Light irradiance through novel CAD-CAM block materials and degree of conversion of composite cements.

OBJECTIVE: To assess light irradiance (LI) delivered by two light-curing units (LCU's) and to measure the degree of conversion (DC) of three composite cements, when cured through different thicknesses of two novel CAD-CAM block materials. METHODS: 100-µm-thick films of a dual-curable composite cement (G-CEM LinkAce, GC), a light-curable flowable resin-based composite (RBC) (G-ænial Universal Flo, GC) and a micro-hybrid RBC (G-ænial Posterior, GC) were investigated as luting agents. Two 'polymer-ceramic' CAD-CAM blocks (Cerasmart, GC; Enamic, Vita Zahnfabrik) were sectioned in slabs with different thicknesses (1, 3 and 5mm). LI at the bottom of the specimens was measured using a calibrated spectrometer, while being light-cured through the CAD-CAM block slabs for 40s with a low- (±500mW/cm2) or high- (±1,600mW/cm2) irradiance LCU (n=5). After light-curing, micro-Raman spectra of the composite films were acquired to determine DC at 5min, 10min, 1h and 24h. LI data were statistically analyzed by Kruskal-Wallis followed by post-hoc comparisons, while a linear mixed-effect model was applied for the DC analysis. In addition, the CAD-CAM blocks ultrastructure was characterized upon argon-ion slicing using scanning transmission electron microscopy (STEM). Finally, light transmission (LT) through each CAD-CAM block material was assessed using a spectrophotometer. RESULTS: Curing-light attenuation and DC were significantly influenced by thickness and type of the overlying material. LCU only had a significant effect on DC of the micro-hybrid RBC. DC significantly increased over time for all composite cements. CAD-CAM block structural analysis revealed a relatively small and homogenous filler configuration (mean filler size of 0.2-0.5µm) for Cerasmart, while Enamic contained ceramic grains varying in shape and size (1-10µm), which were interconnected by the polymer-based network. LT was much higher at a wavelength range of 300-800nm for Cerasmart than for Enamic. SIGNIFICANCE: Light-curable composite cements can be cured through a restoration up to 2.7-mm thickness, depending on the kind of CAD-CAM material. A high-irradiance LCU only has a limited effect on the maximum thickness of the polymer-ceramic CAD-CAM material that can be cured through.

Effect of non-thermal atmospheric plasma on the dentin-surface topography and composition and on the bond strength of a universal adhesive.

This study investigated the effect of application of non-thermal atmospheric plasma (NTAP) on the topography and composition of the dentin surface, as well as the microtensile bond strength (µTBS) of a universal adhesive to NTAP-treated dentin. Exposed flat dentin surfaces from human third molars were either treated with NTAP for 10 and 30 s or untreated (control). The dentin-surface topography and chemical composition were characterized by atomic force microscopy (n = 3) and Raman confocal spectroscopy (n = 5), respectively. The µTBS (n = 8) of Scotchbond Universal to dentin was determined after storage for 24 h and 1 yr, either by direct water exposure or under simulated pulpal pressure. In-situ zymography was used to evaluate the influence of NTAP on the dentin-enzymatic activity. Non-thermal atmospheric plasma produced no remarkable topographical or chemical alterations at the dentin surface; only the amount of phosphate decreased following 10 s of treatment with NTAP. After 1 yr of direct water exposure, the µTBS of NTAP-treated specimens did not differ statistically significantly from that of untreated controls, whereas simulated pulpal pressure-aging resulted in a significantly higher µTBS for NTAP-treated dentin. The dentin-enzymatic activity appeared to be treatment-dependent, but the untreated controls showed more intense fluorescence within the hybrid layer. Scotchbond Universal maintained its µTBS strength after 1 yr of direct water exposure and simulated pulpal pressure, although remarkable statistical differences between treatments were observed depending on the aging condition.

3D-microleakage assessment of adhesive interfaces: exploratory findings by µCT.

OBJECTIVES: To explore the feasibility of a 3D-microleakage protocol for the evaluation of various configurations of adhesive-tooth interfaces. METHODS: Three different kinds of specimens were prepared: (1) a Class-I composite restoration placed without any bonding to maximize gap formation at the interface; (2) a glass-fiber post cemented with a self-adhesive composite cement into a prepared root canal; and (3) inlay MOD composite restorations placed with either a 1-step self-adhesive or a 2-step etch-and-rinse composite cement. After silver-nitrate (AgNO3) infiltration, the specimens were scanned using a Skyscan 1172 X-ray microtomograph (µCT; Skyscan Bruker) at 100kV, 100µA and 7.8-9.5µm resolution. Projection images were reconstructed, after which maximum-intensity projections (MIPs) and 3D-volumetric renderings were produced. For the inlays, an additional conventional stereomicroscopic (SM) microleakage evaluation was accomplished after specimen sectioning. RESULTS: MIPs and 3D-renderings from specimens (1) and (2) revealed strongly varying microleakage patterns along the marginal gap/interface. For the specimens of setup (3), the high radiopacity of the 2-step composite cement hindered evaluation of the MIPs. MIP-microleakage patterns along the enamel margin of the restoration cemented with the 1-step composite cement corresponded well to the stereomicroscopic images. SIGNIFICANCE: The reported µCT-protocol revealed good sensitivity to detect AgNO3 infiltration at the adhesive-tooth interface when considerable microleakage was present. When microleakage was less apparent and spread in a more diffuse pattern, evaluation with µCT was less sensitive compared to stereomicroscopic evaluation.