The Effect of Different Decontamination Methods on the Micro-Tensile Bond Strength of CAD/CAM Resin-Based Blocks to Resin Cement.

INTRODUCTION: This study evaluates the impact of decontamination methods on Microtensile bond strength (µTBS) between resin cement and resin blocks. METHODS: Twenty CAD/CAM resin blocks from two manufacturers were wet-polished, sandblasted, and ultrasonically cleaned. After blood and saliva contamination, blocks were divided into subgroups: control, water rinsing, acid etching, alkaline cleaning paste, or 10-MDP containing cleaner. Resin-based cement was then applied. After 24 hours, the blocks were sectioned to obtain bars for testing. Half of the specimens were tested immediately for µTBS, and the other half underwent artificial aging. The surfaces of the blocks were inspected with a scanning electron microscope (SEM). Three-way ANOVA was performed for µTBS values (α=0.05). RESULTS: In one of the substrates, the positive control subgroup obtained the highest value (56,01 MPa, SD:6,96) followed by 10-MDP cleaner and universal cleaning paste, when immediately tested, with significant differences respect to the water rinsing (p⟨0.041) and acid etching (p⟨0.048) groups. After thermocycling, higher values were found in the 10-MDP cleaner (47,57 MPa, SD:8,15), but differences were not significant. In the other substrate group, the 10-MDP cleaner subgroup showed highest bond strengths (64,46 MPa SD: 10,92) at the initial test. After thermocycling, 10-MDP cleaner (58,66 MPa, SD: 9,93) gave the highest µTBS value. Significant differences between water rinsing group and the rest of subgroups (p⟨0.001), and between 10-MDP cleaner and the positive control group (p⟨0.006) were observed. CONCLUSION: Cleaning after contamination improves bonding. 10-MDP containing cleaner can help to restore initial µTBS value and maintain it in the long-term.

Fracture strengths of chair-side-generated veneers cemented with glass fibers.

INTRODUCTION: CAD/CAM (computer-aided design and computer-aided manufacturing) systems have refreshed the idea of chair-side production of restorations, but the fracture of ceramic veneers remains a problem. Cementation with glass fibers may improve the fracture strengths and affect the failure modes of CAD/CAM-generated ceramic veneers. Therefore, this study compared the fracture strengths of ceramic veneers produced at chair side and cemented with or without glass fibers with those of composite veneers. METHODOLOGY: Thirty intact mandibular incisors were randomly divided into three groups ( n = 10) and treated with CAD/CAM-fabricated veneers cemented with dual-cure composite resin luting cement (CRLC; Group 1), CAD/CAM-fabricated veneers cemented with a glass fiber network (GFN) and dual-cure CRLC (Group 2), and a direct particulate filler composite veneer constructed utilizing fiber and a restorative composite resin (Group 3). The specimens were tested with a universal testing machine after thermal cycling treatment. RESULT: The loads at the start of fracture were the lowest for traditionally fabricated composite veneers and higher for CAD/CAM-generated. Veneers cemented either without or with the GFN. The failure initiation loads (N) for the veneers were 798.92 for Group 1, 836.27 for Group 2, and 585.93 for Group 3. The predominant failure mode is adhesive failure between the laminates and teeth for Group 1, cohesive failure in the luting layer for Group 2, and cohesive laminate failure for Group 3, which showed chipping and small fractures. CONCLUSION: Ceramic material is a reliable alternative for veneer construction at chair side. Fibers at the cementation interface may improve the clinical longevity and provide higher fracture strength values.

Flexural strength,water sorption and solubility of a methylmethacrylate-free denture base polymer reinforced with glass fibre reinforcement.

A methylmethacrylate-free denture base polymer (Eclipse) in comparison to a conventional denture base polymer (Palapress vario) was evaluated after water saturation and Stick glass fibre reinforcement. The data were analysed with ANOVA at a = 0.05. Water-storage caused a decrease in the flexural strength and stiffness of the materials (p > 0.05). Conventional denture base material with fibre reinforcement gave highest flexural strength (201.1 MPa) compared to fibre reinforced Eclipse (79.1 MPa) (p < 0.05). Water sorption after 76 days was 2.08% (Palapress vario) and 1.55% (Eclipse). Fibre-reinforcement of methylmethacrylate-free material was not as successful as conventional denture base and needs to be further optimized.

Effect of pretreatment with collagen crosslinkers on dentin protease activity.

OBJECTIVES: This study evaluated the effect of dentin pretreatment with collagen crosslinkers on matrix metalloproteinase (MMP) and cathepsin K mediated collagen degradation. METHODS: Dentin beams (1mm×2mm×6mm) were demineralized in 10% H3PO4 for 24h. After baseline measurements of dry mass, beams were divided into 11 groups (n=10/group) and, were pretreated for 5min with 1% glutaraldehyde (GA); 5% GA; 1% grape-seed extract (GS); 5% GS; 10% sumac (S); 20µM curcumin (CR); 200µM CR; 0.l% riboflavin/UV (R); 0.5% R; 0.1% riboflavin-5-phosphate/UV (RP); and control (no pretreatment). After pretreatment, the beams were blot-dried and incubated in 1mL calcium and zinc-containing medium (CM, pH 7.2) at 37°C for 3, 7 or 14 days. After incubation, dry mass was reassessed and aliquots of the incubation media were analyzed for collagen C-telopeptides, ICTP and CTX using specific ELISA kits. Data were analyzed by repeated-measures ANOVA. RESULTS: The rate of dry mass loss was significantly different among test groups (p<0.05). The lowest 14 day mean dry mass loss was 6.98%±1.99 in the 200µM curcumin group compared to control loss of dry mass at 32.59%±5.62, p<0.05, at 14 days. The ICTP release over the incubation period (ng/mg dry dentin) ranged between 1.8±0.51 and 31.8±1.8. CTX release from demineralized beams pretreated with crosslinkers was significantly lower than CM (5.7±0.2ng/mg dry dentin). SIGNIFICANCE: The results of this study indicate that collagen crosslinkers tested in this study are good inhibitors of cathepsin K activity in dentin. However, their inhibitory effect on MMP activity was highly variable.

