Particle abrasion as a pre-bonding dentin surface treatment: A scoping review.

OBJECTIVE: This scoping review aims to assess the influence of air abrasion with aluminum oxide and bioactive glass on dentin bond strength. MATERIALS AND METHODS: An electronic search was conducted in three databases (PubMed, Cochrane Library, and Embase), on March 3rd, 2023, with previously identified MeSH Terms. A total of 1023 records were screened. Exclusion criteria include primary teeth, air abrasion of a substrate other than sound dentin, use of particles apart from aluminum oxide or bioactive glass, and studies in which bond strength was not assessed. RESULTS: Out of the 1023 records, title and abstract screening resulted in the exclusion of 895 and 67 studies, respectively, while full-text analysis excluded another 25 articles. In addition, 5 records were not included, as full texts could not be obtained after requesting the authors. Two cross-references were added. Thus, 33 studies were included in this review. It is important to emphasize the absence of standardization of air abrasion parameters. According to 63.6% of the studies, air abrasion does not influence dentin bond strength. Moreover, 30.3% suggest improving bonding performance, and 6.1% advocate a decrease. CONCLUSIONS: Air abrasion with aluminum oxide does not enhance or impair dentin bond strength. The available data on bioactive glass are limited, which hinders conclusive insights. CLINICAL SIGNIFICANCE: Dentin air abrasion is a widely applied technique nowadays, with numerous clinical applications. Despite the widespread adoption of this procedure, its potential impact on bonding performance requires a thorough analysis of the existing literature.

Impact of sandblasting on the flexural strength of highly translucent zirconia.

The objective of this study was to assess the influence of alumina sandblasting on the flexural strength of the latest generation of highly translucent yttria partially stabilized dental zirconia (Y-PSZ). Fully-sintered zirconia disk-shaped specimens (14.5-mm diameter; 1.2-mm thickness) of four Y-PSZ zirconia grades (KATANA HT, KATANA STML, KATANA UTML, all Kuraray Noritake; and Zpex Smile, Tosoh) were sandblasted at 0.2 MPa with 50-µm alumina (Al2O3) sand (Kulzer) or left as-sintered (control). For each zirconia grade, the yttria (Y2O3) content was determined using X-ray fluorescence (XRF). Surface roughness was assessed using 3D confocal laser microscopy. Micro-Raman spectroscopy (µ-Raman) and X-ray diffraction (XRD) were used to assess potentially induced residual stresses. Biaxial flexural strength (n = 20) was statistically compared by Weibull analysis. Focused ion beam - scanning electron microscopy (FIB/SEM) was used to observe the subsurface microstructure. Fracture surfaces after biaxial flexural strength testing were observed by SEM. KATANA UTML had the highest Y2O3 content (6 mol%), followed by KATANA STML and Zpex Smile (5 mol%), and KATANA HT (4 mol%). Al2O3-sandblasting significantly increased surface roughness of KATANA UTML and Zpex Smile. µRaman and XRD revealed the presence of residual compressive stress on all Al2O3-sandblasted surfaces. FIB/SEM revealed several sub-surface microcracks in the sandblasted specimens. Weibull analysis revealed that Al2O3-sandblasting increased the characteristic strength of KATANA HT, KATANA STML, whereas it decreased the strength of KATANA UTML. The strength enhancement after Al2O3-sandblasting of KATANA HT was the highest, followed by KATANA STML. For Zpex Smile, the influence was statistically insignificant. The impact of Al2O3-sandblasting on the Weibull modulus was controversial. The strength of zirconia after Al2O3-sandblasting is determined by the balance between microcrack formation (decreased strength) and surface compressive stress build-up (increased strength).

Crystallographic and morphological analysis of sandblasted highly translucent dental zirconia.

