Adhesion of Conventional, 3D-Printed and Milled Artificial Teeth to Resin Substrates for Complete Dentures: A Narrative Review.

BACKGROUND: One type of failure in complete or partial dentures is the detachment of resin teeth from denture base resin (DBR). This common complication is also observed in the new generation of digitally fabricated dentures. The purpose of this review was to provide an update on the adhesion of artificial teeth to denture resin substrates fabricated by conventional and digital methods. METHODS: A search strategy was applied to retrieve relevant studies in PubMed and Scopus. RESULTS: Chemical (monomers, ethyl acetone, conditioning liquids, adhesive agents, etc.) and mechanical (grinding, laser, sandblasting, etc.) treatments are commonly used by technicians to improve denture teeth retention with controversial benefits. Better performance in conventional dentures is realized for certain combinations of DBR materials and denture teeth after mechanical or chemical treatment. CONCLUSIONS: The incompatibility of certain materials and lack of copolymerization are the main reasons for failure. Due to the emerging field of new techniques for denture fabrication, different materials have been developed, and further research is needed to elaborate the best combination of teeth and DBRs. Lower bond strength and suboptimal failure modes have been related to 3D-printed combinations of teeth and DBRs, while milled and conventional combinations seem to be a safer choice until further improvements in printing technologies are developed.

Sol-Gel Synthesis and Characterization of YSZ Nanofillers for Dental Cements at Different Temperatures.

BACKGROUND: Yttria-stabilized zirconia nanoparticles can be applied as fillers to improve the mechanical and antibacterial properties of luting cement. The aim of this study was to synthesize yttria-stabilized zirconia nanoparticles by the sol-gel method and to investigate their composition, structure, morphology and biological properties. METHODS: Nanopowders of ZrO2 7 wt% Y2O3 (nY-ZrO) were synthesized by the sol-gel method and were sintered at three different temperatures: 800, 1000 and 1200 °C, and their composition, size and morphology were investigated. The biocompatibility was investigated with human gingival fibroblasts (hGFs), while reactive oxygen species (ROS) production was evaluated through fluorescence analysis. RESULTS: All synthesized materials were composed of tetragonal zirconia, while nanopowders sintered at 800 °C and 1000 °C additionally contained 5 and 20 wt% of the cubic phase. By increasing the calcination temperature, the crystalline size of the nanoparticles increased from 12.1 nm for nY-ZrO800 to 47.2 nm for nY-ZrO1200. Nano-sized particles with good dispersion and low agglomeration were received. Cell culture studies with human gingival fibroblasts verified the nanopowders' biocompatibility and their ROS scavenging activity. CONCLUSIONS: the obtained sol-gel derived nanopowders showed suitable properties to be potentially used as nanofillers for dental luting cement.

Air Quality in a Dental Clinic during Er:YAG Laser Usage for Cavity Preparation on Human Teeth-An Ex-Vivo Study.

Chemical air pollution in dental clinics consists of the emission of gases and particulate matter (PM), both generated by dental equipment and tooth tissues. One basic application of Erbium Laser devices is cavity preparation on human teeth due to its strong affinity to water and hydroxyapatite. The objective of this study was the evaluation of indoor air quality during the application of an Er:YAG laser, as a dentin removal instrument, in a Dental Clinic. Particulate Matter (PM) was measured using the standard method of EN legislation. In order to measure total Volatile Organic compounds (VOCs), a portable monitor was used. In the first experiment, PM10 and PM2.5 concentrations were increased by approximately 10 and 15 times, respectively. From the second experiment it can be concluded that neither of the measured particle concentrations exceeded the recommended indoor limit values while windows were open, although laser influence was still detectable. Within the limitations applied herein, it was found that Er:YAG laser activity for hard dental tissue removal was associated with high PM and TVOCs concentration values in the working environment, under insufficient or no ventilation. Physical ventilation in the aforementioned setting proved to be an important key factor in improving air quality, as both PM and TVOCs concentrations decreased significantly.

Effect of Water Storage on Hardness and Interfacial Strength of Resin Composite Luting Agents Bonded to Surface-Treated Monolithic Zirconia.

