Effect of surface treatment strategies on bond strength of additively and subtractively manufactured hybrid materials for permanent crowns.

OBJECTIVES: The purpose of this study is to evaluate the bond strength of different computer-aided design / computer-aided manufacturing (CAD/CAM) hybrid ceramic materials following different pretreatments. METHODS: A total of 306 CAD/CAM hybrid material specimens were manufactured, n = 102 for each material (VarseoSmile Crownplus [VSCP] by 3D-printing; Vita Enamic [VE] and Grandio Blocs [GB] by milling). Each material was randomly divided into six groups regarding different pretreatment strategies: control, silane, sandblasting (50 µm aluminum oxide particles), sandblasting + silane, etching (9% hydrofluorics acid), etching + silane. Subsequently, surface roughness (Ra) values, surface free energy (SFE) were measured. Each specimen was bonded with a dual-cured adhesive composite. Half of the specimens were subjected to thermocycling (5000 cycles, 5-55 °C). The shear bond strength (SBS) test was performed. Data were analyzed by using a two-way analysis of variance, independent t-test, and Mann-Whitney-U-test (α = 0.05). RESULTS: Material type (p = 0.001), pretreatment strategy (p < 0.001), and the interaction (p < 0.001) all had significant effects on Ra value. However, only etching on VSCP and VE surface increased SFE value significantly. Regarding SBS value, no significant difference was found among the three materials (p = 0.937), while the pretreatment strategy significantly influenced SBS (p < 0.05). Etching on VSCP specimens showed the lowest mean value among all groups, while sandblasting and silane result in higher SBS for all test materials. CONCLUSIONS: The bond strength of CAD/CAM hybrid ceramic materials for milling and 3D-printing was comparable. Sandblasting and silane coupling were suitable for both millable and printable materials, while hydrofluoric etching should not be recommended for CAD/CAM hybrid ceramic materials. CLINICAL RELEVANCE: Since comparable evidence between 3D-printable and millable CAD/CAM dental hybrid materials is scarce, the present study gives clear guidance for pretreatment planning on different materials.

Sandblasting increases the microtensile bond strength between resin and sclerotic dentin in noncarious cervical lesions.

PURPOSE: To evaluate the effect of sandblasting on the microtensile strength between sclerotic dentin and resin composite. METHODS: 32 premolars with noncarious cervical lesions (NCCLs) were collected, and the teeth were randomly assigned to the control group (C group) and the sandblasted group (S group). Teeth in the S group were sandblasted with 110 µm Al2O3 particles at a pressure of 75 psi, while those in the C group received no further treatment. The characteristics of the tooth surface were observed by scanning electron microscopy (SEM), and the relative area of open dentin tubules (OTs) was calculated by IPP6.0 software. Surface roughness (Ra) was also assessed. The noncarious cervical lesions of all teeth were restored with a resin composite and subsequently sectioned into sticks to measure the microtensile bond strength (µTBS). RESULTS: The mean ± SD µTBS (in MPa) of the sandblasted group was 17.9 ± 0.69 and 14.23 ± 0.44 in the control group (P< 0.05). The relative area of OTs at the gingival wall of the sandblasted group was 69.74 ± 5.23%, and 47.24 ± 7.67% in the control group (P< 0.05). The average surface roughness (µm) was 1.01 ± 0.05 in the sandblasted group and 0.16 ± 0.03 in the control group. Sandblasting could increase the bond strength of sclerotic dentin and resin restorations. CLINICAL SIGNIFICANCE: After sandblasting, the microtensile strength of sclerotic dentin on the surface of noncarious cervical lesions increased, prolonging the resin adhesion longevity. Sandblasting could also alleviate the pain of patients during the treatment process and achieve a minimally invasive treatment.

Effect of laser etching on surface characteristics and porcelain bond to soft milled and direct metal laser sintered cobalt chromium alloys.

