Pınar Çevik

Effects of different surface treatments on shear bond strength between ceramic systems and metal brackets

Abstract The aim of this study was to evaluate the shear bond strength of orthodontic brackets bonded to different kinds of ceramic surfaces after different surface conditioning methods. A total of 120 ceramic disks were divided into two main groups in terms of feldspathic or lithium disilicate. Each ceramic group was further subdivided into six subgroups depending on surface treatment (n = 10). The ceramic surfaces were conditioned by one of the following methods: Group C: control group; Group P: %37.5 orthophosphoric acid; Group HF: %9.6 hydrofluoric acid; Group L: Nd-YAG laser irradiation; Group SB: sandblasting with 50 µm Al2O3 particles; and Group DB: grinding with a diamond bur. Surface roughness value was evaluated with a digital profilometer. Surface topographies of one specimen from each group were observed by atomic force microscopy (AFM) after surface treatments. All samples were primed with silane before the bracket bonding, including the control group. Metal brackets were bonded to the specimens with a light curing composite resin. The samples were stored in distilled water for 24 h and thermocycled 2500× at 5 and 55 ºC for 30 s. Shear bond strengths between the ceramic surface and the bracket were measured with a universal testing machine at a crosshead speed of 0.5 mm/min. Failure modes were classified as adhesive, cohesive, or mixed. Data were analyzed using ANOVA and Tukeys tests (α = .05). Group SB had significantly rougher surface compared with the other groups in each ceramic system (p < .05), and Group SB demonstrated significantly higher shear bond strengths than other groups as well. Within the limitations of this study, surface conditioning methods, except for sandblasting and grinding, were associated with lower shear bond strengths; however, thermocycling may have had negative effects on bond strengths of specimens. Furthermore, in each ceramic system, there was a significant difference between surface-conditioning methods and surface roughness with regard to shear bond strength.

Different techniques in fabrication of ocular prosthesis.

Introduction Loss of an eye caused by cancer, trauma, or congenital defect creates a deep psychological impact on an individual’s life especially social and professional life. Custom-made prosthesis, compared to stock prosthesis, provides a better fit to the eye socket, better cosmetic results, and less discomfort to the patient in the long term. The main objective of this article was to describe 3 different alternative and practical techniques of fabricating custom-made ocular prosthesis. Case Report An impression of anophthalmic socket was made with the addition of cured silicone-based precision impression material in all techniques. A master cast was prepared and duplicated with condensation silicone. A self-cure acrylic resin was polymerized in the silicone model and was fitted into the patient’s eye socket. A digital photograph of the patient’s iris was made using a digital camera and printed on good-quality photo paper in various shades and sizes in the first and the second techniques. Then the photo paper was coated with PVC so as not to allow any color flowing. The proper iris was then inserted to the acrylic base. The prosthesis was final processed using orthodontic heat polymerizing clear acrylic resin. In the other technique, after the trying-in process with wax pattern, an acrylic base was fabricated using heat polymerizing scleral acrylic resin. The prosthetic iris was fabricated from a transparent contact lens by painting the lens with watercolor paints and attaching it to an acrylic resin with tissue conditioner. The final process was made with heat polymerizing transparent acrylic resin. Conclusions Custom-made prosthesis allows better esthetic and functional results to the patient in comparison to stock prosthesis. Further follow-up is necessary to check the condition and fit of the ocular prosthesis in such patients.

Effects of the Addition of Titanium Dioxide and Silaned Silica Nanoparticles on the Mechanical Properties of Maxillofacial Silicones

