Does surface priming increase the bond strength of orthodontic brackets? An experimental study.

OBJECTIVE: To evaluate the effects of metal primer II (MP II) on the shear bond strength (SBS) of orthodontic brackets bonded to teeth and bis-acryl composite provisional material (Bis-Acryl). MATERIAL AND METHODS: Twenty extracted human premolars specimens and 20 premolar shaped Bis-Acryl specimens were obtained and randomly divided into two surface groups. The first group consisted of human premolars (T) bonded to brackets in the conventional way while in the second (T-MP) MP II was applied on the bracket base before bonding. Similarly, one group of provisional material (PM) was prepared according to conventional treatment and another with the application of MP-II metal bonder (PM-MP). In all cases Ortho-brackets (Victory Series, 3 M) were bonded employing Transbond XT resin cement. Then the brackets were debonded under shear and the results were statistically analyzed by two-way analysis of variance and Holm Sidak at α = .05. The debonded surfaces of all specimens were examined by light microscopy and the Adhesive Remnant Index (ARI) was recorded. RESULTS: The SBS results exhibited significant differences er (p < .001). For both the T and TM the application of MP-II increased the SBS compared to respective control groups (p < .001). The T-C group was found inferior compared to PM-C (p < .001) and the same is true for the comparison between T-MP and PM-MP (p < .001). ARI indexes demonstrated that the tooth groups were characterized by a predominantly adhesive failure at the resin-dentin interface. In contrast, the control group for provisional crowns (PM-C) showed a predominantly cohesive failure mode, which moved to predominantly adhesive after the application of MP II. CONCLUSION: The application of MP II enhances the SBS on both, human enamel and provisional crown materials.

Effects of various beverages on characteristics of provisional restoration materials.

OBJECTIVE: To investigate the effect of common beverages on four currently used provisional restoration materials: Protemp®4, Integrity®, polymethyl methacrylate (PMMA) block, and acrylic resin. Flowable resin composite is included as a control group. MATERIALS AND METHODS: Each material was formed into disks of 10-mm diameter and 4-mm thickness (N = 40) by loading the material into acrylic molds. The exposed surface in the mold was covered using a glass slide to prevent an oxygen inhibition layer, and polymerization then proceeded. The solidified disks were placed in distilled water for 24 h. These samples (n = 8) were then immersed for 14 days in one of four different beverages: water, orange juice, cola, and coffee. Changes in color dimension, hardness, and roughness were observed and then analyzed using two-way repeated analysis of variance. RESULTS: The provisional materials had more obvious changes in all three color dimensions than the flowable resin composite. Integrity showed the biggest changes, followed by acrylic resin and PMMA block, whereas Protemp had the smallest changes. The hardness of all the materials significantly decreased after immersion in any of the beverages for 14 days. There were no changes in surface roughness when the materials were immersed in distilled water. The surface roughness of the PMMA block significantly decreased in orange juice whereas that of Integrity and acrylic resin significantly increased in cola. CONCLUSION: Different kinds of provisional materials had different degrees of staining due to their composition. Moisture had a significant influence on the hardness of materials, and the acidity of cola significantly roughened the surface of the provisional materials.

Biaxial flexural strength of different provisional restorative materials under chemo-mechanical aging: An in vitro study.

PURPOSE: Durability is a critical factor for the success of long-term provisional restorations. This study evaluated the effect of different storage media and cyclic loading on the biaxial flexural strength of different types of provisional materials. MATERIALS AND METHODS: Discs (N = 360, 10 × 2 mm) were prepared from different provisional materials; conventional (Protemp 4, Tuff-Temp, Tempron), CAD-CAM milled (VITA CAD-Temp, breCAM.multiCOM), and 3D-printed (Nextdent C&B MFH) (n = 60). Each material group was subdivided into four subgroups according to the storage media (n = 15): nonaged, artificial saliva, mouthwash, and coffee. The specimens in storage media were placed in an incubator at 37°C for 4 weeks followed by 60,000 simulated chewing cycles. Biaxial flexural strength test was done. Data were analyzed using two-way ANOVA. Weibull distribution parameters were estimated. RESULTS: Both the material and aging protocol showed a significant effect on the biaxial flexural strength. Both Protemp 4 and Nextdent C&B MFH showed a significantly higher biaxial flexural strength before and after aging compared to all other materials. Protemp 4 and Tuff Temp showed a significant decrease in strength with aging. CAD-CAM materials showed higher Weibull moduli. CONCLUSIONS: The 3D-printed polymethylmethacrylate provisional material presents with both greater biaxial flexural strength and increased durability against chemical and mechanical aging compared to conventional and CAD-CAM milled provisional materials tested.

Shear Strength of Repaired 3D-Printed and Milled Provisional Materials Using Different Resin Materials with and without Chemical and Mechanical Surface Treatment.

