1-Year clinical study of indirect resin composite restorations luted with a self-adhesive resin cement: effect of enamel etching.

In vitro studies have recommended enamel-etching before luting indirect restorations with self-adhesive resin cement. However, there is no scientific proof that this procedure has any clinical relevance. Thus, the aim of this study was to evaluate the effect of enamel-etching on the marginal quality of indirect composite resin restorations (inlay/onlay) using the self-adhesive cement RelyX Unicem clicker. Forty-two posterior teeth were selected from 25 patients that presented one or two teeth with large restorations in need of replacement. All teeth were prepared by the same operator and impressed with polyvinylsiloxane material. The composite resin restorations were built over plaster casts using the incremental technique with a LED device for light-curing the increments. The inlays/onlays were cemented according to one of the following protocols: 1. Etched group (ETR) - selective enamel phosphoric-acid etching + RelyX Unicem clicker; 2. Non-etched group (NER) - RelyX Unicem clicker alone. Each surface was light-cured for 60 s. Recalls occurred after 1 week (baseline), 6 and 12 months when the teeth were evaluated according to previously established scores (modified USPHS criteria). The clinical analysis showed little or no visible changes in the marginal quality after 1 year, even though a probe could detect all the restorations margins. Statistical analysis (Fisher's exact test, p<0.05) detected no differences between the groups after 12 months. No restorations failed and no secondary caries were found. Enamel acid etching had no clinical relevance on the marginal quality of indirect composite resin restorations luted with RelyX Unicem clicker after 1 year of follow up.

1-Year clinical study of indirect resin composite restorations luted with a self-adhesive resin cement: effect of enamel etching

In vitro studies have recommended enamel-etching before luting indirect restorations with self-adhesive resin cement. However, there is no scientific proof that this procedure has any clinical relevance. Thus, the aim of this study was to evaluate the effect of enamel-etching on the marginal quality of indirect composite resin restorations (inlay/onlay) using the self-adhesive cement RelyX Unicem clicker. Forty-two posterior teeth were selected from 25 patients that presented one or two teeth with large restorations in need of replacement. All teeth were prepared by the same operator and impressed with polyvinylsiloxane material. The composite resin restorations were built over plaster casts using the incremental technique with a LED device for light-curing the increments. The inlays/onlays were cemented according to one of the following protocols: 1. Etched group (ETR) - selective enamel phosphoric-acid etching + RelyX Unicem clicker; 2. Non-etched group (NER) - RelyX Unicem clicker alone. Each surface was light-cured for 60 s. Recalls occurred after 1 week (baseline), 6 and 12 months when the teeth were evaluated according to previously established scores (modified USPHS criteria). The clinical analysis showed little or no visible changes in the marginal quality after 1 year, even though a probe could detect all the restorations margins. Statistical analysis (Fisher’s exact test, p<0.05) detected no differences between the groups after 12 months. No restorations failed and no secondary caries were found. Enamel acid etching had no clinical relevance on the marginal quality of indirect composite resin restorations luted with RelyX Unicem clicker after 1 year of follow up.

Estudos in vitro têm recomendado condicionamento ácido do esmalte antes da cimentação de restaurações indiretas com cimento resinoso autoadesivo. Entretanto, não há nenhuma prova científica de que este procedimento tenha relevância clínica. Assim, o objetivo deste estudo foi avaliar o efeito do condicionamento ácido do esmalte na qualidade marginal de restaurações indiretas de resina composta (inlay/onlay) usando o cimento autoadesivo RelyX Unicem clicker. Quarenta e dois dentes posteriores foram selecionados de 25 pacientes com 1 ou 2 restaurações amplas com necessidade de substituição. Todos os dentes foram preparados pelo mesmo operador e impressos com material à base de polivilsiloxano. As restaurações de resina composta foram construídas sobre troquel de gesso usando a técnica de colocação em camadas e polimerizadas usando aparelho de luz emitida por diodo (LED). Osinlays/onlays foram cimentados de acordo com um dos protocolos: 1. Grupo condicionado (ETR)- condicionamento seletivo do esmalte com ácido fosfórico + cimentação com RelyX Unicem clicker; 2. Grupo não condicionado (NER)- cimentação com RelyX Unicem clicker somente. Cada superfície foi fotoativada por 60 s. Os retornos para acompanhamento foram feitos após 1 semana (baseline), 6 e 12 meses onde os dentes foram avaliados de acordo com critérios previamente estabelecidos (USPHS Modificado). A análise clínica mostrou pouca ou nenhuma alteração visível na qualidade marginal após 1 ano, porém uma sonda clínica pode detectar todas as margens restauradoras. A análise estatística (Teste exato de Fisher, p<0,05) não detectou diferença entre os grupos após 12 meses. Nenhuma restauração falhou e nenhuma cárie secundária foi encontrada. O condicionamento ácido do esmalte não teve relevância clínica na qualidade marginal de restaurações indiretas de resina composta cimentadas com RelyX Unicem clicker após 1 ano de acompanhamento.

