Effect of surface flattening and phototherapy on shear bond strength immediately after bleaching with different modes of universal adhesive.

OBJECTIVE: The aim of this study was to compare to effect of phototherapy and surface flattening after immediately bleaching on the shear bond strength to bleached enamel. METHODS: Ninety-six human upper incisors were divided into 4 groups (n = 24). Group NB: no bleached, group P: phototherapy with YSGG laser, group F: 0.5 mm surface flattening, group PF: 0.5 mm surface flattening and phototherapy with Er;Cr:YSGG laser. Then, each group was assigned to 2 subgroups according to adhesive mode (n = 12) as; subgroup S (self-etching mode), subgroup T (total-etching mode) which are universal adhesives. All surface conditionings and restorations were performed with composite resin materials immediately after bleaching. Shear bond strength test was performed by using universal testing machine. The surfaces were also evaluated with SEM. The data were statistically analyzed with one-way ANOVA post-hoc Tukey tests. RESULTS: The lowest SBS values were achieved in FS (13.72 ± 2.29) while the highest ones in PT (28.01 ± 6.81). However, the differences were not significant (P > 0.05). All surface conditioning methods provided SBS values similar to the control (P > 0.05). All subgroups of self-etching mode were significantly lower than their total-etching counterparts (P < 0.05). CONCLUSIONS: The present study showed that surface removal and phototherapy have a potential clinical application for eliminate to undesirable effect of bleaching treatment. Surface conditioning with either flattening and/or phototherapy may provide clinicians to restore bleached teeth at the same visit with bleaching and reduce chair-time.

Shear Bond Strength of Composite and Ceromer Superstructures to Direct Laser Sintered and Ni-Cr-Based Infrastructures Treated with KTP, Nd:YAG, and Er:YAG Lasers: An Experimental Study.

OBJECTIVE: The aim of this study was to examine the shear bond strength (SBS) of ceromer and nanohybrid composite to direct laser sintered (DLS) Cr-Co and Ni-Cr-based metal infrastructures treated with erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser modalities in in vitro settings. METHODS: Experimental specimens had four sets (n = 32) including two DLS infrastructures with ceromer and nanohybrid composite superstructures and two Ni-Cr-based infrastructures with ceromer and nanohybrid composite superstructures. Of each infrastructure set, the specimens randomized into four treatment modalities (n = 8): no treatment (controls) and Er:YAG, Nd:YAG, and KTP lasers. The infrastructures were prepared in the final dimensions of 7 × 3 mm. Ceromer and nanohybrid composite was applied to the infrastructures after their surface treatments according to randomization. The SBS of specimens was measured to test the efficacy of surface treatments. Representative scanning electron microscopy (SEM) images after laser treatments were obtained. RESULTS: Overall, in current experimental settings, Nd:YAG, KTP, and Er:YAG lasers, in order of efficacy, are effective to improve the bonding of ceromer and nanohybrid composite to the DLS and Ni-Cr-based infrastructures (p < 0.05). Nd:YAG laser is more effective in the DLS/ceromer infrastructures (p < 0.05). KTP laser, as second more effective preparation, is more effective in the DLS/ceromer infrastructures (p < 0.05). SEM findings presented moderate accordance with these findings. CONCLUSIONS: The results of this study supported the bonding of ceromer and nanohybrid composite superstructures to the DLS and Ni-Cr-based infrastructures suggesting that laser modalities, in order of success, Nd:YAG, KTP, and Er:YAG, are effective to increase bonding of these structures.

Efficacy of Various Pretreatments on the Bond Strength of Denture Teeth to Denture Base Resins.