The aim of this study was to assess the shear bond strength of 3D-printed and milled provisional restorations using various resin materials and surface finishes. There were 160 preliminary samples in all, and they were split into two groups: the milled group and the 3D-printed group. Based on the resin used for repair (composite or polymethylmethacrylate (PMMA)) and the type of surface treatment utilized (chemical or mechanical), each group was further divided into subgroups. The specimens were subjected to thermocycling from 5 °C to 55 °C for up to 5000 thermal cycles with a dwell time of 30 s. The mechanical qualities of the repaired material underwent testing for shear bond strength (SBS). To identify the significant differences between the groups and subgroups, a statistical analysis was carried out. Three-way ANOVA was used to analyze the effects of each independent component (the material and the bonding condition), as well as the interaction between the independent factors on shear bond strength. Tukey multiple post-hoc tests were used to compare the mean results for each material under various bonding circumstances. The shear bond strengths of the various groups and subgroups differed significantly (p < 0.05). When compared to the milled group, the 3D-printed group had a much greater mean shear bond strength. When compared to PMMA repair, the composite resin material showed a noticeably greater shear bond strength. In terms of surface treatments, the samples with mechanical and chemical surface treatments had stronger shear bonds than those that had not received any. The results of this study demonstrate the effect of the fabrication method, resin type, and surface treatment on the shear bond strength of restored provisional restorations. Particularly when made using composite material and given surface treatments, 3D-printed provisional restorations showed exceptional mechanical qualities. These results can help dentists choose the best fabrication methods, resin materials, and surface treatments through which to increase the durability and bond strength of temporary prosthesis.

Knowledge and awareness of polycaprolactone and its applications as provisional material in prosthodontic practice: A questionnaire-based survey.

Aim: The present study was done to evaluate the knowledge and awareness of different provisional materials, especially polycaprolactone (PCL) and their application in prosthodontic practice. Setting and Design: A questionnaire based survey was carried out to assess the knowledge and awareness of PCL and its applications as provisional material in prosthodontic practice. Materials and Method: A questionnaire-based descriptive study consisting of 10 questions related to different provisional materials and their applications in prosthodontic practice was formulated on Google Forms. The link was created and circulated among the prosthodontist faculty members of various dental institutes and private practitioners of India with the use of digital platforms such as E-mail and social media. The data were collected and examined using Microsoft Excel software for statistical evaluation. Statistical Analysis Used: For this descriptive type of study, knowledge and awareness among prosthodontists across India was evaluated using Microsoft Excel software. Results: The use of PCL was known only to 20.75% of prosthodontists. Moreover, its application and indications are known to only <1% of the study participants. Autopolymerizing resin was most commonly used for the custom tray and temporary base fabrication as well as temporization in crown and bridge prosthesis, while muscle deprogrammer and surgical template were commonly fabricated in heat-cure and clear acrylic resin, respectively. Pattern resin was found to be commonly used in splinting implant impression copings. Conclusion: The use of PCL as a temporary denture base, custom tray, muscle deprogrammer, implant impression splinting, and provisional for crown and bridge and templates should be encouraged and incorporated to get benefits of its characteristic properties. Considering the overall performance of PCL, its use should be incorporated into prosthodontic research and practice.

Flexural Strength of Various Provisional Restorative Materials for Rehabilitation After Aging.

PURPOSE: Durability of provisional restoration is crucial for full-mouth reconstruction, which may be influenced by aging. This study evaluated the effect of aging on the flexural strength of provisional materials for oral rehabilitation. MATERIALS AND METHODS: Bar specimens (2×2×25 mm) were fabricated from CAD-CAM [Vita CAD-Temp® (VC), Telio® CAD (TC), artBloc® (RC)], autopolymerized [Protemp™IV (PA), Luxatemp® (LA), Unifast™Trad (UA)], and heat-polymerized polymer [Major® C & B; (MH)]. Each was divided into aging (AG, 5000 thermocycles of 5°/55°C) and nonaging groups (NG, n = 15/group). Flexural strength (σ, MPa) was determined in a universal testing machine at 1 mm/min crosshead speed. An analysis of variance and multiple comparisons were determined for significant difference (α = 0.05). RESULTS: TCNG indicated the highest mean of σ (133.49 ±4.32), whereas VCNG indicated the lowest mean of σ (84.62 ±3.73) for nonaging. Upon aging process, TCAG revealed the highest mean of σ (123.11 ±4.55), while VCAG possessed the lowest mean of σ (84.05 ±6.39). Significant differences among various provisional materials were indicated (p = 0.001). Aging significantly affected flexural strength (p = 0.001). CONCLUSIONS: The CAD-CAM provisional material possessed higher flexural strength than heat-polymerized PMMA and autopolymerized PMMA, which was suggested as a provisional material for rehabilitation. Aging reduced strength for all materials tested.

