In vitro damping and strain distribution for implant-supported crowns using 5 different CAD-CAM crowns and 3 different luting cements.

STATEMENT OF PROBLEM: Dental implants are particularly susceptible to occlusal overloading because, unlike natural teeth, they lack a periodontal ligament to help absorb occlusal forces. However, studies evaluating the impact of different crown and luting materials on the damping behavior and strain distribution of implant-supported crowns are lacking. PURPOSE: The purpose of this in vitro study was to investigate the damping behavior and strain distribution of peri-implant bone associated with 5 different CAD-CAM implant-supported crowns and 3 luting materials. MATERIAL AND METHODS: A titanium implant was embedded in a plastic tube with epoxy resin and 5 different crown materials (polymethyl methacrylate, resin-infiltrated ceramic, lithium disilicate, titanium, and zirconia) luted to prosthetic abutments with 3 different luting materials (zinc oxide non-eugenol cement, zinc phosphate cement, and adhesive resin cement) and an uncemented condition were tested (n=5). Strain gauges were attached at the crestal and apical levels of the implant model. All specimens were load tested from 0 to 200 N. Slopes of load/time, microstrain/time, and time required to reach the maximum load were examined to represent the damping behavior. Absolute maximum strain (AMS) and its occurrence level were examined to represent the strain distribution. Two-way ANOVA, followed by the Tukey HSD test, were used for statistical analysis (α=.05). RESULTS: All slopes and times to reach the maximum load in each crown material were statistically similar (P>.05), except for the polymethyl methacrylate group, which showed less steepness in all slopes and more time required to reach the maximum load significantly (P<.05). Both the polymethyl methacrylate group (224.5 ±30.2) and the titanium group (224.0 ±24.3) exhibited significantly higher AMS at the crestal level compared with the resin-infiltrated ceramic group (210.6 ±5.0) (P<.05). The lithium disilicate (218.1 ±15.0) and zirconia groups (217.3 ±14.8) demonstrated comparable AMS values with the others (P>.05). The uncemented group demonstrated steeper slopes and less time required to reach the maximum load compared with the adhesive resin group (P<.05), while slopes and times of the zinc phosphate and zinc oxide non-eugenol groups were comparable (P>.05). The uncemented group (242.7 ±25.3) exhibited significantly higher AMS at the crestal level than the other groups (P<.05). CONCLUSIONS: The crown material significantly affected the damping behavior of peri-implant bone, unlike the luting material. Polymethyl methacrylate with a high damping behavior exhibited high strain at the crestal level. In contrast, resin-modified ceramic with a moderate damping behavior exhibited low strain at the crestal level. Strain at the crestal level could be effectively reduced by approximately 13% through cementation.

In vitro cytotoxicity of different dental resin-cements on human cell lines.

Adhesive resin-cements are increasingly used in modern dentistry. Nevertheless, released substances from resin materials have been shown to cause cellular toxic effects. Disc-shaped specimens from 12 different resin cements and one conventional zinc phosphate cement were prepared and used for direct stimulation of five different human cell lines via transwell cell culture system or in an indirect way using conditioned cell culture media. Cytotoxicity was determined using LDH and BCA assays. All tested cements led to a decrease of cell viability but to a distinct extent depending on cell type, luting material, and cytotoxicity assay. In general, cements exhibited a more pronounced cytotoxicity in direct stimulation experiments compared to stimulations using conditioned media. Interestingly, the conventional zinc phosphate cement showed the lowest impact on cell viability. On cellular level, highest cytotoxic effects were detected in osteoblastic cell lines. All resin cements reduced cell viability of human cells with significant differences depending on cell type and cement material. Especially, osteoblastic cells demonstrated a tremendous increase of cytotoxicity after cement exposure. Although the results of this in vitro study cannot be transferred directly to a clinical setting, it shows that eluted substances from resin cements may disturb osteoblastic homeostasis that in turn could lead to conditions favoring peri-implant bone destruction. Thus, the wide use of resin cements in every clinical situation should be scrutinized. A correct use with complete removal of all cement residues and a sufficient polymerization should be given the utmost attention in clinical usage.

