Effect of different cleaning regimens on the adhesion of resin to saliva-contaminated ceramics.

PURPOSE: The aim of this study was to evaluate the influence of different cleaning regimens on the microshear bond strength (µSBS) of three different all-ceramic surfaces after saliva contamination. MATERIAL AND METHODS: Cubic ceramic specimens (3 × 3 × 3 mm(3) ) were prepared from three types of ceramics: zirconium dioxide (Z), leucite-reinforced glass ceramic (E), lithium disilicate glass ceramic (EX; n = 12/subgroup). A total of 144 composite resin cylinders (diameter: 1 mm, height: 3 mm) were prepared. Three human-saliva-contaminated surfaces of ceramic specimens were cleaned with either water spray (WS), with 0.5% sodium hypochlorite solution (HC), or with a cleaning paste (CP). Control surface (C) was not contaminated or cleaned. Composite cylinders were bonded to each surface with a resin luting cement. All specimens were stored at 37°C in deionized water until fracture testing. µSBS tests were performed in a universal testing machine (0.5 mm/min), and the results (MPa ± SD) were statistically analyzed (two-way ANOVA, Bonferroni a = 0.05). Fractured surfaces were analyzed to identify the failure types using an optical microscope at 50× magnification. Two representative specimens from all groups were examined with scanning electron microscopy. RESULTS: µSBS test results were significantly affected by the saliva cleaning regimens (p = 0.01) and the ceramic types (p = 0.03). The interaction terms between the ceramic type and saliva cleaning regimen were also significant (p < 0.05). There were no significant differences among the µSBS values (MPa ± SD) for the Z group (C = 17.5 ± 8.8; WS = 16.0 ± 4.9; HC = 17.6 ± 5.8; CP = 16.6 ± 7.5; p > 0.05). In the EX group, C resulted in significantly higher µSBS values (32.6 ± 7.4) than CP (17.4 ± 8.9), WS (15.6 ± 7.3), and HC (14.3 ± 4.5) (p < 0.05); however, C (20.4 ± 7.1) and HC (19.2 ± 7.5) showed higher µSBS values than CP (13.8 ± 4.8) and WS (10.9 ± 5.7) in the E group. Some cohesive failures within the luting resin were observed in the E and EX groups, whereas only adhesive failures were seen in zirconia groups for all surface treatments. CONCLUSIONS: Different ceramic surface cleaning regimens after saliva contamination of the zirconium dioxide revealed µSBS similar to the control group, whereas all surface cleaning regimens tested significantly decreased the bond strength values in the lithium disilicate glass ceramic. The leucite-reinforced glass-ceramic group benefited from 0.5% sodium hypochlorite solution cleaning with increased bond strengths. CLINICAL SIGNIFICANCE: Adhesive cementation of zirconia presents a clinically challenging protocol, and the cementation surface contamination of the zirconia restorations and the inadequate removal of the contaminants increase the risk of failure, as for all ceramic types. This study demonstrated that surface cleaning regimens should be applied according to different ceramic properties.

Cytotoxicity of hard and soft denture lining materials.

The cytotoxicity of nine soft and hard lining materials (Mollosil Plus, Ufi Gel SC, Visco-gel, Molloplast-B, GC Tissue Conditioner, Vertex Rapid Simplified, GC Reline Hard, Vertex Self-Curing, Ufi Gel hard C) was evaluated using human gingival fibroblasts (HGFs). Twelve disk samples per lining material were prepared and incubated for 24, 48, 72, and 96 h. Cytotoxicity of each lining material's extract on cultured HGFs was measured using XTT assay. Data were analyzed using one-way ANOVA, post hoc Dunnett's T3 and Bonferroni tests at a significance level of p<0.05. At all incubation periods, all the hard lining materials (Vertex-SC, GC Reline Hard, Vertex-RS, and Ufi Gel hard C) showed cell viability higher than 90%. Among the soft lining materials, although there were no significant differences in cell viability among the different incubation periods for each lining material (p>0.05), autopolymerized acrylic-based GC Tissue Conditioner showed significantly lower cell viability than the other soft lining materials at each incubation period. Among the hard lining materials, there were no significant differences both among the materials and across all incubation periods for each lining material (p>0.05). In conclusion, all soft and hard liners exhibited good biocompatibility regardless of incubation time, except for GC Tissue Conditioner.

Resin cement color stability and its influence on the final shade of all-ceramics.

OBJECTIVES: Adhesive resin cements may go through internal discoloration, which may show-through and affect the appearance of translucent all-ceramic restorations. This in vitro study evaluated the amount of resin cement color change and its effect on the final shade of the all-ceramics. METHODS: Three different resin cements in both light and dual-cure forms were included in the study (Nexus-2/Kerr; Appeal/Ivoclar Vivadent; Calibra/Dentsply). All resin cements contained veneered (IPS Empress Esthetic, ETC1 shade, 20 mm × 1 mm ingot discs) and uncovered groups (n=10/group), all luted on white backgrounds (acetalpolyoxymethylene/Delrin(®)). Curing was performed according to ISO standards with a calibrated LED curing-light (Flashlite 1401). Samples were stored in 37°C distilled water at dark. Spectrophotometric baseline color measurements (Color Eye 7000A) were performed from the samples' top surfaces at 24h (D65 illuminator). Samples were subjected to 65 h of accelerated ageing (Atlas Ci4000). Further color measurements from the same areas were recorded in CIEL*a*b* coordinates where a ΔE data above 3 was accepted as visible discoloration (OptiviewLite-1.9software). Statistical analysis was performed using a nested random effects model and Tukey's post hoc analysis. RESULTS: Light-cure groups showed better color stability in all three resins but only in Appeal resin cement, the dual-cure group discolored significantly more (p<0.001). More discoloration was recorded on uncovered cement groups that represented the exposed cement at the margins. There was no visible color change (ΔE>3) through the ceramic surface on any veneered group. CONCLUSIONS: All resin cements showed varying degrees of discoloration after accelerated ageing however their actual color change was partially masked by the ceramic. Dual-cure resin cements may affect aesthetics on restoration margins if directly exposed.

Comparison of the hardness and microbiologic adherence of four permanent denture soft liners.

Resilient denture linings cannot be used for extended periods due to the loss of softness and the adhesion of microorganisms on their surfaces. This study investigated the hardness and microbiologic adherence of four permanent soft denture lining materials. In addition, the adherence of Candida albicans and Staphylococcus aureus was studied in vitro by quantitative culture method and scanning electron microscopy (SEM). Surface properties of the materials also were observed with SEM. The hardness of all materials increased throughout the study. Molloplast-B was the most adequate permanent soft lining material for clinical use under these laboratory conditions.