Omar El-Mowafy

Chemical versus dual curing of resin inlay cements.

Dual-cure inlay resin cements polymerize both chemically and through light activation; however, clinically some aspects of the cement are not readily accessible to the light source. This study investigated the degree of cement hardening achieved through chemical curing only versus dual curing and the effect of inlay thickness on cement hardness. Disks 6 x 2.5 mm were prepared from seven commercially available cements. Eight specimens were prepared from each material; half of the specimens were cured chemically only, and the remainder were dual-cured. Knoop hardness measurements were then recorded at 1-hour, 1-day, and 1-week intervals. In addition, 24 specimens of the same dimensions were prepared from each cement. Twelve specimens were dual-cured through resin composite spacers of varying thicknesses (1 to 6 mm), and the others were cured through similar ceramic spacers, and hardness measurements were recorded. Multivariate analysis of variance revealed significant differences in hardness of chemically cured versus dual-cured specimens at the 5% level of significance for all examined cements. Significant differences were also found in the hardness of specimens dual cured through ceramic or resin composite spacers 2 to 3 mm in thickness or more versus those that were dual cured without spacer regardless of the spacer material. It is concluded that chemical curing alone was not sufficient to achieve maximum hardening of the examined cements. Cement hardness was significantly reduced when inlay thickness was 2 to 3 mm or more.

Fracture Strength and Fatigue Resistance of All‐Ceramic Molar Crowns Manufactured with CAD/CAM Technology

PURPOSE All-ceramic crowns are subject to fracture during function, especially in the posterior area. The use of yttrium-stabilized zirconium-oxide ceramic as a substructure for all-ceramic crowns to improve fracture resistance is unproven. The aim of this study was to compare fracture strength and fatigue resistance of new zirconium-oxide and feldspathic all-ceramic crowns made with computer-aided design/computer-aided manufacturing (CAD/CAM). MATERIALS AND METHODS An ivorine molar was prepared to receive an all-ceramic crown. Using epoxy resin, 40 replication dies were made of the prepared tooth. Twenty feldspathic all-ceramic crowns (Vita Mark II) (VMII) and 20 zirconium-oxide crown copings (In-Ceram YZ) (YZ) were made using CAD/CAM technique (CEREC-3D). The YZ copings were sintered and veneered manually with a fine-particle ceramic (VM9). All crowns were cemented to their respective dies using resin cement (Panavia F 2.0). Ten crowns in each group were subjected to compressive fatigue loading in a universal testing machine (instron). The other ten crowns from each group were loaded to fracture at a crosshead speed of 1 mm/min. Data were statistically analyzed using independent t-test and Fishers exact test at alpha= 0.05. RESULTS There was a significant difference between the survival rates of the two materials during the fatigue test (p < 0.001). All VMII crowns survived without any crack formation, while all YZ crowns fractured (40%) or developed cracks (60%). All the YZ crown fractures occurred within the veneering layer during the fatigue test. There was no significant difference in mean fracture load between the two materials (p= 0.268). Mean fracture loads (standard deviation) in N were: 1459 (492) for YZ crowns and 1272 (109) for VMII crowns. CONCLUSIONS The performance of VMII crowns was superior to YZ crowns in the fatigue test. The premature fractures and cracks of the YZ crowns were attributed to weakness in the YZ veneer layer or in the core/veneer bond.

Fatigue Resistance and Microleakage of CAD/CAM Ceramic and Composite Molar Crowns