Retention of luting agents used for implant-supported restorations: A comparative In-Vitro study.

AIMS: The aim of this study was to compare the retention of different luting agents used with implant-supported restorations. MATERIALS AND METHODS: A total of 90 custom metal frameworks and copings were prepared and divided into six different luting agent groups (n = 15/group): polycarboxylate cement (PC), resin-modified glass-ionomer cement (RMGIC), two self-adhesive resin cements (SARC), copper-ion zinc-phosphate cement (CZPC), and non-eugenol temporary resin cement (TRC). After sandblasting with 50 µm Al2O3, the copings were cemented on frameworks and stored in artificial saliva for 48 h at 37°C and thermocycled between 5-55°C for 37,500 cycles. Samples were subjected to tensile testing by a universal testing machine, and data were statistically analyzed. RESULTS: The differences between the retention values of types of cement were significant (P < 0.05). The maximum retention value was calculated for CZPC (755,12 ± 55 MPa) while the lowest value was for TRC (311,7 ± 61 Mpa). CONCLUSION: Neither of the tested cement had superiority over another to ensuring retention. The types of cement presented were meant to be a discretionary guide for the clinician in deciding the amount of the desired retention between castings and abutments.

The effect of conventional, half-digital, and full-digital fabrication techniques on the retention and apical gap of post and core restorations.

STATEMENT OF PROBLEM: Conventional cast metal posts and cores are fabricated using direct and indirect techniques, both of which need impression materials and considerable laboratory work. Digital techniques have the capacity to substitute for conventional methods in fabricating the posts and cores. However, the accuracy of restorations resulting from a digital workflow is unknown. PURPOSE: The purpose of this in vitro study was to compare the retention of posts and cores fabricated using full-digital, half-digital, and conventional techniques and to define the accuracy of each technique in terms of the apical gap. METHOD AND MATERIALS: Thirty newly extracted mandibular first and second premolar teeth were selected for this in vitro study. Impressions were made using direct acrylic resin patterns (conventional), indirect silicone impressions of the intracanal which scanned with a 3Shape laboratory scanner (half digital), and intracanal scan posts captured with an intraoral 3Shape scanner (full digital). Casting and milling were conducted for the conventional impression and digital scans. The obtained posts were cemented using zinc phosphate cement. A universal pullout test was used to measure retention at a crosshead speed of 0.5 mm/min. The apical gap of each post in the canals was defined with parallel digital radiography. The data were analyzed using the Kruskal-Wallis test (α=.05) and Mann-Whitney test at the adjusted α=.016. RESULTS: Significant differences were found among the conventional, full-digital, and half-digital techniques in terms of the apical gap (0.11, 0.29, and 0.66 mm; P<.001) and retention (171.6 ±1.9, 107.1 ±5.6 and 91.8 ±6.6 N; P<.001). The correlation between gap and retention in conventional (P=.43), full-digital (P=.09), and half-digital techniques (P=.06) was not statistically significantly different. CONCLUSIONS: The conventional technique was more accurate and resulted in higher retention than both the full- and half-digital techniques. However, the retention and gap of all the posts fell within clinical guidelines.

The Effect of Temporary Cement Cleaning Methods on the Retention of Crowns.

PURPOSE: To evaluate the effect of temporary cement cleaning methods on the retention of cemented crowns using zinc phosphate cement and resin-modified glass ionomer cement. MATERIALS AND METHODS: Forty titanium specimens were fabricated to simulate prepared molars with minimally retentive taper. The Ni-Cr cast crowns were fabricated, temporarily cemented, and separated. The specimens were divided into four groups according to the temporary cement cleaning method (n = 10) as follows: control group (no temporary cementation), orange solvent group, ultrasonic cleaning group, and air-abrasion group. After the cleaning procedures, the specimens were cemented with definitive cements (zinc phosphate cement and resin-modified glass ionomer, RMGI, cement) and subjected to thermocycling (5000 cycles, 5-55°C, dwell time, 10 seconds). The tensile bond strength of each specimen was measured using a universal testing machine, and the results were analyzed using the Kruskal-Wallis and Mann-Whitney U test (α = 0.05). RESULTS: When cemented with zinc phosphate cement, the statistical analysis showed that the value of the air-abrasion group was significantly higher than those of the other groups (p < 0.01). There was no statistically significant difference among the other groups. When cemented with RMGI cement, the air-abrasion group showed the lowest value, and the control group showed the highest value (p < 0.01). The difference between the ultrasonic cleaning group and the orange solvent group was not statistically significant. CONCLUSION: The use of temporary cement did not have a significant influence on retention of permanently cemented crowns when zinc phosphate cement was used for permanent cementation. Airborne-particle abrasion after provisional cementation improved retention of crowns cemented with zinc phosphate cement; however, the use of temporary cement significantly decreased retention of permanently cemented crowns when RMGI cement was used regardless of the temporary cement cleaning method.