STATEMENT OF PROBLEM: The surface topography of metal substrate can affect its bond to porcelain. A neodynium-doped yttrium aluminum garnet (Nd:YAG) laser has been introduced to modify the metal surface topography and improve porcelain bond strength. However, studies on the effect of laser etching on metal to porcelain bond strength are lacking. PURPOSE: The purpose of this in vitro study was to determine the effect of Nd:YAG laser etching on the surface roughness and wettability of and the porcelain bond strength to cobalt chromium (Co-Cr) substrate fabricated by milling and direct metal laser sintering (DMLS). MATERIAL AND METHODS: Thirty-two 0.5×3×25-mm Co-Cr specimens were fabricated by milling soft Co-Cr (M group) and DMLS Co-Cr metal powder (DML group). The surface topography of representative specimens from each study group was assessed under a scanning electron microscope (SEM) and an atomic force microscope (AFM). All specimens were assessed for surface roughness using a contact profilometer, and for wettability with a contact angle goniometer. Half of the specimens of each study group (n=8) were subjected to surface laser etching by using a Nd:YAG laser. The specimens subjected to etching were assessed again for surface topography and wettability. All specimens in both study groups were veneered with porcelain. The porcelain bond strength was tested with a 3-point bend test in a universal testing machine. The results were statistically analyzed with 2-way ANOVA test followed by the post hoc Tukey test for pairwise comparisons (α=.05). RESULTS: After etching, the M group had a higher mean ±standard deviation Ra and Rz of 2.9 ±0.6 and 17.7 ±3.2 µm and significantly better wettability and bond strength of 79 ±6 and 52 ±13 MPa. In contrast, after etching, the DMLS group had a significantly lower Ra and Rz of 7.9 ±2.4 and 41.8 ±9.3 µm and significantly lower wettability and bond strength of 87 ±4 and 70 ±10 MPa. The DMLS group had a significantly higher roughness and bond strength than the M group before and after laser etching. The SEM and AFM showed different surface topography in the study groups. CONCLUSIONS: The manufacturing process of Co-Cr substrate had a significant effect on surface characteristics and porcelain bond strength. Laser etching improved the surface topography and bond strength of milled Co-Cr but not of DMLS Co-Cr.

Effect of surface treatment and resin cement type on the bond strength of polyetheretherketone to lithium disilicate ceramic.

BACKGROUND: This study aims to evaluate the effect of surface treatment and resin cement on the shear bond strength (SBS) and mode of failure of polyetheretherketone (PEEK) to lithium disilicate ceramic (LDC). This is suggested to study alternative veneering of PEEK frameworks with a ceramic material. METHODS: eighty discs were prepared from PEEK blank and from lithium disilicate ceramic. Samples were divided into four groups according to surface treatment: Group (A) air abraded with 110 µm Al2O3, Group (AP) air abrasion and primer application, Group (S) 98% sulfuric acid etching for 60 s, Group (SP) Sulfuric acid and primer. Each group was subdivided into two subgroups based on resin cement type used for bonding LDC:1) subgroup (L) self- adhesive resin cement and 2) subgroup (B) conventional resin cement (n = 10). Thermocycling was done for all samples. The bond strength was assessed using the shear bond strength test (SBS). Failure mode analysis was done at 50X magnification with a stereomicroscope. Samples were chosen from each group for scanning electron microscope (SEM). The three-way nested ANOVA followed by Tukey's post hoc test were used for statistical analysis of results. Comparisons of effects were done utilizing one way ANOVA and (p < 0.05). RESULTS: The highest mean of shear bond strength values was demonstrated in Group of air abrasion with primer application using conventional resin cement (APB) (12.21 ± 2.14 MPa). Sulfuric acid groups showed lower shear bond strength values and the majority failed in thermocycling especially when no primer was applied. The failure mode analysis showed that the predominant failure type was adhesive failure between cement and PEEK, while the remaining was mixed failure between cement and PEEK. CONCLUSION: The air abrasion followed by primer application and conventional resin cement used for bonding Lithium Disilicate to PEEK achieved the best bond strength. Primer application did not have an effect when self-adhesive resin cement was used in air-abraded groups. Priming step is mandatory whenever sulfuric acid etching surface treatment is utilized for PEEK.

[Impact of chemical surface treatment of samples made of domestic zirconium dioxide on adhesive strength]. / Vliyanie khimicheskikh metodov podgotovki poverkhnosti obraztsov iz otechestvennogo dioksida tsirkoniya na pokazateli adgezionnoi prochnosti.

Ceramic based on zirconium dioxide (ZD) is a modern, durable material for the manufacture of dentures. It is known that ZD is not etched as glass-ceramic, making it difficult to prepare this material before fixing. OBJECTIVE: To study the impact of various methods of surface treatment of ZD-based ceramic on adhesive strength. MATERIALS AND METHODS: Sandblasting with Al2O3 particles sized 50 µm and application of primers with 10-MDP phosphate monomer were used. Adhesive strength values for following 4 groups of samples were obtained: 1st group - RelyX U200 + sandblasting + Compofix new primer (n=9); 2nd group - Compofix + sandblasting + Compofix new primer (n=9); 3rd group - Panavia F 2.0 + sandblasting (n=9); 4th group (control) - Variolink Esthetic DC + sandblasting + Monobond Plus primer (n=9). RESULTS: The highest strength of adhesion was in the 4th group - 48.71±5.71MPa, the smallest in the 3rd group - 9.49±35.24 MPa. Fully domestic components used in the 2nd group allowed to obtain values of 42.50±9.79 MPa. Adhesive strength in the 1st group was 34.11±4.78 MPa. CONCLUSION: The absence of the 10-MDP-based primers application in the preparation of ZD ceramic reduces the adhesive strength between resin cement and its surface. The domestic set for fixation of dentures can be effectively used for ZD on the same basis as European analogue.