OBJECTIVE: This in vitro study evaluated the shear bond strength (SBS) of heat-cured denture base resin (PMMA) to acrylic resin teeth treated with different pretreatments, especially laser irradiation of different powers (1-4 W). MATERIALS AND METHODS: The acrylic resin teeth were separated into seven groups (n = 10) for the following different pretreatments: control group (no surface treatment) (G1), grinding with a tungsten carbide bur (G2), sandblasting (G3), and erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation at 1 W, 2 W, 3 W, 4 W output powers in (G4-7), respectively. Test specimens were produced according to the PMMA manufacturers' instructions and were subjected to a SBS test at a crosshead speed of 1 mm/min until fracture. Debonded surfaces were evaluated by a stereomicroscope for the type of failure. SEM (scanning electron microscope) analyses were done to estimate the surface changes of the acrylic resin teeth. The data were submitted using a one-way ANOVA and post hoc Tukey-Kramer multiple comparison tests (p = 0.05). RESULTS: The highest bond strength was obtained in G3, and similar SBS values were considered in other groups, and no significant differences were found among the surface treatments and the control group (p < 0.05). All groups had a high percentage of adhesive failures. CONCLUSIONS: Laser irradiations promote surface topography alterations. However laser irradiation of the adhesive surface was found ineffective. The SBS of acrylic resin teeth to a PMMA denture base material is independent of the surface pretreatments Er,Cr:YSGG laser irradiation, sandblasting, and grinding with a carbide bur. All the surface treatments provided a similar bond between the acrylic denture base and the teeth.

Influence of plasma-based dry etching on the bond strength of Y-TZP ceramic.

The aim of this study was to evaluate the bond strength between an yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic and a luting agent when submitted to plasma etching surface treatment before and after thermocycling (TC) with 3000 cycles of 5°C-55°C. The null hypothesis was that the surface treatments and thermocycling would not influence the bond strength. A total of 160 Y-TZP ceramic blocks in 2 sizes (10 size 1 and 10 size 2 blocks in each group) were distributed into 8 groups: group C (control), no surface treatment; group C-TC, TC without prior surface treatment; group SAO, sandblasting with aluminum oxide (Al2O3); group SAO-TC, sandblasting with Al2O3 followed by TC; group SAOS, sandblasting with silica-coated Al2O3; group SAOS-TC, sandblasting with silica-coated Al2O3 followed by TC; group PE, plasma etching; and group PE-TC, plasma etching followed by TC. In each group, size 1 blocks were cemented to size 2 blocks to fabricate specimens for microshear bond strength testing (n = 10 per group). Cementation followed surface treatments (except in control groups) and preceded any TC. All specimens were cemented using a luting agent that contained 10-meth-acryloyloxydecyl dihydrogen phosphate (MDP). The specimens were submitted to a microshear bond strength test and the means were analyzed with a 2-factor analysis of variance and Tukey test. Group PE showed the highest bond strength value before thermocycling (17.31 MPa). After thermocycling, the highest value was observed in the SAO-TC group (9.73 MPa), and statistically significant differences were observed between SAOS-TC and SAO-TC (P < 0.05) and PE-TC and SAO-TC (P < 0.05). Plasma etching improved the bond strength values between the Y-TZP ceramic and MDP-containing luting agent before thermocycling. After thermocycling, all groups showed lower bond strength values.

Influence of Surface Treatment on Composite Adhesion in Noncarious Cervical Lesions: Systematic Review and Meta-analysis.

The purpose of this study was to analyze the influence of dentin surface treatments on the retention rate of resin composite restorations in non-carious cervical lesions (NCCLs). Seven randomized clinical trials were included in this review. Data regarding retention rate, type of surface treatment, and the main characteristics of studies were analyzed. Two reviewers performed a literature search up to December 2016 in eight databases: PubMed (Medline), Lilacs, Ibecs, Web of Science, BBO, Scopus, Scielo and The Cochrane Library. Only clinical trials evaluating dentin surface treatments in resin composite restoration in NCCLs were included. Noncontrolled clinical trials, reviews, editorial letters, case reports, case series and studies published in a language other than English, Portuguese, or Spanish were not included. The included studies evaluated different surface treatments, such as using an adhesive system with a frictional technique, drying the dentin, and removing sclerotic dentin by using a bur and applying EDTA before primer use. The analysis considering the mechanical removal of dentin surface with a bur and the application of an adhesive system in a frictional mode showed these treatments improved retention rates of the resin composite restorations in NCCLs ( p<0.05). There is evidence in the literature suggesting that the mechanical removal of dentin surface with a bur and the application of an adhesive system in a frictional mode could improve the retention rates of resin composite restorations in NCCLs. However, the studies showed high heterogeneity, and additional clinical trials are needed to determine the best dentin treatment option in NCCLs.