Effect of 830 nm Diode Laser Irradiation of Root Canal on Bond Strength of Metal and Fiber Post.

OBJECTIVE AND BACKGROUND: The correct selections of the cementing agent, the endodontic post material and placement protocol are critical to provide an increased longevity of the teeth that went through endodontic treatment. The irradiation with diode laser before post cementation, can promote an antimicrobial effect. However, there is a lack of information about the effect of 830 nm diode laser on the post bond strength. This study analyzed the effect of dentin root canal irradiation with high-intensity diode laser, at 830 nm, operating in continuous or pulsed mode, on the retention of metal or fiber posts, cemented with self-etching resinous composite (Panavia F) and zinc phosphate cement (ZnPO4). MATERIALS AND METHODS: Human roots were irradiated with diode laser (continuous and pulsed mode). The fiber posts were luted with Panavia F and the metal posts with Panavia F or ZnPO4 cement. Specimens were sectioned into three sections (cervical, middle, and apical). The bond strength was measured by a push-out mechanical analysis. For the statistical analysis, a three-way ANOVA test was applied following a Tukey's pairwise comparison with a significance level of p = 0.05. RESULTS: The irradiated groups presented higher bond strength compared with nonirradiated group (p < 0.05), and the cervical and middle thirds presented higher on bond strength than the apical. The association of metal post and Panavia F presented higher bond strength when irradiated on continuous mode (p < 0.05). Fiber post and Panavia F presented higher bond strength associated to pulsed mode. The mode seems not to make a significant difference. CONCLUSIONS: These results corroborate the importance of the post bond to dentin and root canal debris removal to increase the tooth longevity. It was shown that the dentin to post bond strength were enhanced by the diode laser irradiation either on continuous or pulsed modes.

Effect of Temperature on Film Thickness of Two Types of Commonly used Luting Cements.

AIM: The aim of this study is to evaluate the effect of temperature change on film thickness of both types of cements. MATERIALS AND METHODS: Totally, 60 samples were prepared with 10 in each subgroup, thus comprising 30 in each group. Materials tested were glass ionomer cement (GIC) type I and zinc phosphate type I. Samples were manipulated with manufacturer's instructions and tested according to American Dental Association (ADA) guidelines. RESULTS: The mean values of film thickness were recorded for both groups I and II. In intragroup comparison of group 1, subgroup III (26.560 ± 0.489 urn) was found to have the highest film thickness followed by subgroup II (24.182 ± 0.576 urn) and the lowest in subgroup I (20.209 ± 0.493 urn). In intragroup comparison of group II, the film thickness recorded in subgroup III (25.215 ± 0.661 urn) was the highest followed by subgroup II (21.471 ± 0.771 urn) and the least in subgroup I (17.951 ± 0.654 urn; p < 0.01). In intergroup comparison of groups I and II, group II (21.545 ± 0.841) was found to have less film thickness than group I (23.650 ± 0.271). The results were found to be statistically significant (p < 0.01). CONCLUSION: Both zinc phosphate and GICs can be used satisfactorily for luting purpose. The temperature fluctuations have a direct influence on the film thickness. Zinc phosphate has less film thickness than GIC. CLINICAL SIGNIFICANCE: Zinc phosphate should be preferred over GIC in clinical practice, and more stress should be given in mechanical preparation of crowns for better retentive quality of prosthesis.

Dislodgement Resistance of Zirconia Copings Cemented onto Zirconia and Titanium Abutments.