Effect of surface treatment and manufacturing process on the shear bond strength of veneering composite resin to polyetherketoneketone (PEKK) and polyetheretherketone (PEEK).

STATEMENT OF PROBLEM: Polyaryletherketones (PAEKs) are high-performance polymer materials in which polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) are the most used. Although mechanical and shear bonding strength tests have been performed on the 2 materials, studies on the influence of processing on bonding are scarce. PURPOSE: The purpose of this in vitro study was to determine the influence of the surface treatment and the manufacturing process on the shear bond strength of veneering composite resin to PEKK and PEEK. MATERIAL AND METHODS: Thirty pressed PEKK, 30 milled PEKK, and 30 milled PEEK specimens were distributed in 6 groups (n=13) as per the manufacturing process and treatment surface. The specimens were either treated with airborne-particle abrasion with 110-µm aluminum oxide, or no surface treatment was applied. Moreover, the PEKK specimens were grouped regarding their manufacturing process, as either milled or heat-pressed. The specimens were all bonded by using a methyl methacrylate-based adhesive (visio.link), and composite resin (Gradia Revolution 2) was bonded to the specimens. An Instron universal machine was used to calculate the shear bond strength between the PEEK or PEKK and the composite resin. Two specimens from each group had their topography modification assessed with a scanning electron microscope. Statistical analysis was performed by using a 3-way ANOVA for multiple comparisons (α=0.05) RESULTS: The groups that were surface treated with 110-µm aluminum oxide (Al2O3) before bonding showed significantly higher shear bond strength (P=.001) than the other groups. However, no statistically significant difference was observed among the groups, regardless of the manufacturing process (milled or heat-pressed) (P=.607). CONCLUSIONS: PEEK and PEKK surfaces treated with 110-µm aluminum oxide airborne-particle abrasion displayed better shear bond strength to composite resin. The manufacturing process (milled or heat-pressed) did not significantly affect the bond strength of PEKK when subjected to the same bonding process.

Optical changes of human dentin after non-vital bleaching and effect of Er,Cr:YSGG laser on micro-shear bond strength of a self-etch and an etch-and-rinse adhesive system.

The aim was to evaluate the optical changes of bleached human dentin and the efficacy of Er,Cr:YSGG laser on micro-shear bond strength (µSBS) of two adhesive systems for immediate and delayed applications. Seventy-two human dentin specimens (1 mm) were obtained. Colour measurements of 30 specimens (control and bleaching groups) were made at baseline, after bleaching and a 7-day delay. Differences at colour (ΔE00), translucency (ΔTP00) and whiteness (ΔWID) were calculated by recorded data. Forty-two specimens were used to compare µSBS of a self-etch (Clearfil SE Bond [SE]) and an etch-and-rinse (Prime&Bond NT [PBNT]) adhesive to bleached dentin. Additional to a negative group, six groups were contemplated for each adhesive, considering the time of composite application (immediate, delayed) and whether additional surface treatment by laser (1 W, 2 W) or not. Colour and µSBS data were statistically analysed. For optical analysis, only ΔE00 and ΔWID calculated for the difference between baseline and bleaching were found significantly different for control and bleaching groups. Whiteness of bleached specimens was remarkably decreased after a 7-day delay. Despite immediate applications of SE showing lower µSBS than negative control, delayed applications showed no significant differences except that of the 2 W laser etching. For PBNT, laser etching increased µSBS for both of the immediate and delayed applications, and no significant difference was observed from negative control. Related with the preferred adhesive system, Er,Cr:YSGG laser etching can be an alternative for optimal bond strength of immediate restorations, but the clinicians should always keep in mind that perceived colour and whiteness will change by the passing time which can affect the shade match.

Evaluation of bond strength of resin cement to Er:YAG laser-etched enamel and dentin after cementation of ceramic discs.

