Load-bearing capacity and failure types of premolars restored with sonic activated bulk-fill-, nano-hybrid and silorane-based resin restorative materials

This study evaluated the load-bearing capacity of premolars restored with three types of resin composite materials in mesio-occluso-distal (MOD) cavities. Extracted human premolars (N = 30, n = 10 per group) were randomly divided into three groups; MOD cavities were prepared and restored with one of the following resin materials: Group BFC: Bulk-fill composite (SonicFill, Kerr Corporation), Group NC: Nanohybrid resin composite (Filtek Z550, 3M ESPE), Group SC: Silorane-based composite (Filtek Silorane, 3M ESPE). For NC Clearfil SE Bond (Kuraray, Japan) and for SC, Silorane adhesive resin (Filtek Silorane System Adhesive, 3M ESPE) were used. The cavities in NC and SC groups were restored incrementally, while those in BFC groups were restored in bulk. After water storage (24 h, 37 °C), each tooth was subjected to compressive loading with a stainless steel ball (diameter: 4 mm) perpendicular to the occlusal surface (1 mm/min). Failure types were categorized according to being repairable or irrepairable. Data were statistically analysed using Kruskal-Wallis test (α = 0.05). Two-parameter Weibull distribution values including the Weibull modulus, scale (m) and shape (0) values were calculated. Fracture resistance of premolars restored with BFC (829.84), NC (701.35) and SC (807.73) did not show significant difference (p = 0.72). Weibull distribution presented lower shape (0) for SC (m = 2.77) and NC (m = 3.09) compared to BFC (m = 5.01). The incidence of repairable failures was more common in BFC (80%) compared to NC (60%) and SC (50%). Adhesive failures were more often observed in NC (80%) and SC (70%) groups.     

Could readily silanized silica particles substitute silica coating and silanization in conditioning zirconium dioxide for resin adhesion?

This study investigated the effect of particle types with different morphology and surface properties on the wettability and adhesion of resin cement to zirconia. Zirconia specimens (5 × 5 × 1 mm³) were wet polished. Specimens were randomly assigned to one of the following protocols (N = 36, n = 9 per group): Group CON: Control, no surface conditioning; Group AL: Chairside air-abrasion with aluminium trioxide (50 μm Al₂O₃) + silane; Group SIL: Chairside air-abrasion with alumina particles coated with silica (SIL) (30 μm SiO2, SilJet) + air-drying + silane; Group 4: Chairside air-abrasion with readily silanized silica particles (SILP) (30 μm SiO_2, SilJet Plus). Adhesive resin was applied and resin cement (Variolink II, Ivoclar) was bonded using polyethylene moulds and photo-polymerized and aged (thermocycling, 6.000 cycles, 5–55 °C). Shear bond test was performed using Universal Testing Machine (1 mm/min). Pretest failures were considered 0 MPa. Contact angle measurements were performed (n = 2/group, sessile drop with water). Data (MPa) were analyzed (ANOVA, Tukey’s (α = 0.05). Two-parameter Weibull distribution values including the Weibull modulus, scale (m) and shape (0), values were calculated. Contact angle measurements were in descending order as follows: SIL (74°)^c < CON (60°)^c < AL (51°)^b < SILP (40°)^a. Bond strength (MPa) with SIL (17.2 ± 4)^a and SILP (17.3 ± 1.9)^a demonstrated no significant difference (p > 0.05), being higher than AL (8.4 ± 1.5)^b and CON (0)^c (p < 0.05). Failure types were exclusively adhesive in all groups. Weibull distribution presented the highest shape (0) for SILP (10.8). SILP presented better wettability than AL. SILP provided similar bond strength to SIL. Readily silanized silica particles may substitute for conventional silica coating and silanization.     

Effect of surface conditioning methods,adhesive systems and resin composite on repair strength of dimethacrylate and silorane resin composites

