Performance of zirconia abutments for implant-supported single-tooth crowns in esthetic areas: a retrospective study up to 12-year follow-up.

OBJECTIVE: The aim of this clinical study was to assess complications, success, and survival rates of zirconia abutments from different implant designs. MATERIAL AND METHODS: Anterior implant-supported single-tooth restorations, after 1-12 years of clinical function, were evaluated. One hundred and fifty-eight zirconia implant abutments placed in 141 patients were evaluated. Mechanical complications were observed, such as presence or absence of abutment fractures and loss of retention. In addition, the peri-implant parameters were observed. Statistical analysis was performed using Fisher's exact tests, and bone level was analyzed using the nonparametric Mann-Whitney U-test for non-normally distributed data. RESULTS: Sixteen restorations exhibited different complications. However, no significant difference was observed between the standard and platform switching. The standard platforms exhibited higher marginal bone loss than platform switching design followed up to 5 years. Platform switching has a potentially higher risk of fracture in some designs. In our study, one standard platform as well as two-platform switch designs seem to withstand fracture in the anterior area, regardless of the implant width. Survival and success rates were 93.8% and 81.2% (up to >7 years ≤12), respectively, for standard platform; and 90 and 84% (up to >2 years ≤5), respectively, for platform switching. CONCLUSIONS: In general, standard platform implants restored with zirconia abutments were successful for the longest periods of observation and are a viable treatment alternative in anterior areas. Some of the studied designs of platform switching implants with zirconia abutments performed well for up to 5 years.

In vitro fracture toughness of commercial Y-TZP ceramics: a systematic review.

PURPOSE: The aim of this review was to assess research methods used to determine the fracture toughness of Y-TZP ceramics in order to systematically evaluate the accuracy of each method with regard to potential influencing factors. MATERIALS AND METHODS: Six databases were searched for studies up to April 2013. The terms "tough*," "critical stress intensity factor," "zirconi*," "yttri*," "dent*," "zirconia," "zirconium," and "stress" were searched. Titles and abstracts were screened, and literature that fulfilled the inclusion criteria was selected for a full-text reading. Test conditions with potential influence on fracture toughness were extracted from each study. RESULTS: Ten laboratory studies met the inclusion criteria. There was a significant variation in relation to test method, ambient conditions, applied/indentation load, number of specimens, and geometry and dimension of the specimen. The results were incomparable due to high variability and missing information. Therefore, 10 parameters were listed to be followed to standardize future studies. CONCLUSIONS: A wide variation in research methods affected the fracture toughness reported for Y-TZP ceramics among the selected studies; single-edge-precracked beam and chevron-notched-beam seem to be the most recommended methods to determine Y-TZP fracture toughness; the indentation methods have several limitations. CLINICAL SIGNIFICANCE: The accurate calculation of toughness values is fundamental because overestimating toughness data in a clinical situation can negatively affect the lifetime of the restoration.

Effect of ceramic thickness and shade on mechanical properties of a resin luting agent.

PURPOSE: This study aimed to investigate the influence of ceramic thickness and shade on the Knoop hardness and dynamic elastic modulus of a dual-cured resin cement. MATERIALS AND METHODS: Six ceramic shades (Bleaching, A1, A2, A3, A3.5, B3) and two ceramic thicknesses (1 mm, 3 mm) were evaluated. Disk specimens (diameter: 7 mm; thickness: 2 mm) of the resin cement were light cured under a ceramic block. Light-cured specimens without the ceramic block at distances of 1 and 3 mm were also produced. The Knoop hardness number (KHN), density, and dynamic Young's moduli were determined. Statistical analysis was conducted using ANOVA and a Tukey B rank order test (p = 0.05). RESULTS: The bleaching 1-mm-thick group exhibited significantly higher dynamic Young's modulus. Lower dynamic Young's moduli were observed for the 3-mm-thick ceramic groups compared to bleaching 3-mm-thick group, and no difference was found among the other 3-mm groups. For the KHN, when A3.5 3-mm-thick was used, the KHN was significantly lower than bleaching and A1 1-mm-thick ceramic; however, no difference was exhibited between the thicknesses of the same shade. CONCLUSIONS: The dual-cured resin cement studied irradiated through the 1-mm-thick ceramic with the lightest shade (bleaching ceramic) exhibited a better elastic modulus, and there was no effect in KHN of the resin cement when light cured under different ceramic shades and thicknesses (1 and 3 mm), except when the A3.5 3-mm-thick ceramic was used. CLINICAL SIGNIFICANCE: Variolink II irradiated through ceramic with the lowest chroma exhibited the highest elastic modulus; therefore, the light activation method might not be the same for all clinical situations.