The purpose of this study was to investigate the shear bond strength (SBS) of ceramic discs luted to differently etched enamel and dentin surfaces. Occlusal surfaces of 64 carious-free human molars and vestibule surfaces of 64 first maxillary incisors were ground to get flat superficial dentin and flattened enamel respectively. After generating 4 groups according to the surface etching method (37% orthophosphoric acid, Er:YAG laser-contact handpiece/scanning handpiece (1 or 2 times of scanning)), ceramic discs were luted to the surfaces with adhesive resin cement (Variolink N, Vivadent Ets., Schaan/Liechtenstein). After etching and cementation, thermocycling of 5000 cycles (Sd Mechatronik Gmbh, Feldkirchen-Westerham, Germany) and SBS test (Servopulser EHFFD1; Shimadzu, Kyoto, Japan) were performed respectively. The surface morphologies of 2 specimens, etched enamel and dentin, prepared for each group were examined with SEM analysis. Failure modes were determined under a USB digital microscope. Data were analyzed with one-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). SBS values in dentin surfaces showed statistically significant differences (p < 0.05) among tested groups. The highest SBS among dentin groups was determined in the group which had 2 times etching by Er:YAG laser (11.42 MPa) by a scanning handpiece. No statistical differences were observed in the other dentin or enamel groups. Laser etching seems to be a viable alternative to acid etching on both enamel and dentin surfaces while double etching of dentin with a scanning handpiece can improve the adhesion.

Effect of airborne-particle abrasion of a titanium base abutment on the stability of the bonded interface and retention forces of crowns after artificial aging.

STATEMENT OF PROBLEM: Published data have shown that a mechanical surface treatment of titanium surfaces increases bonding potential. However, most of the studies are based on shear or tensile tests performed on flat-surfaced specimens and do not take into consideration the retention given by the titanium base (ti-base) axial walls and the thermomechanical loading seen in a clinical setting. PURPOSE: The purpose of this in vitro study was to evaluate the influence of different airborne-particle abrasion (APA) methods of the ti-base surface on the stability of the bonded interface and retention forces between these titanium bases and lithium disilicate crowns after thermomechanical aging. MATERIAL AND METHODS: Sixty internal connection implants (Conelog) were restored with lithium disilicate crowns and bonded to the corresponding ti-bases (Conelog). The ti-bases were divided into 4 groups (n=15), 3 experimental groups applying different APA methods, 30-µm silica-modified Al2O3 particles (CoJet) (30-SiO-AlO), 50-µm Al2O3 (Cobra Aluoxyd) (50-AlO), 110-µm silica-modified Al2O3 particles (Rocatec Plus) (110-SiO-AlO), and 1 control group (NoT). Ti-bases were airborne-particle abraded (10 seconds, 0.25 MPa at a 10-mm distance) under standardized conditions in a custom-made APA device. All crowns were cemented with a resin cement (Multilink Hybrid Abutment). After aging (1 200 000 cycles, 49 N, 1.67 Hz; 5 °C-55 °C, 120 seconds), all specimens were assessed for the presence of bond failures by optical microscopy (×50). The retention forces (N) were tested by using a pull-off test (0.5mm/min). Modes of failure were classified (Type 1, 2, or 3). An additional ti-base representing each group was prepared for surface roughness (µm) calculation (Ra, Rc, Rz) with a noncontact laser profilometer, and representative scanning electron microscope (SEM) images were recorded (×1000). Chi-squared tests were performed to analyze the bonded interface failure and modes of failure, and a Kruskal-Wallis test was selected to evaluate retention force values (α=.05). RESULTS: The percentages of bonding failure after aging were 73.3% (NoT), 40% (30-SiO-AlO), 6.7% (50-AlO), and 40% (110-SiO-AlO). The stability of the bonded interface was influenced by the APA method applied (P<.05). Mean ±standard deviation retention force values varied from 206.3 ±86.3 N (NoT) to 420 ±139.5 N (50-AlO), and the differences between these 2 groups were significant (P<.05). Modes of failure were predominantly Type 2 (30-SiO-AlO; 50-AlO; 110-SiO-AlO) and Type 3 (NoT). CONCLUSIONS: Airborne-particle abrasion of the titanium surface increased the bond stability and retention forces between the ti-base and the respective crown. The use of 50-µm Al2O3 provided the most stable bonded interface among the different treatments.

Effect of zirconia etching solution on the shear bond strength between zirconia and resin cement.

