Ultrasonic activation of adhesive systems increases bond strength and intratubular penetration of resin cement in root dentin subjected to radiation therapy.

OBJECTIVE: This study aimed to evaluate the effect of ultrasonic activation of etch-and-rinse and self-etch adhesive systems on the bond strength of resin cement to irradiated root dentin. MATERIALS AND METHODS: Eighty human maxillary anterior teeth were distributed into 8 groups (n = 10), according to the type of adhesive system used (etch-and-rinse and self-etch), the ultrasonic activation of the adhesive systems, and the dentin condition (irradiated or non-irradiated - 70 Gy). Endodontic treatment was performed followed by fiberglass post-space preparation. After fiberglass posts' luting, the roots were transversely sectioned on dentin discs and submitted to the push-out bond strength test (0.5 mm/min). The fractured specimens were analyzed under a stereomicroscope and Scanning Electron Microscope (SEM) for failure mode classification. One of the dentin discs was analyzed under SEM to evaluate the characteristics of the adhesive interface. RESULTS: Irradiated specimens had lower bond strength than non-irradiated specimens (P < 0.0001). Ultrasonic activation of both adhesive systems increased the bond strength of the resin cement to irradiated dentin (P < 0.0001). Radiotherapy significantly affected the failure mode in the middle (P = 0.024) and apical thirds (P = 0.032) (adhesive failure). CONCLUSION: Non-irradiated specimens had a more homogeneous adhesive interface. When ultrasonically activated, both adhesive systems showed a greater number of resinous tags, regardless of the dentin condition. CLINICAL RELEVANCE: Ultrasonic activation of adhesive systems is a feasible strategy to enhance fiberglass posts retention in oncological patients.

Influence of Different Surface Treatments on the Bond Strength of Yttria-Stabilized Tetragonal Zirconia Ceramic.

Objective: This in vitro study evaluates the shear bond strength (SBS) of yttria-stabilized tetragonal zirconia (Y-TZP) and resin cement after different surface treatments. Materials and methods: Forty-eight ceramic cubes were divided into four groups (n = 12): G1 (control) sandblasting with Al2O3; G2-sandblasting with silica-coated Al2O3 (Rocatec); G3-Rocatec + CO2 laser; and G4-CO2 laser + Rocatec. A metallic primer was applied to the pretreated ceramic. A rubber ring was adapted on the central area, and then, the resin cement was inserted into the matrix and photoactivated. The samples were evaluated regarding surface roughness (Ra), SBS, failure type, and qualitatively with scanning electron microscopy (SEM). The data were analyzed by one-way analysis of variance followed by Tukey's test (p < 0.05). Results: The mean values of Ra (µm) were as follows: G1-4.52a, G2-4.24a,b, G3-4.10a,b, and G4-2.90b and the mean values of SBS (MPa) were as follows: G1-7.84a , G2-4.41b , G3-4.61b and G4-6.14a,b. SEM analyses showed superficial irregularities for all groups, being more prominent for G1. The presence of silica deposits was observed for G2, G3, and G4, but in the last two groups there were some linear areas, promoted by the fusion of silica, due to the thermomechanical action of the CO2 laser. Conclusions: The surface treatment with CO2 laser + Rocatec, using one MDP-based cement, can be an alternative protocol for the adhesion cementation of Y-TZP ceramic since it was as effective as the conventional pretreatment with aluminum oxide sandblasting.

Assessing push-out bond strength in re-irradiated teeth: Universal resin cement performance in self-etch and self-adhesive modes.

OBJECTIVES: To investigate the effect of cumulative doses of radiation on the pushout bond strength (BS) of a universal resin cement used in the self-etch (SE) and self-adhesive (SA) modes to the intraradicular dentin. MATERIALS AND METHODS: Forty-eight human teeth were distributed into three groups (n = 16) according to the radiation therapy dose (RT): NoRT (no-radiotherapy), 70RT (70 Gy), and 70 + 70RT (70 Gy + 70 Gy). The teeth were redistributed into two subgroups (n = 8), according to the adhesive mode: SE (NoRT-SE, 70RT-SE, and 70 + 70RT-SE) and SA (NoRT-SA, 70RT-SA, and 70 + 70RT-SA). Data were statistically compared after BS test (ANOVA, Tukey's post hoc test, and Fisher's exact test). RESULTS: In the SA mode, BS was significantly higher in nonirradiated teeth compared with 70RT and 70 + 70RT (p < 0.0001). There were no significant differences between SE and SA modes in nonirradiated teeth (p = 0.14). In the 70RT group, SE mode increased BS compared with SA mode (p < 0.0001). Most specimens had adhesive and mixed failures in SA and SE modes, respectively. CONCLUSIONS: The universal resin cement in the SE mode had greater BS to the irradiated dentin. When teeth were re-irradiated, the universal resin cement had similar performance in terms of BS, regardless of the adhesive approach. CLINICAL SIGNIFICANCE: There is no research establishing a correlation between radiotherapy and its impact on the BS of a universal resin cement used in SE and SA modes to intraradicular dentin.

The capacity of conservative preparations for lithium disilicate glass-ceramic laminates luted with different resin cements to mask different substrate shades: A minimally invasive esthetic approach.

