Effect of Different Laser Treatments on the Bond Strength of Intracanal Fiber Posts Cemented with a Self-Adhesive Resin Cement.

PURPOSE: To evaluate the influence of laser-activated irrigation by Er:YAG and Er:YSGG (LAI) protocols and Nd:YAG laser irradiation on the bond strength of self-adhesively cemented fiber posts to root canal dentine. MATERIALS AND METHODS: The study sample consisted of 84 human single-rooted permanent teeth instrumented with ProTaper Next technique. After obturation, post space preparations were created for fiber-reinforced composite posts. The prepared specimens were divided according to the laser treatment of the post space preparations: group 1: LAI (Er:YAG) + saline solution (pulse energy: 20 mJ, repetition rate: 15 Hz); group 2: LAI (Er:YAG) + QMiX solution (pulse energy: 20 mJ, repetition rate: 15 Hz); group 3: LAI (Er,Cr:YSGG) + saline solution (pulse energy: 62.5 mJ, 20 Hz); group 4: LAI (Er,Cr:YSGG) + QMiX (pulse energy: 62.5 mJ, 20 Hz); Nd:YAG laser (pulse energy: 100 mJ, 10 Hz). Fiber-reinforced posts were cemented with a self-adhesive cement. The bond strength was evaluated by the push-out bond strength test, and the mode of failure was determined under a stereomicroscope. Kruskal-Wallis test was used for the intergroup comparative analysis with 5% level of significance. RESULTS: The highest bond strength was recorded in the Er:YAG + QMiX group (mean 3.401 MPa) (p < 0.05), followed by the Er,Cr:YSGG and the Er:YAG + saline solution (mean 1.111 MPa and 1.094 MPa, respectively), which did not differ significantly (p = 0.232). The irradiation with the Nd:YAG laser caused similar bond strength as the Er,Cr:YSGG + QMiX (p = 0.942). CONCLUSION: All laser protocols enhanced the bond strength of the self-adhesive cement in root canals compared to only saline irrigation. The bond strength of the self-adhesive cement depended on the laser parameters and irrigant used for the LAI.

[Curing mode of universal adhesives affects the bond strength of resin cements to dentin].

OBJECTIVE: To determine the effects of curing mode of one-step and two-step universal adhesives on the micro-tensile bond strength (µTBS) of different dual-cure resin cements to dentin. METHODS: One-step universal adhesive Single Bond Universal (SBU), and two-step universal adhesive OptiBond Versa (VSA) were chosen as the subjects, one-step self-etching adhesive OptiBond All in One (AIO) and two-step self-etching adhesive Clearfil SE Bond (SEB) were control groups, and two dual-cure resin cements RelyX Ultimate (RLX) and Nexus 3 Universal (NX3) were used in this study. In this study, 80 extracted human molars were selected and the dentin surface was exposed using diamond saw. The teeth were divided into 16 groups according to the adhesives (AIO, SBU, SEB, VSA), cure modes of adhesives (light cure, non-light cure) and resin cements (RLX, NX3). The adhesives were applied on the dentin surface following the instruction and whether light cured or not, then the resin cements were applied on the adhesives with 1 mm thickness and light cured (650 mW/cm(2) for 20 s. A resin was built up (5 mm) on the cements and light cured layer by layer. After water storage for 24 h, the specimens were cut into resin-cement-dentin strips with a cross sectional area of 1 mm×1 mm and the µTBS was measured. RESULTS: Regarding one-step universal adhesive (SBU) light cured, the µTBS with RLX [(35.45±7.04) MPa] or NX3 [(26.84±10.39) MPa] were higher than SBU non-light cured with RLX [(17.93±8.93) MPa)] or NX3 [(10.07±5.89) MPa, P<0.001]. Compared with AIO, light-cured SBU combined with RLX presented higher µTBS than AIO group [(35.45±7.04) MPa vs. (24.86±8.42) MPa, P<0.05]. When SBU was not lighted, the µTBS was lower than AIO [(17.93±8.93) MPa vs. (22.28±7.57) MPa, P<0.05]. For two-step universal adhesive (VSA) and control adhesive (SEB), curing mode did not affect the µTBS when used with either RLX or NX3 (25.98-32.24 MPa, P>0.05). CONCLUSION: Curing mode of one-step universal adhesive may affect the µTBS between dual-cure resin cements and dentin, while for two-step universal adhesive, the curing mode and the type of resin cements did not influence the µTBS.

Evaluation of the In Vitro Effects of Cervical Marginal Relocation Using Composite Resins on the Marginal Quality of CAD/CAM Crowns.