STATEMENT OF PROBLEM: The bond between resin cement and zirconia is essential to the long-term retention of a zirconia crown. However, it is unclear if the existing methods provide a long-term bond between resin cement and zirconia. PURPOSE: The purpose of this in vitro study was to evaluate the effects of a zirconia etching solution on the shear bond strength between zirconia and resin cement. MATERIAL AND METHODS: Sixty yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) disks (Ø8×5 mm) were divided into 4 groups (n=15). Each group was then treated with 1 of the following methods: airborne-particle abraded with 50-µm Al2O3 (AA); etched with zirconia etching solution (ZES); airborne-particle abraded with 50-µm Al2O3 and then etched with ZES (AA-ZES); etched with ZES and then airborne-particle abraded with 50-µm Al2O3 (ZES-AA). Sixty composite resin cylinders (Ø2.3×2.4 mm) were luted to the zirconia disks with a self-adhesive resin cement under constant load and then light-polymerized for 40 seconds. Specimens were stored in a 37 °C incubator in distilled water for 24 hours and then thermocycled for 1000 cycles between 5 °C and 55 °C. A universal testing machine with a crosshead speed of 0.5 mm/min was used to measure the shear force (N). The shear bond strength (MPa) was then calculated. One-way ANOVA was used to compare the mean shear bond strength among the groups (α=.05). The failure mode was evaluated by using light microscopy at ×90 magnification and categorized as an adhesive, cohesive, or mixed failure. RESULTS: Mean ±standard deviation shear bond strength for AA, ZES, AA-ZES, and ZES-AA groups were 9.9 ±2.6, 8.9 ±2.9, 9.6 ±3.9, and 11.0 ±2.3 MPa, respectively. There was no significant difference among the treatment groups (P>.05). CONCLUSIONS: A zirconia etching solution did not significantly improve the shear bond strength between zirconia and resin cement compared with airborne-particle abrasion with Al2O3.

Adhesive luting of orthodontic devices to silica-based ceramic crowns-comparison of shear bond strength and surface properties.

OBJECTIVES: The aim of this study was to analyse the impact of different clinical conditioning approaches and an ammonium polyfluoride- and trimethoxysilylpropyl methacrylate-based experimental primer for intraoral luting of buccal tubes on silica-based ceramic surfaces. MATERIALS AND METHODS: A total of 60 leucite-reinforced glass ceramic molar crowns were conditioned using different methods (n = 10): I-roughening, hydrofluoric acid, silane; II-roughening, silane; III-roughening, experimental coupling agent; IV-experimental coupling agent; V-roughening; VI-no treatment. A buccal tube was adhesively luted to the ceramic surface. Subsequently, water storage, thermocycling and chewing simulation were carried out. The shear bond strength (SBS) was determined, and changes in the surface were assessed. RESULTS: All tubes of the control group (group VI) debonded after incubation. The conditioning methods using coupling agents revealed mean values for SBS of 61.56 MPa (group I), 45.53 MPa (group III), 41.65 MPa (group II), and 23.14 MPa (group IV). In groups I-III, both composite residues and cracks/tear-outs were detected. CONCLUSIONS: The conditioning of silicate ceramic surfaces with a suitable coupling agent system appears to allow sufficient adhesive luting of buccal tubes. The intraoral luting of fixed appliance elements on silicate ceramic surfaces using an ammonium polyfluoride- and trimethoxysilylpropyl methacrylate-based ceramic primer can withstand orthodontic forces. CLINICAL RELEVANCE: Ammonium polyfluoride- and trimethoxysilylpropyl methacrylate-based ceramic primers revealed promising results for the intraoral adhesive luting of orthodontic devices to silica-based ceramic crowns.

Effect of reduced airborne-particle abrasion pressure on the retention of zirconia copings resin bonded to titanium abutments.

