Bonding stability of universal adhesives to feldspathic ceramic with or without prior silane application.

PURPOSE: This study aimed to assess the bonding stability of three universal adhesives to a CAD-CAM feldspathic ceramic with or without prior silane application. MATERIALS AND METHODS: The universal adhesives tested were Ambar Universal (FGM), Single Bond Universal (3M), and Ybond Universal (Yller). Scotchbond Multipurpose Plus (3M) was used as a control. The silane used was RelyX Ceramic Primer (3M). Microtensile bond strength (µTBS) to Vitablocs Mark II was measured after 24 h or 6 months of water aging (n = 20). Failure modes were observed through scanning electron microscopy, and pH and degree of C=C conversion (DC) of the adhesives were measured (n = 3). Data were analyzed using one-, two-, and three-way ANOVA. RESULTS: The pH values differed significantly among the adhesives (p < 0.001), while the DC was similar (p = 0.141). The universal adhesives showed significant differences in µTBS, with higher immediate results when using silane and lower results after aging. Notably, a significant decrease in µTBS was observed after 6 months when silane was applied. In contrast, the control adhesive exhibited consistent results between the 24-h and 6-month storage periods. The universal adhesives showed a decrease in µTBS ranging from 25.5% to 40.1% after prolonged storage. Adhesive failures were predominant in all groups. The presence or absence of silane in the adhesive composition did not affect the bonding performance. CONCLUSIONS: The application of a separate silane coupling agent improved the immediate bond strength of universal adhesives to CAD-CAM feldspathic ceramic. However, this bond strength significantly decreased after 6 months of water aging. The bond strength remained stable for universal adhesives when applied without silane after 6 months of aging.

Bonding to Sound and Caries-Affected Dentin: A Systematic Review and Meta-Analysis.

PURPOSE: This study systematically reviewed the literature to compare the bonding ability of dental adhesives applied to sound dentin (SoD) vs caries-affected dentin (CAD). MATERIALS AND METHODS: Three international databases (Medline/PubMed, Scopus, and Web of Science) were searched. Eligible studies which evaluated the bond strength to both SoD and CAD were included. Random effects meta-analyses were conducted to calculate pooled mean difference between substrates, separately for etch-and-rinse and self-etch adhesives. Subgroup analyses were carried out to explore heterogeneity considering the methods used for removal of infected carious dentin. A comparison between etch-and-rinse and self-etch adhesives restricted to CAD was also performed. Statistical heterogeneity was considered using the I2 test. The risk of bias of all included studies was assessed. RESULTS: In total, 2260 articles were found, 65 were selected for full-text reading, and 40 studies were included. The meta-analyses favored SoD over CAD for both etch-and-rinse (effect size: -10.04; 95% confidence interval [CI]: -11.94, -8.14; I2 = 95%) and self-etch adhesives (effect size: -6.76; 95% CI: -8.23, -5.30; I2 = 89%). In the subgroup analyses, SoD was favored irrespective of the method used for caries removal (effect size ≤ -4.86; I2 ≥ 28%): excavation (manual or with burs), grinding with abrasive papers, combination of more than one method, and when the method was not mentioned. The meta-analysis restricted to CAD favored etch-and-rinse over self-etch adhesives (effect size: 3.13; 95% CI: 1.82, 4.44; I2 = 72%). Most included studies were judged as having an unclear risk of bias. CONCLUSION: Bonding to SoD yields better results compared to CAD. Etch-and-rinse adhesives performed better than self-etch adhesives when applied to CAD.

Effect of Diamond Bur Grit Size on Composite Repair.

PURPOSE: This study investigated the effect of diamond bur grit size on the repair bond strength of fresh and aged resin composites. MATERIALS AND METHODS: Blocks of microhybrid composite (Opallis, FGM) were stored in distilled water at 37°C for 24 h (fresh composite) or subjected to 5000 thermal cycles (aged composite). The surfaces were roughened using diamond-coated, flame-shaped carbide burs with medium grit (#3168), fine grit (#3168F), or extra-fine grit (#3168FF). The control group underwent no surface treatment. Surface roughness, water contact angle, and surface topography by scanning electron microscopy (SEM) were evaluated (n = 3). Samples were restored with resin composite and sectioned into beam-shaped specimens, which were subjected to microtensile bond testing. Failure modes were classified using a stereomicroscope. Data were statistically analyzed using the Student- Newman-Keuls test and two-way ANOVA, with significance set at p < 0.05. RESULTS: Higher surface roughness was observed for groups treated with the medium- and fine-grit burs; aged composites were rougher than fresh composites. The water contact angle formed on the aged composite was lower than that on the fresh composite. The highest repair bond strength was observed for the fine-grit bur group, and the lowest was recorded for control. Interfacial failures were more predominant. SEM images showed that the surfaces treated with fine- and extra-fine-grit burs had a more irregular topography. CONCLUSION: Surface roughening of fresh or aged resin composites with diamond burs improved retention of the repair material. Fine-grit burs generally performed better than medium- and extra-fine-grit burs.