PURPOSE: To evaluate the effect of cervical margin relocation (CMR) for crowns designed using CAD/CAM technology, and made of pre-cured resin or lithium disilicate, before and after thermomechanical loading. The test hypothesis was that the marginal quality of the crowns would not be influenced by the CMR with composite resins before or after thermomechanical loading. MATERIALS AND METHODS: Standard crown preparations were created in 40 human molars. The margins were located in enamel, except for the mesial proximal box, where the cervical margin was 2.0 mm below the cementoenamel junction, with 4.0 mm in the buccolingual and 2.0 mm in the mesiodistal dimension. For the CMR technique, a 2-mm layer of conventional or flowable composite resin was applied to the mesial box. Using the Cerec CAD/CAM system, 40 standard crowns were prepared, and restorations were luted using a dual-curing adhesive cement. SEM analysis was performed using epoxy resin replicas before and after loading to assess the marginal quality of interfaces of the mesial proximal box with CMR/crown and the distal face of the tooth without CMR. Statistical differences between groups were analyzed using the Kruskal-Wallis test and Bonferroni's post-hoc test. RESULTS: The null hypothesis was accepted, since no statistically significant differences were found in marginal quality before and after thermomechanical cycling (p > 0.05). CONCLUSION: The implementation of CMR before and after thermomechanical cycling had no effect on the quality of cervical margins. To establish whether CMR is a suitable procedure for the adhesive luting of composite resin crowns in deep proximal boxes, additional studies are required.

Accelerated Fatigue Resistance of Thick CAD/CAM Composite Resin Overlays Bonded with Light- and Dual-polymerizing Luting Resins.

PURPOSE: To evaluate the accelerated fatigue resistance of thick CAD/CAM composite resin overlays luted with three different bonding methods. MATERIALS AND METHODS: Forty-five sound human second mandibular molars were organized and distributed into three experimental groups. All teeth were restored with a 5-mm-thick CAD/CAM composite resin overlay. Group A: immediate dentin sealing (IDS) with Optibond FL and luted with light-polymerizing composite (Herculite XRV). Group B: IDS with Optibond FL and luted with dual-polymerizing composite (Nexus 3). Group C: direct luting with Optibond FL and dual-polymerizing composite (Nexus 3). Masticatory forces at a frequency of 5 Hz were simulated using closed-loop servo-hydraulics and forces starting with a load of 200 N for 5000 cycles, followed by steps of 400, 600, 800, 1000, 1200 and 1400 N for a maximum of 30,000 cycles. Each step was applied through a flat steel cylinder at a 45-degree angle under submerged conditions. RESULTS: The fatigue test generated one failure in group A, three failures in group B, and no failures in group C. The survival table analysis for the fatigue test did not demonstrate any significant difference between the groups (p = 0.154). The specimens that survived the fatigue test were set up for the load-to-failure test with a limit of 4600 N. The survival table analysis for the load-to-failure test demonstrates an average failure load of 3495.20 N with survival of four specimens in group A, an average failure load of 4103.60 N with survival of six specimens in group B, and an average failure load of 4075.33 N with survival of nine specimens in group C. Pairwise comparisons revealed no significant differences (p < 0.016 after Bonferroni correction). CONCLUSION: Within the limitations of this in vitro study, it can be concluded that although the dual-polymerizing luting material seems to provide better results under extreme conditions, light-polymerizing luting composites in combination with IDS are not contraindicated with thick restorations.

Influence of different surface treatments on push-out bond strengths of fiber-reinforced posts luted with dual-cure resin cement.

OBJECTIVES: The objective was to evaluate whether fiber postsurface conditioning with air abrasion or erbium:yttrium-aluminum-garnet (Er:YAG) laser would influence the bond strength of dual-cure resin cement to the fiber-reinforced (FRC) posts. MATERIALS AND METHODS: Twenty-one FRC posts were divided into three groups according to surface treatment methods as follows: An untreated control group air abrasion with Al2O3group, and Er:YAG laser treated group with 150 mJ parameter. Fiber posts were then built up to dual-cure resin cement. Eighteen specimens were set and sectioned perpendicularly along the long axis of the post using a saw. Two disks (thickness of 2 mm) were obtained from each specimen (n = 12). Remaining three posts were stored for scanning electron microscopic evaluation. Push out test was performed on the each specimen and the values were recorded as MPa. The data were analyzed using one-way analysis of variance and Tukey post-hoc tests (P < 0.05). RESULTS: The bond strength values for the groups were as follows: Control (15, 28 MPa), air abrasion group (19, 73 MPa), and Er:YAG group (17, 84 MPa). Air abrasion affected the bond strength significantly (P < 0.05). CONCLUSION: Air abrasion attained higher bond strengths when FRC posts were luted to dual-cure resin cement. Additional studies should be designed with different types and parameters of laser devices to understand the effect of these devices on bond strength.