This study evaluated the effect of surface conditioning methods and adhesive systems on the repair bond strength of resin composites. Specimens (FLS: Filtek LS) (N = 144) were prepared using a silicone matrix. The specimens were stored in distilled water and then were randomly divided into the twelve groups (n = 12) according to the surface conditioning method (unground or diamond bur) and adhesive system (no adhesive, LS: Filtek LS, AS: Adper Scotchbond SE Plus) and resin composite (FLS: Filtek LS; FS: Filtek Supreme). The specimens were fixed in an hourglass-shaped silicone matrix and the other half of the specimen was restored. Hourglass-shaped specimens (n = 12) were used as positive control to measure the cohesive strength of the resin composite (Filtek LS). Microtensile bond test was performed (0.5 mm/min) and failure types were analyzed. Data were analyzed using two-way analysis of variance, Tukey’s and Dunnett’s tests (α = 0.05). Adhesive protocol and resin composite significantly affected the results (p < 0.05). For the FS composite, the highest results were obtained using LS adhesive with (18.4 ± 7.7) and without (18.8 ± 4.8) bur roughening. For FLS composite, the highest results were obtained using AS adhesive with (33.2 ± 7.1) and without (25.7 ± 3.6) bur roughening. Without the use of adhesive resin, significantly lower bond strength results were observed with both LS (5 ± 2.1, 4.5 ± 1.5) and FLS (2.2 ± 1.2, 4.4 ± 1.1) for unground and diamond bur roughened groups, respectively (p < 0.0001). Cohesive strength of the FLS (52.3 ± 7.6) was significantly higher than any of the repaired groups (p < 0.0001). FS–LS combination and the groups repaired without adhesive presented more adhesive (Type I) failures.     

Adhesion of orthodontic brackets to indirect laboratory-processed resin composite as a function of surface conditioning methods and artificial aging

This study compared the shear bond strength of orthodontic brackets to laboratory-processed indirect resin composites (IRC) after different surface conditioning methods and aging. Specimens made of IRC (Gradia Indirect, GC) (thickness: 2 mm; diameter: 10 mm) (N = 80) were randomly assigned to one of the following surface conditioning methods: C – Control: no treatment; AA – Air-abrasion (50 μm Al₂O₃ particles); DB – Diamond bur and HF – Etching with hydrofluoric acid (9.6%). After adhesive primer application (Transbond XT), orthodontic brackets were bonded to the conditioned IRC specimens using adhesive resin (Transbond XT). Following storage in artificial saliva for 24 h at 37 °C, the specimens were thermocycled (×1000, 5–55 °C). The IRC–bracket interface was loaded under shear in a Universal Testing Machine (0.5 mm/min). Failure types were classified using modified adhesive remnant index criteria. Data were analyzed using two-way ANOVA and Tukey`s HSD (α = 0.05). Surface conditioning method did not significantly affect the bond strength results (p = 0.2020), but aging significantly decreased the results (p = 0.04). Interaction terms were not significant (p = 0.775). In both non-aged and aged conditions, non-conditioned C group presented the lowest bond strength results (MPa) (p < 0.05). In non-aged conditions, surface conditioning with DB (8.03 ± 0.77) and HF (7.87 ± 0.64) showed significantly higher bond strength results compared to those of other groups (p < 0.05). Thermocycling significantly decreased the mean bond strength in all groups (2.24 ± 0.36–6.21 ± 0.59) (p < 0.05). The incidence of Score 5 (all adhesive resin remaining on the specimen) was the highest in HF group without (80%) and with aging (80%) followed by DB (40, 70%, respectively). C groups without and with aging showed exclusively Score 1 type (no adhesive resin on the specimen) of failures indicating the least reliable type of adhesion.     

Adhesion to zirconia as a function of primers/silane coupling agents,luting cement types,aging and test methods

This study evaluated the adhesion of resin cements to zirconia with different primers/silane coupling agents using two test methods with and without aging. Zirconia discs (Cercon) (N = 900, n = 15 per group) were ground finished to 2000 grit silicone carbide and randomly divided into seven groups: (a) C: No treatment (Control), (b) SG: Signum, (c) CL: Clearfil Ceramic Primer, (d) AP: Alloy Primer, (e) Monobond Plus, (f) ES-R: ESPE-Sil after Rocatec and (g) ES-C: ESPE-Sil after CoJet. Methacrylate (Variolink II-VL) and MDP based (Panavia F2.0-PN) dual-polymerized and self-adhesive resin cements (RelyX Unicem-RX) were adhered and polymerized accordingly. The specimens were further randomly divided into two groups to be tested after (a) 24-h dry storage at 37 °C and (b) thermocycling (×5000, 5–55 °C). Macroshear (MSB) and macrotensile bond tests (MTB) were conducted in an universal testing machine (crosshead speed: 1 mm/min) and failure types were analyzed after debonding. Data were analyzed using Univariate analysis and Tukey’s tests (α = 0.05). Two-parameter Weibull modulus, scale (m) and shape (0) were calculated. While primer/silane (p < 0.001), cement type (p < 0.001) and aging (p < 0.001) significantly affected the bond results, test method did not show significant difference (p = 0.237). In MSB test, Weilbul moduli were more favorable for MP-VL (4.2) and AP-PN (6) combinations and after aging for MP-VL (4.2) and AP-PN (5.66). In MTB test, after aging, Weilbul moduli were more favorable for AP-PN (5.41). Bond strength results mostly decreased with SG (24–92%) after aging. Cohesive failures in the cement were more frequent with PN (252) compared to VL (83).     