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.

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.

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.

Microtensile Bond Strength of Resin-bonded Hightranslucency Zirconia Using Different Surface Treatments.

PURPOSE: To evaluate the effect of a novel surface treatment intended to improve bond strength to high-translucency zirconia. MATERIALS AND METHODS: Fully sintered high-translucency zirconia disks (Incoris TZI) were divided into four groups according to the surface treatment received: modified fusion sputtering technique, selective infiltration etching, low pressure particle abrasion using 30-µm alumina particles, while 50-µm particle abrasion served as control. Surface roughness was evaluated quantitatively using a contact profilometer. The disks were bonded to pre-aged composite resin disks using a light-polymerized adhesive resin (RelyX ultimate). The bilayered disks were sectioned into microbars and zirconia-resin bond strength was evaluated using the microtensile bond strength test (MTBS). The test was repeated after 3 months of water storage (37°C). Scanning electron microscopic examination of the zirconia resin interface was performed at different magnifications. A repeated measures ANOVA and Bonferroni post-hoc test were used to analyze the data (n = 20, α = 0.05). RESULTS: One-way ANOVA revealed significant differences in average surface roughness (Ra) between the tested groups (p < 0.001). The highest Ra value was recorded for fusion sputtering (12.23 ± 0.11 µm), followed by 50-µm particle abrasion (6.400 ± 0.887), then low pressure 30-µm particle abrasion (2.4 ± 0.15 µm), while the lowest surface roughness was recorded for the selective infiltration group (0.368 ± 0.04 µm). Modified fusion sputtering and selective infiltration etching produced significantly higher MTBS values at each of the tested intervals (p < 0.001) compared to particle abrasion using different particle sizes. Water storage resulted in reduction in the bond strength of 30-µm abraded specimens, which was attributed to structural defects observed at the zirconia/ resin interface. Scanning electron microscopic examination revealed a nanoporous surface characteristic of selective etching surface treatment, and modified fusion sputtering resulted in the creation of surface-fused microbeads. CONCLUSION: Within the limitations of this study, selective infiltration etching and modified fusion sputtering techniques established a strong, stable, durable bond to high-translucency zirconia.

Different Strategies to Bond Bis-GMA-based Resin Cement to Zirconia.

PURPOSE: To evaluate the effect of different bonding strategies on short- and long-term bis-GMA-based resin cement bond strengths to zirconia. MATERIALS AND METHODS: One hundred twenty samples of fully-sintered zirconia (Prettau Zirconia) were sandblasted and randomly distributed into 5 groups (n = 24): UA: Scotchbond Universal Adhesive; SZP: Signum Zirconia Bond I + II; ZPP: Z-Prime Plus; EXP: MZ experimental primer; CO: no primer application (control). After performing these surface treatments, translucent tubes (0.8 mm diameter and 1.0 mm height) were placed on the zirconia specimens, and bis-GMA-based cement (Duo-Link) was injected into them and light cured. Specimens were tested for microshear bond strength either 24 h or 6 months (m) after water storage (37°C) and surfaces were characterized by SEM and EDX. Two-way ANOVA and Tukey's post-hoc test (p < 0.05) were used to evaluate bond strength results. RESULTS: The mean bond strengths (MPa ± SD) were: UA=14.6 ± 4.7a (24 h); 16.0 ± 4.8a (6 m); SZP = 14.0 ± 5.4ab (24 h); 11.9 ± 2.6ab (6 m); ZPP=8.0 ± 1.8b (24 h); 8.6 ± 3.3b (6 m); EXP = 1.2 ± 0.5c (24 h); 0.6 ± 0.7c (6 m); CO=1.0 ± 1.2c (24 h); 1.3 ± 1.2c (6 m). Bonding strategy significantly influenced bond strength (p = 0.0001), but storage time did not (p = 0.841). Groups UA and SZP showed a homogeneous layer covering the zirconia surface. In these groups, EDX demonstrated the presence of phosphorus. Group ZPP resulted in a nonhomogeneous layer, exposing the zirconia substrate underneath. EXP application resulted in an undetectable layer. CONCLUSION: Water storage did not affect resin cement bond strengths to zirconia irrespective of the surface treatment. Bis-GMA-based resin cement bond strengths to zirconia are affected by specific bonding strategies.