In vitro wear behavior of zirconia opposing enamel: a systematic review.

PURPOSE: The aim of this systematic review was to assess enamel wear on teeth opposing zirconia restorations and to evaluate factors related to the wear of natural teeth opposing zirconia restorations. MATERIALS AND METHODS: Five electronic databases were searched through May 2013 without limitations. The terms "antagonist*," "enamel," "wear," and "zirconi*" were used. Titles and abstracts were initially screened, and those that fulfilled the inclusion criteria were selected for a full-text assessment. Studies that evaluated only the material wear were not included. RESULTS: The database search strategy retrieved 142 potentially eligible studies. After the duplicate studies were removed, 62 studies were obtained. Titles and abstracts that fulfilled the inclusion criteria were selected for a full-text assessment (25). Seven laboratory studies met the inclusion criteria. In addition, reference lists from the finally selected studies were also screened. CONCLUSIONS: There was a large variation in relation to wear test method quantification, applied force, lateral movement, number and frequency of cycles, number of specimens, and enamel specimen preparation. In all studies, enamel wear rates were lower against polished zirconia. Differences in the test methods did not allow for comparisons of wear rates among the studies. CLINICAL SIGNIFICANCE: Polishing the surface is recommended for a full-contour zirconia restoration because polished zirconia presents favorable wear behavior opposing natural teeth.

Bond strength of different resin cement and ceramic shades bonded to dentin.

PURPOSE: To evaluate the microtensile bond strength (MTBS) of ceramic cemented to dentin varying the resin cement and ceramic shades. MATERIALS AND METHODS: Two VITA VM7 ceramic shades (Base Dentine 0M1 and Base Dentine 5M3) were used. A spectrophotometer was used to determine the percentage translucency of ceramic (thickness: 2.5 mm). For the MTBS test, 80 molar dentin surfaces were etched and an adhesive was applied. Forty blocks (7.2 x 7.2 x 2.5 mm) of each ceramic shade were produced and the ceramic surface was etched (10% hydrofluoric acid) for 60 s, followed by the application of silane and resin cement (A3 yellow and transparent). The blocks were cemented to dentin using either A3 or transparent cement. Specimens were photoactivated for 20 s or 40 s, stored in distilled water (37°C/24 h), and sectioned. Eight experimental groups were obtained (n = 10). Specimens were tested for MTSB using a universal testing machine. Data were statistically analyzed using ANOVA and Tukey's post-hoc tests (α <= 0.05). RESULTS: The percentage translucency of 0M1 and 5M3 ceramics were 10.06 (± 0.25)% and 1.34 (± 0.02)%, respectively. The lowest MTBS was observed for the ceramic shade 5M3. For the 0M1 ceramic, the A3 yellow cement that was photocured for 20 s exhibited the lowest MTBS, while the transparent cement that was photocured for 40 s presented the highest MTBS. CONCLUSIONS: For the 2.5-mm-thick 5M3 ceramic restorations, the MTBS of ceramic cemented to dentin significantly increased. The dual-curing cement Variolink II photocured for 40 s is not recommended for cementing the Base Dentine 5M3 feldspathic ceramic to dentin.

Durability of adhesion between feldspathic ceramic and resin cements: effect of adhesive resin, polymerization mode of resin cement, and aging.