Adhesive bond strength and compressive strength of a novel bulk fill composite with zirconia nano-hybrid filler

The aim of the study was to investigate the adhesive bond and compressive strength of novel bulk fill resin composite with zirconia (Zr) nano-hybrid filler. Sixty molars were mounted in acrylic resin with flat occlusal surface. Half of the specimen (n = 30) were bonded using total etch (TE) and the other half with self-etch (SE) technique. Specimens treated with SE (n = 30) and TE (n = 30) bonding protocol were divided into three groups, based on the type of bulk fill build-up materials (ZC–ZirconCore, MC–MulticCore Flow and LC–Luxacore Dual), resulting in six study groups [MC-TE, MC-SE, LC-TE, LC-SE, ZC-TE, ZC-SE]. Cylindrical (3 × 3 mm) build-ups were performed followed by shear bond strength testing (crosshead speed-1 mm/min). Ten specimens for each bulk fill build-up material (MC, LC and ZC) were prepared for compressive strength testing. All specimens were tested for maximum failure loads (crosshead speed?0.5 cm/min). Analysis of variance and paired t-test were performed to statistically analyze the data. TE technique showed significantly higher bond strength values as compared to SE technique (p < 0.001) for all three materials (MC, LC and ZC). Shear bond strength for MC [TE,17.88(2.00)-SE,9.43(0.98)] and LC [TE,18.91(2.57)-SE,6.35(1.12)] groups were significantly higher than ZC group [TE,13.99(1.09)-SE,4.61(0.84)]. Specimens in ZC group (266.73 ± 9.76) showed significantly higher compressive strength in comparison to MC (247.66 ± 9.72) (p = 0.004) and LC (249.87 ± 13.17) (p < 0.001) groups. Zirconia nano-hybrid filler resin bulk fill material has comparatively high compressive strength and low bond strength making them suitable for clinical applications in the posterior region with favorable conditions for adhesive bonding.     

Effect of mechanical and air-particle cleansing protocols of provisional cement on immediate dentin sealing layer and subsequent adhesion of resin composite cement

Immediate dentin sealing (IDS) could avoid contamination of dentin from impression material and provisional cement but prior to final cementation of indirect restorations, removal of the provisional cement may damage the IDS. The objectives of this study were to investigate the effect of mechanical and air-particle cleansing protocols of provisional cement on IDS layer and subsequent adhesion of resin composite cement. The cuspal dentin surfaces of human third molars (N = 21, n_quadrant = 84) were exposed by a low-speed diamond saw under water cooling and conditioned with an adhesive system based on the three-step etch and rinse technique (OptiBond FL). Provisional cement (Freegenol) was applied on each specimen. They were then randomly divided into six subgroups where the provisional cement was removed either by (1) air-borne particle abrasion with 50-μm Al₂O₃ particles at 2 bar (AL2), (2) air-borne particle abrasion with 50-μm Al₂O₃ particles at 3.5 bar (AL3.5), (3) air-borne particle abrasion with 30-μm SiO₂ particles at 2 bar (SL2), (4) air-borne particle abrasion with 30-μm SiO₂ particles at 3.5 bar (SL3.5), (5) prophylaxy paste (Cleanic) (PP) or (6) pumice-water slurry (PW) at 1500 rpm for 15 s. The dentin surface on each tooth was assigned to four quadrants and each quadrant received the cleansing methods in a clockwise sequence. The non-contaminated and non-cleansed teeth acted as the control (C). Two separate teeth, contaminated and cleansed according to six cleansing protocols, were allocated for scanning electron microscopy (SEM) analysis (×2000). The dentin surfaces in each quadrant received resin composite luting cement (Variolink II, Ivoclar Vivadent) incrementally in a polyethylene mould (diameter: 1 mm²; height: 4 mm) and photopolymerized. The specimens were stored in distilled water for 24 h at 37 °C until the testing procedures and then shear force was applied to the adhesive interface until failure occurred in a universal testing machine (0.5 mm/min). Microshear bond (μSBS) was calculated by dividing the maximum load (N) by the bonding surface area of the resin cement. Failure types were analysed using optical microscope and SEM. Data (MPa) were analysed using one-way ANOVA (α = 0.05). Two-parameter Weibull distribution values including the Weibull modulus, scale (m) and shape (₀), values were calculated. Mean μSBS results (MPa) showed a significant difference between the experimental groups (p = 0.011) and were in a descending order as follows: C (8 ± 2.3)^a < AL2 (6.7 ± 2.4)^b < PP (6.9 ± 2)^b < PW (6.5 ± 2.1)^b < AL3.5 (5.8 ± 1.1)^b < SL2 (5.3 ± 1)^b < SL3.5 (5.2 ± 1)^b. Failure types were predominantly mixed failure type between the dentin and the adhesive resin which is a combination of adhesive and cohesive failures in the adhesive resin. Cohesive failure in the dentin was not observed in any of the groups. Weibull distribution presented lower shape (₀) for C (3.9), AL2 (3.2), PP (3.5) and PW (3.6). SEM analysis showed rough surfaces especially in the air-abraded groups whereas mechanical cleansing methods presented smoother surfaces and partially covered by particle remnants all of which occluded the dentin tubuli.     