Effects of barriers on chemical and biological properties of two dual resin cements.

The aim of this study was to investigate the degree of conversion, monomer release, and cytotoxicity of two dual-cure resin cements (Cement-One and SmartCem2), light-cured across two indirect restorative materials in an attempt to simulate in vitro the clinical conditions. The results obtained show that the degree of conversion was influenced by both barriers, but the effect of the composite material was greater than that of the ceramic one. The amount of monomers released from the polymerized materials in the absence of barriers was significantly lower than that released in the presence of either the ceramic or the composite barrier. However, a higher amount of monomers was released in the presence of the ceramic barrier. All materials, in all the experimental conditions employed, induced slight cytotoxicity (5-10%) on human pulp cells. Our examinations showed that the two resin cements had similar chemical and biological properties. The decreased degree of conversion of the dual-curing self-adhesive composite showed that the light-curing component of these materials has an important role in the polymerization process. In clinical practice, it is therefore important to pay attention to the thickness of the material used for the reconstruction.

Influence of 3-month Simulated Pulpal Pressure on the Microtensile Bond Strength of Simplified Resin Luting Systems.

PURPOSE: To assess the influence of simulated pulpal pressure (SPP) on the microtensile bond strength (µTBS) of four simplified luting strategies to indirect composite restorations. MATERIALS AND METHODS: Dentin disks from 40 human molars were prepared and treated with 4 different techniques: (1) SB+ARC: two-step etch-and-rinse adhesive + conventional dual-curing resin cement (Adper Single Bond 2 + RelyX ARC, 3M ESPE); (2) ED+PAN: self-etching primer + conventional dual-curing resin cement (ED Primer + Panavia F2.0, Kuraray Medical); (3) S3+PAN: one-step self-etching adhesive (Clearfil S3, Kuraray) + Panavia F2.0; (4) U200: self-adhesive resin cement (RelyX U200, 3M ESPE). Pre-made indirect composite restorations (Filtek Z100, 3M ESPE) were luted onto the specimens. The luted specimens were cut into resin-dentin beams and the µTBS was tested after two different aging regimes: water storage at 37°C for one week (control) or three months under 20 cm H2O simulated pulpal pressure (SPP). The µTBS data was analyzed with two-way ANOVA and Tukey's test (p < 0.05). RESULTS: SB+ARC showed significantly higher µTBS after both aging regimes (p < 0.001). The statistically significantly lowest µTBS was measured for control S3+PAN and U200 after 3 months SPP (p < 0.001). S3+PAN was the only group not negatively affected by SPP (p = 0.699). CONCLUSIONS: Two-step etch-and-rinse adhesives associated with dual-curing conventional resin cements may achieve the highest µTBS, even after 3 months of SPP. The one-step self-etching adhesive along with the dualcuring conventional resin cement was able to maintain bond stability.

Effects of dentin surface treatments including Er,Cr:YSGG laser irradiation with different intensities on the push-out bond strength of the glass fiber posts to root dentin.

OBJECTIVE: Intra-canal post systems are commonly used to restore root-filled teeth. Bond strengths of the posts can be affected by various surface treatments of the post or the dentin. The aim of this study was to evaluate the effects of dentin surface treatments including erbium-chromium; yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation with different intensities on the push-out bond strength of the glass fiber posts to root dentin. MATERIALS AND METHODS: Forty single-rooted human maxillary incisors were filled and post spaces were prepared. After these procedures, the specimens were divided randomly into four groups according to the dentin surface treatments, as follows: (i) untreated surface (control), (ii) 1W Er,Cr:YSGG laser application, (iii) 2W Er,Cr:YSGG laser application and (iv) 3W Er,Cr:YSGG laser application. Then the posts were cemented into the root canals using dual-cured resin cement. Bonded specimens were cut into 1-mm-thick slices and push-out tests were performed using a universal testing device. All specimens were loaded until fracture and the failure modes were evaluated with a stereomicroscope at 32× magnification. Representative specimens were analyzed by scanning electron microscopy. Data were analyzed using a one-way ANOVA, Tukey and Wilcoxon tests. RESULTS: The bond strength values ranged from 3.22-4.68 MPa. There were no statistically significant differences among the groups, regardless of the different levels. The coronal and middle levels of the post space had significantly higher bond strength values compared with the apical level (p < 0.05). CONCLUSION: Er,Cr:YSGG laser irradiation with different intensities did not increase the bond strength of the fiber posts to the root canal dentin walls.

Degree of conversion of dual-polymerizing cements light polymerized through monolithic zirconia of different thicknesses and types.

