The loss of resin cement adhesion to ceramic influences the fatigue behavior of bonded lithium disilicate restorations.

When partial and/or non-retentive preparation, such as those for occlusal veneers, is indicated, a proper and stable adhesion is essential. Therefore, the aim of this in vitro study was to evaluate the effect of loss of adhesion in different regions of the bonding interface on the fatigue behavior of simplified lithium disilicate restorations. For this, lithium disilicate (IPS e.max CAD) discs (1 mm thick and Ø = 10 mm) were fabricated, polished with #400-, #600-, #1200-grit silicon carbide (SiC) papers, and crystallized. As substrate, fiber-reinforced resin epoxy discs (2.5 mm thick and Ø = 10 mm) were fabricated and polished with #600-grit SiC paper. The ceramic bonding surface was treated with 5% hydrofluoric acid and a silane-containing primer (Monobond N), while the substrate was etched with 10% hydrofluoric acid followed by the application of the bonding system primers (Primer A + B). A lacquer (nail polish) was used to simulate the loss of adhesion in specific areas according to the study design to compose the testing groups: bonded (control; did not received nail polish application); - non-bonded (loss of adhesion in the whole specimen area); - margin (loss of adhesion in the ceramic margin); - center (loss of adhesion in the ceramic central area). The adhesive area of partially bonded groups was 50% of the adhesive surface. Then, the discs (n = 12) were bonded to the respective substrate using a resin cement (Multilink N), light-cured, water-stored for 90 days, and subjected to thermocycling (25,000 cycles, 5° to 55 °C) before testing. A cyclic fatigue test was run (20 Hz, initial load of 200 N for 5000 cycles, 50 N step size for 10,000 cycles each until specimen failure), and the fatigue failure load and number of cycles for failure were recorded. As complementary analysis, finite element analysis (FEA) and scanning electron microscopy analysis were performed. Kaplan-Meier log-rank (Mantel-Cox) was conducted for survival analysis. The results showed that as the loss of adhesion reaches the central area, the worse is the fatigue behavior and the higher is the stress peak concentration in the ceramic bonding surface. The bonded specimens presented better fatigue behavior and stress distribution compared to the others. In conclusion in a non-retentive preparation situation, proper adhesion is a must for the restoration fatigue behavior even after aging; while the loss of adhesion reaches central areas the mechanical functioning is compromised.

Hybrid ceramic repair strength, surface roughness, and bond failure, using methylene blue-activated low-level laser therapy, Carbon dioxide, and Ti: Al2O3 laser.

AIMS: To evaluate the impact of various pretreatment regimes (LLLT, Ti-sapphire laser, CO2, and HFA-S) on hybrid ceramics, specifically focusing on their ability to enhance repair strength and minimize surface roughness (Ra). MATERIAL AND METHODS: Discs were made from hybrid ceramics and after disinfection were randomly divided into four groups based on different surface conditioning techniques. Each group consisted of 15 discs, resulting in a total sample size of 60. dics in group 1 was surface treated with Low-level laser therapy (LLLT) using methylene blue (MB), Discs in group 2 with Ti-sapphire laser, Discs in group 3 with CO2 laser, and discs in group 4 with HFA-S. Five samples from each group were assessed for Ra. The remaining 10 samples from each group underwent repair using a porcelain repair kit in adherence to the planned instructions. The bond strength of each sample in all groups was measured using a universal testing machine. Following the bond strength testing, the specimens from all study groups were analyzed to determine the mode of failure. To evaluate the data, a two-way analysis of variance (ANOVA) was used, followed by post hoc multiple comparisons. RESULTS: The highest repair bond strength was observed in group 4 hybrid ceramics pretreated with HFA-S (19.05±0.79 MPa). The lowest repair bond scores were observed in group 1 hybrid ceramics preconditioned with LLLT in the presence of Photosensitizer (13.41±0.36 MPa). The highest Ra scores were exhibited in group 2 surface treated with Ti-sapphire laser (0.0515±0.16 µm) and the lowest Ra scores were observed in Group 4 HFA-S (0.0311±0.79 µm). Predominant bond failure among different investigated groups was cohesive. CONCLUSION: The current gold standard for hybrid ceramic conditioning is the use of hydrofluoric acid (HFA) combined with a silane coupling agent. Low-level laser therapy with methylene blue photosensitizer is not recommended for the treatment of hybrid ceramics.