PURPOSE Silicone-based elastomeric materials are commonly used to fabricate maxillofacial prostheses. The aim of this study was to evaluate the effect of different types of silica and nanosized titanium dioxide addition on the mechanical properties of two RTV silicone elastomers. MATERIALS AND METHODS A-2000 and A-2006 silicone elastomers were used, and each was divided into four subgroups (n = 5). The first group was the control without additives. Other groups were titanium dioxide, fumed silica, and silaned silica. Each specimen was prepared in compliance with the manufacturers instructions for the tensile strength, percent elongation, tear resistance, and the hardness tests according to ISO and ASTM standards. A factorial ANOVA with pairwise interaction indicated that the pattern for all four outcomes of the materials was different for A-2000 and A-2006 (p < 0.05). Therefore, the average outcome values for the materials within silicone elastomers were then analyzed by Tukey HSD. For the hardness test results, Kruskal-Wallis and Mann-Whitney U test methods were used. The level of statistical significance was p < 0.05. RESULTS There was a statistically significant interaction (p < 0.05) between materials and silicone type for all four tests (tensile strength, tear, hardness, percent elongation). The hydrophobic silica group had significantly higher tensile strength than TiO2 for A-2000. The fumed hydrophilic silica group had significantly higher tensile strength than TiO2 for A-2006. Most of silica specimens had higher tensile strength when compared with the control and TiO2 groups for A-2000 and A-2006 silicones. The TiO2 group had the highest hardness value for A-2000 while the lowest hardness value for A-2006 (p < 0.05). There was no significant difference of tear strength among the type of additives (p > 0.05) for A-2000. The fumed silica and TiO2 groups had significantly higher tear strength than the control group for A-2006. The fumed silica and the hydrophobic silica groups had significantly higher percent elongation than the control group (p < 0.05) for A-2000. The TiO2 group had the lowest percent elongation for A-2006. CONCLUSIONS Results in this in vitro study may clarify future studies about the effect of different additives on the physical and mechanical properties of maxillofacial elastomers. There is a great interest in the effect of a new-generation hydrophobic silica incorporation into A-2000 silicone as well as the effect of fumed hydrophilic silica incorporation into A-2006 silicone. Future research should be supported with more in vitro trials in different percentages of such additives used in this study.

Bond strength of veneering porcelain to zirconia after different surface treatments

Abstract Aim: The aim of this study was to evaluate the effect of various surface treatments on the bond strength of veneering feldspathic porcelain to zirconia. Methods: Fifty yttria-stabilized tetragonal zirconia polycrystalline specimens were divided into five groups (n = 10) according to various surface treatments. The groups were as follows: Group 1: control group with liner application and no further surface treatment; Group 2: air-particle abrasion with 110 μm of alumina (Al2O3) particles; Group 3: grinding with a diamond disk; Group 4: Nd:YAG laser irradiation (the laser and the energy parameters were 10 Hz, and 2 W and 200 mJ, and the pulse duration (short pulse) range was up to 180 μs); Group 5: selective infiltration etching (SIE). After surface treatments, a liner application was performed for all surfaces according to the manufacturer’s instructions. Veneering porcelain was applied on zirconia surfaces using a Teflon mold. Shear bond strength was tested using a universal testing machine. The fractured surface morphologies were examined with scanning electron microscopy. The data were statistically analyzed using Mann–Whitney U and Kruskal–Wallis tests (α = .05). Results: The Megapascal values of the bonding groups were as follows: G1 = 8.62 ± 1.12, G2 = 13.87 ± 5.08, G3 = 12.31 ± 3.35, G4 = 17.32 ± 6.16, and G5 = 16.17 ± 4.55. Statistically significant differences were observed between the control group and the other groups (p < 0.05). Group 4 had the highest bond strength while G1 showed the lowest bond strength. No significant differences were found between the Nd:YAG, grinding, sandblasting, and SIE groups. Conclusion: Surface treatments had different effects on the shear bond strength of feldspathic porcelain to zirconia. Surface treatment techniques used in this study can be used on zirconia specimens prior to liner application to obtain an acceptable bond strength of veneering porcelain to zirconia. The effect of Nd:YAG laser irradiation and SIE techniques on bond strength of veneering ceramic to zirconia should be evaluated with further studies.

In Vitro Cytotoxicity of Maxillofacial Silicone Elastomers: Effect of Nano-particles