BACKGROUND: Durable bonding between resin composite luting agents (CLA) and zirconia is still a matter of controversy. The purpose of this study was to evaluate the effect of water storage on hardness and interfacial strength of three CLA, a non-adhesive (Multilink Automix/ML), an adhesive (Panavia F 2.0/PF) and a self-adhesive (PermaCem 2.0/PC), bonded to polished (CL) and grit-blasted (AL: 50 µm alumina, SJ: Sil-Jet + Monobond Plus silane) monolithic zirconia surfaces. METHODS: CLA specimens (n = 5/cement, condition) were prepared, stored under dry conditions or immersed in water, and Vickers hardness (VH) measurements were obtained at 1 h, 24 h, 1 week and 3 weeks intervals. Optical profilometry was used to determine the roughness parameters (Sa, Sz, Sdr, Sci) of zirconia surfaces (n = 5/treatment). A shear strength test (SBS, n = 10 × 2/cement) was performed to assess the strength and fractography of the cements bonded to zirconia after isothermal water storage and thermal-cycling (TC). RESULTS: PF demonstrated significantly lower VHN after water storage at all time intervals, PC at 1 w, 3 w and ML at 3 w. SJ and AL showed significantly higher values from CL in all roughness parameters. Weibull analysis revealed the following significance in σο ranking within the same material: AL, SJ, ALTC > SJTC, CL > CLTC (PF); SJ, SJTC, AL, ALTC > CL, CLTC (PC) and SJ, SJTC > AL > ALTC > CL, CLTC (ML). Within the same surface treatment subgroups, the significance in σo ranking was PC, ML > PF (before/after TC) for SJ; PC > PF > ML (before TC), PC, PF > ML (after TC) for AL, and PC > PF > ML (before/after TC) for CL. For the m ranking, the only significant difference within each material group was found in PC (AL > ALTC) and for the same surface treatment in AL (PC > ML). CONCLUSION: There are significant differences in the water plasticization susceptibility of the CLA tested; the materials with adhesive monomers were the most affected. Tribo-chemical silica coating combined with a silane coupling agent was the most efficient bonding treatment for the non-adhesive and the self-adhesive materials. The adhesive CLA performed better on alumina-blasted than on tribo-chemically coated surfaces.

The Use of Lasers in Dental Materials: A Review.

Lasers have been well integrated in clinical dentistry for the last two decades, providing clinical alternatives in the management of both soft and hard tissues with an expanding use in the field of dental materials. One of their main advantages is that they can deliver very low to very high concentrated power at an exact point on any substrate by all possible means. The aim of this review is to thoroughly analyze the use of lasers in the processing of dental materials and to enlighten the new trends in laser technology focused on dental material management. New approaches for the elaboration of dental materials that require high energy levels and delicate processing, such as metals, ceramics, and resins are provided, while time consuming laboratory procedures, such as cutting restorative materials, welding, and sintering are facilitated. In addition, surface characteristics of titanium alloys and high strength ceramics can be altered. Finally, the potential of lasers to increase the adhesion of zirconia ceramics to different substrates has been tested for all laser devices, including a new ultrafast generation of lasers.

Novel Femto Laser Patterning of High Translucent Zirconia as an Alternative to Conventional Particle Abrasion.

BACKGROUND: currently applied surface treatments for zirconia bonding may create undesired microcracks and surface flaws. The aim of the present study was to evaluate the efficacy of alternative surface treatments on the shear bond strength of high translucency zirconia to 10-Methacryloyloxydecyl dihydrogen phosphate (MDP)-containing resin-based cement. METHODS: fifty disk-shaped specimens (10 mm × 5 mm) were fabricated from a commercial yttria-stabilized zirconia with 5 mole% yttrium oxide tetragonal zirconia polycrystal (5Y-TZP), and underwent air-abrasion with alumina particles (50 µm-AL50 and 90 µm-AL90), glass beads (GB 10-60 µm), and ablation with femtosecond laser (FEMTO). Shear bond strength was evaluated with a universal testing machine under a crosshead speed of 0.5 mm/min until fracture. Fracture type was evaluated with an optical stereomicroscope. Differences among groups were evaluated by one-way ANOVA and Bonferroni pairwise comparison tests (p < 0.05). RESULTS: the highest shear bond strength values were presented by the laser treated group (23.97 ± 3.7 MPa). No statistically significant differences were found among the Cl, Al50, Al90 and FEMTO groups. The lowest mean value was presented by the glass-beads treated group (11.93 ± 2.88 MPa) which was significantly lower compared to all other groups (p < 0.001). CONCLUSIONS: under the limitations of this in vitro study, femtosecond laser treatment of High-translucent monolithic zirconia (HTZ) ceramics is a promising alternative method for the mechanical retention of resin cements.

Is there a potential for durable adhesion to zirconia restorations? A systematic review.

STATEMENT OF PROBLEM: With a number of zirconia ceramic materials currently available for clinical use, an overview of the scientific literature on the adhesion methods and their potential influence is indicated. PURPOSE: The purpose of this systematic review was to classify and analyze the existing methods and materials proposed to improve adhesion to zirconia surfaces. MATERIAL AND METHODS: The current literature of in vitro studies examining the bond strength on zirconia ceramics, including clinical studies from 1998 until 2014, was analyzed. A search of the English language literature was undertaken using MEDLINE and PubMed, and a hand search was made for any relevant research paper from the library of a dental school. Papers evaluating only alumina restoration bond or ceramic-zirconia bond were excluded. RESULTS: A total of 134 publications were identified for analysis. Different adhesive techniques with different testing methods were reviewed. Results were difficult to compare in that the parameters varied in each research protocol. CONCLUSIONS: Airborne-particle abrasion and tribochemical silica coating are reference pretreatment methods. Adhesive monomers are necessary for chemical bonding. Surface contamination and aging have negative effects on adhesion to zirconia. Many factors influence each combination of zirconia material, such as surface treatment, adhesive medium, and aging conditions. Laboratory studies should be confirmed by clinical trials.