Degradation in the fatigue strength of dentin by cutting, etching and adhesive bonding.

UNLABELLED: The processes involved in placing resin composite restorations may degrade the fatigue strength of dentin and increase the likelihood of fractures in restored teeth. OBJECTIVE: The objective of this study was to evaluate the relative changes in strength and fatigue behavior of dentin caused by bur preparation, etching and resin bonding procedures using a 3-step system. METHODS: Specimens of dentin were prepared from the crowns of unrestored 3rd molars and subjected to either quasi-static or cyclic flexural loading to failure. Four treated groups were prepared including dentin beams subjected to a bur treatment only with a conventional straight-sided bur, or etching treatment only. An additional treated group received both bur and etching treatments, and the last was treated by bur treatment and etching, followed by application of a commercial resin adhesive. The control group consisted of "as sectioned" dentin specimens. RESULTS: Under quasi-static loading to failure there was no significant difference between the strength of the control group and treated groups. Dentin beams receiving only etching or bur cutting treatments exhibited fatigue strengths that were significantly lower (p≤0.0001) than the control; there was no significant difference in the fatigue resistance of these two groups. Similarly, the dentin receiving bur and etching treatments exhibited significantly lower (p≤0.0001) fatigue strength than that of the control, regardless of whether an adhesive was applied. SIGNIFICANCE: The individual steps involved in the placement of bonded resin composite restorations significantly decrease the fatigue strength of dentin, and application of a bonding agent does not increase the fatigue strength of dentin.

Accelerated fatigue of dentin with exposure to lactic acid.

Composite restorations accumulate more biofilm than other dental materials. This increases the likelihood for the hard tissues supporting a restoration (i.e. dentin and enamel) to be exposed to acidic conditions beyond that resulting from dietary variations. In this investigation the fatigue strength and fatigue crack growth resistance of human coronal dentin were characterized within a lactic acid solution (with pH = 5) and compared to that of controls evaluated in neutral conditions (pH = 7). A comparison of the fatigue life distributions showed that the lactic acid exposure resulted in a significant reduction in the fatigue strength (p ≤ 0.001), and nearly 30% reduction in the apparent endurance limit (from 44 MPa to 32 MPa). The reduction in pH also caused a significant decrease (p ≤ 0.05) in the threshold stress intensity range required for the initiation of cyclic crack growth, and significant increase in the incremental rate of crack extension. Exposure of tooth structure to lactic acid may cause demineralization, but it also increases the likelihood of restored tooth failures via fatigue, and after short time periods.

Carbodiimide cross-linking inactivates soluble and matrix-bound MMPs, in vitro.

Matrix metalloproteinases (MMPs) cause collagen degradation in hybrid layers created by dentin adhesives. This in vitro study evaluated the feasibility of using a cross-linking agent, 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC), to inactivate soluble rhMMP-9, as an example of dentin MMPs, and matrix-bound dentin proteases. The inhibitory effects of 5 EDC concentrations (0.01-0.3 M) and 5 incubation times (1-30 min) on soluble rhMMP-9 were screened with an MMP assay kit. The same EDC concentrations were used to evaluate their inhibitory effects on endogenous proteinases from completely demineralized dentin beams that were incubated in simulated body fluid for 30 days. Decreases in modulus of elasticity (E) and dry mass of the beams, and increases in hydroxyproline content of hydrolysates derived from the incubation medium were used as indirect measures of matrix collagen hydrolysis. All EDC concentrations and pre-treatment times inactivated MMP-9 by 98% to 100% (p < 0.05) compared with non-cross-linked controls. Dentin beams incubated in 0.3 M EDC showed only a 9% decrease in E (45% decrease in control), a 3.6% to 5% loss of dry mass (18% loss in control), and significantly less solubilized hydroxyproline when compared with the control without EDC cross-linking (p < 0.05). It is concluded that EDC application for 1 min may be a clinically relevant and effective means for inactivating soluble rhMMP-9 and matrix-bound dentin proteinases if further studies demonstrate that EDC is not toxic to pulpal tissues.

The inhibitory effects of quaternary ammonium methacrylates on soluble and matrix-bound MMPs.

Matrix metalloproteinases (MMPs) bound to dentin contribute to the progressive degradation of collagen fibrils in hybrid layers created by dentin adhesives. This study evaluated the MMP-inhibiting potential of quaternary ammonium methacrylates (QAMs), with soluble rhMMP-9 and a matrix-bound endogenous MMP model. Six different QAMs were initially screened by a rhMMP-9 colorimetric assay. For the matrix-bound endogenous MMPs, we aged demineralized dentin beams for 30 days in calcium- and zinc-containing media (CM; control), chlorhexidine, or QAMs in CM to determine the changes in dry mass loss and solubilization of collagen peptides against baseline levels. The inhibitory effects of QAMs on soluble rhMMP-9 varied between 34 and 100%. Beams incubated in CM showed a 29% decrease in dry mass (p < 0.05), whereas beams incubated with QAMs showed only 0.2%-6% loss of dry mass. Significantly more solubilized collagen was detected from beams incubated in CM (p < 0.05). It is concluded that QAMs exhibited dentin MMP inhibition comparable with that of chlorhexidine, but required higher concentrations.