STATEMENT OF PROBLEM: Monolithic zirconia restorations are increasingly common. Dual-polymerizing cements have been advocated for cementation. The opacious nature of zirconia restoration can attenuate light, compromising optimal resin polymerization and eventually restoration debonding. PURPOSE: The purpose of this in vitro study was to evaluate the influence of material thickness on light irradiance, radiant exposure, and the degree of monomer conversion (DC) of 2 dual-polymerizing resin cements light-polymerized through different brands of monolithic zirconia. MATERIAL AND METHODS: Dual-polymerizing resin cements (RelyX Ultimate; 3M-ESPE, and Variolink II; Ivoclar, Vivadent) were mixed according to the manufacturers' instructions with a film thickness of 40 µm, placed under a 10 × 10 mm specimen of monolithic zirconia (Prettau Anterior by Zirkonzahn, Katana by Noritake, BruxZir by Glidewell, and Zenostar by Wieland) and a zirconia core control (ICE zirkon by Zirkonzahn) at various thicknesses (0.50, 1.00, 1.50, and 2.00 mm, n = 5 of each thickness). Each specimen was irradiated for 20 seconds (RelyX Ultimate) and 40 seconds (Variolink II) with Elipar S10 (3M-ESPE, 1200 mW/cm(2)). The amount of irradiance and radiant exposure was quantified for each specimen. Fourier transform infrared spectroscopy was used to measure the DC from the bottom surface of the resin. Statistical analysis was performed with 2-way ANOVA and post hoc Tukey honest significant difference (HSD) tests (α = .05). RESULTS: Light irradiance and radiant exposure decreased as the thickness of the specimen increased (P < .05) regardless of the brand. The ranking from least to highest was BruxZir < ICE zircon = Wieland < Katana = Prettau Anterior. The zirconia brand, thickness, and cement type had a significant effect on the DC (P < .001). The DC decreased significantly as the thickness of the zirconia increased (P < .001). Katana and Prettau Anterior showed the highest DC and BruxZir showed the lowest. CONCLUSION: The thickness of zirconia affects the DC of resin-based cements. The DC of the resin cements differed significantly between cements and among zirconia brands. More polymerizing time may be needed to deliver sufficient energy through some brands of zirconia.

The effect of photopolymerization on the degree of conversion, polymerization kinetic, biaxial flexure strength, and modulus of self-adhesive resin cements.

STATEMENT OF PROBLEM: Understanding the effect of the degree of conversion on the mechanical properties of auto- and dual-polymerizing self-adhesive resin cements leads to a better estimation of their performance in different clinical scenarios. PURPOSE: The purpose of this study was to evaluate the effect of photopolymerization on the degree of conversion (DC) and polymerization kinetic of 4 dual-polymerized resin cements, 20 minutes after mixing, and its effects on the mechanical properties (biaxial flexural strength [FS] and modulus [FM]) after short-term aging. MATERIAL AND METHODS: Conventional (RelyX ARC and Clearfil Esthetic Cement) and self-adhesive resin cements (RelyX Unicem and Clearfil SA Cement) were applied to a Fourier infrared spectrometer to assess the DC (n=5) under the following 3 polymerization conditions: direct light exposure (dual-polymerizing mode), exposure through the prepolymerized disk, or autopolymerizing. The polymerization kinetic was recorded for 20 minutes. Then, disk-shaped specimens (n=11) were prepared to evaluate the effect of polymerization on the FS and FM in both extreme polymerization conditions (dual-polymerizing or autopolymerizing). Data were statistically analyzed by 2-way repeated measure ANOVA (DC) and by 2-way ANOVA (FS and FM), followed by the Tukey-Kramer post hoc test (α=.05). RESULTS: Autopolymerizing groups exhibited reduced DC means, whereas intermediate values were observed when resin cements were polymerized through the disk. All groups exhibited higher DC at the end of 20 minutes. The polymerization kinetic revealed a rising curve, and materials, when directly photopolymerized, reached a plateau immediately after light exposure. Regarding the flexural biaxial testing, most of the resin cements were affected by polymerization mode and differences among groups were product dependent. CONCLUSIONS: The resin cements achieved immediate higher DC and mechanical properties when photopolymerized. The total absence of photoactivation may still impair their mechanical properties even after short-term aging.

Bisphenol A release from orthodontic adhesives and its correlation with the degree of conversion.