OBJECTIVE: Demonstrate the ability of 0.5 mm thickness lithium disilicate laminates associated with resin cement to mask different substrate saturations. METHODS: 60 specimens (n = 5) were prepared with CAD/CAM lithium disilicate glass-ceramic IPS e.max CAD, 0.5 mm thick, in three degrees of translucency (HT, MT and LT); cemented by Variolink Esthetic LC Light+ (L) and Neutral (N) on composite resin substrates A1 and A4 shades. Color measurements were performed by a spectrophotometer (CM-3700d -Konica Minolta). The L*, a*, b* parameters of the tri-layer structure (laminate/ resin cement/ substrate) were used to calculate color difference ( ∆ E 00 ) by CIEDE2000 formula and Translucency Parameter ( TP 00 ). This study adopted ∆ E 00 = 0.8, as perceptibility threshold (PT), and ∆ E 00 = 1.8, as acceptability threshold (AT). Statistical analyses were performed by one-way ANOVA and Tukey tests (a = 0.05). RESULTS: Color difference between resin cement shades showed statistical differences (p < 0.0001) and ∆ E 00 > 1.8 for all groups. Color difference between substrates saturations showed a significant statistical difference (p < 0.0001) and ∆ E 00 values above AT for all groups. The TP 00 demonstrated significant statistical differences (p < 0.0001). The LTL combination, the opaquest set, showed the smallest ∆ E 00 values between substrate shades differences, however, above AT. CONCLUSION: The translucency of the lithium disilicate, the substrate saturation and the resin cement opacity influenced final color of restoration. The ceramic translucency impact on final color was reduced by opaque resin cement. Furthermore, the LT lithium disilicate and the Light+ resin cement reduced the translucency of the restoration, contributing to mask saturated substrate. CLINICAL RELEVANCE: This study shows the influence of conservative lithium disilicate laminates with different degrees of translucency associated with resin cement on final color of saturated substrate restorations. A minimally invasive esthetic protocol for masking substrates is demonstrated by associating low translucency ceramic laminates and opaque resin cement.

Toothbrushing effects on the surface roughness and cement volume loss of bonded enamel-ceramic interface

Abstract This study evaluated the effect of toothbrushing on enamel-cementing material-ceramic bonded interfaces, using different cementing materials. Materials and Methods: Thirty enamel and thirty ceramic blocks were bonded with cementing materials to produce the samples that were bonded with three types of cementing materials: 1- RelyX Ultimate resin cement (REXU), 2- RelyX Unicem 2 self-adhesive resin cement (REU2) and 3- heated Z100 restorative composite (60°C). Bonded interfaces of the samples were toothbrushed and the surfaces of the 3 cementing materials were evaluated for roughness (RG, in µm), roughness profile (RP, in µm), and volume loss (VL, in µm3) (baseline and after 20,000 and 60,000 toothbrushing cycles). Data were evaluated by Generalized Linear Analysis (two factors: "material" and "toothbrushing cycle") and Bonferroni test (α=0.05). Results: REXU and Z100 exhibited lower RG than that presented by REU2, except after 60,000 toothbrushing cycles when only Z100 differed from REU2. The increase in toothbrushing cycles increased the RG and RP for all materials. REU2 also showed higher RP than those showed by REXU and Z100 when it was analyzed regarding the enamel. The VL of Z100 was the lowest with 20,000 toothbrushing cycles, regarding the enamel and ceramic. For 60,000 cycles, REXU showed the lowest VL regarding the ceramic, and REU2 had the highest VL regarding the enamel and ceramic. Conclusion: In general, REXU and Z100 showed the best results regarding the evaluations performed and the REU2 exhibited the highest RG, RP, and VL.

Resumo Este estudo avaliou o efeito da escovação nas interfaces de união esmalte-material cimentante-cerâmica, utilizando diferentes materiais cimentantes. Materiais e Métodos: Trinta esmaltes e trinta blocos cerâmicos foram unidos com materiais de cimentação para produzir as amostras que foram unidas com três tipos de materiais de cimentação: 1- cimento resinoso RelyX Ultimate (REXU), 2- cimento resinoso autoadesivo RelyX Unicem 2 (REU2) e 3-compósito restaurador aquecido Z100 (60°C). As interfaces coladas das amostras foram escovadas e as superfícies dos 3 materiais cimentantes foram avaliadas quanto à rugosidade (RG, em µm), perfil de rugosidade (RP, em µm) e perda de volume (VL, em µm3) (baseline e após 20.000 e 60.000 ciclos de escovação). Os dados foram avaliados por Análise Linear Generalizada (dois fatores: "material" e "ciclo de escovação") e teste de Bonferroni (α=0,05). Resultados: REXU e Z100 apresentaram menor RG do que REU2, exceto após 60.000 ciclos de escovação, quando Z100 diferiu apenas de REU2. O aumento dos ciclos de escovação aumentou o RG e RP para todos os materiais. O REU2 também apresentou PR maior que o REXU e Z100, quando analisado em relação ao esmalte. O VL de Z100 foi o menor com 20.000 ciclos de escovação em relação ao esmalte e cerâmica. Para 60.000 ciclos, o REXU apresentou o menor VL em relação à cerâmica e o REU2 o maior VL em relação ao esmalte e à cerâmica. Conclusão: De maneira geral, REXU e Z100 apresentaram os melhores resultados nas avaliações realizadas e o REU2 apresentou os maiores RG, RP e VL..

In vitro cytotoxicity of resin cement and its influence on the expression of antioxidant genes.

AIM: This study evaluated cytotoxicity and antioxidant gene expression of resin cements on human gingival fibroblasts (hGF). MATERIALS AND METHOD: RelyX Ultimate™(RXU), Variolink™II(VLII), and RelyXU200™(RXU200) resin cements were incubated with culture medium for 24 h to obtain eluates. Then, the eluates were applied over hGF to assess cell viability at 24 h, 48 h, and 72 h and antioxidant gene expression at 24 h. hGF cultures non-exposed to the eluates were used as Control. Data were submitted to ANOVA and Bonferroni tests (α≤0.05). RESULTS: RXU and RXU200 reduced the number of viable cells in 24 h. Longer exposure to cement extracts caused cell death. Gene expression showed peroxiredoxin 1 (PRDX1) induction by all resin cement types, and superoxide dismutase 1 (SOD1) induction by RXU200 and VLII. Moreover, RXU200 induced not only PRDX1 and SOD1, but also glutathione peroxidase 1 (GPX1), catalase (CAT), and glutathione synthetase (GSS). CONCLUSIONS: All resin cements showed toxicity, and induced antioxidant genes in hGF. Antioxidant gene induction is at least partly associated with cytotoxicity of tested cements to oxidative stress experience.