A biofilm cariogenic challenge model for dentin demineralization and dentin bonding analysis.

OBJECTIVES: This study was designed to adapt a previously developed in vitro microcosm biofilm model to create carries-affected dentin (CAD) and establish conditions for using the model in bonding studies. MATERIALS AND METHODS: Biofilms were originated from human saliva and grown on dentin discs for 0 (sound dentin), 3, 5, 7, 14, or 21 days under intermittent cariogenic condition (n = 10). At each time point, composite cylinders were bonded to the dentin using self-etch adhesive (Clearfil SE Bond). The response variables were integrated mineral loss (ΔS), lesion depth (LD), shear bond strength (SBS), and failure mode. Data were statistically analyzed (α = 0.05). Bonded interfaces were analyzed by scanning electron microscopy (SEM), and dentin surfaces characterized by infrared spectroscopy (Fourier transform infrared spectroscopy, FTIR). RESULTS: Lower ΔS was found for sound dentin than for CAD in all experimental groups, except for the group under cariogenic challenge for 3 days. The SBS to CAD was significantly lower than control for all cariogenic challenge times. Adhesive failures were predominant in all groups. ΔS and LD had a significant negative correlation with SBS. A significant exponential decay in SBS was associated with increased ΔS values. CAD had lower mineral and amide I content and an irregular hybridization interface compared to sound dentin. CONCLUSIONS: The microcosm biofilm model was able to artificially induce CAD, which imposed challenge to the bonding of the polymeric adhesive material. CLINICAL RELEVANCE: Presence of CAD might interfere with the bonding of polymeric materials. The microcosm biofilm model proposed could be useful for preclinical dentin bonding studies.

Effect of ultrasound on preheated resin composites used as ceramic luting agents.

This study investigated the effect of ultrasound application when luting ceramic using two preheated composites that show distinct responses to preheating at 69°C: Filtek Z100 and Z350XT. RelyX Veneer was the control. Feldspar disks were luted using the resin-based luting agents (RBLAs), and ultrasound was tested. Biaxial flexure strength (σbf) was calculated at z-axial positions of the luted disks (z=0; z=-t2). Microtensile bond strength (µTBS) to ceramic was tested (n=30). Data were analyzed at α=0.05. At z=0, the σbf was higher for Z350 when ultrasound was not used. When ultrasound was applied, the σbf was similar between Z350 and Z100. At z=-t2, differences across the RBLAs were observed: Z350 was superior than Z100 and control without ultrasound. Ultrasound increased σbf for Z100 at both axial positions. The preheated composites yielded higher µTBS than the control. Ultrasonication increased the mechanical performance of ceramic luted with Z100 without influencing the film thickness.

Ceramic Laminate Veneers Luted with Preheated Resin Composite: A 10-Year Clinical Report.

Resin cement and preheated restorative resin composite may be used for luting laminate veneers. The main advantage of resin composite is increased wear resistance, which could lead to better marginal performance in long term. This article reports a clinical treatment with feldspar laminate veneers luted to the maxillary teeth with preheated resin composite in a private practice. Case was finalized in May 2009 and followed by 10 years. Excellent clinical service and remarkable long-lasting marginal integrity were observed after 123 months. Scanning electron microscopy analysis showed no wear, gaps, or ditching at the margins. Restorative margins showed a smooth transition between ceramic and tooth with no signs of degradation. Preheated resin composite for luting ceramic laminate veneers may be considered an excellent clinical option.

Effects of alternatively used thermal treatments on the mechanical and fracture behavior of dental resin composites with varying filler content.