PURPOSE: To determine the effect of the cement type and abutment material on the tensile strength required to dislodge zirconia copings. MATERIALS AND METHODS: Two experimental groups of abutments were prepared: (1) titanium abutments (n = 30) and (2) zirconia abutments (n = 30). Sixty zirconia copings (custom designed) were fabricated using 3-dimensional computer-assisted design to have a 6-mm projection above the abutment to accommodate a hole, through which a wire was inserted to attach the zirconia coping to a universal testing machine. Each abutment was placed onto an implant analog embedded in acrylic resin blocks to fit onto the universal testing machine. The zirconia copings were cemented onto the abutments with a provisional luting agent, zinc phosphate (ZP) cement, and adhesive resin cement, and after 5500 thermocycles, a tensile force was applied at a crosshead speed of 0.5 mm/min. The removal force was recorded for each specimen. Two-way analysis of variance (ANOVA) and 1-way ANOVA were used for the statistical analysis (P < 0.05). RESULTS: The mean forces necessary to remove the zirconia copings from titanium abutments were 6.52, 83.09, and 251.18 N for temporary cement, ZP cement, and resin cement, respectively. For zirconia abutments, the required forces were 17.82, 116.41, and 248.72 N. CONCLUSIONS: The abutment material had no effect on retention, but the cement type affected the retention of the zirconia copings.

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

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

Effect of Luting Cement Space on the Strain Response of Gold Crowns Under Static Compressive Loading.

The aim the work was to investigate the effect of varying degrees of luting cement thickness on the strain of the cemented gold alloy crowns under compression. Five dies with their corresponding crowns were fabricated using a lost wax technique. Three gold crowns for each die were fabricated under the control of specific die spacer layers to provide a space of 40 µm (10 layers of die-spacer thickness) and 80 µm (20 layers of die-spacer thickness). The crowns were subsequently cemented using zinc phosphate cement. The crowns were subjected to gradual static compressive loading between 10N to 250N (Newton) and the strain measured simultaneously. The results were statistically analysed using Independent t-test for the different die-spacer thickness at the 95% confidence interval (p = 0.05). It was found that a significant relationship in the three thicknesses. It was concluded that the absence of die-spacer significantly reduced strain response, whereas a very little change in the strain recorded as the die spacer layers has increased. Clinically, decreasing the number of die-spacer layers is advantageous as it provides a lower strain response under static compressive loading that would improve the longevity of the cemented full crowns inside the patient's mouth.

Various cements and their effects on bond strength of zirconia ceramic to enamel and dentin.

Zirconia ceramic disks (Cercon) were fabricated using a computer-aided design/ computer-assisted manufacture system and fitted to hard tooth tissues from freshly extracted bovine mandibular incisors using seven cements (zinc phosphate, zinc polycarboxylate, Eco-Link, Panavia F 2.0, Clearfil SA Cement, MaxCem Elite, and GC Fuji Plus) with various physicochemical and bonding properties. Bond strengths were determined using a universal testing machine (Hounsfield H5KS) with a 5,000-N head and a cutting knife speed of 0.5 mm per minute. The study showed that the strongest bond between zirconia ceramic and hard tooth tissues was obtained with Panavia F 2.0 adhesive cement based on 10 methacryloyloxydecyl dihydrogen phosphate monomer.

Biofilms in restorative dentistry: A clinical report.

This clinical report describes the structure and characteristics of the biofilm formed under a cemented restoration, confirming the need to develop new cementation protocols to disrupt and minimize the formation of biofilm before cementing definitive restorations.

Cytotoxicity of commonly used luting cements -An in vitro study.