Decontamination of lithium disilicate ceramics using various photosensitizers, herbal and chemical disinfectants, and the effect of surface conditioners on bond strength values.

AIM: To assess and compare the antimicrobial efficacy of disinfectants on lithium disilicate ceramic (LDC) used in dental applications and shear bond strength (SBS) of LDC after using different conditioners hydrofluoric acid (HF), self-etching ceramic primers (SECP) and Neodymium-doped yttrium orthovanadate (Nd: YVO4). MATERIALS AND METHODS: One hundred and twenty LDC discs were fabricated by auto-polymerizing acrylic resin using the lost wax technique. S. aureus, S. mutans, and C. albican were inoculated on thirty discs (n = 30 each). Each group was further divided into three subgroups based on different disinfecting agents used (n = 30) Group 1: Garlic extract, Group 2: Rose Bengal (RB) activated by PDT, and Group 3: Sodium hypochlorite (NaOCl). An assessment of the survival rate of microorganisms was performed. The remaining thirty samples were surface treated using three different LDC surface conditioners (n = 10) Group 1: HF + Silane (S), group 2: SECP, and Group 3: Nd: YVO4 laser+S. SBS and failure mode analysis were performed using a universal testing machine and stereomicroscope at 40x magnification, The statistical analysis was conducted using one-way ANOVA and Post Hoc Tukey test. RESULTS: Garlic extract, RB, and 2% NaOCl sample displayed comparable outcomes of antimicrobial potency against C. albicans, S aureus, and S. mutans (p > 0.05). Furthermore, SBS analysis showed HF+S, SECP, and Nd: YVO4+S exhibited comparable outcomes of bond strength (p > 0.05). CONCLUSION: Garlic extract and Rose bengal activated by PDT can be contemplated as alternatives to the chemical agent NaOCl used for LDC disinfection. Similarly, SECP and Nd: YVO4 possess the potential to be used for the surface conditioning of LDC to improve the bond integrity with resin cement.

Non-stick properties of thin-film coatings on dental-restorative instruments.

The non-stick properties of thin-film coatings on dental-restorative instruments were investigated by static contact-angle measurement using dental filler resin as well as by scanning electron microscopy of the amount of sticking dental restorative material. Furthermore, using a customized dipping measurement set-up, non-stick properties were evaluated by measuring force-by-time when the instrument was pulled out of restorative material. Minor improvements in non-stick properties were obtained with commercial diamond-like carbon and commercial polytetrafluoroethylene-based coatings. Major improvements were obtained with an in-house fabricated superhydrophobic coating prepared by a multistep process consisting of surface microstructuring by etching in hydrogen fluoride (HF): hydrogen peroxide (H2 O2 ) (1:1; vol/vol), atomic layer deposition of a 7 nm coating of aluminium oxide and titanium oxide, and a self-assembled monolayer of fluorinated organosilicon. Superhydrophobic coatings provide a possible future solution to prevent unwanted adnerence of composite restorative material to dental instruments.

Phosphorus in recycling fertilizers - analytical challenges.

The importance of secondary raw materials for phosphorus (P) fertilizer production is expected to increase in the future due to resource depletion, supply risks, and heavy metal contamination of fossil phosphate resources. Municipal wastewater is a promising source for P recovery. In Germany for instance, it contains almost 50% of the total amount of P that is currently applied as mineral fertilizer. Several procedures have been developed to recover and re-use P resulting in a growing number of recycling fertilizers that are currently not regulated in terms of fertilizer efficiency. We tested various materials and matrices for their total P content, solubility of P in neutral ammonium citrate (Pnac) and water, and performed robustness tests to check if existing analytical methods are suitable for those new materials. Digestion with inverse aqua regia was best suited to determine the total P content. Pnac sample preparation and analyses were feasible for all matrices. However, we found significant time and temperature dependencies, especially for materials containing organic matter. Furthermore, several materials didn't reach equilibrium during the extractions. Thus, strict compliance of the test conditions is strongly recommended to achieve comparable results.