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.

Fracture Strength of Endodontically Treated Teeth Restored with Composite Overlays with and without Glass-fiber Reinforcement.

PURPOSE: To evaluate the fracture strength and the failure mode of endodontically treated teeth restored with composite resin overlays with and without glass-fiber reinforcement. MATERIALS AND METHODS: A total of 32 extracted molars were divided into four equal groups. In the NFR-NFRC (no foundation restoration, no fiber-reinforced composite) and NFR-FRC (no foundation restoration, fiber-reinforced composite) groups, only a 5-mm-thick composite resin layer sealed the pulp chamber floors, whereas in the FR-NFRC (foundation restoration, no fiber-reinforced composite) and FR-FRC (foundation restoration, fiber-reinforced composite) groups, a 3.0-mm foundation restoration was used. NFR-NFRC and FR-NFRC groups were restored with composite resin overlays, whereas NFR-FRC and FR-FRC groups were restored with fiber-reinforced composite resin overlays. All specimens were subjected to mechanical loading in a computer-controlled masticator and then the fracture resistance was evaluated. Differences in means were compared using two-way ANOVA and Tukey's test. The level of significance was set at ɑ = 0.05. RESULTS: All specimens successfully completed the fatigue test. The least fracture-resistant group was NFR-FRC, exceeded by FR-NFRC, NFR-NFRC, and FR-FRC, in that order, with FR-FRC being the most fracture-resistant group. Statistically significant differences were detected between the pairs NFR-NFRC/FR-FRC (p = 0.001), NFR-FRC/FR-FRC (p = 0.001), and FR-NFRC/FR-FRC (p = 0.001). Eight vertical root fractures occurred in group FR-NFRC, six in group NFR-NFRC, four in group NFR-FRC, and none occurred in group FR-FRC. CONCLUSIONS: Within the limitations of this in vitro study, the incorporation of glass fibers and the presence of a foundation restoration were found to increase the fracture resistance and can favorably influence the fracture mode.

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.

Low Energy Surface Activation of Zirconia Based Restorations.

PURPOSE: To evaluate the influence of low energy surface activation technique on the biaxial flexure strength of zirconia frameworks. MATERIALS AND METHODS: Zirconia discs were prepared by cutting CAD/CAM zirconia blocks. Sintered discs were airborne particle abraded using one of the following particles: 30 µm alumina particles, 50 µm alumina particles, or modified round edges 30 µm alumina particles at low pressure. Scanning electron microscopy, x-ray diffraction analysis, surface roughness, and biaxial flexure strength tests were performed (n = 20). Fractured specimens were fractographically analyzed (α = 0.05). RESULTS: Low energy surface activation resulted in 7% monoclinic crystallographic transformation, increasing surface roughness from 0.05 to 0.3 µm and in significant increase in biaxial flexure strength (1718 MPa) compared 30 µm (1064 MPa), 50 µm (1210 MPa), and as-sintered specimens (1150 MPa). CONCLUSIONS: Low energy surface activation of zirconia specimens improved the biaxial flexure strength of zirconia frameworks without creation of surface damage. Clinical implications: by controlling particle size and shape of alumina, the flexure strength of zirconia restorations could be increased usinglow pressure particle abrasion.

Durability of Resin-Zirconia Bonds Produced Using Methods Available in Dental Practice.