The study aimed to 1) evaluate the cytotoxicity of luting cements: Hoffmann's Zinc Phosphate (Hoffmann's ZP), GC Fuji Plus Resin Modified Glass Ionomer (Fuji Plus RMGI) and 3M ESPE RelyX Unicem Resin Cement (RelyX Unicem RC) and 2) test if pre-washing reduces the cements' cytotoxicity. In vitro human gingival fibroblast (HGF) culture model was chosen. The cytotoxicity was evaluated by MTT test, the cell viability -by staining the cells with AO/EB dye mixture. The means±SD of Cell Survival Ratio (CSR%) were compared among different cement types under two testing conditions, with or without cement pre-washing. The CSR%s were compared by ANOVA and linear multiple regression (LMR). Hoffmann's ZPC was less cytotoxic, while Fuji Plus RMGIC and RelyX Unicem RC were more cytotoxic (ANOVA, p<0.001). The type of cement and cement pre-washing jointly explained 90% of cell survival (LMR, p<0.001, adjusted squared R=0.889). The commonly used luting cements such as Hoffmann's ZP, Fuji Plus RMGI and RelyX Unicem RC may have a cytotoxic potential.

Effect of thermocycling with or without 1 year of water storage on retentive strengths of luting cements for zirconia crowns.

STATEMENT OF PROBLEM: Bond stability between zirconia crowns and luting cement and between cement and dentin is a main concern; however, only limited evidence is available as to its longevity. PURPOSE: The purpose of this in vitro study was to measure the retentive strengths of 7 self-adhesive cements (RelyX Unicem Aplicap, RelyX Unicem Clicker, RelyX Unicem 2 Automix, iCEM, Maxcem Elite, Bifix SE, SpeedCem), 2 adhesive cements with self-etch primers (Panavia 21, SEcure), 1 glass ionomer cement (Ketac Cem), 1 resin-modified glass ionomer cement (Meron Plus), and 1 zinc phosphate cement for luting zirconia crowns (LAVA) to extracted teeth after thermocycling with or without 1 year of water storage. MATERIAL AND METHODS: Two-hundred-forty extracted human molars (2 treatments; n=10 per cement) were prepared in a standardized manner. All cements were used according to the manufacturers' recommendations. The intaglios of the crowns were treated with airborne-particle abrasion. After thermocycling (×5000, 5°C/55°C) with or without 1 year of water storage, the cemented ceramic crowns were removed by using a Zwick universal testing device. Statistical analyses were done with the Wilcoxon rank sum and the 2-independent-samples Kolmogorov-Smirnov test. RESULTS: Median retentive strengths [MPa] for specimens thermocycled only/thermocycled with 1 year of water storage were as follows: Panavia 21: 1.7/2.5, SEcure: 3.0/3.0, RelyX Unicem Aplicap: 3.1/3.4, RelyX Unicem Clicker: 4.1/4.2, RelyX Unicem 2 Automix: 3.8/3.1, iCEM: 2.3/2.7, Maxcem Elite: 3.0/3.2, Bifix SE: 1.7/1.7, SpeedCem: 1.3/1.6, Meron Plus: 3.1/2.7, Ketac Cem: 1.4/1.4, and zinc phosphate cement: 1.1/1.6. Statistically significant differences were found only among specimens thermocycled only or thermocycled with 1-year water storage (P<.001). CONCLUSIONS: Significant differences in retentive strengths were observed among cements after thermocycling only or thermocycling with 1 year of water storage, but not for the effect of the additional 1 year of water storage.

Retrievability of implant-supported crowns when using three different cements: a controlled clinical trial.

PURPOSE: The purpose of this study was to analyze the removal of implant-supported crowns retained by three different cements using an air-accelerated crown remover and to evaluate the patients' response to the procedure. MATERIALS AND METHODS: This controlled clinical trial was conducted with 21 patients (10 women, 11 men; mean age: 51 ± 10.2 years) who had received a total of 74 implants (all placed in the posterior zone of the mandible). Four months after implant surgery, the crowns were cemented on standard titanium abutments of different heights. Three different cements (two temporary: Harvard TEMP and Improv; and one definitive: Durelon) were used and randomly assigned to the patients. Eight months later, one blinded investigator removed all crowns. The number of activations of the instrument (CORONAflex, KaVo) required for crown removal was recorded. The patients completed a questionnaire retrospectively to determine the impact of the procedure and to gauge their subjective perception. A linear regression model and descriptive statistics were used for data analysis. RESULTS: All crowns could be retrieved without any technical complications or damage. Both abutment height (P = .019) and cement type (P = .004) had a significant effect on the number of activations, but the type of cement was more important. An increased total number of activations had no or only a weak correlation to the patients' perception of concussion, noise, pain, and unwillingness to use the device. CONCLUSIONS: Cemented implant crowns can be removed, and the application of an air-accelerated device is a practicable method. A type of cement with appropriate retention force has to be selected. The impact on the patients' subjective perception should be taken into account.