INTRODUCTION: Our objective was to quantitatively assess and compare the bisphenol A (BPA) released from an orthodontic adhesive using a light-emitting diode device (LED) or a halogen light-curing unit (HLC) at 3 tip-to-bracket distances (0, 5, and 10 mm) and varying curing times using high-performance liquid chromatography. BPA release with self-etching and moisture-insensitive primers with light-cured and chemically cured composites was also evaluated. BPA release was correlated to the corresponding degree of conversion. METHODS: Our sample consisted of 598 stainless steel first premolar brackets. Of these, 520 were used for assessing BPA release and divided into 13 groups of 40 each. In groups I, II, and III, the composite was cured with the LED for 20 seconds at distances of 0, 5, and 10 mm, respectively. Groups IV, V, and VI were cured with the HLC for 40 seconds at the same 3 distances. Groups VII and VIII were cured for 5 and 10 seconds with the LED, and groups IX and X were cured for 10 and 20 seconds with the HLC at 0-mm distance. Groups XI, XII, and XIII consisted of brackets bonded with a self-etching primer and Transbond (3M Unitek, Monrovia, Calif), with a moisture-insensitive primer and Transbond, and with a chemically cured composite. The remaining 78 brackets were also divided into 13 groups and used for assessing the degree of conversion. RESULTS: The LED devices demonstrated significantly less BPA release and greater degrees of conversion (P <0.05). For both units, BPA release increased and the degree of conversion decreased as the tip distance increased and curing time decreased. The chemically cured group showed significantly less BPA release (P <0.05). Among the light-cured composites, those cured according to the manufacturers' recommendations (40 seconds and 0-mm distance for the HLC unit) released less BPA than did the self-etching primer and the moisture-insensitive primer. The degree of conversion was greatest for the chemically cured composite, whereas it was similar for the conventional, self-etching primer, and moisture-insensitive primer groups. However, correlations ranged from strongly negative to weakly positive between BPA release and degree of conversion. CONCLUSIONS: Clinicians should consider using LEDs in clinical practice and should keep the light-cure tip as close to the bracket as clinically possible. Curing time should be according to the manufacturer's recommendations. These steps will ensure less BPA release and a greater degree of conversion. Since chemically cured composites had less BPA release and a greater degree of conversion, they can be considered superior to light-cured composites in this aspect.

Bond strengths of a self-etching adhesive to dentin surfaces treated with saliva, blood, and different hemostatic agents.

The aim of this study was to evaluate the microtensile bond strengths of a self-etching adhesive to dentin surfaces after treatment with 4 different hemostatic agents in the presence of saliva and blood. After testing, no significant differences were found between the mean bond strength of Clearfil SE (CSE) Bond resin adhesive to normal dentin and those of CSE to dentin treated with the hemostatic agents ViscoStat Clear, Astringedent, or Astringedent X (P > 0.05). However, the mean bond strength of CSE Bond to dentin treated with Ankaferd Blood Stopper (ABS) was significantly greater than those of the other groups (P < 0.05). Thus, while 3 of the tested hemostatic agents did not have significant effects on the bond strength of composite resin to dentin, ABS increased the bond strength of CSE Bond to dentin.

Effect of Different Thicknesses of Pressable Ceramic Veneers on Polymerization of Light-cured and Dual-cured Resin Cements.

AIM: This study evaluated the effects of ceramic veneer thicknesses on the polymerization of two different resin cements. MATERIALS AND METHODS: A total of 80 ceramic veneer disks were fabricated by using a pressable ceramic material (e.max Press; Ivoclar Vivadent) from a Low Translucency (LT) ingot (A1 shade). These disks were divided into light-cured (LC; NX3 Nexus LC; Kerr) and dual-cured (DC; NX3 Nexus DC; Kerr) and each group was further divided into four subgroups, based on ceramic disk thickness (0.3, 0.6, 0.9, and 1.2 mm). The values of Vickers microhardness (MH) and degree of conversion (DOC) were obtained for each specimen after a 24-hour storage period. Association between ceramic thickness, resin cement type, and light intensity readings (mW/cm(2)) with respect to microhardness and degree of conversion was statistically evaluated by using analysis of variance (ANOVA). RESULTS: For the DOC values, there was no significant difference observed among the LC resin cement subgroups, except in the 1.2 mm subgroup; only the DOC value (14.0 ± 7.4%) of 1.2 mm DC resin cement had significantly difference from that value (28.9 ± 7.5%) of 1.2 mm LC resin cement (p < 0.05). For the MH values between LC and DC resin cement groups, there was statistically significant difference (p < 0.05); overall, the MH values of LC resin cement groups demonstrated higher values than DC resin cement groups. On the other hands, among the DC resin cement subgroups, the MH values of 1.2 mm DC subgroup was significantly lower than the 0.3 mm and 0.6 mm subgroups (p < 0.05). However, among the LC subgroups, there was no statistically significant difference among them (p > 0.05). CONCLUSION: The degree of conversion and hardness of the resin cement was unaffected with veneering thicknesses between 0.3 and 0.9 mm. However, the DC resin cement group resulted in a significantly lower DOC and MH values for the 1.2 mm subgroup. CLINICAL SIGNIFICANCE: While clinically adequate polymerization of LC resin cement can be achieved with a maximum 1.2 mm of porcelain veneer restoration, the increase of curing time or light intensity is clinically needed for DC resin cements at the thickness of more than 0.9 mm.