PURPOSE: To evaluate the strength, after artificial aging, of resin-zirconia bonds yielded by methods available in dental practice. MATERIALS AND METHODS: Standardized test specimens consisting of composite resin cylinders cemented to Y-TZP disks were assigned to 24 groups (n=20 per group) on the basis of the surface conditioning of the disks and the adhesive used (cement+manufacturer-specific primer). Conditioning methods were: none (control), airborne particle abrasion (50-µm Al2O3 at 0.05, 0.10, or 0.25 MPa), or tribochemical silica coating (Rocatec or CoJet). Panavia 21+Clearfil Ceramic Primer, Multilink Automix+Monobond Plus, BiFix QM+Ceramic bond, or RelyX Ultimate+Scotchbond Universal were used for cementation. Specimens were stored in water at 37°C either for 3 days or for 150 days in conjunction with 37,500 thermocycles before being submitted to a tensile test (crosshead speed: 1 mm/min). Nonparametric ANOVA and post-hoc tests within the same model were applied to the results (α=0.05). RESULTS: Conditioning, cement, aging, and all their interactions significantly affected bond strength (p<0.0001). After storage in water for 3 days, bond strengths ranged between 4 and 45 MPa (values were lowest in the BiFix QM groups). After long-term aging, the best results were obtained for silica-coated (Rocatec) zirconia samples cemented with Panavia 21/Clearfil Ceramic Primer; this was the only group for which bond strengths were >10 MPa. Premature failure of the resin-ceramic bond was usually observed during long-term aging, the only exception being the non-control groups cemented with Panavia. CONCLUSION: Most bonding strategies failed to create bonds to zirconia with acceptable strength after long-term aging. It might therefore be unwise to rely solely on adhesion for retention of load-bearing Y-TZP restorations.

Tensile strength of Ni-Cr copings subjected to inner surface sandblasting using different cementing agents: An in vitro study.

OBJECTIVES: To evaluate the effect of thermal cycling and inner surface treatment with aluminum oxide at different granulations on the tensile strength of Ni-Cr copings cemented with different cementing agents. MATERIALS AND METHODS: Ninety-six metal copings were manufactured and divided into two groups: before and after thermal cycling (n = 48). The copings of both groups were internally treated by sandblasting with aluminum oxide particles of 100 (n = 24) and 320 (n = 24) mesh. The copings were cemented on previously manufactured metal cores using zinc phosphate (n = 8), conventional glass ionomer (CGIC) (n = 8) and resin-modified glass ionomer (RMGIC) (n = 8) cements. The tensile strength before and after thermal cycling was then determined (Newtons). RESULTS: The tensile strength before and after thermal cycling was significantly higher in copings cemented with RMGIC compared to CGIC (p < 0.05) and was similar to that for zinc phosphate (p > 0.05). Thermal cycling and sandblasting of the inner surface of the metal copings with different granulations did not influence retention (p > 0.05). CONCLUSIONS: Zinc phosphate cements and RMGIC showed similar retention. Additionally, the retention of the cements was not influenced by either thermal cycling or the particle size of the aluminum oxide.

Structural and Chemical Analysis of the Zirconia-Veneering Ceramic Interface.

The interfacial interaction of veneering ceramic with zirconia is still not fully understood. This study aimed to characterize morphologically and chemically the zirconia-veneering ceramic interface. Three zirconia-veneering conditions were investigated: 1) zirconia-veneering ceramic fired on sandblasted zirconia, 2) zirconia-veneering ceramic on as-sintered zirconia, and 3) alumina-veneering ceramic (lower coefficient of thermal expansion [CTE]) on as-sintered zirconia. Polished cross-sectioned ceramic-veneered zirconia specimens were examined using field emission gun scanning electron microscopy (Feg-SEM). In addition, argon-ion thinned zirconia-veneering ceramic interface cross sections were examined using scanning transmission electron microscopy (STEM)-energy dispersive X-ray spectrometry (EDS) at high resolution. Finally, the zirconia-veneering ceramic interface was quantitatively analyzed for tetragonal-to-monoclinic phase transformation and residual stress using micro-Raman spectroscopy (µRaman). Feg-SEM revealed tight interfaces for all 3 veneering conditions. High-resolution transmission electron microscopy (HRTEM) disclosed an approximately 1.0-µm transformed zone at sandblasted zirconia, in which distinct zirconia grains were no longer observable. Straight grain boundaries and angular grain corners were detected up to the interface of zirconia- and alumina-veneering ceramic with as-sintered zirconia. EDS mapping disclosed within the zirconia-veneering ceramic a few nanometers thick calcium/aluminum-rich layer, touching the as-sintered zirconia base, with an equally thick silicon-rich/aluminum-poor layer on top. µRaman revealed t-ZrO2-to-m-ZrO2 phase transformation and residual compressive stress at the sandblasted zirconia surface. The difference in CTE between zirconia- and the alumina-veneering ceramic resulted in residual tensile stress within the zirconia immediately adjacent to its interface with the veneering ceramic. The rather minor chemical elemental shifts recorded in the veneering ceramic did not suffice to draw definitive conclusions regarding potential chemical interaction of the veneering ceramic with zirconia. Sandblasting damaged the zirconia surface and induced phase transformation that also resulted in residual compressive stress. Difference in CTE of zirconia versus that of the veneering ceramic resulted in an unfavorable residual tensile stress at the zirconia-veneering ceramic interface.