In vitro evaluation of the internal and marginal misfit of CAD/CAM zirconia copings.

STATEMENT OF PROBLEM: The constant updating of computer-aided design/computer-aided manufacture (CAD/CAM) systems and the introduction of new systems confirm the need for scientific evidence on internal and marginal adaptation. PURPOSE: The purpose of this in vitro study was to measure and compare the degree of internal and marginal misfits of zirconia single-unit copings made by using 3 different CAD/CAM systems (Ceramill, Lava 3M, and Neoshape). MATERIAL AND METHODS: Twenty-four anatomic prefabricated abutments (Neodent) were used to fabricate zirconia copings in Ceramill (n=8), Lava (n=8), and Neoshape (n=8). All copings were cemented and cut with a precision cutting machine to obtain 5 surfaces (mesial, distal, buccal, palatal, and incisal) and angle regions (internal axiogingival and axioincisal angles). Measurements were obtained from images at a magnification of ×100 and ×200 made with a digital camera attached to an optical microscope and adapted with a measuring device. The data were statistically analyzed with the 2-way ANOVA and Tukey honestly significant difference tests (α=.05). RESULTS: In the internal misfit evaluation, the mean values observed for Ceramill, Lava, and Neoshape were palatal surface 76.5, 65.5, and 77.7 µm (P=.003); angle regions 69.4, 68.6, and 74.5 µm (P=.010); incisal surface 127.7, 97.2, and 182.2 µm (P<.001); and overall mean 72.1, 69.4, and 76.4 µm (P=.003). Significant differences were not found for mesial, distal, or buccal surfaces (P>.05). In the evaluation of marginal misfit (marginal discrepancy and absolute marginal discrepancy), the mean values found were 40.9 and 65.8 µm for Ceramill, 34.2 and 70.0 µm for Lava, and 39.3 and 74.5 µm for Neoshape. No significant differences were found among the 3 systems (P>.05). CONCLUSIONS: Although the Lava system showed a significantly lower value of internal misfit than the Neoshape system, all systems showed clinically acceptable marginal misfit values.

Retention of crowns cemented on implant abutments with temporary cements.

This study was to examine the retentive force of crowns to implant abutments with commercial temporary cements. Six different temporary cements were investigated. Cast crowns were cemented to the abutments using each cement and their retentive forces to abutments were determined 7 or 28 days after cementing (n=10). The retentive force of the cements to abutments varied widely among the products [27-109 N (7-day), 18-80 N (28-days)]. The retentive force of all the cements was not reduced as the time elapsed, except for two products tested. The polycarboxylate cements and paste-mixing type eugenol-free cements revealed comparable retentive force after 28 days of storage. The powder-liquid type cements showed a positive correlation (p<0.05) between the retentive force and the shear strength, while a negative correlation (p<0.05) was obtained for paste-mixing type cement between the retentive force and compressive strength. Mechanical strength of temporary cements could not be a prominent predicting factor for retention of the crowns on the abutments.

Tri-calcium phosphate (ß-TCP) can be artificially synthesized by recycling dihydrate gypsum hardened.

Calcium phosphate is known as a major component of biological hard tissues. This study aimed to produce calcium phosphate by recycling kneaded surplus gypsum. ß-dihydrate gypsum was derived from commercial dental ß-hemihydrate gypsum, which was mechanically powdered and mixed with the liquid component of a commercial zinc phosphate cement. This mixture was fired at 1,200°C and evaluated by XRD analysis, thermal analysis and scanning electron microscopy (SEM). An acceptable ratio of mixing was 4 g of ß-dihydrate gypsum powder to 1.5 mL of phosphoric acid liquid. XRD peaks were monotonic below 800°C, but new ß-TCP was formed by firing at 900°C or more, although TG-DTA analysis of synthetic ß-TCP suggested that some residual dihydrate gypsum remained in the sample. SEM images indicated a fused-block bone-like structure covered with phosphorus and calcium. These results suggest that production of synthetic ß-TCP is possible through ecological techniques using recycled materials.