OBJECTIVE: To assess the influence of alumina sandblasting on four highly translucent dental zirconia grades. METHODS: Fully sintered zirconia disk-shaped specimens (15-mm diameter; 0.5-mm thickness) of four highly translucent yttria partially stabilized zirconia (Y-PSZ) grades (KATANA HT, KATANA STML, KATANA UTML, Kuraray Noritake; Zpex Smile, Tosoh) were sandblasted with 50-µm alumina (Al2O3) sand (Kulzer) or left 'as-sintered' (control) (n=5). For each zirconia grade, the translucency was measured using a colorimeter. Surface roughness was assessed using 3D confocal laser microscopy, upon which the zirconia grades were statistically compared for surface roughness using a Kruskal-Wallis test (n=10). X-ray diffraction (XRD) with Rietveld analysis was used to assess the zirconia-phase composition. Micro-Raman spectroscopy was used to assess the potentially induced residual stress. RESULTS: The translucency of KATANA UTML was the highest (36.7±1.8), whereas that of KATANA HT was the lowest (29.5±0.9). The 'Al2O3-sandblasted' and 'as-sintered' zirconia revealed comparable surface-roughness Sa values. Regarding zirconia-phase composition, XRD with Rietveld analysis revealed that the 'as-sintered' KATANA UTML contained the highest amount of cubic zirconia (c-ZrO2) phase (71wt%), while KATANA HT had the lowest amount of c-ZrO2 phase (41wt%). KATANA STML and Zpex Smile had a comparable zirconia-phase composition (60wt% c-ZrO2 phase). After Al2O3-sandblasting, a significant amount (over 25wt%) of rhombohedral zirconia (r-ZrO2) phase was detected for all highly translucent zirconia grades. SIGNIFICANCE: Al2O3-sandblasting did not affect the surface roughness of the three highly translucent Y-PSZ zirconia grades, but it changed its phase composition.

Bonding Effectiveness of Luting Composites to Different CAD/CAM Materials.

PURPOSE: To evaluate the influence of different surface treatments of six novel CAD/CAM materials on the bonding effectiveness of two luting composites. MATERIALS AND METHODS: Six different CAD/CAM materials were tested: four ceramics - Vita Mark II; IPS Empress CAD and IPS e.max CAD; Celtra Duo - one hybrid ceramic, Vita Enamic, and one composite CAD/CAM block, Lava Ultimate. A total of 60 blocks (10 per material) received various mechanical surface treatments: 1. 600-grit SiC paper; 2. sandblasting with 30-µm Al2O3; 3. tribochemical silica coating (CoJet). Subsequent chemical surface treatments involved either no further treatment (control), HF acid etching (HF), silanization (S, or HF acid etching followed by silanization (HF+S). Two specimens with the same surface treatment were bonded together using two dual-curing luting composites: Clearfil Esthetic Cement (self-etching) or Panavia SA Cement (self-adhesive). After 1 week of water storage, the microtensile bond strength of the sectioned microspecimens was measured and the failure mode was evaluated. RESULTS: The bonding performance of the six CAD/CAM materials was significantly influenced by surface treatment (linear mixed models, p < 0.05). The luting cement had a significant influence on bond strength for Celtra Duo and Lava Ultimate (linear mixed models, p < 0.05). Mechanical surface treatment significantly influenced the bond strength for Celtra Duo (p = 0.0117), IPS e.max CAD (p = 0.0115), and Lava Ultimate (p < 0.0001). Different chemical surface treatments resulted in the highest bond strengths for the six CAD/CAM materials: Vita Mark II and IPS Empress CAD: S, HF+S; Celtra Duo: HF, HF+S; IPS e.max CAD: HF+S; Vita Enamic: HF+S, S. For Lava Ultimate, the highest bond strengths were obtained with HF, S, HF+S. Failure analysis showed a relation between bond strength and failure type: more mixed failures were observed with higher bond strengths. Mainly adhesive failures were noticed if no further surface treatment was done. The percentage of adhesive failures was higher for CAD/CAM materials with higher flexural strength (Celtra Duo, IPS e.max CAD, and Lava Ultimate). CONCLUSION: The bond strength of luting composites to novel CAD/CAM materials is influenced by surface treatment. For each luting composite, an adhesive cementation protocol can be specified in order to obtain the highest bond to the individual CAD/CAM materials.

Influence of Light Irradiation Through Zirconia on the Degree of Conversion of Composite Cements.