PURPOSE The aim of this study was to determine effect of compressive cyclic loading on fatigue resistance and microleakage of monolithic CAD/CAM molar ceramic and composite crowns. MATERIALS AND METHODS Thirty-two extracted molars were prepared to receive CEREC crowns according to manufacturers guidelines using a special paralleling device (Parallel-A-Prep). Sixteen feldspathic ceramic crowns (VITABLOCS Mark II) (VMII) and 16 resin-composite crowns (Paradigm-MZ100 blocks) (PMZ) were milled using a CEREC-3D machine. Eight crowns of each group were cemented to their respective teeth using self-etching resin cement (Panavia-F-2.0) (PAN), and eight were cemented using self-adhesive resin cement (RelyX-Unicem-Clicker) (RXU). Following storage for 1 week in water, specimens were subjected to uniaxial compressive cyclic loading in an Instron testing machine at 12 Hz for 1,000,000 cycles. Load was applied at the central fossa, and the cycle range was 60-600 N. Specimens were then subjected to microleakage testing. Data were statistically analyzed using factorial ANOVA and Post Hoc (Tukey HSD) tests. RESULTS All composite crowns survived compressive cyclic loading without fracture, while three ceramic crowns from the subgroup cemented with RXU developed surface cracks at the center of occlusal surfaces, extending laterally. Microleakage scores of ceramic crowns cemented with PAN were significantly lower than those of the other three subgroups (p < 0.05). CONCLUSIONS After 1,000,000 cycles of compressive cyclic loading, PMZ composite molar crowns were more fatigue-resistant than VMII ceramic crowns. Cement type had a significant effect on fatigue resistance of the ceramic crowns but not the composite ones. Microleakage scores of ceramic crowns cemented with PAN were significantly lower than those of the other subgroups (p < 0.05).Purpose: The aim of this study was to determine effect of compressive cyclic loading on fatigue resistance and microleakage of monolithic CAD/CAM molar ceramic and composite crowns. Materials and Methods: Thirty-two extracted molars were prepared to receive CEREC crowns according to manufacturers guidelines using a special paralleling device (Parallel-A-Prep). Sixteen feldspathic ceramic crowns (VITABLOCS Mark II) (VMII) and 16 resin-composite crowns (Paradigm-MZ100 blocks) (PMZ) were milled using a CEREC-3D machine. Eight crowns of each group were cemented to their respective teeth using self-etching resin cement (Panavia-F-2.0) (PAN), and eight were cemented using self-adhesive resin cement (RelyX-Unicem-Clicker) (RXU). Following storage for 1 week in water, specimens were subjected to uniaxial compressive cyclic loading in an Instron testing machine at 12 Hz for 1,000,000 cycles. Load was applied at the central fossa, and the cycle range was 60–600 N. Specimens were then subjected to microleakage testing. Data were statistically analyzed using factorial ANOVA and Post Hoc (Tukey HSD) tests. Results: All composite crowns survived compressive cyclic loading without fracture, while three ceramic crowns from the subgroup cemented with RXU developed surface cracks at the center of occlusal surfaces, extending laterally. Microleakage scores of ceramic crowns cemented with PAN were significantly lower than those of the other three subgroups (p < 0.05). Conclusions: After 1,000,000 cycles of compressive cyclic loading, PMZ composite molar crowns were more fatigue-resistant than VMII ceramic crowns. Cement type had a significant effect on fatigue resistance of the ceramic crowns but not the composite ones. Microleakage scores of ceramic crowns cemented with PAN were significantly lower than those of the other subgroups (p < 0.05).

Torsional Profiles of New and Used 20/.06 GT Series X and GT Rotary Endodontic Instruments

INTRODUCTION M-Wire (Sportswire LLC, Langley, OK) is reportedly created by altering alloy temperatures during the manufacturing process of GT series X instruments (Dentsply Tulsa Dental Specialties, Tulsa, OK). Currently, there are few published studies looking at torsional profiles of these instruments. The purpose of this study was to investigate the torsional profiles of new and used 20/0.06 GT series X (GTX) and GT (GT) instruments (Dentsply Tulsa Dental Specialties). METHODS Thirty instruments were allocated to one of eight groups and were used 2, 6, or 10 times in simulated canals or remained as unused controls. Testing of torque (TF) and angle at fracture (AF) were conducted in accordance with American National Standards Institute/American Dental Association (ANSI/ADA) specification No. 28. Data analyses were performed by using one- and two- way analysis of variance with honesty significance difference post hoc comparison with alpha = 0.05. RESULTS Overall, there were significant differences in TF and AF among the experimental groups (p < 0.001). GTX instruments showed a significant initial increase in TF with two and six uses (p < 0.001) in contrast to the GT, which showed a linear reduction in TF with increased use (p < 0.004). Both GTX and GT instruments showed no statistical difference in AF of new instruments but did show a significant decrease in AF in all groups except the GT two-use group (p < 0.02). CONCLUSION The GTX instruments had a higher resistance to torsional failure after use as compared with the GT.

Fracture toughness of chairside CAD/CAM materials - Alternative loading approach for compact tension test.