Long-term bond strength of fiber posts cement to dentin with self-adhesive or conventional resin cements

The aim of this study was to evaluate the immediate and the long-term push-out bond strength of glass fiber posts (GFP) cemented with conventional or self-adhesive dual-curing resin cements, at different root depths. Prior to cementation, the GFP (Reforpost #3, Angelus) were etched with 37% phosphoric acid for 30 s followed by silane for 1 min. Thirty canine roots were divided into two groups (n = 15) according to resin cement type: ARC – dual resin cement (RelyX ARC/3M ESPE) combined with an three-step etch-and-rinse adhesive (Adper Scotch Bond Multi-Purpose Plus 3M/ESPE) or U200 – self-adhesive resin cement (RelyX U200/3M ESPE). The manufacturer’s instructions were followed. After 48 h, the roots were cross-sectioned at three different depths, resulting in serial slices corresponding to the cervical, middle, and apical root thirds. Slices were randomly divided into two groups, according to the period of water storage prior to push-out bond strength analysis: 48 h or 180 days. The data (MPa) were analyzed using three-way ANOVA for randomized blocks (p < 0.05), which showed no significant interaction between the three factors (p = 0.716). The main study factors were also proven not significant (cement: p = 0.711; time: 0.288; root third: p = 0.646). In conclusion, root depth, cement type (self-adhesive or conventional), and storage in water for 180 days did not influence the bond strength of GFP to intracanal dentin.     

Adhesion of resin composite to enamel and dentin: a methodological assessment

This study compared the impact of four test methods on adhesion of resin composite to enamel and dentin. Human molars (N = 54) were randomly assigned to test the adhesion of resin composite material (Quadrant Universal LC) using one of the following test methods: (a) macroshear test (SBT; n = 16), (b) macrotensile test (TBT; n = 16), (c) microshear test (μSBT; n = 16) and (d) microtensile test (μTBT; n = 6). In a randomized manner, buccal or lingual surfaces of each tooth, were assigned as enamel or dentin substrates. Enamel and dentin surfaces were conditioned using an etch-and-rinse adhesive system (Syntac Classic). After storage (24 h, 37 °C), bond tests were conducted in a Universal Testing Machine (1 mm/min) and failure types were analyzed. Data were analyzed using Univariate and Tukey`s, Bonneferroni tests (α = 0.05). Two-parameter Weibull modulus, scale (m) and shape (0) were calculated. Test method (p < 0.001) and substrate type (p < 0.001) significantly affected the results. When testing adhesion of resin composite to enamel, SBT (25.9 ± 5.7)^a, TBT (17.3 ± 5.1)^a,c and μSBT (27.2 ± 6.6)^a,d test methods showed significantly higher mean bond values compared to μTBT (10.1 ± 4.4)^b (p < 0.05). Adhesion of resin composite to dentin did not show significant difference depending on the test method (12 ± 5.7–20.4 ± 4.8; p > 0.05). Only with SBT, significant difference was observed for bond values between enamel (25.9 ± 5.7) and dentin (12 ± 5.7; p < 0.05). Weibull distribution presented the highest shape values for enamel-μSBT (29.7) and dentin-μSBT (22.2) among substrate-test combinations. Regardless of the test method, cohesive failures in substrate were more frequent in enamel (19.1%) than in dentin (9.8%).     