PURPOSE: To assess the light irradiance (LI) delivered by two light-curing units and to measure the degree of conversion (DC) of three composite cements and one flowable composite when cured through zirconia or ceramic-veneered zirconia plates with different thicknesses. MATERIALS AND METHODS: Three dual-curing composite cements (Clearfil Esthetic Cement, Panavia F2.0, G-CEM LinkAce) and one light-curing flowable composite (G-aenial Universal Flo) were investigated. Nine different kinds of zirconia plates were prepared from three zirconia grades (YSZ: Aadva and KATANA; Ce-TZP/Al2O3: NANOZR) in three different thicknesses (0.5- and 1.5-mm-thick zirconia, and 0.5-mm-thick zirconia veneered with a 1.0-mm-thick veneering ceramic). Portions of the mixed composite cements and the flowable composite were placed on a light spectrometer to measure LI while being light cured through the zirconia plates for 40 s using two light-curing units (n = 5). After light curing, micro-Raman spectra of the composite films were acquired to determine DC at 5 and 10 min, 1 and 24 h, and at 1 week. RESULTS: The zirconia grade and the thickness of the zirconia/veneered zirconia plates significantly decreased LI. Increased LI did not increase DC. Only the Ce-TZP/Al2O3 (NANOZR) zirconia was too opaque to allow sufficient light transmission and resulted in significantly lower DC. CONCLUSION: Although zirconia-based restorations attenuate the LI of light-curing units, the composite cements and the flowable composite could be light cured through the YSZ zirconia. LI is too low through Ce-TZP/Al2O3 zirconia, necessitating the use of self-/dual-curing composite cements.

Effect of resin and photoinitiator on color, translucency and color stability of conventional and low-shrinkage model composites.

OBJECTIVE: To study the effect of a low-shrinkage methacrylate monomer and monoacylphosphine oxide photoinitiator on color, translucency, and color stability of model resin-based composites (RBCs). METHODS: Four micro-hybrid RBCs were prepared containing barium-glass fillers in bisphenol A-glycidyl-methacrylate (BisGMA) and triethyleneglycol-dimethacrylate (TEGDMA) or urethane-based low-shrinkage monomer FIT-852 (FIT; Esstech Inc.) and TEGDMA matrix. Camphorquinone (CQ)/amine or Lucirin TPO were used as photoinitiators. Commercial low-shrinkage RBCs (Charisma Diamond, Heraeus Kulzer and N'Durance, Septodont) and conventional RBCs (Tetric EvoCeram, Ivoclar Vivadent and Filtek Z250, 3M ESPE) were used as controls. Color and translucency were measured using Thermo Scientific Evolution (Thermo Fisher Scientific) and SpectroShade™ Micro (MHT Optic Research) spectrophotometers. Color stability was evaluated after immersion in black tea (pure, with milk or lemon) and distilled water. Data were analyzed using analyses of variance with Tukey's post-test (α=0.05). RESULTS: Photoinitiators had no significant effect on baseline color. Initially whiter FIT-based RBCs showed greater staining in all staining solutions than BisGMA-based RBCs. TPO-containing RBCs showed better color stability than CQ-containing RBCs irrespective of the base monomer. Tea and tea with lemon induced greatest color changes. Adding milk to tea significantly reduced material staining. SIGNIFICANCE: Urethane-based low-shrinkage monomer FIT and conventional BisGMA affected color, translucency and color stability of their respective RBCs. Despite being used in posterior teeth, low-shrinkage RBCs are expected to have favorable optical and esthetic properties. Manufacturers are urged to provide information on optical properties of monomers and monomer mixtures in their low-shrinkage RBCs to allow understanding of interaction with fillers and photoinitiators.

Bonding Effectiveness to Differently Sandblasted Dental Zirconia.

PURPOSE: To evaluate the effect of different mechanical pre-treatments on the bond durability to dental zirconia. MATERIALS AND METHODS: Fully sintered IPS e.max ZirCAD (Ivoclar Vivadent) blocks were randomly assigned to one of 4 groups: (1) kept as-sintered (control), (2) sandblasted with 50-µm Al2O3(Danville), or tribochemically silica sandblasted using (3) CoJet (3M ESPE) and (4) SilJet (Danville). The zirconia specimens were additionally pre-treated chemically using a 10-MDP/silane ceramic primer (Clearfil Ceramic Primer, Kuraray Noritake). Two identically pre-treated zirconia blocks were bonded together using resin-composite cement (RelyX Ultimate, 3M ESPE). The specimens were trimmed at the interface to a cylindrical hourglass shape and stored in distilled water (7 days, 37°C), after which they were randomly tested as is or subjected to additional mechanical aging involving cyclic tensile stress (10 N, 10 Hz, 10,000 cycles). Subsequently, the microtensile bond strength was determined and SEM fractographic analysis performed. RESULTS: Weibull analysis revealed the highest Weibull scale and shape parameters when zirconia was tribochemically silica sandblasted using either CoJet or SilJet. The Weibull shape parameter of Al2O3-sandblasted zirconia was significantly reduced upon mechanical aging, but not when zirconia was tribochemically silica sandblasted. CONCLUSION: The mechanical surface pre-treatment of zirconia using tribochemical silica sandblasting (CoJet, SilJet) resulted in the most favorable bond durability of a resin-composite cement (RelyX Ultimate) to dental zirconia before and after aging.