Effect of modulated photo-activation on polymerization shrinkage behavior of dental restorative resin composites.

This study investigated the influence of modulated photo-activation on axial polymerization shrinkage, shrinkage force, and hardening of light- and dual-curing resin-based composites. Three light-curing resin composites (SDR bulk-fill, Esthet X flow, and Esthet X HD) and one dual-curing material (Rebilda DC) were subjected to different irradiation protocols with identical energy density (27 J cm(-2) ): high-intensity continuous light (HIC), low-intensity continuous light (LIC), soft-start (SS), and pulse-delay curing (PD). Axial shrinkage and shrinkage force of 1.5-mm-thick specimens were recorded in real time for 15 min using custom-made devices. Knoop hardness was determined at the end of the observation period. Statistical analysis revealed no significant differences among the curing protocols for both Knoop hardness and axial shrinkage, irrespective of the composite material. Pulse-delay curing generated the significantly lowest shrinkage forces within the three light-curing materials SDR bulk-fill, Esthet X flow, and Esthet X HD. High-intensity continuous light created the significantly highest shrinkage forces within Esthet X HD and Rebilda DC, and caused significantly higher forces than LIC within Esthet X flow. In conclusion, both the composite material and the applied curing protocol control shrinkage force formation. Pulse-delay curing decreases shrinkage forces compared with high-intensity continuous irradiation without affecting hardening and axial polymerization shrinkage.

Self-adhesive resin cements: adhesive performance to indirect restorative ceramics.

PURPOSE: To evaluate the bonding performance of self-adhesive resin cements to zirconia and lithium disilicate in self- and dual-curing modes before and after thermocycling. MATERIALS AND METHODS: Rectangular bars (3 mm high, 3 mm wide, 9 mm long) were manufactured from zirconia (Vita In-Ceram YZ for inLab, VITA) and lithium disilicate blocks (IPS e.max Press, Ivoclar Vivadent) (n=240 per material). Zirconia bars were sandblasted (35 µm Al2O3, 1.5 bar pressure). Lithium disilicate bars were HF etched (20 s, IPS Ceramic Etching Gel, Ivoclar Vivadent) and silanized with ESPE Sil (3M ESPE). Forty bars of zirconia were luted in twos perpendicular to each other as were 40 bars of lithium disilicate using RelyX Unicem Automix 2 (3M ESPE), G-Cem LinkAce (GC Europe) or Maxcem Elite (Kerr) in self- or dual-curing mode. Half of the specimens from each material were submitted to tensile bond strength (TBS) testing after 24-h storage in distilled water at 37°C, and half underwent TBS testing after thermocycling (5000 cycles, 5°C/55°C, 30-s dwell time). Bond strength values for each bonding substrate were analyzed using one-way ANOVA (Student-Newman- Keuls, α=0.05). RESULTS: On zirconia, dual-curing resulted in significantly (p<0.05) higher tensile bond strengths compared to self-curing, with the exception of RelyX Unicem 2 after thermocycling. Thermocycling significantly (p<0.05) reduced the tensile bond strength of Maxcem Elite to zirconia in both curing modes. The TBS of self-adhesive cements to lithium disilicate showed no significant (p>0.05) difference between the different curing modes and after thermocycling. CONCLUSION: For most of the investigated self-adhesive cements, bond strengths to zirconia were increased by dual curing; this was not true for lithium disilicate. For luting on zirconia with self-adhesive cements, dual curing is strongly recommended in clinical situations.

Microhardness of dual-polymerizing resin cements and foundation composite resins for luting fiber-reinforced posts.