STATEMENT OF PROBLEM: The optimal conditioning of zirconia is essential for a durable bond between zirconia copings and titanium inserts in 2-piece dental implant abutments. Low-pressure activation of the zirconia surface may be adequate for retention. PURPOSE: The purpose of this in vitro study was to evaluate the influence of airborne-particle abrasion (APA) of the zirconia surface with different pressures on the retention of zirconia copings bonded to titanium abutments. In addition, 2 luting systems were compared. MATERIAL AND METHODS: Computer-aided design and computer-aided manufacturing (CAD-CAM) zirconia copings were divided into 3 groups (n=32): 0.1 MPa, 0.25 MPa, and not airborne-particle abraded surfaces with 50-µm alumina (Al2O3) particles. Compatible titanium abutments were airborne-particle abraded at a pressure of 0.25 MPa. All specimens were ultrasonically cleaned before bonding. Each group was divided into 2 subgroups (n=16) with different luting composite resins. A 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) containing self-adhesive luting composite resin (Panavia SA Cement Plus) and a conventional luting composite resin (Multilink Hybrid Abutment) in combination with a 10-MDP-containing universal primer (Monobond Plus) was compared. Two storage conditions were tested: in water (37 °C) for 3 days or 150 days with 37 500 thermocycles between 5 °C and 55 °C. After artificial aging, retention was measured in tension, and the failure modes were analyzed by using a light microscope and a scanning electron microscope. Statistical analysis was performed with 1-way ANOVA and the Games-Howell test for post hoc analysis (α=.05). RESULTS: The mean retention of the airborne-particle abraded groups ranged from 576.0 N to 1049.3 N after 150 days of water storage and 37 500 thermocycles. No significant difference in bond strength was found between the 2 luting composite resin groups with airborne-particle abraded zirconia surfaces after 150 days (P<.05). Both bonding systems provided durable bond strength after 3 and 150 days. Failure mode was mainly cohesive at the titanium surfaces and predominantly adhesive at the zirconia surfaces. The retention was significantly higher if APA was used versus no APA (P<.05), while the APA pressure used made no significant difference. CONCLUSIONS: The APA of zirconia copings at a pressure of 0.1 MPa in combination with 10-MDP-containing luting composite resins and primers is adequate for the durable bonding of zirconia copings to titanium inserts.

Effect of Various Treatment Modalities on Surface Characteristics and Shear Bond Strengths of Polyetheretherketone-Based Core Materials.

PURPOSE: To investigate the effect of different surface treatments on the surface roughness (Ra), wettability, and shear bond strength of polyetheretherketone (PEEK) to composite resin. MATERIALS AND METHODS: One hundred ninety eight PEEK specimens were divided into six groups (n = 33). Specimen surfaces were treated with the following surface treatment modalities: silicoating (CoJet), acetone treatment, acid etching (H2 SO4 ), airborne particle abrasion (Al2 O3 ), laser irradiation (Yb:PL laser), and the nontreated surface serving as the control. Surface roughness was measured with an profilometer (n = 11) and a goniometer was used to measure the surface wettability through contact angle (θ)(n = 11). PEEK surfaces were veneered with a composite resin (n = 11). The specimens were then thermocycled for 10,000 cycles at 5 to 55°C. Shear bond strengths between the PEEK and composite resin were measured with an universal test machine. One-way ANOVA was used to analyze the data. Tukey's post-hoc test was used to determine significant differences between groups (α = 0.05). RESULTS: Surface roughness and wettability of PEEK surfaces along with shear bond strength of PEEK to composite resin were influenced by the surface treatments. (p < 0.01) Highest mean Ra values were obtained for PEEK surfaces treated by laser irradiation (2.85 ± 0.2 µm) followed by airborne particle abrasion (2.26 ± 0.33 µm), whereas other surface treatment modalities provided similar Ra values, with the acid-etched PEEK surfaces having the lowest mean Ra values (0.35 ± 0.14 µm). Silicoating provided the most wettable PEEK surfaces (48.04 ± 6.28º), followed by either acetone treatment (70.19 ± 4.49º) or acid treatment (76.07 ± 6.61º). Decreased wettability was observed for airborne particle abraded (84.83 ± 4.56º) and laser-treated PEEK surfaces (103.06 ± 4.88º). The highest mean shear bond strength values were observed for acid-etched PEEK surfaces (15.82 ± 4.23 MPa) followed by laser irradiated (11.46 ± 1.97 MPa), airborne particle abraded (10.81 ± 3.06 MPa), and silicoated PEEK surfaces (8.07 ± 2.54 MPa). Acetone-treated (5.98 ± 1.54 MPa) and untreated PEEK surfaces (5.09 ± 2.14 MPa) provided the lowest mean shear bond strengths. CONCLUSIONS: The highest mean shear bond strengths were observed for acid-etched PEEK surfaces, followed by laser-irradiated, airborne particle abraded, and silicoated PEEK surfaces providing similar mean shear bond strengths. Since shear bond strengths higher than 10 MPa are considered acceptable, acid etching, laser irradiation, and airborne particle abrasion of PEEK surfaces may be considered viable surface treatment modalities for the PEEK material tested.

The effect of diode laser application on restoration of non carious cervical lesion: Clinical follow up.