Aging resistance of surface-treated dental zirconia.

UNLABELLED: The influence of surface treatment on the low-temperature degradation (LTD) of tetragonal zirconia polycrystalline (TZP) is still unclear. OBJECTIVES: The effect of surface treatments on the LTD behavior of zirconia was investigated. METHODS: Fully-sintered specimens of seven commercial dental zirconia (Aadva, GC; In-CeramYZ, VITA; IPS e.max ZirCAD, Ivoclar Vivadent; LAVA Frame and LAVA Plus, 3M ESPE; NANOZR, Panasonic; ZirTough, Kuraray Noritake) were provided by the manufacturers with specimen dimensions of approximately 10mm×5mm×3mm. For each zirconia grade, samples were kept 'as sintered' (untreated) or were subjected to one of the three surface treatments: rough polished, sandblasted with Al2O3, tribochemical silica sandblasted (n=3/group). The tetragonal to monoclinic transformation was evaluated by X-ray diffraction at several intervals during LTD testing up to 40h in steam in an autoclave (134°C, 2bar). RESULTS: The five yttria-stabilized TZP (Y-TZP: Aadva, In-CeramYZ, IPS e.max ZirCAD, LAVA Frame, LAVA Plus) zirconia showed a similar trend in LTD behavior. The Al2O3 sandblasted zirconia showed the highest monoclinic volume fraction. The as sintered (untreated) zirconia degraded faster than the surface-treated zirconia. Although the surface-treated ceria-stabilized TZP/alumina (Ce-TZP/Al2O3: NANOZR) zirconia had a higher initial monoclinic volume fraction compared to the Y-TZP zirconia, it showed a stronger aging resistance. The as sintered (untreated) Y-TZP/alumina (Y-TZP/Al2O3: ZirTough) zirconia showed a strong aging resistance, whereas the surface-treated Y-TZP/Al2O3 zirconia degraded slightly. SIGNIFICANCE: Surface treatment improved the aging resistance of Y-TZP zirconia. Surface treatment did not affect the LTD behavior of Ce-TZP/Al2O3 zirconia, while surface treatment decreased the aging resistance of Y-TZP/Al2O3 zirconia.

Durable bonding to mechanically and/or chemically pre-treated dental zirconia.

OBJECTIVES: To evaluate the effect of mechanical and chemical surface pre-treatment on the bond durability of two composite cements to dental zirconia. METHODS: Fully sintered IPS e.max ZirCAD (Ivoclar-Vivadent) blocks were either subjected to tribochemical silica sandblasting (CoJet, 3M ESPE) or not mechanically pre-treated. Next, the zirconia samples were either additionally pre-treated using one of two silane/MDP-combined ceramic primers (Clearfil Ceramic Primer, Kuraray; Monobond Plus, Ivoclar-Vivadent), or not further chemically pre-treated. Finally, two identically pre-treated zirconia blocks were bonded together using either a conventional BisGMA-based (Clearfil Esthetic Cement, Kuraray) or an MDP-based (Panavia F2.0, Kuraray) 'self-etch' dual-cure composite cement. The specimens were trimmed at the interface to a cylindrical hour-glass shape and stored for 7 days in distilled water (37°C), after which they were randomly exposed to one of three ageing protocols: (1) immersed in 37°C water for 10 days (10d); (2) subjected to 10,000 thermo-cycles (TC); or (3) immersed in 37°C water for 6 months (6m). After storage, the micro-tensile bond strength (µTBS) was determined in MPa (n=15-21/group). Fractographic analysis was performed using SEM. RESULTS: Weibull analysis revealed the highest Weibull scale and shape parameters for the 'CoJet/Clearfil Ceramic Primer/Panavia F2.0/10d' combination. While the BisGMA-based composite cement Clearfil Esthetic Cement (Kuraray) bonded equally well to zirconia using either tribochemical silica sandblasting (CoJet, 3M ESPE) or not, sandblasting appeared indispensable for the MDP-based and more hydrophilic composite cement Panavia F2.0 (Kuraray). CONCLUSIONS: Combined mechanical and chemical pre-treatment can best be recommended to durably bond to zirconia. CLINICAL SIGNIFICANCE: As a standard procedure to durable bond zirconia to tooth tissue, both mechanical (tribochemical silica coating) and chemical (silane/MDP-combined ceramic primers) is clinically highly recommended.