OBJECTIVE This in-vitro study determined plane-strain fracture toughness (KIC) of five different chairside CAD/CAM materials used for crown fabrication, following alternative innovative loading approach of compact tension test specimens. METHODS Rectangular-shaped specimens were cut from CAD/CAM blocks (n=10): Vita Mark II (Vident) (VMII); Lava-Ultimate (3M/ESPE) (LU); Vita Enamic (Vident) (VE); IPS e.max CAD (Ivoclar Vivadent); crystallized and un-crystallized (E-max and E-max-U, respectively); and Celtra Duo (Dentsply) fired and unfired (CD and CD-U, respectively). Specimens were notched with thin diamond disk prior to testing. Instead of applying tensile loading through drilled holes, a specially-made wedge-shaped steel loading-bar was used to apply compressive load at the notch area in Instron universal testing machine. The bar engaged the top ¼ of the notch before compressive load was applied at a cross-head speed of 0.5mm/min. Fracture load was recorded and KIC calculated. Data was statistically-analyzed with one-way ANOVA at 95% confidence level and Tukeys tests. RESULTS Means and SDs of KIC in MPam(1/2) for VMII, LU, VE, E-max, E-max-U, CD and CD-U were: 0.73 (0.13), 0.85 (0.21), 1.02 (0.19), 1.88 (0.62), 0.81 (0.25), 2.65 (0.32) and 1.01 (0.15), respectively. ANOVA revealed significant difference among the groups (p<0.001). CD and E-max had significantly highest mean KIC values. SIGNIFICANCE Mean KIC values of the tested materials varied considerably, however, none of them reached mean KIC of dentin (3.08MPam(1/2)) previously reported. For E-max and CD, specimens firing significantly increased mean KIC. The modified test arrangement was found to be easy to follow and simplified specimen preparation process.

Bond strength of orthodontic brackets with new self-adhesive resin cements

INTRODUCTION In this investigation, we determined the shear bond strength (SBS) of metallic and ceramic orthodontic brackets with new self-adhesive cements. METHODS One hundred extracted premolars were used. They were sterilized and their roots embedded in stone bases, with the facial surfaces perpendicular to the bottom of the bases. The teeth were divided into 2 main groups, to receive metallic or ceramic brackets (Victory series 3M Unitek, Monrovia, Calif). In each group, the specimens were further divided into 5 subgroups according to the cement used: an etch-and-rinse control, Transbond-XT (3M Unitek); a resin cement with self-etch primer, Esthetic Cement system NC-100, (Kuraray, Okayama, Japan); and 3 self-adhesive resin cements: Rely-X Unicem (3M ESPE, Seefeld, Germany), Biscem DC (Bisco, Schaumburg, Ill), and Breeze (Pentron, Wallingford, Conn). Ten brackets were cemented in each subgroup. The specimens were stored in distilled water at 37 degrees C for 7 days and subjected to 3000 thermocycles between 5 degrees C and 55 degrees C. The brackets were then debonded in shear with a testing machine. RESULTS Mean values for the metallic brackets cemented with Transbond XT, Esthetic Cement system, Rely-X Unicem, Biscem DC, and Breeze were 18.6, 6.0, 6.0, 2.2, and 8.4 MPa, respectively. For the ceramic brackets, the values were 22.7, 17, 7.7, 1.6, and 9.5 MPa, respectively. Analysis of variance (ANOVA) showed significant differences among the subgroups (P <0.05) for both bracket types. For the ceramic brackets, the Tukey test showed no statistical difference in mean SBS between Transbond XT and Esthetic Cement system. CONCLUSIONS The SBS values of brackets cemented with etch-and-rinse cement were significantly higher than those of the 3 self-adhesive cements. However, when the self-etch adhesive, Esthetic Cement system, was used with ceramic brackets, no significant difference was found in the SBS compared with Transbond XT (P = 0.052).

Microleakage of porcelain and composite machined crowns cemented with self-adhesive or conventional resin cement.

PURPOSE Resistance of machined crowns to microleakage when cemented with new self-adhesive cements has not been fully investigated. This study evaluated microleakage of machined crowns milled from porcelain and composite blocks and bonded to teeth with self-adhesive and conventional resin cement. MATERIALS AND METHODS Thirty-two freshly extracted premolars of similar shape and size were sterilized and mounted in resin blocks. Teeth received standard crown preparations with 1-mm circumferential shoulder finish line, flat occlusal surface reduced by 2 mm, and ideal angle of convergence. Prepared teeth were divided into two equal groups and assigned to either porcelain (Vita Mark II, Vident) or composite (Paradigm MZ100, 3M ESPE) blocks for crown fabrication. Optical impressions were captured for each tooth with the intraoral camera of a CEREC 3D machine. Crowns were designed and milled from both materials. Each group was then subdivided into two subgroups (n = 8) according to cement used (self-adhesive resin cement, RelyX Unicem, 3M ESPE or resin cement with self-etching adhesive, Panavia F 2.0, Kuraray). Following seating, a 5-kg weight was applied on the occlusal surface of the crown for 5 minutes. Specimens were then stored in water at 37°C for 24 hours. Specimens were thermocycled for 3000 cycles between 5°C and 55°C, then coated with nail varnish and immersed in a 2.0% basic red fuchsine dye solution for 24 hours. Teeth were then rinsed and sectioned mesiodistally and assessed under magnification for microleakage. A five-point scale was used to score degree of microleakage. Data were statistically analyzed with 2-way ANOVA and Kruskal-Wallis nonparametric test. RESULTS Crown material had no significant effect on microleakage (p= 0.67); however, cement type had a significant effect (p < 0.0001), with Panavia F 2.0 resulting in lower microleakage scores than RelyX Unicem. CONCLUSIONS Compared to the self-adhesive cement, the resin cement with separate primer/bonding agent resulted in significantly lower microleakage scores, irrespective of crown material.