PURPOSE Silicone elastomers are generally used for maxillofacial extraoral prostheses. The purpose of this in vitro study was to evaluate the cytotoxicity of different kinds of nanoparticles added to two types of maxillofacial elastomers. MATERIALS AND METHODS A-2000 and A-2006 silicone elastomers were used. The silicone specimens were divided into eight groups according to the presence of additional nanoparticles (n = 18). The following represents the groups in the study: Group A: A-2000 silicone (control group); Group B: A-2006 silicone (control group); Group C: A-2000 silicone and the addition of titanium dioxide (TiO2 ); Group D: A-2006 silicone and the addition of TiO2 ; Group E: A-2000 silicone and the addition of fumed silica; Group F: A-2006 silicone and the addition of fumed silica; Group G: A-2000 silicone and the addition of silaned silica; Group H: A-2006 silicone and the addition of silaned silica. A paired sample t-test was used to analyze the cytotoxicity of each group after 24, 48, and 72 hours. RESULTS Based on the results of the 24-hour analysis, the biocompatibility values of the (A-2006) fumed silica group were higher than those of the control groups. There was no statistically significant difference in A-2006 and A-2000 groups. The cytotoxicity values of the control groups and TiO2 (A-2000 silicone) elastomer groups increased at all test times; however, the cytotoxicity values of the TiO2 (A-2006), fumed silica (A-2006), silaned silica (A-2006), fumed silica (A-2000), and silaned silica (A-2000) groups increased significantly only from 24 to 48 hours. CONCLUSION Nanoparticles of TiO2 , fumed silica, and silaned silica added to a commercial silicone-based elastomer used for fabrication of maxillofacial prostheses are nontoxic.

Shear bond strength of ceramic brackets bonded to surface-treated feldspathic porcelain after thermocycling

Purpose: The aim of this study was to evaluate the effect of six different surface conditioning methods on the shear bond strength of ceramic brackets bonded to feldspathic porcelain. Materials and methods: A total of 60 feldspathic porcelain disks were fabricated and divided into six subgroups including 10 specimens in each. Specimens were first treated one of the following surface conditioning methods, namely, 37% phosphoric acid (G-H3PO4), 9.4% hydrofluoric acid (G-HF), grinding with diamond burs (G-Grinding), Nd:YAG laser (G-Nd:YAG), Airborne-particle abrasion (G-Abrasion). Specimens were also coated with silane without surface treatment for comparison (G-Untreated). A total of 60 ceramic brackets were bonded to porcelain surfaces with a composite resin and then subjected to thermocycling 2500× between 5°C and 55°C. The shear bond strength test was carried out using a universal testing device at a crosshead speed of 0.5 mm/min. Failure types were classified according to the adhesive remnant index. Analysis of variance and Tukey tests were used for statistical analysis (α = 0.05). Microstructure of untreated and surface-treated specimens was investigated by scanning electron microscopy. Results: Using G-Abrasion specimens resulted in the highest shear bond strength value of 8.58 MPa for feldspathic porcelain. However, the other specimens showed lower values: G-Grinding (6.51 MPa), G-Nd:YAG laser (3.37 MPa), G-HF (2.71 MPa), G-H3PO4 (1.17 MPa), and G-Untreated (0.93 MPa). Conclusion: Airborne-particle abrasion and grinding can be used as surface treatment techniques on the porcelain surface for a durable bond strength. Hydrofluoric acid and phosphoric acid etching methods were not convenient as surface treatment methods for the feldspathic porcelain.

Effect of different types of disinfection solution and aging on the hardness and colour stability of maxillofacial silicone elastomers

Introduction: Understanding the effect of aging and different disinfecting agents on the physical properties of pigmented maxillofacial silicones may help eliminate the current uncertainty as to the best follow-up suggestions for the patients treated with silicone prostheses. Methods: One hundred fifty specimens (14 × 2 mm) were evaluated for colour and 75 specimens (30 × 10 mm) for hardness (total, 225 specimens). Five specimens were used for hardness testing in each disinfecting solution while 10 silicone specimens were used for colour evaluation. The samples were separated into 5 groups and the initial hardness and colour evaluations were performed and placed in disinfectant solution (neutral soap, effervescent tablet, 0.2% chlorhexidine, 4% chlorhexidine, sodium hypochlorite). A second set of colour and hardness measurements was taken after 48 hours of disinfection and 1,008 hours of artificial aging in a QUV-accelerated weathering tester. Two-way and 1-way analysis of variance with Tukey tests and paired t-test were used for statistical analysis (α = 0.05). Results: Before artificial aging, the hardness value of the red pigment group was found to be significantly lower than that of the brown pigment group. After aging, the lowest Shore A value was seen in the neutral soap group, while the highest was seen in the effervescent tablet. Conclusions: Based on the results of this study, chlorohexidine 0.2% was found to be most suitable agent for disinfection of the prostheses. Washing with neutral soap caused loss of pigment from the surface of the silicones. Sodium hypochlorite was found to have a colour-fading effect on silicone specimens.