Can 10% hydrofluoric acid be used for reconditioning of orthodontic brackets?

CONTEXT: Bracket debonding is a common problem during orthodontic treatment. This type of failure is associated to masticatory forces, poor adhesion, and the need for repositioning the piece. AIMS: The objective of this work was to compare the shear bond strength of debonded brackets that were reconditioned using different protocols (alumina blasting versus hydrofluoric etching). SETTINGS AND DESIGN: This was an in vitro experimental study with 45 stainless steel orthodontic brackets. SUBJECTS AND METHODS: They were randomly divided into three groups: (1) New brackets (n = 15), (2) brackets reconditioned using 10% hydrofluoric acid for 60 s (n = 15), and (3) brackets reconditioned by aluminum oxide blasting until complete removal of the remaining resin (n = 15). In Groups 2 and 3, the insertion of composite resin proceeded in two stages to simulate a type of bracket failure in which the bonding resin was left at the bracket base. For the shear test, the assembly composed by the metallic support, and specimen was taken to the Instron universal testing machine in which the specimens were loaded using a semicircle-shaped active tip in the region of the bonding interface parallel to the surface of the bracket at a speed of 0.5 mm/min. STATISTICAL ANALYSIS USED: The data were subjected to D'Agostino's normality test to have their distribution checked. Analysis of variance and Tukey's test (P < 0.01) were used to compare the findings between groups. RESULTS: The results indicated that Group 1 (new brackets) showed higher bond strength than that obtained for the group treated with hydrofluoric acid (Group 2, P < 0.01). The bond strength value obtained for the group treated with alumina blasting (Group 3) was statistically similar to those obtained for Groups 1 and 2. CONCLUSIONS: The aluminum oxide blasting technique was effective for the reconditioning of orthodontic brackets. Nevertheless, the reconditioning technique using 10% fluoridric acid for 60 s was not efficient for clinical use.

Porcelain surface conditioning protocols and shear bond strength of orthodontic brackets.

AIM: The objective of the present study was to determine which of six bonding protocols yielded a clinically acceptable shear bond strength (SBS) of metal orthodontic brackets to CAD/CAM lithium disilicate porcelain restorations. A secondary aim was to determine which bonding protocol produced the least surface damage at debond. METHODS: Sixty lithium disilicate samples were fabricated to replicate the facial surface of a mandibular first molar using a CEREC CAD/CAM machine. The samples were split into six test groups, each of which received different mechanical/chemical pretreatment protocols to roughen the porcelain surface prior to bonding a molar orthodontic attachment. Shear bond strength testing was conducted using an Instron machine. The mean, maximum, minimal, and standard deviation SBS values for each sample group including an enamel control were calculated. A t-test was used to evaluate the statistical significance between the groups. RESULTS: No significant differences were found in SBS values, with the exception of surface roughening with a green stone prior to HFA and silane treatment. This protocol yielded slightly higher bond strength which was statistically significant. CONCLUSION: Chemical treatment alone with HFA/silane yielded SBS values within an acceptable clinical range to withstand forces applied by orthodontic treatment and potentially eliminates the need to mechanically roughen the ceramic surface.

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 Surface Conditioning Protocols on Reparability of CAD/CAM Zirconia-reinforced Lithium Silicate Ceramic.