Influence of desensitizing procedures on adhesion of resin cements to dentin

This study evaluated the effect of two desensitizer agents with different contents and Nd:YAG laser irradiation on the shear bond strength (SBS) of adhesive resin cements to dentin. New treatment options of Nd:YAG laser irradiation and tetracalcium phosphate-containing agent applications were compared with routinely used glutaraldehyde-containing agents. One hundred and twenty human, caries-free premolars were embedded in acrylic resin blocks 2 mm below the cementoenamel junction. Buccal surfaces of the teeth were ground to expose dentin. The specimens were randomly assigned into three different surface treatments (desensitizing agents, Nd:YAG laser) and the control, then into three different adhesive resin cement applications (n = 10). Resin cements (Panavia SA cement (PA), Panavia SA cement with Clearfil Universal Bond (PACU), and Multilink N (MN)) were applied to the conditioned teeth surfaces using Teflon tubes. The specimens were thermocycled (5000 cycles, 5–55 ± 1 °C, dwell time 30 s). The SBS test was performed in all groups. The results were submitted to two-way ANOVA and Tukey HSD tests (p < .05). Further, SEM analysis was performed on the dentin surfaces. SBS values were significantly difference among the surface treatment groups and also among adhesive resin cement groups (p < .05). The specimen cemented with PA showed lower SBS values than PACU- and MN-applied specimens. The highest SBS value was obtained in the Nd:YAG laser group which was cemented with PACU cement. The lowest SBS value was obtained in the control group which was cemented with PA cement. In addition, SEM evaluation revealed that desensitizing agents and Nd:YAG laser occluded dentin tubules.     

Effect of cigarette smoking on the bond strength between resin cement and dental CAD/CAM ceramics

Although the effects of cigarette smoking on several dental problems have been widely studied, the association between tobacco exposure and resin-ceramic bonding is rarely reported. This study investigated the resin-ceramic adhesion (shear bond strength, SBS) and associated risk factors on three selected dental CAD/CAM ceramics using a novel model to simulate the exposure to cigarette smoking. Specimens from IPS e.max® CAD, Vitabloc® Mark II for Cerec and Zirconia Cercon were prepared and treated using silicacoating and silane. A layer of resin cement was applied on the treated ceramic surfaces and light activated. Specimens were placed in a chamber and challenged with various numbers of cigarettes (0, 1, 5, 10, and 15). Then, the specimens were subjected to SBS test and fractured surfaces were examined using scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDX) to determine the failure mode and surface composition. Overall, the mean SBS of IPS e.max^® CAD (9.6 ± 3.4 MPa), Vitabloc^® Mark II for Cerec (9.3 ± 2.5 MPa) and Zirconia Cercon (8.7 ± 3.0 MPa) did not show any statistical significant difference (p = 0.192 > 0.05), such that the adhesion of resin bonded to glass-based ceramics (IPS e.max® CAD and Vitabloc® Mark II for Cerec) decreased with cigarette smoke exposure, but increased for the resin bonded to zirconia ceramic (Zirconia Cercon). Furthermore, the number of cigarettes has a statistically significant effect on the SBS (p = 0.001), such that in general 5 cigarettes yielded the lowest mean SBS (7.6 ± 2.1 MPa). SEM-EDX analyses showed mostly adhesive failures in all experimental groups with changes in surface morphology and chemical composition after smoking challenge. Cigarette smoking produces a different effect on resin-ceramic bonding depending on ceramic type that may be due to chemical reactions in the bonding interface and changes in temperature and moisture. Further work should explore the mechanism to which cigarette smoke affects the resin-ceramic bonding and its clinical relevance.     

Effect of experimental primers on hydrolytic stability of resin zirconia bonding

This study assessed the effect of experimental silane primers and two adhesive resin cements on resin zirconia adhesion strength. The surfaces of cut Y-TZP zirconia blocks (Lava? Frame), 16 mm × 16 mm × 4.5 mm, were pretreated twice. First, they were grit-blasted with Korox? alumina powder (110 μm) followed by silica-coating with Rocatec? Soft. Next, the blocks were randomly assigned into eighteen sub-groups (n = 6, N = 108) according to three primers (control ESPE Sil?, 1.0 vol.-% 3-acryloxypropyltrimethoxysilane, and 1.0 vol.-% 3-acryloxypropyltrimethoxysilane + 0.5 vol.-% bis-12-(triethoxysilyl)ethane), two in dentistry used resin cement products (Multilink? Speed, and Multilink? N), and three storage conditions (24 h dry, 1 month immersed in distilled water, and 6 months immersed in distilled water at room temperature) used. Onto each pretreated zirconia block, four cylindrical resin composite cement stubs were prepared and light-cured. The surface roughness, contact angle, and adhesion (shear bond) strength (SBS) were measured, and statistically analyzed (ANOVA, the Tukey’s test, p < 0.05). No statistical differences were observed in surface roughness values of different primer-treated zirconia groups. After six months of water aging, the shear bond strength of the groups that employed 1.0 vol.-% 3-acryloxypropyltrimethoxysilane (9.0 MPa ± 0.8 MPa), and the blend of 1 vol.-% 3-acryloxypropyltrimethoxysilane + 0.5 vol.-% bis-12-(triethoxysilyl)ethane (8.9 MPa ± 2.0 MPa) with Multilink? Speed resin composite cement were statistically insignificantly higher compared to using ESPE Sil? (8.7 MPa ± 1.8 MPa). The experimental primers may have potential to be used for long-term resin zirconia adhesion.     