Disparity in the Influence of Implant Provisional Materials on Human Gingival Fibroblasts with Different Phases of Cell Settlement: An In Vitro Study.

The development of healthy peri-implant soft tissues is critical to achieving the esthetic and biological success of implant restorations throughout all stages of healing and tissue maturation, starting with provisionalization. The purpose of this study was to investigate the effects of eight different implant provisional materials on human gingival fibroblasts at various stages of cell settlement by examining initial cell attachment, growth, and function. Eight different specimens-bis-acrylic 1 and 2, flowable and bulk-fill composites, self-curing acrylic 1 and 2, milled acrylic, and titanium (Ti) alloy as a control-were fabricated in rectangular plates (n = 3). The condition of human gingival fibroblasts was divided into two groups: those in direct contact with test materials (contact experiment) and those in close proximity to test materials (proximity experiment). The proximity experiment was further divided into three phases: pre-settlement, early settlement, and late settlement. A cell culture insert containing each test plate was placed into a well where the cells were pre-cultured. The number of attached cells, cell proliferation, resistance to detachment, and collagen production were evaluated. In the contact experiment, bis-acrylics and composites showed detrimental effects on cells. The number of cells attached to milled acrylic and self-curing acrylic was relatively high, being approximately 70% and 20-30%, respectively, of that on Ti alloy. There was a significant difference between self-curing acrylic 1 and 2, even with the same curing modality. The cell retention ability also varied considerably among the materials. Although the detrimental effects were mitigated in the proximity experiment compared to the contact experiment, adverse effects on cell growth and collagen production remained significant during all phases of cell settlement for bis-acrylics and flowable composite. Specifically, the early settlement phase was not sufficient to significantly mitigate the material cytotoxicity. The flowable composite was consistently more cytotoxic than the bulk-fill composite. The harmful effects of the provisional materials on gingival fibroblasts vary considerably depending on the curing modality and compositions. Pre-settlement of cells mitigated the harmful effects, implying the susceptibility to material toxicity varies depending on the progress of wound healing and tissue condition. However, cell pre-settlement was not sufficient to fully restore the fibroblastic function to the normal level. Particularly, the adverse effects of bis-acrylics and flowable composite remained significant. Milled and self-curing acrylic exhibited excellent and acceptable biocompatibility, respectively, compared to other materials.

Temporary materials: comparison of in vivo and in vitro performance.

OBJECTIVE: The aim of this investigation was to compare clinical performance and in vitro wear of temporary CAD/CAM and cartridge crowns. This study is an approach to estimate the influence of in vivo use and laboratory simulation on temporary crowns. MATERIALS AND METHODS: A total of 90 crowns were fabricated from each temporary CAD/CAM or cartridge material. Also, 10 crowns of each material were clinically applied for 14 days, and 80 identical duplicate restorations were investigated in the laboratory after storage in water (14 days; 37 °C) and subsequent thermal cycling and mechanical loading (TCML, 240.000 × 50N ML, 600 × 5°C/55 °C). After in vivo application or in vitro aging, facture force, superficial wear (mean and maximum), surface roughness (Ra, Rz), thermal weight loss (TGA), and heat of reaction (DSC) were determined for all crowns. STATISTICS: Bonferroni post hoc test; one-way analysis of variance (ANOVA); α = 0.05). RESULTS: The fracture resistance of the temporary materials varied between 1196.4 (CAD in vivo) and 1598.3 N (cartridge crown in vitro). Mean (maximum) wear data between 204.7 (386.7 µm; cartridge in vitro) and 353.0 µm (621.8 µm; CAD in vitro) were found. Ra values ranged between 4.4 and 4.9 µm and Rz values between 36.0 and 40.8 µm. DSC and TG analysis revealed small differences between the materials but a strong influence of the aging process. CONCLUSIONS: Comparison of in vivo and in vitro aging led to no significant differences in fracture force and wear but differences in roughness, DSC, and TGA. SEM evaluation confirmed comparability. Comparison of CAD/CAM and cartridge temporary materials partially showed significant differences. CLINICAL RELEVANCE: In vitro aging methods might be helpful to estimate materials' properties before principal clinical application. CAD/CAM and cartridge temporary materials provided comparable good clinical performance.