PURPOSE: To test the effect of surface conditioning protocols on the reparability of CAD/CAM zirconia-reinforced lithium silicate ceramic compared to lithium-disilicate glass ceramic. MATERIALS AND METHODS: Zirconia-reinforced lithium silicate ceramic (Vita Suprinity) and lithium disilicate glass-ceramic blocks (IPS e.max CAD) were categorized into four groups based on the surface conditioning protocol used. Group C: no treatment (control); group HF: 5% hydrofluoric acid etching for 60 s, silane (Monobond-S) application for 60 s, air drying; group HF-H: 5% HF acid etching for 60 s, application of silane for 60 s, air drying, application of Heliobond, light curing for 20 s; group CO: sandblasting with CoJet sand followed by silanization. Composite resin (Tetric EvoCeram) was built up into 4 x 6 x 3 mm blocks using teflon molds. All specimens were subjected to thermocycling (5000x, 5°C to 55°C). The microtensile bond strength test was employed at a crosshead speed of 1 mm/min. SEM was employed for evaluation of all the debonded microbars, the failure type was categorized as either adhesive (failure at adhesive layer), cohesive (failure at ceramic or composite resin), or mixed (failure between adhesive layer and substrate). Two-way ANOVA and the Tukey's HSD post-hoc test were applied to test for significant differences in bond strength values in relation to different materials and surface pretreatment (p < 0.05). RESULTS: The highest microtensile repair bond strength for Vita Suprinity was reported in group CO (33.1 ± 2.4 MPa) and the lowest in group HF (27.4 ± 4.4 MPa). Regarding IPS e.max CAD, group CO showed the highest (30.5 ± 4.9 MPa) and HF the lowest microtensile bond strength (22.4 ± 5.7 MPa). Groups HF, HF-H, and CO showed statistically significant differences in terms of all ceramic types used (p < 0.05). The control group showed exclusively adhesive failures, while in HF, HF-H, and CO groups, mixed failures were predominant. CONCLUSIONS: Repair bond strength to zirconia-reinforced lithium silicate ceramics and lithium-disilicate glass ceramic could be improved when ceramic surfaces are sandblasted with CoJet sand followed by silanization.

Adhesive luting of new CAD/CAM materials.

OBJECTIVE: To evaluate the adhesive bonding performance of recently introduced tooth-colored CAD/CAM materials after different pretreatment protocols and using different luting materials. MATERIALS AND METHODS: The CAD/CAM materials under investigation were e.max CAD (lithium disilicate glass ceramic; Ivoclar Vivadent, Schaan, Liechtenstein), Celtra Duo (zirconia-reinforced lithium disilicate ceramic; Dentsply DeTrey, Konstanz, Germany), Lava Ultimate (resin nano ceramic; 3M ESPE, Neuss, Germany), and Enamic (resin infiltrated ceramic; Vita, Bad Säckingen, Germany). A total of 240 blocks (n = 5) received various pretreatments (no pretreatment, silane, sandblasting, sandblasting + silane, hydrofluoric acid, hydrofluoric acid + silane), and then different classes of adhesive luting composites were applied (adhesive: Prime&Bond XP + SCA + Calibra; Dentsply DeTrey; self adhesive: RelyX Unicem; 3M ESPE). After 24 h water storage and 10,000 thermocycles (5°C/55°C), specimens were cut into beams and microtensile bond strengths were recorded. RESULTS: Bonding performance of recent CAD/CAM materials was clearly influenced by the pretreatment method (P < 0.05). In general, significantly higher µ-TBS values were recorded for the ceramic materials compared to the hybrid materials (P < 0.05). Among the hybrid materials, Enamic exhibited higher bond strengths than Lava Ultimate (P < 0.05). However, despite the differences found, all materials showed a high level of bonding performance, being sufficient to withstand intraoral chewing forces during mastication. CONCLUSION: When pretreated as recommended by the manufacturers, recent tooth-colored CAD/CAM materials show an encouraging bonding performance for adhesive luting.

Label-free electrochemical detection of the human adenovirus 40/41 fiber gene.