OBJETIVO: O objetivo deste estudo foi avaliar a toxicidade dos cimentos resinosos Rely X Ultimate 2, Rely X U200 e Variolink II, bem como sua influência na expressão de genes antioxidantes em fibroblastos gengivais humanos. Materiais e Método: Corpos de prova de cada cimento foram colocados em meio de cultura por 24 h e os extratos correspondentes foram aplicados aos fibroblastos. A viabilidade celular foi avaliada após 24, 48 e 72 h de exposição pelo ensaio de exclusão do azul de tripano e MTT. A expressão gênica foi avaliada por PCR quantitativo após 24 h de exposição aos extratos. Estes parâmetros foram comparados aos das células não expostas aos cimentos. Os dados foram submetidos ao teste ANOVA, seguido pelo pós-teste de Bonferroni (a≤0.05). RESULTADOS: Os resultados demonstraram que todos os cimentos promoveram redução do número de células viáveis e da atividade mitocondrial nos períodos de 48 e de 72 h (p< 0,01), sendo que o Variolink II apresentou o menor efeito e os cimentos Rely X Ultimate e Rely X U200 promoveram similarmente os maiores efeitos. A análise de expressão gênica evidenciou influência significativa em todos os cimentos avaliados sobre os níveis de transcritos de PRDX1, SOD1, GPX1 e GSS (p> 0,05), com um aumento considerável no Rely X U200. Conclusão: A indução de genes antioxidantes está, pelo menos em parte, associada à citotoxicidade dos cimentos testados para a experiência de estresse oxidativo.

Does the Elapsed Time from Bleaching and the Use of Sodium Ascorbate Influence the Bond Strength of Resin Cement to Bleached Enamel?

The objective of this study was to evaluate different delaying times after bleaching and the use of different sodium ascorbate (SA) concentrations (10% and 35%) in the bond strength of adhesive cementation to enamel. This study used 54 sound bovine incisors, which were randomly assigned to the following groups: G1 (unbleached/control+ adhesive cementation (AC)); G2 (bleached + AC after 7 days); G3 (bleached + 10% SA + AC after 24 h); G4 (bleached + 10% SA + AC after 7 days); G5 (bleached + 35% SA + AC after 24 h); and G6 (bleached + 35% SA + AC after 7 days). After bleaching, G3, G4, G5, and G6 received an application of SA before the cylinders build up with RelyX Veneer cement. The samples were subjected to microshear test, and the results were analyzed by two-way ANOVA with Tukey's post hoc test. Group one presented the highest mean bond strength (19.1 MPa) and G3 the lowest (16.96 MPa). There was no statistical difference between the groups tested (p ˃ 0.05). The fracture pattern observed was predominantly mixed. The adhesive cementation may be performed 24 h after bleaching when SA (10% or 35%) is used or after 7 days, without compromising bond strength.

In vitro cytotoxicity of resin cement and its influence on the expression of antioxidant genes / Avaliação in vitro da toxicidade de cimentos resinosos e sua influência na expressão de genes antioxidantes em fibroblastos humanos

ABSTRACT Aim: This study evaluated cytotoxicity and antioxidant gene expression of resin cements on human gingival fibroblasts (hGF). Materials and Method: RelyX Ultimate™(RXU), Variolink™II(VLII), and RelyXU200™(RXU200) resin cements were incubated with culture medium for 24 h to obtain eluates. Then, the eluates were applied over hGF to assess cell viability at 24 h, 48 h, and 72 h and antioxidant gene expression at 24 h. hGF cultures non-exposed to the eluates were used as Control. Data were submitted to ANOVA and Bonferroni tests (α≤0.05). Results: RXU and RXU200 reduced the number of viable cells in 24 h. Longer exposure to cement extracts caused cell death. Gene expression showed peroxiredoxin 1 (PRDX1) induction by all resin cement types, and superoxide dismutase 1 (SOD1) induction by RXU200 and VLII. Moreover, RXU200 induced not only PRDX1 and SOD1, but also glutathione peroxidase 1 (GPX1), catalase (CAT), and glutathione synthetase (GSS). Conclusions: All resin cements showed toxicity, and induced antioxidant genes in hGF. Antioxidant gene induction is at least partly associated with cytotoxicity of tested cements to oxidative stress experience.

RESUMO Objetivo: O objetivo deste estudo foi avaliar a toxicidade dos cimentos resinosos Rely X Ultimate 2, Rely X U200 e Variolink II, bem como sua influência na expressão de genes antioxidantes em fibroblastos gengivais humanos. Materiais e Método: Corpos de prova de cada cimento foram colocados em meio de cultura por 24 h e os extratos correspondentes foram aplicados aos fibroblastos. A viabilidade celular foi avaliada após 24, 48 e 72 h de exposição pelo ensaio de exclusão do azul de tripano e MTT. A expressão gênica foi avaliada por PCR quantitativo após 24 h de exposição aos extratos. Estes parâmetros foram comparados aos das células não expostas aos cimentos. Os dados foram submetidos ao teste ANOVA, seguido pelo pós-teste de Bonferroni (a≤0.05). Resultados: Os resultados demonstraram que todos os cimentos promoveram redução do número de células viáveis e da atividade mitocondrial nos períodos de 48 e de 72 h (p < 0,01), sendo que o Variolink II apresentou o menor efeito e os cimentos Rely X Ultimate e Rely X U200 promoveram similarmente os maiores efeitos. A análise de expressão gênica evidenciou influência significativa em todos os cimentos avaliados sobre os níveis de transcritos de PRDX1, SOD1, GPX1 e GSS (p> 0,05), com um aumento considerável no Rely X U200. Conclusão: A indução de genes antioxidantes está, pelo menos em parte, associada à citotoxicidade dos cimentos testados para a experiência de estresse oxidativo.

Effect of the type of resin cement on the fracture resistance of chairside CAD-CAM materials after aging.