Physical properties of two bis-acryl interim materials: color stability, flexural strength and shear bond strength to flowable composite resin as add-on material

Aims: The objective of this study was to evaluate the mechanical properties of two bis-acryl interim resin materials, such as color stability, flexural strength and shear bond strength to flowable composite resin, simulating clinical situations when this material has to be used for repair as add-on. Two shades of two bis-acryl interim resin materials [Structur 2 SC (shades Bleach and A2); Protemp 4 (shades A1 and A2)] were evaluated. Discs (5 x 1 mm) were fabricated and baseline color was determined after 1 h. Ten specimens were immersed at 37oC in solutions of distilled water (control) and cola-based soft drink (Coca-Cola). Color measurements were performed with a spectrophotometer using CIELab parameters. Color readings were again measured after 2 hours, 4 hours, 24 hours and 7 days. Flexural strength was determined using the three-point bending test (10 x 1 x 2 mm) on a universal testing machine (0.5 mm/min) (n = 10). Discs of bis-acryl resin were embedded in acrylic resin, planned and distributed in 2 groups: G1 - Filtek Z350 Flow/Protemp4 and G2 - Grandio SO Flow/Structure 3 (n = 15). Cylinders (3.5 x 2 mm) were made with the flowable composite resins and polymerized for 20 s. The specimens were stored in distilled water at 37oC for 24 h and subjected to shear bond strength test. Data were analyzed using one-way ANOVA and Tukey's test (α = 0.05). ΔE values were higher for Structur Bleach (3.08)a compared with Protemp 4 (shade A1, 2.22)b (shade A2, 2.25)b. There were no significant differences between Structur Bleach and Structur A2 (2.62)ab. Coca-Cola presented higher ΔE values (3.08)a than (2.00)b. Regarding time, ΔE values increased from 1.84a after 2 h to 2.31b after 4 h. The higher values were observed after 24 h and 7 days (2.93c and 3.09d, respectively). No significant differences were observed for the flexural strength of Structur (22.05 MPa)a and Protemp 4 (19.01 MPa)a. The repairs executed with Structur/Grandio flow (9.21 MPa)a were similar to those performed with Protemp 4/Z350XT flow (10.71 MPa)a. It can be concluded that the two bis-acyl resins evaluated showed similar physical and mechanical properties (AU)

In vitro comparative evaluation of mechanical properties of temporary restorative materials used in fixed partial denture.

INTRODUCTION: Materials used to fabricate provisional restorations can be classified as acrylics or resin composites. Provisional crows can be either prefabricated or custom made. ACRYLICS: These materials have been used to fabricate provisional restorations since the 1930s and usually available as powder and liquid. They are the most commonly used materials today for both single-unit and multiple-unit restorations. In general, their popularity is due to their low cost, acceptable esthetics, and versatility. COMPOSITES: Composite provisional materials use bis-acryl resin, a hydrophobic material that is similar to bis-GMA. Composites are available as auto-polymerized, dualpolymerized and visible light polymerized. PREFORMED CROWNS: Preformed provisional crowns or matrices usually consist of tooth-shaped shells of plastic, cellulose acetate or metal. They are commercially available in various tooth sizes and are usually selected for a particular tooth anatomy. They are commonly relined with acrylic resin to provide a more custom fit before cementation, but the plastic and metal crown shells can also be cemented directly onto prepared teeth. AIMS AND OBJECTIVES: The aim of this study is to choose a material to serve as a better interim prosthesis and to compare three different properties - flexural strength, compressive strength, and color stability. MATERIALS AND METHODS: The samples were made with three different provisional materials (Revotek LC, Protemp 4, TemSpan). RESULT: It was inferred from the study that no one material was superior in all three tested parameters.

Effects of surface treatment and artificial aging on the shear bond strength of orthodontic brackets bonded to four different provisional restorations.

OBJECTIVE: To evaluate the combined effects of material type, surface treatment, and thermocycling on the bond strength of orthodontic brackets to materials used for the fabrication of provisional crowns. MATERIALS AND METHODS: Four materials were included in this study (ProTemp, Trim Plus, Trim II, and Superpont C+B). Sixty cylindrical specimens (1 × 3 cm) were prepared from each material and equally divided into three groups. The first group was ground with silica carbide paper, the second was polished with pumice, and the last group was sandblasted with 50-µm aluminum oxide particles. Stainless-steel maxillary central incisor brackets (Victory Series, 3M) were bonded to the provisional material specimens with Transbond XT light-cured composite resin, and half of the specimens from each group were thermocycled 500 times in 5°C and 55°C water baths. Then the brackets were debonded with shear testing, and the results were statistically analyzed by three-way analysis of variance and Tukey's multiple-comparison tests at α  =  0.05. Adhesive Remnant Index (ARI) was also identified. RESULTS: Before and after thermocycling, ProTemp materials showed the highest shear bond strength with orthodontic brackets (10.3 and 13.1 MPa, respectively). The statistical analysis indicated an interaction among the three independent variables (P < .05) and statistically significant differences in bond strength among provisional materials (P < .001), surface treatments (P < .001), and thermocycling (P < .05). According to the ARI, most groups demonstrated adhesive failure. CONCLUSIONS: The provisional material type, surface treatment, and artificial aging have a significant effect on bond strength. Sandblasting treatment exerts a beneficial effect on shear bond strength.