PURPOSE: Adhesive cementation is an important step for restorations made of feldspathic ceramic as it increases the strength of such materials. Incorrect selection of the adhesive resin and the resin cement to adhere to the ceramic surface and their durability against aging can affect the adhesion between these materials and the clinical performance. This study evaluated the effect of adhesive resins with different pHs, resin cements with different polymerization modes, and aging on the bond strength to feldspathic ceramic. MATERIALS AND METHODS: One surface of feldspathic ceramic blocks (VM7) (N = 90) (6.4 × 6.4 × 4.8 mm(3) ) was conditioned with 10% hydrofluoric acid for 20 seconds, washed/dried, and silanized. Three adhesive resins (Scotchbond Multi-Purpose Plus [SBMP], pH: 5.6; Single Bond [SB], pH: 3.4; and Prime&Bond NT [NT], pH: 1.7) were applied on the ceramic surfaces (n = 30 per adhesive). For each adhesive group, three resin cements with different polymerization modes were applied (n = 10 per cement): photo-polymerized (Variolink II base), dual polymerized (Variolink II base + catalyst), and chemically polymerized (C&B). The bonded ceramic blocks were stored in water (37°C) for 24 hours and sectioned to produce beam specimens (cross-sectional bonded area: 1 ± 0.1 mm(2) ). The beams of each block were randomly divided into two conditions: Dry, microtensile test immediately after cutting; TC, test was performed after thermocycling (12,000×, 5°C to 55°C) and water storage at 37°C for 150 days. Considering the three factors of the study (adhesive [3 levels], resin cement [3 levels], aging [2 levels]), 18 groups were studied. The microtensile bond strength data were analyzed using 3-way ANOVA and Tukey's post hoc test (α= 0.05). RESULTS: Adhesive resin type (p < 0.001) and the resin cement affected the mean bond strength (p= 0.0003) (3-way ANOVA). The NT adhesive associated with the chemically polymerized resin cement in both dry (8.8 ± 6.8 MPa) and aged conditions (6.9 ± 5.9 MPa) presented statistically lower bond strength results, while the SBMP adhesive resin, regardless of the resin cement type, presented the highest results (15.4 to 18.5 and 14.3 to 18.9 MPa) in both dry and aged conditions, respectively (Tukey's test). CONCLUSION: Application of a low-pH adhesive resin onto a hydrofluoric acid etched and silanized feldspathic ceramic surface in combination with chemically polymerized resin cement did not deliver favorable results. The use of adhesive resin with high pH could be clinically advised for the photo-, dual-, and chemically polymerized resin cements tested.

Effect of cement shade and light-curing unit on bond strength of a ceramic cemented to dentin.

PURPOSE: To evaluate the effect of cement shade, light-curing unit, and water storage on tensile bond strength (σ) of a feldspathic ceramic resin bonded to dentin. MATERIALS AND METHODS: The dentin surface of 40 molars was exposed and etched with 37% phosphoric acid, then an adhesive system was applied. Forty blocks of feldspathic ceramic (Vita VM7) were produced. The ceramic surface was etched with 10% hydrofluoric acid for 60 s, followed by the application of a silane agent and a dual-curing resin cement (Variolink II). Ceramic blocks were cemented to the treated dentin using either A3 or transparent (Tr) shade cement that was activated using either halogen or LED light for 40 s. All blocks were stored in 37°C distilled water for 24 h before cutting to obtain non-trimmed bar-shaped specimens (adhesive area = 1 mm2 ± 0.1) for the microtensile bond strength test. The specimens were randomly grouped according to the storage time: no storage or stored for 150 days in 37°C distilled water. Eight experimental groups were obtained (n = 30). The specimens were submitted to the tensile bond strength test using a universal testing machine at a crosshead speed of 1 mm/min. The data were statistically analyzed using ANOVA and Tukey's posthoc tests (a = 0.05). RESULTS: The mean bond strength values were significantly lower for the corresponding water stored groups, except for the specimens using A3 resin cement activated by halogen light. There was no significance difference in mean bond strength values among all groups after water storage. CONCLUSION: Water storage had a detrimental effect under most experimental conditions. For both cement shades investigated (Tr and A3) under the same storage condition, the light-curing units (QTH and LED) did not affect the mean microtensile bond strengths of resin-cemented ceramic to dentin.