PURPOSE: The study objective was to evaluate the influence of the type of resin cement on the flexural strength and load to fracture of two chairside CAD-CAM materials after aging. MATERIALS AND METHODS: A polymer-infiltrated ceramic network (PICN) and a nanoceramic resin (RNC) were used to produce the specimens. Two types of dual-cure resin cements, a self-adhesive and a universal, were investigated. Bilayer specimens were produced (n = 10) and aged for 6 months in a humid environment before the biaxial flexural strength test (σf). Bonded specimens were subjected to a mechanical aging protocol (50 N, 2 Hz, 37℃ water, 500,000 cycles) before the compressive load test (Lf). σf and Lf data were analyzed using two-way ANOVA and Tukey tests (α = .05). Chi-square test was used to analyze the relationship between failure mode and experimental group (α = .05). RESULTS: The type of resin cement and the interaction between factors had no effect on the σf and Lf of the specimens, while the type of restorative material was significant. RNC had higher σf and Lf than PICN. There was a significant association among the type of cracks identified for specimens tested in Lf and the restorative material. CONCLUSION: The type of resin cement had no effect on the flexural strength and load to fracture of the two investigated CAD-CAM chairside materials after aging.

Effect of sodium/calcium hypochlorite on adhesion and adaptation of fiber posts luted with a dual resin cement

Abstract This study aimed to evaluate the effect of different concentrations of sodium hypochlorite (NaOCl) and calcium hypochlorite [Ca(OCl)2] on the bond strength and adaptation of glass fiber posts luted with a dual-curing resin cement. Fifty decoronated premolars were sectioned 14 mm from the apex and endodontically treated. The root canal filling was partially removed. The specimens were divided into 5 groups (n=10) according to the irrigant for post space irrigation: 0.9% sodium chloride (NaCl), (control); 2.5% NaOCl; 5.25% NaOCl; 2.5% Ca(OCl)2; and 5.25% Ca(OCl)2. For each group, irrigation was performed with 5 ml of solution. Afterward, the posts were luted with a dual-curing resin cement. One slice from each third was obtained and submitted to the push-out test and failure modes analysis. An additional slice from the middle third was submitted to confocal images for analysis of adaptation failures (gaps). Two-way ANOVA, Tukey's post-hoc, Kruskal-Wallis with Bonferroni adjusted, and chi-square tests, analyzed data. The group treated with 5.25% NaOCl showed lower bond strength values and generated more cohesive failures compared to the control (p < 0.05). Bond strength decreased from coronal to apical in the post space (p < 0.001). The groups treated with NaOCl had the highest percentages of gaps compared to the control (p < 0.05). Regardless of concentration, Ca(OCl)2 did not influence the bond strength and the occurrence of gaps (P > 0.05). Ca(OCl)2 is a good option for irrigating the post space before luting a fiber post with a dual-curing resin cement.

Resumo Este estudo teve como objetivo avaliar o efeito de diferentes concentrações de hipoclorito de sódio (NaOCl) e hipoclorito de cálcio [Ca(OCl)2] na resistência de união e adaptação de pinos de fibra de vidro cimentados com um cimento resinoso dual. Cinquenta pré-molares tiveram suas coroas removidas, foram seccionados a 14 mm do ápice e tratados endodonticamente. A obturação do canal radicular foi parcialmente removida. Os espécimes foram divididos em 5 grupos (n=10) de acordo com o irrigante para irrigação do espaço do pino: cloreto de sódio 0.9% (NaCl), (controle); NaOCl 2.5%; NaOCl 5.25%; Ca(OCl)2 2.5%; e Ca(OCl)2 5.25%. Para cada grupo, a irrigação foi realizada com 5 ml da solução. Posteriormente, os pinos foram cimentados com um cimento resinoso dual. Uma fatia de cada terço foi obtida e submetida ao teste push-out e análise dos modos de falha. Um corte adicional do terço médio foi submetido a imagens confocais para análise de falhas de adaptação (gaps). Os dados foram analisados pelos testes ANOVA de duas vias, post-hoc de Tukey, Kruskal-Wallis com ajuste de Bonferroni e qui-quadrado. O grupo tratado com NaOCl 5.25% apresentou menores valores de resistência de união e gerou mais falhas coesivas em relação ao controle (p < 0.05). A resistência de união diminuiu de coronal para apical no espaço do pino (p < 0.001). Os grupos tratados com NaOCl apresentaram os maiores percentuais de gaps em relação ao controle (p < 0.05). Independentemente da concentração, o Ca(OCl)2 não influenciou a resistência de união e a ocorrência de gaps (P > 0.05). O Ca(OCl)2 é uma boa opção para irrigar o espaço do pino antes de cimentar um pino de fibra com um cimento resinoso dual.

Influence of thickness and degree of opacity of lithium disilicate on the degree of conversion and bond strength of resin cements.

The aim of this study was to evaluate the influence of various opacities and thicknesses of lithium disilicate on the degree of conversion (DC) of two resin cements and on their bond strength (BS) to the ceramic. Two hundred and forty ceramic samples of lithium disilicate with high translucency (HT), low translucency (LT), and medium opacity (MO) were obtained from IPS e. max CAD in five different thicknesses. Light-cured and dual-cured resin cements were used for DC (n = 9) and BS (n = 8). Cement samples were light-cured under ceramic samples and analyzed using a Raman confocal spectrometer to determine the DC. For BS, resin cement cylinders were fabricated using ceramic samples which were thsen subjected to a microshear bond strength test. The mean values were provided for statistical analysis. The increase in thickness resulted in a decrease in DC for both cements under all experimental conditions, but only affected the BS of the light-cured cement for the MO ceramic. Comparing the opacities, the most translucent ceramics with particular thicknesses exhibited higher DC values than the less translucent ceramics. The LT and MO ceramics with certain thicknesses exhibited the highest BS values than the HT. The dual-cured cement generally showed highest values in both analyses than the light-cured cement. A thicker and more opaque ceramic material can reduce the DC of the cement. The BS decreases with the increasing thickness of the more-opaque ceramics.