The purpose of this study was two-fold: (i) to investigate whether the thermal treatment of direct dental resin composites (RCs) using microwave or autoclave heating cycles would modify the materials' strength as compared to the protocol without heating (control); and (ii) to compare the mechanical performance of direct and indirect RCs. Three RCs (from 3M ESPE) were tested: one indirect (Sinfony); and two direct materials (microhybrid - Filtek Z250; and nanofilled - Filtek Z350). Specimens from the direct RCs were prepared and randomly allocated into three groups according to the thermal treatment (n = 10): Control - no thermal treatment was performed; Microwave - the wet heating was performed using a microwave oven; and Autoclave - the wet heating was performed in an autoclave oven. The indirect RC was prepared following the instructions of the manufacturer. All materials were tested using flexural strength, elastic modulus, work of fracture (Wf), microhardness, and scanning electron microscopy (SEM) analyses. Data were analyzed with ANOVA and Tukey as well as Weibull analysis (α = 0.05). The thermal treatments tended to produce slight changes in the topography of direct RCs, especially by the autoclave' wet heating. Overall, the physico-mechanical properties changed after thermal treatment, although this effect was dependent on the type of RC and on the heating protocol. Sinfony showed the lowest modulus and hardness of the study, although it was the most compliant system (higher work of fracture). The load-deflection ability was also greater for the indirect RC. Reliability of the tested materials was similar among each other (p > 0.05). In conclusion, the alternative thermal treatments suggested here may significantly influence some aspects of the mechanical behavior of dental resin composites, with negative effects relying on both the chemical composition of the restorative material as well as on the wet heating protocol used. Clinicians should be aware of the possible effects that additional wet heating of direct resin composites using microwave or autoclave thermal protocols as performed here could have on the overall fracture and mechanical responses during loading circumstances.

Viscosity and thermal kinetics of 10 preheated restorative resin composites and effect of ultrasound energy on film thickness.

OBJECTIVE: This study investigated viscosity and thermal kinetics of 10 selected preheated restorative resin composites and the effect of ultrasound energy on film thickness. METHODS: A range of different resin composites was tested: Charisma Diamond, IPS Empress Direct, Enamel Plus HRi, Essentia, Estelite Omega, Filtek Z100, Filtek Z350 XT, Gradia, TPH Spectrum and VisCalor. A flowable resin composite (Opallis Flow) and two resin cements (RelyX Veneer, Variolink Esthetic LC) also were tested. Viscosity (Pa s) was measured at 37 °C and 69 °C (preheating temperature) using a rheometer. Film thickness (µm) was measured before and after application of ultrasound energy. Temperature loss within resin composite following preheating (°C/s) was monitored. Data were statistically analyzed (α = 0.05). RESULTS: Viscosity at 69 °C was lower than at 37 °C for all materials except the flowable resin composite. Preheating reduced viscosity between 47% and 92% for the restorative resin composites, which were generally more viscous than the flowable materials. Film thickness varied largely among materials. All preheated resin composites had films thicker than 50 µm without ultrasound energy. Application of ultrasound reduced film thickness between 21% and 49%. Linear and nonlinear regressions did not identify any relationship between filler loading, viscosity, and/or film thickness. All materials showed quick temperature reduction following preheating, showing maximum temperature loss rates after approximately 10 s. SIGNIFICANCE: Distinct restorative resin composites react differently to preheating, affecting viscosity and film thickness. The overall performance of the preheating technique depends on proper material selection and use of ultrasound energy for reducing film thickness.

Effect of Pressure, Post-Pressing Time, and Polymerization Cycle on the Degree of Conversion of Thermoactivated Acrylic Resin.

Herein, the effect of different post-pressing times and pressure in two cycles of polymerization on the degree of conversion (DC) of thermally activated acrylic resin (TRRA) is analyzed to optimize the polymerization of this material. After post-pressing for 0, 6, or 12 h, polymerization was performed with or without a pressure of 60 psi (0.41 MPa) in a short (4 h) or a long (11 h) cycle, totaling 12 groups. To determine the DC, PMMA specimens were analyzed by Fourier transform infrared spectroscopy. The influence of each factor alone on the DC was studied by experimental planning. The statistical tests used were three-way ANOVA, t-test, Tukey's test, and Levene's test, with a margin of error of 5%. Two groups prepared with post-pressing times of 12 h had the lowest DC (p < 0.001). Post-pressing times of 0 and 6 h did not yield statistically different results. Pressure increased the DC in only one group (long cycle +12 h, p=0.001). The short cycle resulted in a higher DC than the long cycle in 2 groups (with pressure +0 h, p=0.002; without pressure +6 h, p=0.015), while the long cycle yielded a statistically higher DC in only one group (with pressure +12 h, p < 0.001). The polymerization showed satisfactory DC in all 12 groups. Small differences found among the specimens indicate that the pressure, post-pressing time, and polymerization cycles herein were not influential factors for the DC of PMMA.