Farklı yüzey işlemlerinin zirkonyanın ağız içi tamirine etkisi

Amac: Bu calismanin amaci, zirkonya yuzeyine uygulanan farkli yuzey islemlerinin yaslandirma sonrasi kompozit rezin ve zirkonya arasindaki makaslama baglanma dayanimina etkisini incelemektir. Gerec ve Yontemler: 40 adet sinterlenmis zirkonya ornek (19x15x2 mm) dort farkli yuzey islemi grubuna ayrildi (n=10): Grup 1, elmas frez ile asindirma; Grup 2, 30 μm Al2O3 ile tribokimyasal silika kaplama; Grup 3, 50 μm Al2O3 ile kumlama ve Grup 4, 110 μm Al2O3 ile kumlama grubu. Yuzey islemi goren zirkonya orneklere adeziv fosfat monomeri uygulanip polimerize edildi. Kompozit rezin polimerizasyonunu takiben ornekler termal yaslandirmaya (x1000, 5-55 °C, 30 saniye) tabi tutuldu. Orneklere hizi 0.5 mm/dakika olan universal test cihazi ile makaslama baglanma dayanimi testi uygulandi. Test sonrasi kirilma tipleri adeziv veya karma tip basarisizlik olarak kaydedildi. Istatistiksel analiz tek yonlu varyans analizi (ANOVA) ve Tukey HSD testleri kullanilarak yapildi (p 0.05). Tum gruplarda adeziv tip basarisizlik gozlenmistir. Sonuc: Tum gruplar klinik olarak kabul edilebilir baglanma dayanimi degerleri gostermistir. Bununla birlikte tribokimyasal silika kaplama yonteminin zirkonya ile kompozit rezin arasindaki baglanma dayanimini anlamli derecede artirdigi gozlenmistir.

A different wax sculpture technique for implant-retained auricular prosthesis

Replacement of missing ears is a challenging task in which extensive array of materials and techniques have been employed. This article describes a different and simplified procedure for fabricating auricular prostheses very similar to the intact left ear of the patient. A 65-year-old male patient was referred to the Department of Prosthodontics with the loss of the right ear. In this case, the impression was made using hydrocolloid material (alginate) from the both defected and the opposite side. After hardening of the stone casts, a custom-made transparent splint plate was designed for the left auricular side. The splint was reversed and a cast model of the right auricular side was obtained as pouring the dental stone into transparent orthodontic splint. After getting the impression from cast model, conventional wax pattern and try on process was done. Finally, silicone elastomer was polymerized and the retention of the prosthesis acquired with the magnetic attachments. The technique described is economical, conventional, and time-saving. Furthermore, the prosthesis imitates the patients intact auricular tissue.

BİFOSFONAT KULLANAN HASTALARDA ORAL CERRAHİ UYGULAMALARDA KARŞILAŞILABİLECEK SORUNLAR VE TEDAVİSİ ORAL COMPLICATIONS AND TREATMENTS IN PATIENTS RECEIVING BISPHOSPHONATES

OZET Bifosfonat kullanimina bagli gelisen cene osteonekrozunun etyolojisinde cesitli risk faktorleri rol oynamaktadir. Ozellikle nitrojen iceren ve intravenoz yoklan kullanilan bifosfonat grubu ilaclarin cene osteonekrozuna daha fa/la neden oldugu bildirilmektedir. Antimikrobiyal kemotcrapiiiin yeterli olmadigi bu osteonekroz tipinde ilacin nitrojen icerigine, kullanim yoluna, kullanim suresine gore klinik seyir ve semptomlari, tedavi yontemleri farkliliklar gostermektedir. Ozellikle kortikosteroid kullanimi tedavinin basarisini olumsuz yonde etkilemektedir. Bifosfonat kullanimina bagli gelisen cene osteonekrozunun tedavisinin guclugu, koruyucu onlemlerin onemini vurgulamaktadir. Tum onlemlere ragmen gelismis cene osteonekrozunda antimikrobiyal kemotcrapiiiin desteklenmesi amaciyla bazen DDLT (Dusuk Doz Lazer Tedavisi), HBO (Hiperbarik Oksijen), ozon tedavisi gibi yontemlerden faydalanilmaktadir. Anahtar Kelimeler: Bifosfonatlar, cene kemikleri, osteonekroz SUMMARY ozon therapy, low level laser treatment and hyperbaric oxygen which must be combined with appropriate antibiotic regime. Key Words: Bisphosphonatcs, osteonecrosis, jaws