Tensile bond strength of dual curing resin-based cements to commercially pure titanium.

OBJECTIVES: The aim of this study was to evaluate the tensile bond strength of dual curing luting resin cements to commercially pure titanium at 10 min and 24h after removal of the oxide layer. METHODS: One hundred and twenty titanium discs were obtained by casting and polishing with silicon carbide papers. The titanium discs were sandblasted with 50 microm aluminum oxide, ultrasonic cleaned and bonded in pairs with the resin-based cements Panavia F and Rely X ARC at 10 min and 24h after the sandblasting. The tensile test was performed with a crosshead speed of 0.5mm/min in an Instron Universal testing machine. RESULTS: The Rely X ARC reached the highest tensile strength value at 24h after sandblasting (18.27 MPa), but there was no statistically significant difference between the two dual curing resin cements for both times tested. All specimens showed a mixture of cohesive fracture in the resin cement and adhesive failure. However, the predominant failure mode for Panavia F was cohesive in resin cement, and the Rely X ARC exhibited a greater proportion of specimens with adhesive failure between the alloy and resin luting cement at 10 min and 24h. SIGNIFICANCE: Both cements had, statistically, the same tensile bond strength. But in the fracture mode analysis, the adhesive predominant fracture mode of Rely X ARC cement indicates a premature clinical adhesive failure. On the other hand, the cohesive predominant fracture mode of Panavia F indicates a longer clinical adhesive bond with titanium.

SEM evaluation of contemporary self-etching primers applied to ground and unground enamel.

PURPOSE: This study evaluated the etching effect of self-etching priming agents applied to intact and ground enamel. MATERIALS AND METHODS: Thirty-two human molars were used. Each tooth was divided into two halves. The buccal or lingual mid-coronal surface of 32 half-teeth was ground with 600-grit silicon carbide paper. The other half-teeth were left intact (control). Teeth were treated with Clearfil SE Bond (SE), Prompt L-Pop (PLP) or Adper (AD). Those in the control group were etched with 35% phosphoric acid. The etching effect of such systems on enamel surfaces was assessed by three different approaches using scanning electron microscopy: 1) in situ or direct morphological examination of the etched enamel; 2) indirect morphological examination, that is, evaluation of the etching pattern left on resin reproductions; 3) adhesive interface examination. RESULTS: SE exhibited the least aggressive dissolution of the intact and ground enamel, with many sites of the intact enamel remaining completely unetched. SE monomer infiltration into etched enamel was restricted to the superficial layer. PLP and AD produced equivalent etching patterns on intact and ground enamel, which resemble that produced by the phosphoric acid control group. PLP and AD monomer penetration extended along the porous subsurface enamel layer. CONCLUSION: SE produced mild morphological changes on intact and ground enamel surface, resulting in a very superficial resin infiltration particularly into intact enamel. No differences were evident among the etching and resin infiltration pattern produced by both all-in-one self-etching adhesives, PLP and AD, and the phosphoric acid system.

Occluding effect of dentifrices on dentinal tubules.

OBJECTIVES: The objective of this study was to evaluate the tubule occluding ability of three commercial available dentifrices (Sensodyne, Emoform and Sorriso) by Scanning Electron Microscopy. METHODS: Fifty cervical areas from buccal and lingual surfaces of sound third human molars were used. Cervical enamel was wet abraded to expose flat dentin surfaces and further polished with diamond pastes. Specimens were randomly divided into five groups (n=10): G1-no brushing; G2-brushing without dentifrice; G3-brushing with Sensodyne; G4-brushing with Emoform; G5-brushing with Sorriso. Brushed specimens were treated for 4 min per day, for 7 days in a toothbrushing machine. Specimens were prepared and observed under SEM for calculation of the percentage of occluded tubules. In addition, slurries of toothpastes were analyzed by X-ray microanalysis. Data were statistically analyzed by ANOVA and Tukey test (p<0.05). RESULTS: Means of occluded tubules in descending order were: G5-98.83+/-3.31% (a), G4-96.02+/-5.24% (a), G3-80.12+/-24.65% (a), G1-37.31+/-24.22% (b); G2-22.92+/-15.19% (b). The three tested dentifrices produced increased dentinal occlusion as compared to controls (p<0.05) but equivalent occlusion among each other. Calcium from calcium-carbonate abrasive was identified in all dentifrices. CONCLUSIONS: Results indicated that the use of all dentifrices occluded tubules more than no brushing and brushing without dentifrices groups. Thus, the tested dentifrices seem effective for desensitization by tubule occlusion.

Effect of etching and airborne particle abrasion on the microstructure of different dental ceramics.