The influence of cutting speed and cutting initiation location in specimen preparation for the microtensile bond strength test.

PURPOSE: This study evaluated the effect of cutting initiation location and cutting speed on the bond strength between resin cement and feldspathic ceramic. MATERIALS AND METHODS: Thirty-six blocks (6.4 x 6.4 x 4.8 mm) of ceramic (Vita VM7) were produced. The ceramic surfaces were etched with 10% hydrofluoric acid gel for 60 s and then silanized. Each ceramic block was placed in a silicon mold with the treated surface exposed. A resin cement (Variolink II) was injected into the mold over the treated surface and polymerized. The resin cement-ceramic blocks were divided into two groups according to experimental conditions: a) cutting initiation location - resin cement, ceramic and interface; and b) cutting speed - 10,000, 15,000, and 20,000 rpm. The specimens were sectioned to achieve non-trimmed bar specimens. The microtensile test was performed in a universal testing machine (1 mm/min). The failure modes were examined using an optical light microscope and SEM. Bond strength results were analyzed using one-way ANOVA and Tukey's test (α = 0.05). RESULTS: Significant influences of cutting speed and initiation location on bond strength (p < 0.05) were observed. The highest mean was achieved for specimens cut at 15,000 rpm at the interface (15.12 ± 5.36 MPa). The lowest means were obtained for specimens cut at the highest cutting speed in resin cement (8.50 ± 3.27 MPa), and cut at the lowest cutting speed in ceramic (8.60 ± 2.65 MPa). All groups showed mainly mixed failure (75% to 100%). CONCLUSION: The cutting speed and initiation location are important factors that should be considered during specimen preparation for microtensile bond strength testing, as both may influence the bond strength results.

Shear bond strength of resin cement bonded to alumina ceramic after treatment by aluminum oxide sandblasting or silica coating.

PURPOSE: To evaluate the shear bond strength and bond durability between a dual-cured resin cement (RC) and a high alumina ceramic (In-Ceram Alumina), subjected to two surface treatments. MATERIALS AND METHODS: Forty disc-shaped specimens (sp) (4-mm diameter, 5-mm thick) were fabricated from In-Ceram Alumina and divided into two groups (n = 20) in accordance with surface treatment: (1) sandblasting by aluminum oxide particles (50 µm Al(2) O(3) ) (SB) and (2) silica coating (30 µm SiO(x) ) using the CoJet system (SC). After the 40 sp were bonded to the dual-cured RC, they were stored in distilled water at 37°C for 24 hours. After this period, the sp from each group were divided into two conditions of storage (n = 10): (a) 24 h-shear bond test 24 hours after cementation; (b) Aging-thermocycling (TC) (12,000 times, 5 to 55°C) and water storage (150 days). The shear test was performed in a universal test machine (1 mm/min). RESULTS: ANOVA and Tukey (5%) tests noted no statistically significant difference in the bond strength values between the two surface treatments (p = 0.7897). The bond strengths (MPa) for both surface treatments reduced significantly after aging (SB-24: 8.2 ± 4.6; SB-Aging: 3.7 ± 2.5; SC-24: 8.6 ± 2.2; SC-Aging: 3.5 ± 3.1). CONCLUSION: Surface conditioning using airborne particle abrasion with either 50 µm alumina or 30 µm silica particles exhibited similar bond strength values and decreased after long-term TC and water storage for both methods.

Diametral tensile strength of composite core material with cured and uncured fiber posts.

The aim of this study was to determine the influence of different types of posts and post head designs on the fracture resistance of a composite resin core material using the diametral tensile strength (DTS ). Seventy-five disc specimens were prepared using a composite core and prefabricated glass fiber posts and were divided into four test groups and one control group (n=15). The use of fiber posts reduced the DTS of the composite core material; the DTS value of the control material was significantly higher (p=0.05) than all of the test groups.

Adhesive quality of self-adhesive and conventional adhesive resin cement to Y-TZP ceramic before and after aging conditions.