Influence of different surface treatments on bond strength of a Self-Adhesive resin cement to CAD-CAM materials / Influencia de los diferentes tratamientos superficiales en la unión del cemento resinoso autoadhesivo a los materiales CAD-CAM

To evaluate the shear bond strength (SBS) of self-adhesive resin cement when used with two different computer-aided design (CAD)-computer-aided manufacturing (CAM) materials after various surface treatments. Nanoceramic resin Lava Ultimate (LU) and feldspathic ceramic Vita Mark II (VM) CAD-CAM block samples were prepared with 1.5-mm thickness, and a total of 90 samples were obtained (N=90), with five samples of each block. The samples were divided into the following five groups according to the surface treatments (n=9): group 1, untreated (control); group 2,5% hydrofluoric acid etching; group 3, Er: YAG laser irradiation; group 4, tribochemical silica coating (Cojet); and group 5, air-abrasion with Al2O3. After silane application, resin cement was applied on a transparent matrix (diameter, 3mm; height, 2mm) on the blocks. SBS was determined using a universal testing device at a crosshead speed of 1mm/min. Two-way analysis of variance (ANOVA) and Tukey's post hoc tests were used to analyze the SBS values. LU showed the highest SBS value in group 4. The average SBS values in groups 3 and were found to be lower than that in the control group (p<0.05). When VM was examined, while all surface treatments increased the SBS values significantly, the highest SBS value was observed in group 4 (p<0.05). This study revealed that all surface treatments used negatively affected the bond strength values of self-adhesive resin cement to LU, except for Cojet application. The SBS values of resin cement with VM increased in all surface treatment application groups.

Evaluar la resistencia de unión al corte (SBS) del cemento de resina autoadhesivo cuando se utiliza con dos materiales diferentes de diseño asistido por computadora (CAD) y fabricación asistida por computadora (CAM) después de varios tratamientos superficiales. Se prepararon muestras de bloques CAD-CAM de resina Lava Ultimate (LU) y cerámica feldespática Vita Mark II (VM) con un espesor de 1,5mm, y se obtuvieron un total de 90 muestras (N=90), con cinco muestras de cada bloque. Las muestras se dividieron en los siguientes cinco grupos según los tratamientos superficiales (n=9): grupo 1, sin tratar (control); grupo 2, grabado con ácido fluorhídrico al 5%; grupo 3, irradiación con láser Er: YAG; grupo 4, recubrimiento triboquímico de sílice (Cojet); y grupo 5, aire-abrasión con Al2O3. Después de la aplicación de silano, se aplicó cemento de resina sobre una matriz transparente (diámetro, 3mm; altura, 2mm) sobre los bloques. La SBS se determinó usando un dispositivo de prueba universal a una velocidad de cruceta de 1mm/min. Se utilizaron análisis de varianza bidireccional (ANOVA) y pruebas post hoc de Tukey para analizar los valores de SBS. LU mostró el valor más alto de SBS en el grupo 4. Los valores promedio de SBS en los grupos 3 y fueron más bajos que en el grupo de control (p<0,05). Cuando se examinó VM, mientras que todos los tratamientos superficiales aumentaron significativamente los valores de SBS, el valor más alto de SBS se observó en el grupo 4 (p<0,05). Este estudio reveló que todos los tratamientos de superficie utilizados afectaron negativamente los valores de resistencia de la unión del cemento de resina autoadhesivo a LU, a excepción de la aplicación Cojet. Los valores de SBS del cemento de resina con VM aumentaron en todos los grupos de aplicación de tratamiento de superficie.

Survival rate and treatment success of glass fiber posts cemented with two adhesive cementation strategies after up to 106 months: a randomized clinical trial.

OBJECTIVES: The objective of this study is to evaluate the longevity of two fiber post cementation strategies in a prospective, multicenter, non-inferiority, double-blind randomized controlled trial. METHODS: A total of 152 teeth, with adequate endodontic treatment and loss of coronal structure and bilateral simultaneous posterior occlusal contacts, were randomly allocated to receive glass fiber posts cemented with a conventional cementation strategy (CRC group: adhesive system + resin cement) (Adper Single Bond + RelyX ARC; 3 M-ESPE) or a self-adhesive cementation strategy (SRC group: self-adhesive resin cement; RelyX U100/U200; 3 M-ESPE). The patients were recalled annually for clinical and radiographical evaluation with a 93% recall rate (142 teeth, with 74 at CR groups and 68 at SRC group). The primary outcome was survival rate, considering the fiber post debonding (loss of retention). The secondary outcome included the success rate of the prosthetic treatment with crown debonding, post fracture, and tooth loss (not related to post failure). Both outcomes were evaluated annually. The Kaplan-Meier method and Cox regression with 95% confidence interval were used for the statistical analysis. RESULTS: For the primary outcome (failures directly related to fiber posts cementation strategy), there were 4 fiber post debondings (2 per group), 8 root fractures (3 for SRC group and 5 for CRC group), and one mixed failure (debonding combined with root fracture for CRC), with both strategies presenting similar survival rates (p = 0.331), with 88.9% for the CRC group and 90.9% for the SRC group. For the secondary outcome (failures not related to fiber post cementation strategies), there were 8 crown debondings, 3 post fractures, and 3 tooth losses, with no statistically difference between groups (p = 0.701), with 77% for SRC and 82% for CRC. CONCLUSION: Fiber post cementation strategies with conventional or self-adhesive resin cement presents similar tooth survival and success rates. TRIAL REGISTRATION: NCT01461239 CLINICAL RELEVANCE: Both adhesive cementation strategies led to high survival and success rates and are indicated for fiber post cementation, even after a long follow-up period (up to 106 months).

Effect of resin cement elastic modulus on the biaxial flexural strength and structural reliability of an ultra-thin lithium disilicate glass-ceramic material.