AIMS: The aim of this study is to evaluate the effect of the diode laser used for dentin sensitivity on the clinical success of non-carious cervical lesion (NCCL) restorations restored with different adhesive systems. METHODS: 20 NCCLs were restorated with Universal Single Bond (Self Etch) (3M, USA) and Grandio (Voco, Germany), 20 NCCLs were restorated with Universal Single Bond (Total Etch) and Grandio. After diode laser application, 20 NCCLs were restorated with Universal Single Bond and Grandio, 20 NCCLs were restorated with Universal Single Bond (Total Etch) and Grandio. The restorations were clinical evaluated by two examiners at baseline, for 6 and 18 months using modified United States Public Health Service (USPHS) Criteria. Chi-square test was used for statistical analyse. RESULTS: The lowest rates of retention was found in the Group 1. There was no statistically significant difference among the groups in marginal discoloration, marginal integrity, sensitivity (P > 0.05). CONCLUSION: Diode laser application prior to the restoration of teeth with NCCL don't reduce the retention rate of restorations, may reduce hypersensitivity and may affect the success of restoration. However, further laboratory and clinical studies are required.

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.

Effect of a novel prime-and-rinse approach on short- and long-term dentin bond strength of self-etch adhesives.

This study investigated the effects of the prime-and-rinse approach, using a 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing primer, on the short- and long-term dentin microtensile bond strengths (MTBSs) of mild self-etch adhesives. Half of sixty human midcoronal dentin surfaces were polished as control (self-etch approach), and the other half were polished and further treated with a 15% MDP-containing primer and thoroughly sprayed with water as prime-and-rinse approach. The dentin surfaces were treated with a self-etch adhesive, and a composite resin was placed on the surfaces. The following materials were used: Clearfil S3 Bond+Clearfil Majesty; G-Bond+Gradia Direct; Adper Easy One+Z250; and i Bond+Charisma. The MTBS was examined after 24 h and 14 months in water storage. The resin-dentin interfaces were analysed using scanning electron microscopy/transmission electron microscopy. Pretreated dentin surfaces were further analysed using scanning electron microscopy and micro-Raman spectroscopy. Compared with the self-etch approach, the prime-and-rinse approach significantly increased the dentin MTBS, regardless of the duration of storage. The scanning electron microscopy/transmission electron microscopy findings revealed that the prime-and-rinse approach removed most of the dentin smear layer. The Raman spectra of the MDP-treated dentin reveal the characteristic spectra of collagen, hydroxyapatite, and the monomer. Therefore, the prime-and-rinse approach using MDP-containing primers prior to the application of mild self-etch adhesives significantly increases the short- and long-term MTBS of dentin.

Surface Processing: An Elegant Way to Enhance the Femtosecond Laser Ablation Rate and Ablation Efficiency on Human Teeth.

BACKGROUND AND OBJECTIVES: The employability of the non-invasive femtosecond laser ablation technique for dental treatment has been severely limited by its low ablation rate despite the advantage of minimal tissue damage. The study explores a means of improving the femtosecond laser ablation rate and efficiency by physiochemical surface modification. MATERIALS AND METHODS: Surface modification of dental hard tissues has been carried out by food graded orthophosphoric acid and Carie care gel pretreatment. The laser ablation characteristics were studied by using a Ti:Sapphire laser (10 kHz, 10 mm/s, 100 fs, 800 nm) to ascertain the influence of pretreatment. Surface morphology and chemical composition were obtained by using an optical profiler, SEM and EDAX. RESULTS: The ablation threshold fluence decreased by almost one-third whereas the ablation rate and ablation efficiency nearly tripled upon pretreatment. The microstructural and compositional analysis clearly reveals that surface modification and demineralization reduce the threshold fluence and increase the ablation rate by effective utilization of the laser beam energy. The pretreatment effect is more pronounced in orthophosphoric acid as compared with Carie care gel. CONCLUSIONS: Physiochemical surface modification can be an efficient method to improve the laser ablation rate and ablation efficiency. Compositional analysis can be an elegant tool for pre-surgery determination of laser ablation characteristics. CLINICAL SIGNIFICANCES: Pretreatment surface modification can be an effective way to overcome the limitation of the femtosecond laser for tooth preparation in the clinical setting by strongly enhancing the ablation rate. An enhanced ablation rate along with de nova prediction of ablation characteristics will enable the clinician to perform dental surgery in real time with minimal tissue damage. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Clinical performance of precoated brackets and self-etch bonding technique: a prospective comparative study.

