Machine-driven simulation of removing luting agent remnants from implant surfaces: An investigator-independent assessment of cleaning protocols.

INTRODUCTION: To simulate removing luting agent remnants from crowns fixed onto implant-abutment analogs using a standardized machine-driven protocol including a scaler and air polishing or sonic. MATERIAL AND METHODS: A motor-driven device was constructed that controlled the rotational speed of the specimens, machining distance, contact pressure, and working time. A standardized layer of cement (Provicol, VOCO; Cuxhaven, G; Ketac Cem, 3MEspe; Seefeld, G; or Rely X Unicem, 3MEspe, Seefeld, G) was placed onto the finishing line of the crowns luted onto titanium-abutment analogs. The cement layer was scaled with a fresh titanium scaler maneuvered by the motor-driven device and treated with air polishing or sonic. Protocol 1: Scaling only for 20s, 40s, or 60s; n=20; protocol 2: 40s of scaling plus 20s of air polishing; protocol 3: 20s of scaling plus 40s of air polishing; protocol 4: 20s of scaling plus 40s of sonic; protocol 5: 40s of scaling plus 20s of sonic; protocols 2-5: n=10. Cement remnants were counted digitally as "percentage of remnants". STATISTICS: mean, standard deviation, Bonferroni post hoc tests; α=0.05. RESULTS: Ketac Cem was easily removed by scaling only and Provicol by scaling and air polishing, but the self-adhesive resin composite cement Rely X Unicem was not removable with the device. Only remnants of Provicol could be significantly reduced by further treatment after scaling (p<0.001). CONCLUSION: The presented motor-driven device enables reproducible investigations of various cleaning protocols and is thus useful to create an overview of cleaning protocols needed for the different types of cement.

An in vitro comparative assessment of different enamel contaminants during bracket bonding.

In orthodontics, adhesive failures can occur because of saliva contamination during bonding. However, most in vitro studies concerning bond strength of saliva-contaminated enamel disregard the influence of temperature changes in a wet environment. The aim of the present study was to compare the influence of saliva, blood and etching gel remnant contamination on shear bond strength (SBS) after thermocycling. After etching of extracted human third molars (n = 80), a conventional primer (Transbond XT) and a moisture-insensitive primer (Transbond MIP) were evaluated using the adhesive, Transbond XT, under dry conditions and after contamination with saliva, blood and etching gel remnants. To simulate temperature changes and the moisture of saliva in the oral cavity, all samples were thermocycled (6,000 x 5 degrees C/55 degrees C) in a mastication device before SBS testing. A Mann-Whitney U test was used to determine statistical differences. Under dry conditions Transbond XT and Transbond MIP showed no significant difference in SBS. However, clinically unacceptable (P = 0.005) bond strength was observed using Transbond XT after saliva and blood contamination. In wet conditions only Transbond MIP showed sufficient bond strength. If contamination during bonding is expected, a hydrophilic primer should be used. Under dry conditions hydrophilic or hydrophobic primers could be applied. Blood contamination seems to be a more serious problem for bond strength than saliva or etching gel contamination.