (TiF4) solution could be used as an alternative ceramic etchant or not. MATERIALS AND METHODS Seventy lithia-based all-ceramic specimens (IPS Empress 2, Ivoclar Vivadent) (diameter: 4 mm, height: 4 mm) were prepared and ultrasonically cleaned for 15 min in ethanol and deionized water, then divided into 1 control and 4 experimental groups (n = 14/group). The control group was acid etched with 4.9% HF for 20 s as described by the manufacturer. The experimental groups were treated with 2.5% TiF4 solution for 60 s, 2.5% TiF4 solution for 120 s and 5% TiF4 solution for 60 s, as well as 5% TiF4 solution for 120 s. Seven of the ceramic specimens in each group were luted to the other seven by a dual-curing cement (Variolink II, Ivoclar Vivadent,) with silane application (Monobond-S). After storage of luted specimens in deionized water at 37 degrees C for 24 h, the specimens were embedded in plastic holders with cyanoacrylate, and the shear-bond strength (SBS) tests were performed with a Shimadzu universal testing machine at a crosshead speed of 0.5 mm/min. A one-way ANOVA and Bonferroni correction, followed by the Tukey test, were applied for statistical analysis. Scanning electron microscopic examination was performed to evaluate the pattern of debonding. RESULTS Significantly higher SBS values (p <or= 0.05) were obtained for the control group (28.71 +/- 9.74). The SBS for 2.5%-60 s (25.25 +/- 5.13) and 2.5%-120 s TiF4 (22.65 +/- 5.68) were significantly higher than 5%-60 s (16.77 +/- 3.92) and 5%-120 s TiF4 (18.54 +/- 3.52) groups (p <or= 0.05). Differences between 60- and 120-s groups irrespective of TiF4 concentrations were insignificant (p > 0.05). CONCLUSION Aqueous TiF4 solution exhibited similar shear bond strength values in comparison to commonly used HF and can be considered as an alternative ceramic etchant within the limitations of this preliminary report.

Güçlendirilmiş dental seramiklerin vickers sertlikleri ve yük altında kırılma davranışları

Objective: The objectives of this study were to determine the Vicker`s hardness of reinforced dental ceramics and determine the modes of fractures under load. Methods: Four ceramic core groups (n=7/group) from leucite (Evopress,WegoldD 5 mm capta). Her bir alt yapi seramigine ozgu kaplama seramikleri; paslanmaz celik bir metal kalipta (5mm cap 5mm yukseklikte) vibrasyonla kondanse edildi ve alt yapi seramiklerinin uzerine pisirildi. Ornekler batirma testlerinden once 37°C’ de 24 saat distile suda bekletildikten sonra polyester kaliplara gomuldu. Vickers sertlik degerleri (DUH±SD) olculdu (cene hizi:7,2 gf/s, yuk:200 gf) ve veriler istatistiksel olarak analiz edildi (ANOVA). Catlak olusumu icin orneklerin ust yuzeylerine makro sertlik test cihazinda batici elmas uc ile (1 mm capli) 400 N yuk uygulandi. Alinan taramali elektron mikroskop goruntuleri ile her bir gruba iliskin catlak sekilleri gozlemlendi. Bulgular: Gruplar arasinda ortalama Vickers sertlik degerleri dusuk losit grubu icin anlamli olarak (P<0.05) en yuksek bulunur iken (236±17), bunu losit (129±51), cam infiltrasyonlu aluminoz seramik (117±38), ve lityum disilikat (85±34) kaplama seramik materyalleri azalan sirayla izledi. Yuk uygulamasi sonrasinda genellikle isinsal ya da koni sekilli catlaklarin olustugu gozlendi. Sonuc: Seramik materyalin sertliginin artmasi daha fazla ve daha uzun catlak olusumuna yol acti. Bu calismadaki deneysel kosullar altinda kaplama seramik gruplarinin hicbirinde alt yapi seramiklerine ulasan catlak olusumu gozlenmedi.