OBJECTIVES: Photo- and dual-polymerized resin-based luting agent was evaluated for elastic moduli effects on ultra-thin lithium disilicate (LD) glass-ceramic strengthening, structural reliability, and stress distribution. MATERIALS AND METHODS: One hundred-sixty LD discs (IPS e.max CAD, Ivoclar/Vivadent) were produced in ultra-thin thicknesses (half with 0.3 mm and the other half with 0.5 mm). The ultra-thin ceramic disks were coated with two different cement types (Variolink Veneer - V and Panavia F 2.0 - P). Two positive control groups were tested following hydrofluoric (HF) acid etching (LDt3, LDt5) and two negative control groups were tested for untreated ceramic (LD 3, LD 5). Biaxial flexural strength (BFS), characteristic strength (σ0) and Weibull modulus (m) were the response variables (n = 20) at the ceramic/resin cement interface (z = 0). Finite element analysis (FEA) was used to calculate maximum principal stress. Data were analyzed using two-way ANOVA, and Tukey's test. Scanning electron microscopy (SEM) was used to analyze the failed specimens using fractography and surface morphology. RESULTS: The BFS of LD at either thickness was not affected by cement types, as also demonstrated by FEA. Structural reliability significantly improved in the positive control group (LDt5). CONCLUSION: The cementation of ultra-thin LD with a resin-cement of varying elastic moduli did not influence BFS. LD surface modification by HF acid-etching increased the reliability. CLINICAL RELEVANCE: Ultra-thin anterior veneer designs made from lithium disilicate have been widely proposed and the apparent success of LD ultra-thin veneers was not influenced by the cement choice in the current studies albeit the elastic moduli luting agents used were of similar values.

Effect of thickness of CAD/CAM materials on light transmission and resin cement polymerization using a blue light-emitting diode light-curing unit.

OBJECTIVE: Evaluate the effect of thickness of high-translucency (HT) CAD/CAM materials on irradiance and beam profile from a blue light-emitting diode light-curing unit (LCU) and on the degree of conversion (DC) and maximum polymerization rate (Rpmax ) of a light-cured resin cement (LCC). MATERIAL AND METHODS: The direct output from the LCU, the light transmission and irradiance ratio (IR) through one conventional composite and nine HT CAD/CAM materials (0.5, 1.0, 1.5, or 2.0-mm thick; n = 5) were measured with a integrating sphere coupled to a spectrometer. The light beam was assessed with a beam profiler camera. The DC at 600 s and the Rpmax of one LCC was determined using a Fourier transform infrared spectrometer (n = 5). Data were analyzed by ANOVA followed by Tukey's tests, and Dunnett's test was also used for irradiance data (α = 0.05). RESULTS: A significant decrease in irradiance through all materials occurred as thickness increased. Thin CAD/CAM materials improved light homogeneity, which decreased with the increase in thickness. The DC of the LCC directly exposed to light was the same as when exposed to 45%, 25%, 15%, or 5% IRs. Rpmax decreased with the decrease in IR. CONCLUSIONS: Although the HT CAD/CAM materials reduced the irradiance from the LCU, minor effects were observed in the LCC's DC. CLINICAL SIGNIFICANCE: Despite the light attenuation of blue light through different CAD/CAM materials that were up to 2-mm thick, the degree of conversion of one brand of light-cured resin cement was clinically acceptable when the LCU was used for 30 s.

Effect of the timing of radiation therapy on the push-out strength of resin cement to root dentine.

This study investigated the effect of radiation timing on the bond strength of resin cement to intraradicular dentine. Fifty human teeth were distributed into 5 groups (n = 10): Control (nonirradiated teeth), Before-RCT (teeth irradiated before root canal treatment), After-CH (teeth irradiated after canal preparation and placement of calcium hydroxide intracanal dressing), After-RCT (teeth irradiated after completion of root canal treatment) and After-FPL (teeth irradiated after luting of a glass fibre post). Each tooth received 70 Gy irradiation. The roots were sectioned for push-out strength testing. After-RCT and After-FPL groups had significantly lower push-out strength than the control at the middle third (p < 0.05). Control and After-CH groups had a higher percentage of cohesive dentine failure. Radiotherapy after root canal obturation and post luting adversely affected the adhesiveness of resin cement to intraradicular dentine. Teeth irradiated before root canal treatment and after placement of calcium hydroxide had the best performance.

Longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores with self-adhesive resin cement: an update of a prospective analysis with up to 106 months of follow-up.

OBJECTIVES: To evaluate the longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores using a self-adhesive resin cement in a prospective clinical descriptive study. METHODS: A total of 152 teeth were endodontically treated and received resin composite prosthetic cores and metal-ceramic crowns cemented with a self-adhesive resin cement. The patients included in the sample were recalled for clinical and radiography evaluation in an up-to-106-month period after the final cementation procedures, with an average of 62 months of follow-up. 91.5% of the sample (142 teeth) were evaluated regarding the treatment survival rate, analyzed considering the loss of crown retention (crown debonding) and tooth loss as the primary outcome. In addition, post debonding, and root fracture occurrences were also recorded as secondary outcomes to evaluate the success rate of the prosthetic treatment. The aesthetic parameters were also evaluated according to the FDI criteria. The Kaplan-Meier method and Cox regression with 95% confidence interval were applied for the statistical analysis. RESULTS: Regarding the primary outcome, the metal-ceramic crowns cemented with self-adhesive resin cement presented a high survival rate (91.5%), with 8 crown debondings and 3 tooth losses (1 due to caries and 2 due to periodontal disease) occurring after the evaluation period. For secondary outcomes, 9 root fractures and 4 post debondings occurred, generating a success rate of 72%. All crowns had a score 1 on the FDI criteria, indicating that they were clinically excellent or very good regarding the aesthetic parameters. CONCLUSION: The metal-ceramic crowns luted with a self-adhesive resin cement presented a survival rate of 91.5% after an average of 62 months of follow-up. Furthermore, the restorations remained aesthetically satisfactory over time, without changes that would indicate prosthetic retreatment. A success rate of 72% was obtained considering the secondary outcome, mainly related to intraradicular retainer failures (root fractures or post debonding). CLINICAL SIGNIFICANCE: The self-adhesive resin cement is clinically indicated for cementation of metal-ceramic crowns onto resin composite prosthetic cores.