Effect of aging type and aged unit on the repair strength of resin composite to feldspathic porcelain in testing microtensile bond strength

The aim of the present study is to investigate the effect of aging type (thermocycling vs. water storage) and aged unit (block vs. stick) on the repair strength of resin composite to feldspathic porcelain in testing microtensile bond strength (μTBS). Ceramic specimens (N = 30) (10 × 5.7 × 4.5 mm³, Vita Mark II, Vita) were obtained from CAD–CAM blocks. One surface was etched with 10% HF and silanized. An adhesive was applied and resin composite blocks were constructed incrementally on the conditioned surface. The specimens were randomly divided into five groups (n = 6): Control (C): Non-aged; BTC: Blocks were thermocycled (5–55 °C, 6000 cycles); STC: Sticks were thermocycled; BS: Blocks aged in water storage (6 months) after themocycling; SS: Blocks aged in water storage (6 months) after thermocycling. After μTBS test, failure types were classified. Data (MPa) were statistically analyzed (1-way and Dunett and 2-way ANOVA, Tukey`s) (α = 0.05). Two-parameter Weibull distribution values including the Weibull modulus, scale (m), and shape (0) values were calculated. Aging type (p = 0.009) and aged unit (p = 0.000) significantly affected the results. Interaction terms were also significant (p = 0.000). Considering the stick level, there was no significant difference between thermocycling (STC: 25.7 ± 2.3) and water storage (SS: 25.3 ± 3.8) (p > 0.05) but the results were significantly higher when blocks were thermocycled (BTC: 31.6 ± 2.9) (p < 0.05). Weibull modulus and characteristic strength was the highest in BTC (m = 4.2; σ_o: 34.4) among all other groups (m = 3–3.9; σ_o: 14.6–28.5). Adhesive failures were common and cohesive failures occurred in less than 5% in all groups. Aging protocol was detrimental on durability of repair strength of resin composite to feldspathic porcelain. Exposing the sticks to either thermocycling or water storage aging should be considered in in vitro studies.     

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

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.     

Effect of caries removal techniques on bond strength to caries affected dentin on gingival wall: AFM observation of dentinal surface

Objective: The purpose of this study was to evaluate the effect of different caries removal techniques on the bond strength of two adhesive systems. Materials and Methods: Seventy human molar teeth that had proximal carious lesions were randomly divided into four groups according to the technique used to remove the caries: a conventional steel bur, an Er:YAG laser, a chemomechanical Carisolv^® gel, and air polishing. The groups were then divided into two subgroups according to the adhesives used: Clearfil S³ (Kuraray Co., Ltd, Tokyo, Japan) and Adper SE Plus (3 M ESPE, St Paul, MN, USA). The enamel and superficial dentin of the crown was flattened and caries were removed using different methods. Teeth were restored with composite and three 1 mm² stick-shaped microtensile specimens were prepared from each tooth. For each removal technique, the surface roughness of one dentin sample was analyzed using atomic force microscopy (AFM). The microtensile bond strength data were then analyzed using a two-way ANOVA, Kruskal–Wallis and Mann–Whitney U tests, and multiple comparison tests (p = 0.05). Results: The two-way ANOVA showed that the effects of the cavity preparation techniques and adhesive systems and their interaction were statistically significant (p < 0.05). The μTBS values were highest when bonding with Adper SE Plus to cavities prepared with the steel bur (37.20 ± 11.65 MPa) and lowest when bonding with Clearfil S³ Bond to cavities prepared with the Er:YAG laser (16.74 ± 6.95 MPa). Conclusion: The caries removal techniques affected the bond strength values of the self-etch adhesive systems.     