Capacidad de sellado de tres agentes cementantes para restauraciones coronarias indirectas / Sealing ability of three luting agents used for cementation of indirect coronal restorations

Objetivo: comparar ex vivo, por medio de un modelo de filtración bacteriana, la capacidad de sellado de un ionómero vítreo modificado con resinas, de un ionómero vítreo convencional y de un cemento de fosfato de cinc, utilizados para la cementación de coronas coladas (AU). Materiales y métodos: un total de 30 premolares humanos sanos, extraídos, fueron preparados de forma estandarizada para recibir una corona metálica con terminación en chamfer sobre dentina. Se realizaron impresiones, se vaciaron en densita tipo IV, se enceraron y se colaron en aleación de oro tipo III. Luego fueron separadas al azar en tres grupos de 10 (n=10) especímenes cada uno. Las coronas del grupo 1 fueron cementadas con Rely-X Luting Plus (3M/ESPE); y las del grupo 2, con Ketac-Cem (3m/ESPE); y las del grupo 3 (control), con el cemento de fosfato de cinc Harvard Cement (Harvard Debtal International GmbH, Hoppengarten, Alemania). Todos los especímenes fueron termociclados. Posteriormente, la superficie metálica oclusal fue reducida 1 mm hasta exponer la dentina, y las muestras se esterilizaron en autoclave. El proceso de filtración se realizó por medio de un sistema de doble cámara con medio de cultivo. El medio de la cámara superior se inoculó con E. faecalis y el sistema fue incubado durante 60 días. En la cámara inferior, la filtración bacteriana se controló diariamente. Los datos registrados fueron analizados por medio de las pruebas de Kaplan-Meyer y de Fischer, con un nivel de significación de P<0,05. Resultados: el tiempo de supervivencia para Rely-X Luting Plus no pudo ser estimado, ya que fue superior a los 60 días, tiempo máximo de duración de la experiencia. Para Ketac-Cem fue de 60 días, con un intervalo de confianza (95 por ciento) de 29,6-90,4. Y para Harvard Cement fue de 40 días, con un intervalo de confianza de 32,6-47,4. Las diferencias entre los grupos fueron estadísticamente significativas. Conclusión: Rely-X Plus demostró una capacidad de sellado superior.

The extent of luting agent remnants on titanium and zirconia abutment analogs after scaling.

PURPOSE: To quantify the cement remnants on titanium and zirconia abutment analogs after cement removal by resin and steel scalers. MATERIALS AND METHODS: Defined areas of titanium or zirconia cylindric samples were covered with thin cement rings of zinc oxide phosphate (ZOP), glass ionomer (GIC), carboxylate (CAB), zinc oxide-eugenol (ZOE), or zinc oxide-eugenol-free (ZOEF). The cements were mixed with liquid-to-powder ratios of 50%, 75%, 100%, and 150% of powder. After setting and aging by thermocycling, each specimen was scaled by a blinded, trained clinician. Standardized digital photos of the scaled areas were analyzed according to a four-point classification scheme for remnants, and the results were analyzed statistically. RESULTS: The main effects of the independent variables "cement type," "abutment material," and "scaler" showed statistically significant differences for all variables. Such differences were also found with regard to the interactions of the variables "cement type" and "material" as well as for the type of cement and scaler. The extent of remnants after scaling differed significantly between titanium and zirconia. Steel scalers achieved statistically significantly better cleaning than resin scalers. The powder-to-liquid ratio of all luting agents significantly influenced the extent of cement surplus after scaling. ZOEF was the only type of cement that could be more successfully removed from titanium than from zirconia. CONCLUSIONS: Nearly complete removal of ZOE could be achieved. This luting agent was not as sensitive to aberrant mixing ratios or to resin or steel scaling as the other types of cement. With the exception of ZOEF, zirconia surfaces were easier to clean. After removal of most of the remnant, some cements showed a barely visible thin greasy or powdery layer.