PURPOSE: This study evaluated the adhesive quality of simplified self-adhesive and conventional resin cements to Y-TZP in dry and aged conditions. METHODS: Y-TZP ceramic blocks (N = 192) (5 x 5 x 2 mm) were embedded in acrylic resin and randomly divided into two groups, based on surface conditioning: 96% isopropanol or chairside tribochemical silica coating and silanization. Conditioned ceramics were divided into four groups to receive the resin cements (Panavia F 2.0, Variolink II, RelyX U100 and Maxcem). After 24 hours, half of the specimens (n = 12) from each group were submitted to shear bond strength testing (0.5 mm/minute). The remaining specimens were tested after 90 days of water storage at 37 degrees C and thermocycling (12,000x, 5 degrees C-55 degrees C). Failure types were then assessed. The data were analyzed using three-way ANOVA and the Tukey's test (alpha = 0.05). RESULTS: Significant effects of ceramic conditioning, cement type and storage conditions were observed (p < 0.0001). The groups cleaned using alcohol only showed low bond strength values in dry conditions and the bond strength was reduced dramatically after aging. Groups conditioned using silica coating and silanization showed higher bond strengths both in dry and aged conditions. A high number of specimens failed prematurely prior to testing when they were cleaned using 96% isopropanol. CONCLUSION: Overall, silica coating and silanization showed higher, stable bond strengths with and without aging. The durability of resin-ceramic adhesion varied, depending on the adhesive cement type.

Does adhesive resin application contribute to resin bond durability on etched and silanized feldspathic ceramic?

PURPOSE: To assess the effect of adhesive application and aging on the bond durability of resin cement to etched and silanized feldspathic ceramic. MATERIALS AND METHODS: Twenty blocks (6.4 x 6.4 x 4.8 mm) of feldspathic ceramic (Vita VM7) were produced. The ceramic surfaces were conditioned with 10% hydrofluoric acid gel for 60 s and silanized. They were then randomly divided into two groups. While half of the group received no adhesive, in the other half, a layer of adhesive (Scotchbond Multi-Purpose Plus) was applied. Each ceramic block was then placed in its silicone mold with the treated surface exposed. The dual-cured resin cement (Variolink II) was injected into the mold over the treated surface and polymerized. Specimens were sectioned to achieve nontrimmed bar specimens (approximately 12 sticks/block) that were randomly divided into 2 groups: a) non-aged--microtensile bond test immediately after sectioning; b) aged-thermocycling (TC) 12,000 times, 5 degrees C to 55 degrees C, and water storage (50 days). The microtensile bond strength test was performed in a universal testing machine (crosshead speed: 1 mm/min). The failure types were examined using an optical light microscope and SEM. Bond strength results were analyzed using two-way ANOVA and Tukey's test (alpha = 0.05). RESULTS: The adhesive application affected the bond strength results significantly (p = 0.0001) (without adhesive > with adhesive). While aging conditions did not reduce the bond strength in the groups that received no adhesive (20 +/- 5.3 MPa non-aged and 21.5 +/- 5.6 aged) (p = 0.1698), it significantly affected the bond strength results of the group with adhesive application (18 +/- 4.4 MPa to 14.4 +/- 4.7 MPa) (p < 0.001). All groups showed mainly mixed type of failures between the ceramic and the resin cement (81% to 100%). The group in which no adhesive was applied presented a higher incidence of cohesive failure of ceramic after aging (18%) than those of the other groups. CONCLUSION: The use of adhesive did not improve resin cement adhesion to the etched and silanized feldspathic ceramic after long-term thermocycling and water storage.

Bond strength durability of direct and indirect composite systems following surface conditioning for repair.