Effect of adhesive primer application on shear bond strength of self-adhesive cement to tooth structure and two different CAD/CAM milled blocks / Efeito da aplicação do primer adesivo na resistência ao cisalhamento do cimento autoadesivo à estrutura dentária e a dois diferentes blocos fresados CAD/CAM

Objective: This study was conducted to evaluate the influence of the G-CEM ONE adhesive enhancing primer on the shear bond strength of self-adhesive resin cement (G-CEM ONE) to both tooth structure and two different CAD/CAM blocks (GC Initial LiSi and Cerasmart 270). Material and Methods: Forty specimens (cylindrical-shaped, 5 mm in diameter and height) were milled from both CAD/CAM blocks (20 specimens from each block type). Forty sound upper premolars were sectioned to the level of peripheral dentin, then randomly divided into four groups (n = 10): A1: GC Initial LiSi without adhesive enhancing primer; B1: Cerasmart 270 without adhesive enhancing primer; A2: GC Initial LiSi with adhesive enhancing primer; B2: Cerasmart 270 group with adhesive enhancing primer application. The CAD/CAM blocks were cemented on teeth using a self-adhesive resin cement (G-cem one). The shear bond strength was assessed using a computerized universal testing machine. A digital microscope was used to study the mode of failure. The shear bond strength values data were analyzed statistically using paired t-test and independent t-test at the significance level of (0.05). Results: A significant difference was shown in the shear bond strength values among groups (P =0.000). The highest shear bond strength value was revealed in group A2, while group B1 exhibited the lowest shear bond strength value. Conclusion: Using the adhesive enhancing primer on the tooth's surface improved the resin cement's bond strength to CAD/CAM blocks. Additionally, GC Initial LiSi exhibited higher bond strength than Cerasmart 270, with or without the primer (AU)

Objetivo: Este estudo foi conduzido para avaliar a influência do primer adesivo G-CEM ONE na resistência ao cisalhamento do cimento resinoso autoadesivo (G-CEM ONE) tanto na estrutura dentária quanto em dois diferentes blocos CAD/CAM (GC Initial LiSi e Cerasmart 270). Material e Métodos: Quarenta corpos de prova (formato cilíndrico, 5 mm de diâmetro e altura) foram fresados em blocos CAD/CAM (20 corpos de prova de cada tipo de bloco). Quarenta pré-molares superiores sadios foram seccionados até o nível da dentina mais externa e, em seguida, divididos aleatoriamente em quatro grupos (n = 10): A1: GC Initial LiSi sem primer adesivo; B1: Cerasmart 270 sem primer adesivo; A2: GC Initial LiSi com primer adesivo; B2: Grupo Cerasmart 270 com aplicação de primer adesivo. Os blocos CAD/CAM foram cimentados nos dentes com cimento resinoso autoadesivo (G-CEM ONE). A resistência ao cisalhamento foi avaliada utilizando uma máquina de ensaios universal computadorizada. Um microscópio digital foi utilizado para estudar o modo de falha. Os dados dos valores de resistência ao cisalhamento foram analisados estatisticamente por meio do teste t pareado e teste t independente ao nível de significância de (0,05). Resultados: Foi demonstrada diferença significativa nos valores de resistência ao cisalhamento entre os grupos (P =0,000). O maior valor de resistência ao cisalhamento foi revelado no grupo A2, enquanto o grupo B1 exibiu o menor valor de resistência ao cisalhamento. Conclusão:A utilização do primer adesivo na superfície dentária melhorou a resistência de união do cimento resinoso aos blocos CAD/CAM. Além disso, o GC Initial LiSi apresentou maior resistência de união que o Cerasmart 270, com ou sem primer.(AU)

The Effect of Immediate Dentin Sealing on the Marginal Adaptation of LithiumDisilicate Overlay Restorations using different types of luting agents / Efeito do selamento imediato da dentina na adaptação marginal de restaurações overlay de dissilicato de lítio utilizando diferentes tipos de agentes de cimentação: estudo in vitro

Objective:This study evaluated the effect of immediate dentin sealing on the marginal adaptation of lithium disilicate overlays with three different types of resin-luting agents: preheated composite, dual-cure adhesive resin, and flowable composite. Materials and Methods: Forty-eight maxillary first premolars of similar size were prepared with a butt joint preparation design. The teeth were separated into two primary groups, each with twenty-four teeth: Group DDS: Delay dentin sealing (non-IDS) teeth were not treated. Group IDS: dentin sealing was applied immediately after teeth preparation. Each group was subsequently separated into three separate subgroups. Subgroups (DDS+Phc, IDS+Phc): cemented with preheated composite (Enamel plus HRi, Micerium, Italy), Subgroups (DDS+Dcrs, IDS+Dcrs): cemented with dual-cured resin cement (RelyX Ultimate, 3M ESPE, Germany) and Subgroups (DDS+Fc, IDS+Fc): Cemented with flowable composite (Filtek supreme flowable, 3M ESPE, USA). Using a digital microscope with a magnification of 230x, the marginal gap was measured before and after cementation at four different locations from each surface of the tooth, and the mean of measurements was calculated and analyzed statistically using the independent t-test, one-way ANOVA test, Bonferroni correction at a significance level of 0.05. Results: The samples that were immediately sealed with dentin bonding agent showed lower marginal gaps than delayed dentin sealing, both pre-and post-cementation for all subgroups, with a statistically significant difference (p˂0.01). The marginal gap was significantly lower in the IDS+Fc (48.888 ±5.5 µm) followed by the IDS+Dcrs group (53.612 ±5.8 µm) and IDS+Phc (79.19 9±6.9 µm) respectively, while the largest marginal gaps were observed in the DDS+Phc group (86.505 ±5.4 µm). Conclusion: Generally, the teeth with IDS showed better marginal adaptation than teeth without IDS. The marginal gap was smaller with flowable composite and dual-cure resin cement than with preheated composite (AU)