OBJECTIVE: The aim was to compare the clinical performance of uncoated and adhesive precoated brackets bonded with either self-etching primer (SEP) or conventional two-step etch and primer method (CEM). SUBJECTS AND METHODS: The sample consisted of 63 patients with a mean age of 15.20 ± 1.6 years. In group I (n = 15), uncoated brackets and CEM; in group II (n = 16), precoated brackets and CEM; in group III (n = 16), uncoated brackets and SEP; in group IV (n = 16), precoated brackets and SEP were used for bonding. Bonding time, bracket failure rate, and adhesive remnant index (ARI) scores were measured. The mean orthodontic treatment time was 1.13 ± 0.18 years. One-way variance ANOVA was used to determine bonding time differences and the chi-square test was used to determine differences in bracket failure rates and ARI scores. RESULTS: The bonding time was significantly lower for Groups III and IV, when compared to Groups I and II (p < 0.001). The bond failure rates were not different between the groups. Significant difference was observed between the procedures in relation to ARI scores (p < 0.001), which were higher in group IV. CONCLUSIONS: Precoated brackets with SEP application significantly reduced chair time without compromising bracket failure rate. CLINICAL RELEVANCE: Precoated brackets with SEP application can be safely used for bonding. Regarding the mode of failure, this group can be thought as favorable with a reduced risk of enamel tear.

The critical bond strength of orthodontic brackets bonded to dental glass-ceramics.

OBJECTIVES: To evaluate the critical bond strength (σ) of ceramic and metal brackets to a lithium disilicate-based glass-ceramic. MATERIALS AND METHODS: Two hundred and forty ceramic specimens (IPS e-max CAD) were randomly distributed in 12 experimental groups (n = 20). Two ceramic brackets (monocrystalline, BCm; and polycrystalline, BCp) and a metal bracket (BM) were bonded to glass-ceramic specimens after one of the following surface treatments: HF-hydrofluoric acid applied for 60 s; S-silane applied for 3 min; HFS-HF followed by S; and MDP-application of an adhesive containing a phosphate monomer (MDP). All brackets were bonded to the treated glass-ceramic using a resin cement, stored in 37 °C water for 48 h before shear bond strength testing. Optical (OM) and scanning electron (SEM) microscopies were used for fractographic analysis. Data was statistically analyzed using Kruskal-Wallis and Student-Newman-Keuls (α = 0.05). RESULTS: BCm bonded to glass-ceramic treated with either HFS or HF showed the highest median σ values, respectively, 10.5 MPa and 8.5 MPa. In contrast, the BCp bonded to glass-ceramic treated with MDP showed the lowest median σ value (0.8 MPa), which was not statistically different from other MDP-treated groups. CONCLUSIONS: The failure mode was governed by the glass-ceramic surface treatment, not by the bracket type. Quantitative (σ values) and qualitative (fracture mode) data suggested a minimum of 5 MPa for brackets bonded to glass-ceramic, which is the lower critical limit bond strength for a comprehensive orthodontic treatment. CLINICAL RELEVANCE: Bonding brackets to glass-ceramic requires micromechanical retention.

Clinical, double blind, randomized controlled trial of experimental adhesive protocols in caries-affected dentin.

OBJECTIVE: To evaluate the clinical performance of posterior resin composite restorations regarding experimental and regular adhesive protocols in caries affected-dentin (CAD). MATERIAL AND METHODS: A total of 92 class I and class II cavities with carious lesions were selected and randomly assigned to the following groups: (1) bioactive glass-ceramic powder/two-step etch and rinse system, (2) control/two-step etch and rinse system, (3) bioactive glass-ceramic powder/two-step self-etching system, and (4) control/two-step self-etching system. Two operators carried out the adhesive protocols and restored the cavities with a nano-hybrid resin composite. Participants were followed up at 1 week and 6, 12, and 18 months for clinical evaluation performed by two blinded examiners and calibrated according to FDI criteria. Data were analyzed using Kruskal-Wallis and Dunn tests with a confidence of 95%. RESULTS: The clinical performance of resin composite restoration was not affected by the experimental use of an adhesive protocol including a bioactive glass-ceramic powder for 18 months post-procedure. However, there was a significant difference between group 2 and group 4 (p < 0.05) for marginal adaptation (18 months). Group 2 was significantly different from group 3 (p < 0.05) for fracture of material/retention (18 months) and marginal adaptation (1 week); group 2 showed a better performance. CONCLUSION: Adhesive protocols can alter the clinical performance of posterior restorations in terms of marginal adaptation and the fracture of material/retention in CAD. CLINICAL SIGNIFICANCE: Adhesive protocols may influence the success of resin composite restorations in CAD; this is important because failure can lead to caries, re-incidence, and/or clinical re-work.