Transmission electron microscopic examination of the interface between a resin-modified glass-ionomer and Er:YAG laser-irradiated dentin.

OBJECTIVE: The aim of this study was to analyze the ultrastructural characteristics of the interface between a resin-modified glass ionomer (RMGI) and Er:YAG laser-irradiated dentin. BACKGROUND DATA: The Er:YAG laser has been considered as a possible alternative for cavity preparation, but the interaction between glass ionomers and Er:YAG-lased dentin still needs further investigation. MATERIALS AND METHODS: Five dentin surfaces were prepared by diamond bur (120,000 rpm) as controls or for Er:YAG laser irradiation (31.45 J/cm(2), 200 mJ, 10 Hz, 100 micros). The RMGI Fuji II LC (GC) was then applied to their surfaces, which were previously conditioned with a 20% polyalkenoic acid conditioner. The samples were sealed with an unfilled resin, stored in distilled water for 1 wk at 37 degrees C, and then processed for transmission electron microscopic (TEM) examination. RESULTS: When applied to bur-cut dentin (controls), Fuji II LC was able to partially demineralize the dentin surface, resulting in the formation of a hybrid layer, on top of which a sub-micron gel-phase was observed. In the laser-irradiated samples, the RMGI was in close contact with the irregular dentin substrate, but no hybrid layer or gel-phase formation could be detected, nor were there signs of dentin demineralization or collagen melting. Horizontal cracks were clearly seen in the sub-surface layer of dentin. CONCLUSION: Although presenting horizontal micro-cracks in its sub-surface, the irregular laser-irradiated dentin showed close contact with the RMGI. However, no hybrid layer or gel-phase could be detected, and there were no signs of dentin demineralization and collagen melting.

Influence of Er,Cr:YSGG laser treatment on microtensile bond strength of adhesives to enamel.

The current trend towards minimum-intervention dentistry has introduced laser technology as an alternative technique for cavity preparation. This study assessed the null hypothesis that enamel prepared either by Er,Cr:YSGG laser or conventional diamond bur is equally receptive to adhesive procedures. The buccal and lingual surfaces of 35 sound human molars were prepared with Er,Cr:YSGG laser or a medium-grit diamond bur. One etch&rinse (OptiBond FL) and three self-etch adhesives (Adper Prompt L-Pop, Clearfil SE Bond and Clearfil S3 Bond) were applied on laser-irradiated and bur-cut enamel, followed by the application of a 5-6 mm build-up of Z100. The micro-tensile bond strength (microTBS) was determined after 24 hours of storage in water at 37 degrees C. Prepared enamel surfaces and failure patterns were evaluated using a stereomicroscope and a field-emission-gun scanning electron microscope (Feg-SEM). The pTBS to laser-irradiated enamel was significantly lower than to bur-cut enamel (p<0.05), with the exception of Clearfil S3 Bond, which bonded equally effectively to both substrates. The latter presented the highest microTBS on laser-irradiated enamel, though it was not statistically different from the microTBS of OptiBond FL. SEM analysis revealed significant morphological alterations of the laser-irradiated enamel surface, such as areas of melted and recrystalized hydroxyapatite and deep extensive micro-cracks. In conclusion, the bonding effectiveness of adhesives to laser-irradiated enamel depends not only on the structural substrate alterations induced by the laser, but also on the characteristics of the adhesive employed.

Analysis of chemical interaction of 4-MET with hydroxyapatite using XPS.

Each dental adhesive contains a specific functional monomer that determines its actual adhesive performance to tooth tissue. 4-methacryloxyethyl trimellitic acid (4-MET) is well-known as one of the functional monomers mostly available and consequently widely used in commercial adhesives. We therefore characterized the chemical interaction of 4-MET with hydroxyapatite (HAp) using X-ray Photoelectron Spectroscopy (XPS). XPS revealed that the peak representing -COO- of 4-MET shifted to a lower binding energy, when 4-MET was adsorbed onto HAp. Deconvolution of this shifted peak disclosed two components with a peak representing unreacted carboxyl groups and ester groups, and a peak suggesting chemical bonding of other carboxyl groups to Ca of HAp. XPS spectra of HAp treated with 4-MET also disclosed the surface to be enriched in calcium and decreased in phosphorus, indicating that phosphorus was extracted at a relatively higher rate than calcium. It can thus be concluded that true chemical bonding of 4-MET with calcium present in HAp occurred, as it was proven using XPS.