Effect of surface conditioning methods on the microtensile bond strength of repair composite to indirect restorative materials

This study evaluated the effect of surface conditioning methods on the microtensile bond strength (µTBS) of a restorative composite to indirect restorative materials. Blocks (5?×?5 × 4?mm³) (N?=?72) of (a) Zirconia (In-Ceram Zirconia, Vita) (ZR), (b) lithium disilicate glass ceramic (IPS Empress II, Ivoclar Vivadent) (LD), (c) Indirect resin composite (Gradia, GC) (GR) were fabricated (n?=?24 per group) and divided randomly into three groups: 1-Control: no conditioning, 2-Silane coupling agent, 3-Hydrofluoric acid (9.5%) (HF)+silane. Each block was duplicated in resin composite. The adhesion surfaces were conditioned with airborne-particle abrasion (110?µm Al₂O₃ particles). Half of the conditioned blocks received no bonding and the other half one coat of bonding (ED Primer II, Kuraray). Each conditioned block was bonded to a composite block with a resin luting agent (Panavia F2.0, Kuraray). The blocks were sectioned into 1?mm² microsticks and tested for microtensile bond strength (µTBS) (0.5?mm/min) in a μTBS testing machine. Failure types were evaluated under stereomicroscope and Scanning Electron Microscope (SEM). Data were analyzed using three-way ANOVA, Bonferroni corrected and independent sample t-tests (p?<?0.05). Significant effect of the bonding (p?<?0.001) and surface conditioning (p?<?0.001) were observed in all groups. The highest mean bond strength values were obtained in the bonded, HF etched and silanized groups of ZR, LD and GR (12.4?±?2.9, 28.1?±?1.5 and 27.2?±?2?MPa, respectively). HF acid?+?silane increased the repair bond values in all materials. Majority of the failure types were adhesive for ZR group, whereas HF?+?silane conditioned LD and GR groups presented predominantly cohesive failures in the cement.     

The effect of different cementing strategies and adhesive interface aging on microtensile bond strength (μTBS) of lithium disilicate ceramics to dentin

This study evaluated the effect of different cementing strategies and adhesive interface aging on microtensile bond strength (μTBS) of lithium disilicate ceramic (IPS e.max CAD) to dentin. Forty coronal dentin fragments were randomly assigned to four groups according to the cementing strategy used to bond lithium disilicate ceramic to coronal dentin surface (n = 10): U200 (self-adhesive resin cement (RC) RelyX U200®/3 M ESPE), SBU (single-step self-etching adhesive system (AS) Single Bond Universal®/3 M ESPE + RelyX ARC®/3 M ESPE RC), AdperSB (two-step etch-and-rinse AS Single Bond 2®/3 M + RelyX ARC®/3 M ESPE RC) and Scotchbond (three-step etch-and-rinse AS Scotchbond Multi-Purpose®/3 M + RelyX ARC®/3 M RC). After 48 h, the ceramic-tooth blocks were sectioned perpendicular to the adhesive interface in the form of sticks and randomly subdivided into two groups according to when they were to be submitted to μTBS testing: immediately or 6 months after storage in water. Some sticks were kept for analysis of the adhesive interface by scanning electron microscopy (SEM). The μTBS test was performed in a universal testing machine (0.5 mm/min). The data (MPa) were analyzed using split-plot ANOVA and Tukey’s test (α = 0.05). Water storage decreased μTBS in all cementing strategies. The μTBS was greatest in the Scotchbond group and lowest in the U200 group, at both storage times. No signs of interface degradation were detected under SEM after water storage. In conclusion, water storage decreased bond strength, regardless of the adhesive cementation strategy, and that the three-step adhesive system/dual-cure resin cement ultimately performed better in terms of bond strength.     

Does 2% chlorhexidine digluconate cavity disinfectant or sodium fluoride/hydroxyethyl methacrylate affect adhesion of universal adhesive to dentin?