STATEMENT OF PROBLEM: The ceramic composition and microstructure surface of all-ceramic restorations are important components of an effective bonding substrate. Both hydrofluoric acid etching and airborne aluminum oxide particle abrasion produce irregular surfaces necessary for micromechanical bonding. Although surface treatments of feldspathic and leucite porcelains have been studied previously, the high alumina-containing and lithium disilicate ceramics have not been fully investigated. PURPOSE: The purpose of this study was to assess the surface topography of 6 different ceramics after treatment with either hydrofluoric acid etching or airborne aluminum oxide particle abrasion. MATERIAL AND METHODS: Five copings each of IPS Empress, IPS Empress 2 (0.8 mm thick), Cergogold (0.7 mm thick), In-Ceram Alumina, In-Ceram Zirconia, and Procera (0.8 mm thick) were fabricated following the manufacturer's instructions. Each coping was longitudinally sectioned into 4 equal parts by a diamond disk. The resulting sections were then randomly divided into 3 groups depending on subsequent surface treatments: Group 1, specimens without additional surface treatments, as received from the laboratory (control); Group 2, specimens treated by use of airborne particle abrasion with 50-microm aluminum oxide; and Group 3, specimens treated with 10% hydrofluoric acid etching (20 seconds for IPS Empress 2; 60 seconds for IPS Empress and Cergogold; and 2 minutes for In-Ceram Alumina, In-Ceram Zirconia, and Procera). RESULTS: Airborne particle abrasion changed the morphologic surface of IPS Empress, IPS Empress 2, and Cergogold ceramics. The surface topography of these ceramics exhibited shallow irregularities not evident in the control group. For Procera, the 50-microm aluminum oxide airborne particle abrasion produced a flattened surface. Airborne particle abrasion of In-Ceram Alumina and In-Ceram Zirconia did not change the morphologic characteristics and the same shallows pits found in the control group remained. For IPS Empress 2, 10% hydrofluoric acid etching produced elongated crystals scattered with shallow irregularities. For IPS Empress and Cergogold, the morphologic characteristic was honeycomb-like on the ceramic surface. The surface treatment of In-Ceram Alumina, In-Ceram Zirconia, and Procera did not change their superficial structure. CONCLUSION: Hydrofluoric acid etching and airborne particle abrasion with 50-microm aluminum oxide increased the irregularities on the surface of IPS Empress, IPS Empress 2, and Cergogold ceramics. Similar treatment of In-Ceram Alumina, In-Ceram Zirconia, and Procera did not change their morphologic microstructure.

Antibacterial and conventional self-etching primer system: morphological evaluation of intact primary enamel.

The aim of this study was to analyze the etching effect of a new dental adhesive system that uses an antibacterial and self-etching primer agent. Non-carious primary human molars were divided into three groups: 35% phosphoric acid etching (3M-ESPE), self-etching primer (Clearfil SE Bond--Kuraray) and antibacterial self-etching primer (ABF experimental system--Kuraray) for SEM evaluation of surface, resin replicas and interface. Both self-etching primers produced shallow grooves and no defined etching morphologies. Phosphoric acid produced definite etching patterns at the enamel surface.

The effects of filling techniques and a low-viscosity composite liner on bond strength to class II cavities.

OBJECTIVE: The aim of this study was to test the hypothesis that the effects of filling technique, cavity configuration and use of a low-viscosity composite liner influence resin bond strength to the dentin of class II cavities gingival floor; and analyze the failure modes of fractured specimens. METHODS: Standardized class II cavities were prepared in the proximal surfaces of freshly extracted third molars, which were randomly assigned to 10 experimental groups. All prepared surfaces were acid-etched, bonded with Single Bond adhesive system and restored with TPH composite, according to each technique: G1 and G2-horizontal layering, G3 and G4-faciolingual layering, G5 and G6-oblique layering, G7 and G8-bulk filling, G9 and G10-control (flat dentin surfaces). Groups were tested, with or without a low-viscosity composite liner (Tetric Flow Chroma). After storage in water for 24h, teeth were vertically serially sectioned to yield a series of 0.8mm thick slabs. Each slab was trimmed into an hourglass shape of approximately 0.8mm(2) area at the gingival resin-dentin interface. Specimens were tested in tension at 0.5mm/min until failure. Fractured specimens were analyzed in an SEM to determine the failure modes. RESULTS: No significant difference was found between groups restored with and without a low-viscosity composite liner (p>0.05). Among filling techniques, the bulk filling groups presented the lowest bond strength values (p<0.05), while incremental filling groups did not differ from control (flat dentin surfaces). Failure modes varied significantly among groups restored with and without the low-viscosity composite liner. SIGNIFICANCE: Bond strengths were not improved when a low-viscosity composite liner was applied, but it remarkably influenced the failure modes. Incremental techniques improved bond strength.