A nanoporous silicon-based label-free DNA biosensor was fabricated to monitor rapidly enteric adenovirus types 40 and 41, a leading cause of viral gastroenteritis in children. Nanoporous silicon (NPS) was formed by an anodic etching process in a mixture solution containing hydrofluoric acid and ethanol. The polypyrrole (PPy) film was directly electropolymerized on The NPS substrate. Twenty-five base pairs of probe DNA (pDNA), derived from the fiber gene, was electrochemically doped on the PPy-coated NPS substrate. The conductivity change due to the immobilized pDNA and hybridized target DNA (tDNA) was expressed as an arbitrary factor, γ, which is a normalized numerical term used for the selective quantification of the tDNA. γ was inversely proportional to the concentration of complementary tDNA, but independent of the non-complementary tDNA. The sensitivity slope for detecting tDNAc was -1.54 µM(-1), based on the factor γ in the range of 0.4 to 1.0 µM of tDNA. The surface roughness was characterized using atomic force microscopy.

Microscopic residues of bone from dissolving human remains in acids.

Dissolving bodies is a current method of disposing of human remains and has been practiced throughout the years. During the last decade in the Netherlands, two cases have emerged in which human remains were treated with acid. In the first case, the remains of a cremated body were treated with hydrofluoric acid. In the second case, two complete bodies were dissolved in a mixture of hydrochloric and sulfuric acid. In both cases, a great variety of evidence was collected at the scene of crime, part of which was embedded in resin, polished, and investigated using SEM/EDX. Apart from macroscopic findings like residual bone and artificial teeth, in both cases, distinct microscopic residues of bone were found as follows: (partly) digested bone, thin-walled structures, and recrystallized calcium phosphate. Although some may believe it is possible to dissolve a body in acid completely, at least some of these microscopic residues will always be found.

Zirconia Surface Treatments for Resin Bonding.

PURPOSE: To evaluate the bond strength of resin to zirconia treated with different surface conditioning methods. MATERIALS AND METHODS: Sintered zirconia was surface treated to create 7 groups. Ceramic liner (L) was fired onto three groups of zirconia and subsequently received the following treatments: hydrofluoric acid etching (L/ HFE), alumina particle abrasion (L/APA), and alumina particle abrasion with hydrofluoric acid etching (L/APAHFE). All three groups were silane treated immediately prior to bonding. Two other zirconia groups received alumina particle abrasion with and without silane coupling (AP-S and AP). Another group underwent selective infiltration etching, in which the specimens received porcelain powder firing, ultrasonic etching with HF for 15 min, then rinsing under running water for 15 min, followed by silane treatment (SIE). The control group was zirconia as-sintered (ZAS). Twenty composite resin cylinders were luted to each group with a resin cement. Each group was divided into two subgroups (n=10) and subjected to 2 storage conditions: 24 h water storage or 21 days with 6000 thermocycles between 5°C and 55°C. Shear bond strength testing (SBS) was performed, followed by statistical analysis of the results using one-way ANOVA (p < 0.05). RESULTS: After 21 days of thermocycling, AP and ZAS groups spontaneously debonded prior to testing. The remaining groups showed a decrease in mean shear bond strength between 11.7% and 58.5% after thermocycling, except the L/HFE group, which increased by 11.7%. L/HFE showed the highest bond strength at both test intervals, and at 21 days was significantly higher than that of the AP-S and L/APA-HFE groups, which in turn were higher than that of the L/APA group, which was higher than that of the SIE group (p < 0.05). CONCLUSION: The etched, fired ceramic liner with silane treatment provided the strongest and most durable bond under the conditions tested. Alumina particle abrasion degraded the durability of the ceramic liner. Alumina particle abrasion, as-sintered zirconia, and SIE did not provide durable bond strengths.

Influence of implant surface topography on bone-regenerative potential and mechanical retention in the human maxilla and mandible.