PURPOSE: This study evaluated the effect of surface conditioning methods and thermocycling on the bond strength between a resin composite and an indirect composite system in order to test the repair bond strength. MATERIALS AND METHODS: Eighteen blocks (5 x 5 x 4 mm) of indirect resin composite (Sinfony) were fabricated according to the manufacturer's instructions. The specimens were randomly assigned to one of the following two treatment conditions (9 blocks per treatment): (1) 10% hydrofluoric acid (HF) for 90s (Dentsply) + silanization, (2) silica coating with 30-im SiOx particles (CoJet) + silanization. After surface conditioning, the bonding agent was applied (Adper Single Bond) and light polymerized. The composite resin (W3D Master) was condensed and polymerized incrementally to form a block. Following storage in distilled water at 37 degrees C for 24 h, the indirect composite/resin blocks were sectioned in two axes (x and y) with a diamond disk under coolant irrigation to obtain nontrimmed specimens (sticks) with approximately 0.6 mm2 of bonding area. Twelve specimens were obtained per block (N=216, n=108 sticks). The specimens from each repaired block were again randomly divided into 2 groups and tested either after storage in water for 24 h or thermocycling (6000 cycles, 5 degrees C to 55 degrees C). The microtensile bond strength test was performed in a universal testing machine (crosshead speed: 1 mm/min). The mean bond strengths of the specimens of each block were statistically analyzed using two-way ANOVA (alpha = 0.05). RESULTS: Both surface conditioning (p = 0.0001) and storage conditions (p = 0.0001) had a significant effect on the results. After 24 h water storage, silica coating and silanization (method 2) showed significantly higher bond strength results (46.4 +/- 13.8 MPa) than that of hydrofluoric acid etching and silanization (method 1) (35.8 +/- 9.7 MPa) (p < 0.001). After thermocycling, no significant difference was found between the mean bond strengths obtained with method 1 (34.1 +/- 8.9 MPa) and method 2 (31.9 +/- 7.9 MPa) (p > 0.05). CONCLUSION: Although after 24 h of testing, silica coating and silanization performed significantly better in resin-resin repair bond strength, both HF acid gel and silica coating followed by silanization revealed comparable bond strength results after thermocycling for 6000 times.

Implant-abutment gap versus microbial colonization: Clinical significance based on a literature review.

Microorganisms from the oral cavity may settle at the implant-abutment interface (IAI). As a result, tissue inflammation could occur around these structures. The databases MEDLINE/PubMed and PubMed Central were used to identify articles published from 1981 through 2012 related to the microbial colonization in the implant-abutment gap and its consequence in terms of crest bone loss and osseointegration. The following considerations could be put forward, with respect to the clinical importance of IAI: (a) the space present at the IAI seems to allow bacterial leakage to occur, in spite of the size of this space; (b) bacterial leakage seems to occur at the IAI, irrespective of the type of connection. More studies are necessary to clarify the relationship between leakage at IAI and abutment connection designs; (c) losses at the peri-implant bone crests cannot be related to the IAI size, since few studies have shown no relationship. Also, the microbial leakage at the IAI cannot be related to the bone crest loss, since there are no articles reporting this relationship; remains controversial the influence of the IAI position on the bone crest losses.

Effects of cement-curing mode and light-curing unit on the bond durability of ceramic cemented to dentin.

The aim of this study was to evaluate the effects of different light-curing units and resin cement curing types on the bond durability of a feldspathic ceramic bonded to dentin. The crowns of 40 human molars were sectioned, exposing the dentin. Forty ceramic blocks of VITA VM7 were produced according to the manufacturer's recommendations. The ceramic surface was etched with 10% hydrofluoric acid / 60s and silanized. The dentin was treated with 37% phosphoric acid / 15s, and the adhesive was applied. The ceramic blocks were divided and cemented to dentin according to resin cement / RC curing type (dual- and photo-cured), light-curing unit (halogen light / QTH and LED), and storage conditions (dry and storage / 150 days + 12,000 cycles / thermocycling). All blocks were stored in distilled water (37°C / 24h) and sectioned (n = 10): G1 - QTH + RC Photo, G2 - QTH + RC Dual, G3 - LED + RC Photo, G4 - LED + RC Dual. Groups G5, G6, G7, and G8 were obtained exactly as G1 through G4, respectively, and then stored and thermocycled. Microtensile bond strength tests were performed (EMIC), and data were statistically analyzed by ANOVA and Tukey's test (5%). The bond strength values (MPa) were: G1 - 12.95 (6.40)ab; G2 - 12.02 (4.59)ab; G3 - 13.09 (5.62)ab; G4 - 15.96 (6.32)a; G5 - 6.22 (5.90)c; G6 - 9.48 (5.99)bc; G7 - 12.78 (11.30)ab; and G8 - 8.34 (5.98)bc. The same superscript letters indicate no significant differences. Different light-curing units affected the bond strength between ceramic cemented to dentin when the photo-cured cement was used, and only after aging (LED > QTH). There was no difference between the effects of dual- and photo-cured resin-luting agents on the microtensile bond strength of the cement used in this study.