Objetivo:Esse estudo avaliou o efeito do selamento imediato da dentina na adaptação marginal de overlays em dissilicato de lítio com três tipos diferentes de agentes de cimentação resinosos: resina composta pré-aquecida, adesivo resinoso dual e resina fluida. Materiais e métodos: Quarenta e oito primeiros pré-molares maxilares com tamanho similar foram preparados com término em ombro. O dente foi separado em dois grupos primários, cada um com vinte e quatro dentes: Grupo DDS: retardado selamento da dentina (non-IDS) dente não foi tratado. Grupo IDS: selamento dentinário foi aplicado imediatamente após a preparação do dente. Cada grupo foi separado de modo subsequente em três subgrupos. Subgrupo (DDS+Phc, IDS+Phc): cimentado com resina pré-aquecida (Enamel plus HRi, Micerium, Italy), Subgrupo (DDS+Dcrs, IDS+Dcrs): cimentado com cimento resinoso dual (RelyX Ultimate, 3M ESPE, Germany) e Subgrupo (DDS+Fc, IDS+Fc): cimentado com resina fluida (Filtek supreme flowable, 3M ESPE, USA). Usando um microscópio digital com magnificação de 230x, o gap marginal foi medido antes e após a cimentação em quatro diferentes localizações de cada superfície do dente e a média das medidas foi calculada e estatisticamente analisada através do uso do teste ANOVA um-fator e teste independente de Tukey e correção Bonferroni com nível de significância de 0,05. Resultado: As amostras que foram imediatamente seladas com agente adesivo dentinário apresentaram menores gaps marginais do que o selamento dentinário retardado, ambos pré e pós cimentação para todos os subgrupos apresentaram diferença estatística significante (p˂0.01). O gap marginal foi significativamente menor para IDS+Fc (48.888 ±5.5 µm) acompanhado do IDS+Dcrs group (53.612 ±5.8 µm) e IDS+Phc (79.19 9 ±6.9 µm) respectividamente, enquanto o maior gap marginal foi observado no grupo DDS+Phc (86.505 ±5.4 µm). Conclusão:Geralmente, o dente com IDS apresentou melhor adaptação marginal do que o dente sem IDS. O gap marginal foi menor com resina fluida e cimento resinoso dual do que com a resina composta pré-aquecida (AU)

Color stability and degree of conversion of amine-free dual cured resin cement used with two different translucencies of lithium disilicate ceramics / Estabilidade de cor e grau de conversão de cimento resinoso dual sem amina usado com duas translucidezes diferentes de cerâmica de dissilicato de lítio

Objective: The present study aims to evaluate the color stability and degree of conversion of amine-free dual cured resin cement compared to light cured and amine-containing dual cured resin cements used with two different translucencies of thin esthetic restorations. Material and Methods: A total of 120 specimens were prepared for color stability testing (n=60). The specimens were divided into three main groups according to the resin cement type. Group 1: amine-free dual cured, Group 2: light cured, Group 3: amine-containing dual cured. Each group was further subdivided according to the ceramic translucency into two subgroups: high and low translucency. Color stability was assessed by a spectrophotometer before and after thermal aging. For the degree of conversion assessment (n=60), Fourier transform infrared spectroscopy was used at three different time intervals. Statistical analysis was performed using multi-factorial ANOVA, followed by one-way ANOVA with Bonferroni correction. Results: Amine-containing resin cement showed significantly higher ΔEab and ΔE00in both translucencies (4.5±0.3, 3.5±0.3 respectively for high translucency ceramic and 3.8±0.4, 3.0±0.3 respectively for low translucency) than the other tested cements (p<0.001). The highest degree of conversion (DC) was shown after 2 weeks by the amine-free dual cured resin cement (86.27±0.74). Conclusion: Amine-free dual cured resin cement can be an alternative to light cured one for cementation of thin veneers since it showed comparable color stability and high degree of conversion (AU)

Objetivo: O presente estudo tem como objetivo avaliar a estabilidade de cor e o grau de conversão do cimento resinoso dual sem amina em comparação com cimentos resinosos fotopolimerizáveis contendo amina usados com duas translucidezes diferentes em restaurações estéticas definitivas. Material e Métodos: Um total de 120 espécimes foram preparados para teste de estabilidade de cor (n=60). Os espécimes foram divididos em três grupos principais de acordo com o tipo de cimento resinoso. Grupo 1: polimerização dupla sem amina, Grupo 2: fotopolimerização, Grupo 3: polimerização dupla contendo amina. Cada grupo foi ainda subdividido de acordo com a translucidez da cerâmica em dois subgrupos: alta e baixa translucidez. A estabilidade da cor foi avaliada por um espectrofotômetro antes e após o envelhecimento térmico. Para a avaliação do grau de conversão (n=60), a espectroscopia de infravermelho com transformada de Fourier foi usada em três intervalos de tempo diferentes. A análise estatística foi realizada usando ANOVA multifatorial, seguida de ANOVA um faot com correção de Bonferroni. Resultados: O cimento resinoso contendo amina apresentou ΔEab e ΔE00 significativamente maiores em ambas as translucidezes (4,5±0,3, 3,5±0,3 respectivamente para cerâmica de alta translucidez e 3,8±0,4, 3,0±0,3 respectivamente para baixa translucidez) do que os outros cimentos testados (p< 0,001). O maior grau de conversão (DC) foi mostrado após 2 semanas pelo cimento resinoso dual sem amina (86,27±0,74). Conclusão: O cimento resinoso dual sem amina pode ser uma alternativa ao cimento polimerizável na restauração de facetas finas, uma vez que apresentou estabilidade de cor comparável e alto grau de conversão. (AU).