PURPOSE: To evaluate the short- and mid-term effects of commercial pure (cp) titanium implant surface topography on osseointegration, bone-regenerative potential and mechanical retention in the human maxilla and mandible. METHODS: 32 micro-implants with the same geometry but with four different surface treatments were implanted in the maxilla and mandible of eight patients. Each patient received four micro-implants, one of each type. Percentage of bone-to-implant contact analysis and histological evaluation was carried 3, 6 and 12 weeks after implantation. Furthermore, reverse removal torque tests were conducted 3 and 6 weeks after implantation to analyze functional bone attachment. Implant surfaces tested were: machined, grit-blasted, acid-etched, and grit-blasted with acid-etch. One-way ANOVA was performed using the multiple comparison Fisher's test to determine significance of observed differences among test groups. The level of significance was established at 5% (P < 0.05). Mean and standard deviations of the test groups were calculated. RESULTS: Surface roughness had a significant correlation with the evolution of bone regeneration. The surfaces with roughness Ra approximately 4 microim (grit-blasted and grit-blasted with acid-etch), showed rapid tissue colonization compared to machine and acid-etched surfaces. The results of reverse removal torque tests confirmed a significant correlation between surface roughness and functional bone attachment. Grit-blasted and grit-blasted with acid etched surfaces showed higher retention values compared to machine and acid-etched implants. This finding was supported by higher bone-to-implant contact observed for rougher surfaces (grit-blasted and grit-blasted with acid etching).

Evaluation of surface roughness and bond strength of quartz fiber posts after various pre-treatments.

PURPOSE: Debonding at the post-adhesive interface is a major problem for quartz fiber posts. The objective of this study was to evaluate surface roughness and bond strength of quartz fiber posts after various surface treatments. MATERIALS AND METHODS: Sixty-six quartz fiber posts were randomly divided into six experimental groups (n = 11) including group C, untreated (control); group SB, sandblasted; group SC, silica coated; group HF, hydrofluoric acid-etched; group N, Nd:YAG laser irradiated; group E, Er:YAG laser irradiated. Surface roughness of the posts was measured before and after pre-treatment. They were then bonded to resin cement and tensile bond strength was determined in a universal testing machine. Furthermore, two-way ANOVA and post hoc comparison tests (α = 0.05) were performed on all data. RESULTS: The highest mean force value was observed in group SB and followed by group E. Tukey's HSD test showed that there was no statistical difference between group SB and group E (p = 0.673). The highest mean roughness value was observed in group SB and a significant difference was found between group SB and all other groups (p < 0.001). This study reveals that sandblasting and Er:YAG laser irradiation provided a significant increase in bond strength between quartz fiber posts and resin cement. CONCLUSIONS: Sandblasting or Er:YAG laser-irradiation of the surface of the quartz fiber post before cementation is recommended for increasing retention.

The strength of sintered and adhesively bonded zirconia/veneer-ceramic bilayers.

OBJECTIVES: Recently all-ceramic restorative systems have been introduced that use CAD/CAM technology to fabricate both the Y-TZP core and veneer-ceramic layers. The aim was to identify whether the CAD/CAM approach resulted in more favourable stressing patterns in the veneer-ceramic when compared with a conventionally sintered Y-TZP core/veneer-ceramic. METHODS: Nominally identical Vita VM9 veneer-ceramic disc-shaped specimens (0.7mm thickness, 12mm diameter) were fabricated. 20 specimens received a surface coating of resin-cement (Panavia 21); 20 specimens were bonded with the resin-cement to fully sintered Y-TZP (YZ Vita Inceram Vita) discs (0.27mm thickness, 12mm diameter). A final series of 20 Y-TZP core/veneer-ceramic specimens were manufactured using a conventional sintering route. Biaxial flexure strength was determined in a ball-on-ring configuration and stress at the fracture origin calculated using multilayer closed-form analytical solutions. Fractography was undertaken using scanning electron microscopy. The experimental test was simulated using Finite Element Analysis. Group mean BFS were compared using a one-way ANOVA and post hoc Tukey tests at a 95% significance level. RESULTS: Resin cement application resulted in significant strengthening of the veneer-ceramic and further significant strengthening of the veneer-ceramic (p<0.01) occurred following bonding to the Y-TZP core. The BFS calculated at the failure origin for conventionally sintered specimens was significantly reduced when compared with the adhesively bonded Y-TZP/veneer-ceramic. CONCLUSIONS: Under the test conditions employed adhesive cementation between CAD/CAM produced Y-TZP/veneer-ceramic layers appears to offer the potential to induce more favourable stress states within the veneer-ceramic when compared with conventional sintered manufacturing routes. CLINICAL SIGNIFICANCE: The current investigation suggests that the stressing patterns that arise in all-ceramic restorations fabricated using CAD/CAM for both the core and veneer-ceramic layers differ from those that occur in conventionally sintered bilayer restorations. Further work is required to ascertain whether such differences will translate into improved clinical outcomes.