Enamel wear opposing different surface conditions of different CAD/CAM ceramics.

OBJECTIVE: The aim of this study was to evaluate bovine enamel wear opposed to four different ceramic substrates (CEREC) in the glazed and polished conditions. METHOD AND MATERIALS: Sixty-three ceramic (IPS Empress CAD, Paradigm C, Vitablocs Mark II) and fourteen composite resin (MZ100) styli were prepared. Ceramics were subdivided into three surface conditions (n = 7), unpolished, polished, and glazed, and the composite resin (n = 7) into unpolished and polished. All styli were used as wear antagonists opposing bovine enamel blocks (8 mm × 9 mm) in an oral wear simulator. Wear tests were conducted at 30 N abrasion and 70 N attrition forces applied at 1.7 Hz for 5,000 simulated mastication cycles. Abrasion and attrition wear were evaluated using an automatic profilometer. Statistical analyses were conducted using Tukey's B rank order test, P = .05. RESULTS: For bovine enamel opposing glazed Vitablocs, abrasion and attrition wear showed a volume loss significantly higher than bovine enamel opposing polished Vitablocs (P < .05). For attrition wear, bovine enamel opposing glazed Vitablocs and untreated Paradigm C showed a volume loss higher than bovine enamel opposing the other ceramic conditions. CONCLUSION: Abrasion and attrition wear of bovine enamel opposing antagonist ceramic was affected according to the ceramic surface condition and the ceramic material. Antagonistic wear against the studied ceramic materials and conditions exhibited wear rates within the range of normal enamel. In addition, the glaze layer presented as a protection, exhibiting fewer cracks and less loss of material on the ceramic surface.

Accuracy of mechanical torque devices for implants used in Brazilian dental offices.

The purpose of this study was to determine the accuracy of mechanical torque devices in delivering target torque values in dental offices in Salvador, Brazil. A team of researchers visited 16 dental offices, and the clinicians applied torque values (20 and 32 Ncm) to electronic torque controllers. Five repetitions were completed at each torque value and data were collected. When 20 Ncm of torque was used, 62.5% of measured values were accurate (within 10% of the target value). For 32 Ncm, however, only 37.5% of these values were achieved. Several of the tested mechanical torque devices were inaccurate.

Effect of silica coating combined to a MDP-based primer on the resin bond to Y-TZP ceramic.

The aim of this study was to evaluate the influence of silica coating and 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based primer applications upon the bonding durability of a MDP-based resin cement to a yttrium stabilized tetragonal zirconia (Y-TZP) ceramic. Ninety-six Y-TZP tabs were embedded in an acrylic resin (free surface for adhesion: 5 × 5 mm(2)), ground finished and randomly divided into four groups (N = 24) according to the ceramic surface conditioning: (1) cleaning with isopropanol (ALC); (2) ALC + phosphoric acid etching + MDP-based primer application (MDP-primer); (3) silica coating + 3-methacryloyloxypropyl trimethoxysilane (MPS)-based coupling agent application (SiO2 + MPS-Sil); and (4) SiO2 + MDP-primer. The MDP-based resin cement was applied on the treated surface using a cylindrical mold (diameter= 3 mm). Half of the specimens from each surface conditioning were stored in distilled water (37 °C, 24 h) before testing. Another half of the specimens were stored (90 days) and thermo-cycled (12,000 x) during this period (90 d/TC) before testing. A shear bond strength (SBS) test was performed at a crosshead speed of 0.5 mm/min. Two factors composed the experimental design: ceramic conditioning strategy (in four levels) and storage condition (in two levels), totaling eight groups. After 90 d/TC (Tukey; p < 0.05), SiO2 + MDP-primer (24.40 MPa) promoted the highest SBS. The ALC and MDP-primer groups debonded spontaneously during 90 d/TC. Bonding values were higher and more stable in the SiO2 groups. The use of MDP-primer after silica coating increased the bond strength.