STATEMENT OF PROBLEM: The optimal luting material for fiber-reinforced posts to ensure the longevity of foundation restorations remains undetermined. PURPOSE: The purpose of this study was to evaluate the suitability of 3 dual-polymerizing resin cements and 2 dual-polymerizing foundation composite resins for luting fiber-reinforced posts by assessing their Knoop hardness number. MATERIAL AND METHODS: Five specimens of dual-polymerizing resin cements (SA Cement Automix, G-Cem LincAce, and Panavia F2.0) and 5 specimens of dual-polymerizing foundation composite resins (Clearfil DC Core Plus and Unifil Core EM) were polymerized from the top by irradiation for 40 seconds. Knoop hardness numbers were measured at depths of 0.5, 2.0, 4.0, 6.0, 8.0, and 10.0 mm at 0.5 hours and 7 days after irradiation. Data were statistically analyzed by repeated measures ANOVA, 1-way ANOVA, and the Tukey compromise post hoc test (α=.05). RESULTS: At both times after irradiation, the 5 resins materials showed the highest Knoop hardness numbers at the 0.5-mm depth. At 7 days after irradiation, the Knoop hardness numbers of the resin materials did not differ significantly between the 8.0-mm and 10.0-mm depths (P>.05). For all materials, the Knoop hardness numbers at 7 days after irradiation were significantly higher than those at 0.5 hours after irradiation at all depths (P<.05). At 7 days after irradiation, the Knoop hardness numbers of the 5 resin materials were found to decrease in the following order: DC Core Plus, Unifil Core EM, Panavia F2.0, SA Cement Automix, and G-Cem LincAce (P<.05). CONCLUSIONS: The Knoop hardness number depends on the depth of the cavity, the length of time after irradiation, and the material brand. Although the Knoop hardness numbers of the 2 dual-polymerizing foundation composite resins were higher than those of the 3 dual-polymerizing resin cements, notable differences were seen among the 5 materials at all depths and at both times after irradiation.

Effect of post translucency on bond strength of different resin luting agents to root dentin.

STATEMENT OF PROBLEM: Translucent fiber posts were developed to conduct light into the root canal more effectively, thereby contributing to the polymerization of dual-polymerized resin luting agents. However, there is no consensus in the literature regarding their effectiveness. PURPOSE: The purpose of this study was to evaluate the tensile bond strength of fiber posts with different degrees of translucency to bovine dentin with 3 types of resin luting agents. MATERIAL AND METHODS: Ninety bovine roots were endodontically treated and divided into 9 groups (n=10) according to the type of post (translucent, white, and black) and resin luting agent (dual-polymerized self-adhesive; dual-polymerized + etch-and-rinse adhesive system; and autopolymerized + etch-and-rinse adhesive system). Tensile tests were performed on a universal testing machine (0.5 mm/min). To determine tensile stress, the bond area of each specimen was calculated. Data were statistically analyzed with ANOVA, Kruskal-Wallis, and Mann-Whitney tests (α=.05). RESULTS: Mean (standard deviation) tensile bond strength values (5.53 ± 2.29 MPa) were significantly lower for translucent posts than for white (9.51 ± 1.31 MPa) and black posts (10.12 ± 3.44 MPa) with a dual-polymerized luting agent in combination with an adhesive system (P=.012). For white (6.02 ± 1.88 MPa) and black posts (4.14 ± 0.6 MPa), the self-adhesive luting agent led to lower tensile bond strength than the dual-polymerized luting agent in combination with an adhesive system (P=.003). Irrespective of post type, the autopolymerized luting agent provided the lowest tensile bond strength (P<.001). Microscopic analysis revealed that resin luting agents adhered more to the post surface than to the root dentin. CONCLUSION: Post translucency did not increase the tensile bond strength of dual-polymerized resin luting agents.

Hardness gradients of dual-polymerized flowable composite resins in simulated root canals.

STATEMENT OF PROBLEM: Information is lacking of the polymerization depth of dual-polymerized flowable composite resin foundation materials in simulated root canals. PURPOSE: The purpose of this study was to investigate the hardness gradients and the polymerization depth of dual-polymerized flowable composite resin foundation materials in simulated root canals. MATERIAL AND METHODS: Slots in steel split cylinders with 1 open end were filled with the following 6 materials: Luxa Core, Para Core, Clearfil DC Core, Multi Core Flow, Gradia Core, and Core-Flo DC. After filling, they were subjected to a light intensity of 1250 mWcm(-2) with a light-emitting diode light through their open ends for 20 seconds. The resulting specimens were stored in a light-proof box at 37°C, and the Knoop hardness gradients of each polymerized material were measured after 0.5 hour, 24 hours, and 120 hours. The surface readings were obtained in 1-mm intervals at 1 mm to 10 mm away from the open ends. The collected data were analyzed by 2-way ANOVA and the Student-Newman-Keuls test (α=.05). RESULTS: Before the Knoop hardness numbers of the 6 materials became stable, they decreased gradually in depth at each time point (P<.001). However, the depths at which they became stable differed. The Knoop hardness numbers of Luxa Core and Core-Flo DC reached stability at a depth of 3 mm, Para Core at 4 mm, and Clearfil DC Core, Multi Core Flow, and Gradia Core at 5 mm. Additionally, at 120 hours after exposure, the ratios of the Knoop hardness numbers at a depth of 5 mm to those at 1 mm were 63.08% for Luxa Core, 70.48% for Clearfil DC Core, 81.38% for Para Core, 80.49% for Gradia Core, 86.30% for Multi Core Flow, and 96.28% for Core-Flo DC. CONCLUSIONS: In simulated root canals, the flowable composite resin foundation materials tested had better polymerization under dual polymerizing than under chemical polymerizing, and their chemical-polymerized capabilities could determine the definitive polymerization depth.