Effects of surface treatments and cement types on the bond strength of porcelain-to-porcelain repair.

PURPOSE: The purpose of this in vitro study was to evaluate the effects of four surface treatments and two resin cements on the repair bond strength of a ceramic primer. MATERIALS AND METHODS: Eighty-eight pairs of disks (10 and 5 mm in diameter, 3 mm thickness) were prepared from heat-pressed feldspar ceramics (GC Initial IQ). After being stored in mucin-artificial saliva for 2 weeks, the 10-mm disks were divided into four surface treatment groups (n = 22) and then treated as follows: (1) no treatment (control); (2) 40% phosphoric acid; (3) 5% hydrofluoric acid + acid neutralizer + 40% phosphoric acid; (4) silica coating (CoJet-sand) + 40% phosphoric acid. The 5-mm disks were treated with 5% hydrofluoric acid + 40% phosphoric acid. The two sizes of porcelain disks, excluding the control group, were primed with Clearfil Ceramic Primer. The specimens in each group were further divided into two subgroups of 11 each, and bonded with Clearfil Esthetic Cement (CEC) or Panavia F 2.0 Cement (PFC). The specimens were stored in distilled water at 37°C for 24 hours, thermocycled for 3000 cycles at 5 to 55°C, and stored at 37°C for an additional 7 days. Shear bond strength (SBS) was measured with a universal testing machine at a 0.5 mm/min crosshead speed until fracture. Statistical analysis of the results was carried out with a two-way ANOVA and Tukey HSD test (α = 0.05). Debonded specimen surfaces were examined under an optical microscope to determine the mode of failure. RESULTS: The statistical analysis showed that the SBS was significantly affected by surface treatment and resin cement (p < 0.05). For treatment groups bonded with CEC, the SBS (MPa) values were (1) 2.64 ± 1.1, (2) 13.31 ± 3.6, (3) 18.88 ± 2.6, (4) 14.27 ± 2.7, while for treatment groups cemented with PFC, the SBS (MPa) values were (1) 3.04 ± 1.1, (2) 16.44 ± 3.3, (3) 20.52 ± 2.2, and (4) 16.24 ± 2.9. All control specimens exhibited adhesive failures, while mixed types of failures were observed in phosphoric acid-treated groups. The other groups revealed mainly cohesive and mixed failures. CONCLUSIONS: Combined surface treatment of etching with hydrofluoric acid and phosphoric acid provides the highest bond strengths to porcelain. Also, PFC exhibited higher SBS than CEC did.

Influence of particle abrasion or hydrofluoric acid etching on lithium disilicate flexural strength.

STATEMENT OF PROBLEM: Lithium disilicate is a translucent, glass-containing material used for ceramic restorations. Clinicians frequently use alumina abrading or hydrofluoric acid etching to create micromechanical retention in the intaglio surface before bonding a lithium disilicate restoration to the tooth. Few studies have investigated how the etching or abrasion processes affect the flexural strength of lithium disilicate ceramics. PURPOSE: The purpose of this study was to measure and compare the flexural strength of e.max CAD after alumina abrasion at differing pressures and acid etching at differing concentrations and times. MATERIAL AND METHODS: Bars of e.max CAD (9 groups of 10; 22×2.5×2.5 mm) were prepared, polished sequentially with 180, 320, and 600 abrasive paper, and sintered according to the manufacturer's instructions. Four groups were particle abraded (30-µm alumina particles from 10 mm at 55, 100, 200, or 300 kPa for 10 seconds). Four groups were etched with either 5% hydrofluoric acid (20 seconds or 120 seconds) or 9.5% hydrofluoric acid (20 seconds or 120 seconds). The control was polished and fired only (no treatment). Specimens were placed onto an Instron (1 mm/min crosshead speed) and loaded to failure in a 3-point flexural test. One-way ANOVA and the Dunnett t test determined intergroup differences (α=.05). RESULTS: Compared with the control, the 100, 200, and 300 kPa alumina abraded groups produced significantly lower flexural strengths (P<.001); however, the flexural strength of the 55 kPa abraded group was not statistically different from the control (P=.080). The flexural strength of the 5% and the 9.5% hydrofluoric acid-etched groups also were not significantly different from the control (P>.050); however, the 9.5% hydrofluoric acid at 20 seconds group was nearly statistically significant (P=.051). CONCLUSION: Alumina particle abrasion at pressures of 100 kPa and higher significantly reduced flexural strength by creating stress risers in e.max CAD and should not be used. Hydrofluoric acid etching should be used to increase micromechanical retention and clean the intaglio surface of the restoration before bonding.