Hardening of a dual-cure resin cement using QTH and LED curing units.

OBJECTIVE: This study evaluated the surface hardness of a resin cement (RelyX ARC) photoactivated through indirect composite resin (Cristobal) disks of different thicknesses using either a light-emitting diode (LED) or quartz tungsten halogen (QTH) light source. MATERIAL AND METHODS: Eighteen resin cement specimens were prepared and divided into 6 groups according to the type of curing unit and the thickness of resin disks interposed between the cement surface and light source. Three indentations (50 g for 15 s) were performed on the top and bottom surface of each specimen and a mean Vickers hardness number (VHN) was calculated for each specimen. The data were analyzed using two-way ANOVA and Tukey-Kramer test was used for post-hoc pairwise comparisons. RESULTS: Increased indirect resin disk thickness resulted in decreased mean VHN values. Mean VHN values for the top surfaces of the resin cement specimens ranged from 23.2 to 46.1 (QTH) and 32.3 to 41.7 (LED). The LED curing light source produced higher hardness values compared to the QTH light source for 2- and 3-mm-thick indirect resin disks. The differences were clinically, but not statistically significant. Increased indirect resin disk thickness also resulted in decreased mean VHN values for the bottom surfaces of the resin cement: 5.8 to 19.1 (QTH) and 7.5 to 32.0 (LED). For the bottom surfaces, a statistically significant interaction was also found between the type of curing light source and the indirect resin disk thickness. CONCLUSION: Mean surface hardness values of resin cement specimens decreased with the increase of indirect resin disk thickness. The LED curing light source generally produced higher surface hardness values.

Bond strength durability of self-etching adhesives and resin cements to dentin.

OBJECTIVES: To evaluate the microtensile bond strength (microTBS) of one- (Xeno III, Dentsply) and two-step (Tyrian-One Step Plus, Bisco) self-etching adhesive systems bonded to dentin and cemented to chemically cured (C&B Metabond) or light-cured paste of a dual-cure resin cement (Variolink II, Ivoclar) within a short (24 h) and long period of evaluation (90 days). MATERIAL AND METHODS: Forty recently extracted human molars had their roots removed and their occlusal dentin exposed and ground wet with 600-grit SiC paper. After application of one of the adhesives, the resin cement was applied to the bonded surface and a composite resin block was incrementally built up to a height of 5 mm (n=10). The restored teeth were stored in distilled water at 37 degrees C for 7 days. The teeth were then cut along two axes (x and y), producing beam-shaped specimens with 0.8 mm(2) cross-sectional area, which were subjected to microTBS testing at a crosshead speed of 0.05 mm/min and stressed to failure after 24 h or 90 days of storage in water. The microTBS data in MPa were subjected to three-way analysis of variance and Tukey's test (alpha= 0.05). RESULTS: The interaction effect for all three factors was statistically significant (three-way ANOVA, p<0.001). All eight experimental means (MPa) were compared by the Tukey's test (p<0.05) and the following results were obtained: Tyrian-One Step Plus /C&B/24 h (22.4+/-7.3); Tyrian-One Step Plus /Variolink II/24 h (39.4+/-11.6); Xeno III/C&B/24 h (40.3+/-12.9); Xeno III/Variolink II/24 h (25.8+/-10.5); Tyrian-One Step Plus /C&B/90 d (22.1+/-12.8) Tyrian-One Step Plus/VariolinkII/90 d (24.2+/-14.2); Xeno III/C&B/90 d (27.0+/-13.5); Xeno III/Variolink II/90 d (33.0+/-8.9). CONCLUSIONS: Xeno III/Variolink II was the luting agent/adhesive combination that provided the most promising bond strength after 90 days of storage in water.