Microhardness of light- and dual-polymerizable luting resins polymerized through 7.5-mm-thick endocrowns.

STATEMENT OF THE PROBLEM: The complete polymerization of luting resins through thick indirect restorations is still questioned. PURPOSE: The purpose of this study was to evaluate the degree of polymerization of light- and dual-polymerizable luting resins under thick indirect composite resin and ceramic endocrowns by means of Vickers microhardness measurements. MATERIAL AND METHODS: The Vickers microhardness measurements of a light-polymerizable microhybrid composite resin and a dual-polymerizable luting cement directly polymerized in a natural tooth mold for 40 seconds with a high-power light-emitting diode lamp (control) were compared with measurements after indirect irradiation through 7.5-mm-thick composite resin and ceramic endocrowns for 3 × 90 seconds. A test-to-control microhardness values ratio of 0.80 at a depth of 0.5 mm below the surface was assumed as the criterion for adequate conversion. RESULTS: For the Vickers microhardness measurements of a dual-polymerizable luting cement, no differences (P>.05) were found between Vickers microhardness control values and values reported after polymerization through composite resin and ceramic endocrowns. For The Vickers microhardness measurements (±SD) of a light-polymerizable microhybrid composite resin, control values were significantly (P<.05) higher (111 ±3.3) than those reported after polymerization through composite resin (100.5 ±3.8) and ceramic (99.7 ±2.3) endocrowns. However, the hardness values of The Vickers microhardness measurements of a light-polymerizable microhybrid composite resin polymerized through the endocrowns were approximately 10% to 12% lower than those of the control values. Two-way ANOVA showed the influence of the luting material on the Vickers microhardness values (P<.05). The effect of endocrown material was not significant (P>.05). CONCLUSIONS: Under the conditions of this in vitro study, Vickers microhardness values of the dual-polymerizable resin cement and the light-polymerizable restorative composite resin irradiated for 3 × 90 seconds with a high irradiance light-emitting diode lamp through 7.5-mm-thick endocrowns reached at least 80% of the control Vickers microhardness values, which means that both materials can be adequately polymerized when they are used for luting thick indirect restorations.

Effect of ultraviolet aging on translucency of resin-cemented ceramic veneers: an in vitro study.

PURPOSE: The aim of this in vitro study was to evaluate the translucency of ceramic veneers cemented with light- or dual-cured resin cements after accelerated aging. MATERIALS AND METHODS: A total of 392 specimens were made of shade A1 with 0.5- and 1.0-mm thickness. Light-cured RelyX Veneer and dual-cured Maxcem Elite and Variolink II resin cements were applied on the porcelain discs with a thickness of 0.1 mm. Translucency parameter (TP) values of the ceramic veneers after cementation and UV aging test were evaluated. Statistical analyses were done with ANOVA and Tukey's tests and paired sample t-test (p < 0.05). RESULTS: All the resin cements affected the TP values of 0.5-mm-thick ceramic, while RelyX Veneer Tr (TP = 11.15; p = 0.608), Variolink II Tr (TP = 10.98; p = 0.55), and Maxcem Clear (TP = 11.81; p = 0.702) did not affect the translucency of 1-mm-thick ceramics (TP = 11.38). The aging process affected TP values of both ceramics and cemented ceramics, as the TP values decreased after aging. Among the TP values of opaque shade resin cements, there were significant differences between the "ceramic," "ceramic + RelyX Veneer WO," "ceramic + Variolink II WO," and "ceramic + Maxcem WO" variables for both 0.5 and 1 mm thicknesses (p < 0.05). There were no significant differences between "ceramic," "ceramic + RelyX Veneer Tr," "ceramic + Variolink II Tr," and "ceramic + Maxcem Clear" variables at 0.5 mm thickness, and there were no significant differences between "ceramic," "ceramic + RelyX Veneer Tr," and "ceramic + Variolink II Tr" variables after aging (p > 0.05). CONCLUSIONS: The TP of the same color of resin cements varied related to the type or brand. Aging caused both the ceramics and cemented ceramics to become more opaque.