Do surface treatments affect the optical properties of ceramic veneers?

STATEMENT OF PROBLEM: Surface treatments may affect the optical properties of ceramic veneers before cementation. PURPOSE: The purpose of this study was to evaluate whether various surface treatments affect the optical properties of different types of ceramic veneers. MATERIAL AND METHODS: Disk-shaped ceramic veneers (N=280) were prepared from the IPS e.max Press, e.max CAD, Empress Esthetic, e.max Ceram, and Inline ceramic systems with 0.5-mm and 1.0-mm thicknesses. The ceramics were divided into 4 groups: no surface treatments; etched with hydrofluoric acid; airborne-particle abraded with 30-µm Al2O3; and irradiated with erbium:yttrium-aluminum-garnet laser. A translucent shade of resin was chosen for cementation. Color parameters were examined with a colorimeter. Statistical analyses were done with 3-way ANOVA and the Bonferroni test (P=.05). RESULTS: Significant interactions were noted between the surface treatments, ceramic type, and thickness for ΔE values (P=.01), and no significant interactions were noted for L* (P=.773), a* (P=.984), and b* (P=.998). The greatest color change occurred after airborne-particle abrasion with 0.5-mm-thick e.max Press (2.9 ΔE). Significant differences in ΔE values were found among the hydrofluoric acid, airborne-particle abrasion, and laser groups for 0.5-mm-thick ceramics, except IPS Inline, and among the hydrofluoric acid, airborne-particle abrasion, and laser groups for 1.0-mm-thick ceramics, except Empress Esthetic ceramics. CONCLUSIONS: The color change of the ceramics increased after the surface treatments, particularly as the ceramics became thinner.

Micromorphology of ceramic etching pattern for two CAD-CAM and one conventional feldspathic porcelain and need for post-etching cleaning.

The aim of this in vitro study was to observe the effect of hydrofluoric acid (HF) on the surface of two glass ceramics for Cerec and to compare it with the effect on a conventional glass ceramic. Discs were cut from a feldspathic ceramic block (VitaMKII) and from a leucite reinforced glass ceramic (IPS EMPRESS CAD) for Cerec. 5% and 9% HF concentrations were used during 1 min and 2 min each. Afterwards samples were thoroughly water rinsed for 30 s. Half of the 9% HF 1 min samples were subsequently submitted to a complex post-etching cleaning. All samples were observed under a scanning electron microscope (SEM). The conventional feldspathic ceramic samples were built up on a refractory die and a platinum foil. They were treated with 9% HF for 2 min and water rinsed for 30 s. Half of the samples were submitted to the same post-etching cleaning protocol. All samples were examined under SEM and EDX. The Cerec ceramic samples and the platinum foil ones were clean and free of any precipitate after 30 s of water rinsing. Acid concentration, times of application and the postetching cleaning treatment did not influence the cleanliness of the samples. A thick layer of deposit was observed only on the refractory die samples. This was only diminished after the post-etching treatment. The EDX analysis detected the presence of fluoride (F) only on the refractory die samples.