The objectives of this study were to investigate the adhesion of a universal adhesive used either in total-etch (TE) or self-etch (SE) mode with and without 2% chlorhexidine digluconate cavity disinfectant (CHX) or sodium fluoride/hydroxyethyl methacrylate (NaF/HEMA) to dentin. Dentin surfaces of extracted human non-carious third molar teeth (N = 18) were exposed and randomly assigned to two groups. Half of the teeth were conditioned with TE and the others with SE adhesive mode. The teeth were then randomly divided into two groups where half were cleaned with 2% CHX (Cavity Cleanser, Bisco, CC) and the other half with NaF/HEMA (Aqua Prep F, Bisco, APF). Control groups in TE (C1) and SE (C2) adhesive system did not receive any cavity disinfectant. Dentin surfaces were conditioned with universal adhesive (Single Bond Universal, SBU) and resin composite blocks (3 M Z550) were bonded incrementally on the conditioned dentin using a mold. The teeth were stored in water for 48 h, and from each tooth, beam-shaped specimens (1 mm²) were prepared (n = 14, per group). Microtensile bond strength (MBS) was measured using a universal testing machine (1 mm/min). Data (MPa) were analyzed using one-way ANOVA and Tukey’s test (α = 0.05). Two-parameter Weibull distribution values including the Weibull modulus, scale (m), and shape (₀) values were calculated. Mean MTBS results (MPa) showed significant difference between the experimental groups (p = 0.001) and were in descending order as follows: C1-CC (32.8 ± 6.4)a?b < C2 (21.1 ± 4.8)^b < C1-APF (19.3 ± 4.4)b < C2-CC (14.1 ± 4.1)^c < C2-APF (8.1 ± 2.1)^d. C1 and C2 presented non-significant bond strength of the resin composite bonded with SBU (p > 0.05). CC application significantly increased the bond strength in TE mode, but significant reduction was observed when used in SE mode (p < 0.05). The use of APF did not significantly decrease the bond strength in TE mode, but significant reduction was observed when used in SE mode. Considering Weibull parameters, characteristics of adhesion seem to be less reliable for C2-CC (m = 3.86) and more reliable for C1-CC (m = 6.77). Failure types were predominantly adhesive between the dentin and the adhesive resin. Mixed failures were more common for both C1 and C2 and total etch-CC combination.     

Compressive strength and failure types of cusp replacing direct resin composite restorations in previously amalgam-filled premolars versus sound teeth

This study evaluated the fracture resistance of cusp replacing direct resin composite restorations (DCR) in premolars that had been previously filled with amalgam mesial–occlusal–distal (MOD) restorations and compared their fracture resistance with those made on sound dentin and intact teeth. Recently extracted human premolars with either MOD amalgam restorations or sound/intact ones were selected for the study. Cavities with cusp reduction were made for the following groups: (a) Group 1: DCRs on previously amalgam-affected dentin (n = 11), (b) Group 2: DCRs on sound dentin (n = 10), and (c) Group 3: intact premolars (n = 9). Teeth in Groups 1 and 2 were restored with a 3-step etch and rinse adhesive (Quadrant Unibond) and filled with hybrid composite (Clearfil Photo Posterior). All specimens were thermocycled for 5000 cycles (5–55 °C). The buccal cusps of the teeth were loaded until fracture under compression at 45° to the long axis of the teeth in a universal testing machine (1 mm/min). Data (N) were statistically analyzed using one-way ANOVA and Student’s t-test (α = 0.01). Intact teeth (Group 3) showed significantly higher fracture resistance (893 ± 196) compared to both restored groups (p < 0.01). No significant difference was found between the DCRs made on amalgam-affected dentin (Group 1: 607 ± 166) and sound dentin (Group 2: 588 ± 183) (p > 0.01). More than half of the teeth of Groups 2 and 3 showed unrepairable fractures with pulp exposure.     

Effect of timing for core preparation,luting cement type and root level on adhesion of fiber posts to intraradicular dentin

This study assessed the effect of timing of core preparation and luting cement on adhesion of fiber-reinforced composite (FRC) posts on different levels of intraradicular dentin when cemented with either conventional dual-polymerized or self-adhesive resin cement. Single-rooted human teeth (N = 80) were endodontically treated and randomly divided into 2 groups (n = 40) according to resin cement: (a) Conventional dual resin cement (Variolink II, V) or (b) Self-adhesive resin cement (RelyX U200, R). They were further divided into two subgroups according to timing of core preparation (n = 20): (a) immediate (i) or (b) delayed (d). FRC posts (Cytec Blanco) were cemented and the roots were sliced into discs at the coronal, middle, and apical levels. Push-out tests were then performed in a Universal Testing Machine (1 mm/min). Data (MPa) were analyzed using three-way ANOVA and Tukey’s tests considering the factors ‘core preparation time’, ‘luting cement’, and ‘root level’ (α = 0.05). Type of luting cement (p < 0.001), time of core preparation (p < 0.001), and root level (p < 0.001) significantly affected the bond strength results. R cement was more significantly affected by core preparation time (Ri: 2.91 ± 1.1; Rd: 4.83 ± 1.68) compared to V cement (Vi: 2.92 ± 1.63; Vd: 2.65 ± 1.6) (p < 0.05). Coronal region demonstrated significantly higher bond strength values than those of middle and apical third in all groups (coronal: 4 ± 1.9; middle: 3.1 ± 1.4; apical: 2.4 ± 1.1) (p < 0.05). Adhesive failure between cement and dentin was the most frequent (64%) followed by adhesive failure between cement and post (18%). Delayed core preparation can improve bond strength of FRC posts to intraradicular dentin when cemented with self-adhesive cement compared to conventional dual-polymerized resin cement.