The Effect of Sandblasting, Er:YAG Laser, and Heat Treatment on the Mechanical Properties of Different Zirconia Cores.

OBJECTIVE: The purpose of this study was to evaluate the effect of surface and heat treatments on the mechanical properties and phase transformation of yttria-stabilized tetragonal zirconia (Y-TZP) materials. BACKGROUND DATA: Zirconia is exposed to several treatments during dental application process. Knowing the effect of applied treatments on zirconia is essential for clinical success. MATERIAL AND METHODS: Forty disk specimens of Zirkonzahn (Z) and DC-Zirkon (DC) materials were fabricated. The specimens were randomly divided into four groups according to surface [control, sandblasting, Erbium: Yttrium Aluminum Garnet (Er:YAG) laser irradiation] and heat (firing) treatments. The surface roughness (Ra, µm) was measured using a surface profilometer. The relative amount of the transformed monoclinic (m) phase was analyzed by X-ray diffractometry (XRD). Biaxial flexural strength was tested using piston-on-three-ball technique. The data were analyzed with the Kruskal-Wallis H test with Bonferroni correction, and the Mann-Whitney U test was used for pairwise comparisons. RESULTS: There were no significant differences in surface roughness among the treated groups (p > 0.05), whereas sandblasting showed higher surface roughness than other treatments for both materials. Scanning electron microscopic (SEM) analyses revealed changes in surface morphology after surface treatments, especially in laser groups with the formation of cracks, and in sandblasting groups with the formation of microretentive grooves. The greatest amount of the monoclinic phase was measured after sandblasting (8.13%) for Z and (19.8%) for DC. The monoclinic phase reverted to the tetragonal phase after heat treatment. Heat treatment groups showed significantly lower flexural strength than other treatments (p < 0.05). CONCLUSIONS: Heat and surface treatments influenced the mechanical properties of zirconia ceramic. The biaxial flexural strength and crystalline phase of materials decreased after heat treatments.

Influence of repair procedure on composite-to-composite microtensile bond strength.

PURPOSE: To investigate the effect of different repair procedures and storage time on microtensile bond strength (µTBS) of a resin composite to an older one from a simulated previous restoration. METHODS: Composite disks were made by layering 2 mm-thick increments of a nanohybrid composite (Grandio) shade A1 in a Teflon mold (4 x 8 mm). Afterwards, they were light-cured and stored (37 degrees C/7 days) in a saline solution. Specimens were randomly divided into groups according to the surface treatment applied: (1) Composite surface was roughened with a bur (Cimara) and Solobond Plus adhesive was applied; (2) Sandblasting with 27 µm aluminum oxide particles (KaVo Rondoflex), and adhesive application; (3) Air-abrasion with 30 µm alumina particles coated with silica (CoJet Sand), silane (Monobond-S) and adhesive application; (4) Negative control group with only adhesive application. Afterwards, Grandio composite (shade A3.5) was packed incrementally on the treated surface obtaining another disk (4 x 8 mm). Repaired blocks were stored (24 hours or 6 months) and afterwards µTBS test was performed and failure mode was evaluated. Also, beams obtained from 8 mm-high composite blocks without any surface treatment were immediately submitted to µTBS test to determine Grandio composite cohesive bond strength (positive control group). Data were analyzed using ANOVA and Tukey's test (P < 0.05). RESULTS: The repair procedure affected µTBS values (P < 0.001) while neither storage time nor interactions did (P > 0.05). All repair procedures achieved bond strength values higher than the negative control group but they did not reach the composite's cohesive bond strength. The overall conclusion was that an increased superficial roughness by means of a bur, silica coating or alumina sandblasting improved µTBS of the repaired composite and bond strength remained stable after 6 months.