Posterior resin-bonded fixed partial denture with a modified retentive design: A clinical report

A uncomplicated clinical procedure to enhance the retention of posterior resin-bonded fixed partial dentures was described. This method involves some modifications to the preparation and casting design and requires slightly more time and attention at the cementation stage of the prosthetic treatment.

Influence of storage times on bond strength of resin cements to root canal

The resin cements are responsible to retention of the indirect materials decreasing marginal leakage, increasing failure resistance compared with conventional cementation. The cementation within root canal is very hard due unfavorable conditions regarding the application of adhesive techniques caused by inadequate access. Therefore, considering the possibility to decrease steps of cementation, this study was performed to evaluate the bond strength of self-adhesive resin cement (RelyXTM U100, 3M ESPE) and resin cement combined with self-ecthing adhesive system (Panavia® F 2.0, Kuraray) light-cured with Quartz Tungsten Halogen (QTH) following storage at 37 °C immediately after light-curing, 24 and 48 hours and 7 days. The root canals were prepared to receive the glass fiber post in the depth of 10 mm, irrigated with 17% EDTA and NaOCl, rinsed with distilled water and dried using paper points. The roots were perpendicularly sectioned into approximately 1 mm thick sections, obtaining ninety-six slices (n = 12). The slices were trimmed using a cylindrical diamond bur in the proximal surfaces until it touched the post and attached into a device, which were mounted on a strength tester (Bisco) and loaded in tension at a speed of 0.5 mm/min until failure occurred at specimens. The analysis of variance (ANOVA) and Tukeys post-hoc tests showed significant statistical differences (P .05). The resin cements 24 and 48 hours after light-curing were statistically similar among themselves (P > .05). The both resin cement showed similar bond strength into root canal on different storage times. The highest bond strength values of the resin cements were showed 7 days after curing.

Influence of light intensity and curing cycle on microleakage of Class V composite resin restorations

The aim of this study was to determine the effect of a softstart polymerization method from Quartz-Tungsten-Halogen (QTH) and Plasma Arc (PAC) curing units on microleakage of Class V composite resin restorations with dentin cavosurface margins. Seventy-five bovine incisors received standardized class V cavities in all dentin margins. Teeth were divided into 5 equal groups according to the curing cycle. The cavities were incrementally restored with a composite resin (Single Bond/Z-100, 3M). Light curing was applied as follows: Group I: PAC light continuous-cycle curing at 1600 mW/cm² for 3s; Group II: PAC light step-cycle curing (2s at 800 mW/cm² then 4s at 1600 mW/cm²); Group III: QTH light continuous-cycle curing at 400 mW/cm² for 40s; Group IV: QTH light ramp-cycle curing (from 100 to 600 mW/cm² in 15s followed by 25s at 600 mW/cm²); Group V: QTH light pulse-delay curing (200 mW/cm² for 3s followed by 3 min delay then 600 mW/cm² for 30s). Teeth were stored in distilled water at 37ºC for 30 days and then subjected to thermocycling for 500 cycles at 5 and 55ºC. Root apices were sealed and teeth coated with nail varnish before they were immersed in 0.5% fuchsine red dye solution. Teeth were then sectioned and slices were scanned with a computer scanner to determine the area of dye leakage using a computer program (Image Tools). Images of tooth slices were also visually examined under magnification and dye penetration along the tooth/restoration interface was scored. Significant differences in the degree of dye penetration and leakage were detected between groups (p<.05). Groups I and II had significantly higher values of dye penetration and leakage than groups III, IV and V. In conclusion, the use of PAC light curing in a continuous or step cycle modes resulted in increased microleakage of Class V resin composite restorations compared with medium intensity QTH light curing. Pulse, ramp and continuous-cycle curing modes with QTH light resulted in similar degrees of microleakage.