Scoping review: Effect of surface treatments on bond strength of resin composite repair.

OBJECTIVE: to evaluate the existing evidence on surface treatment techniques employed in resin composite repair and their effect on the repair short- and long-term bond strength. DATA AND SOURCE: This scoping review was performed under the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform. STUDY SELECTION: A systematic search was conducted in PubMed, Embase, and Scopus and grey literature up to September 2022 without language or date restriction. In vitro studies comparing mechanical surface and/or chemical treatments on repair bond strength of resin composite were included. Studies evaluating experimental adhesive systems or resin composites were excluded. Selection of studies and data extraction were performed. Data from selected studies was qualitatively analyzed. RESULTS: A total of 76 studies were included in the qualitative analysis. Among the mechanical treatments, alumina blasting was the most frequently used, followed by silica coating and diamond bur. As for chemical treatments, dentin bonding systems were the most frequently evaluated, followed by universal adhesive systems and silane/ceramic primer. The combination of mechanical and chemical pre-treatments increased the repair bond strength of resin composite in both short- and long-term simulated aging scenarios. The evidence obtained from the included studies was classified as moderate quality, mainly due to the medium risk of bias observed across most of the studies. CONCLUSION: The techniques used to treat the surface of resin composites for repair are diverse. Incorporating a combination of mechanical and chemical pre-treatments resulted in superior repair bond strength of resin composite materials under both short- and long-term simulated aging conditions. CLINICAL SIGNIFICANCE: The analysis of evidence revealed significant variability among protocols for repairing resin composites. Utilizing both mechanical and chemical pre-treatment methods is important for enhancing the bond strength of resin composites during both short- and long-term simulated aging situations.

Are polywave light-emitting diodes more effective than monowave ones in the photoactivation of resin-based materials containing alternative photoinitiators? A systematic review.

OBJECTIVE: This systematic review aimed to analyze if using polywave light-emitting diodes (LED) to photoactivate resin-based materials (resin composites, adhesive systems, and resin cements) containing alternative photoinitiators provide better physicochemical properties than monowave ones. MATERIAL AND METHODS: Inclusion criteria were in vitro studies that evaluated the degree of conversion, microhardness and flexural strength in resin-based materials containing alternative photoinitiators and light-activated with mono and polywave LEDs. Exclusion criteria were studies that evaluated the physicochemical properties of composites through any material interposed between the LED and the resin composite and studies that exclusively compared different modes and/or light activation times. Selection of studies, data extraction, and risk-of-bias analysis was performed. Data from selected studies were qualitatively analyzed. A systematic search was performed in June 2021 using PubMed/Medline, Embase, Scopus, and ISI Web of Science databases and grey literature without language restriction. RESULTS: A total of 18 studies were included in the qualitative analysis. Nine studies used diphenyl (2,4,6-trimethylbenzoyl) phosphine oxide (TPO) as an alternative photoinitiator for resin composite. Polywave LED improved the degree of conversion of resin composite compared to monowave in 9 of the included studies. Polywave LED improved the microhardness of resin composite compared to monowave in 7 of the included studies. Polywave LED improved the degree of conversion for 11 studies and microhardness of resin composite compared to monowave for 7 included studies. No differences in the flexural strength medium between poly and monowave LEDs were observed. The evidence was graded as low quality due to the high risk of bias for 11 studies. CONCLUSION: The existing studies, with their limitations, revealed that the polywave light-emitting diode maximizes activation, resulting in a higher degree of double-bond conversion and microhardness of resin composites containing alternative photoinitiators. However, the flexural strength of these materials is not influenced by the type of light activation device.

Bonding Efficacy of Universal Resin Adhesives to Zirconia Substrates: Systematic Review and Meta-Analysis.

PURPOSE: To provide an overview of the in-vitro bond strength of universal adhesives to zirconia and analyze whether these adhesives are a reliable alternative to conventional zirconia primers. MATERIALS AND METHODS: A systematic search was conducted in PubMed/Medline, Scopus, and ISI Web of Science databases up to August 2021. Investigations published in English, assessing resin-mediated bond to zirconia using universal adhesives compared to phosphate/silane-based primer or phosphate-based primer were included. After study selection and data extraction, risk of bias analysis was performed. Statistical analyses were performed using RevMan 5.4, with a random effects model, at a significance level of 0.05. RESULTS: In total, 23 studies were included for qualitative and quantitative analysis. Universal adhesives showed higher bond strengths than did phosphate-based primers (p < 0.00001) to aged zirconia without airborne alumina-particle abrasion. Similar results were observed when the zirconia surface was airborne-particle abraded at baseline and after dynamic aging (p < 0.0001). When universal adhesives and phosphate-silane based primers were compared, similar bond strengths (p ≥ 0.001) were observed after surface abrasion, regardless of storage condition. CONCLUSION: The results showed that universal adhesives generate higher bond strengths when compared to conventional zirconia primers.

Effect of Simulated Gastric Acid on the Interface Between Zirconia and Resin Cement

PURPOSE: To evaluate the effect of simulated gastric acid solution (SGAS) and resin cement composition on the shear bond strength (SBS) of zirconia-based materials with different levels of translucency to composite resin. MATERIALS AND METHODS: A total of 40 medium-opacity (MO; 3Y-TZP) and 40 medium-translucency (MT; 4Y-PSZ) zirconia slabs were distributed into four groups according to the composition of the resin luting system (MDP free or with MDP [primer + Panavia V5]) and storage method (distilled water or SGAS [5% hydrochloric acid]). Composite resin cylinders were cemented on the zirconia surface and stored for 91 hours. SBS, failure mode, and surface characterization analyses via scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) were performed. SBS data were analyzed using three-way ANOVA and Tukey test, and failure mode was assessed using one-way ANOVA (P < .05). RESULTS: Storage media (P = .180), resin cement (P = .110), zirconia (P = .404), and their interactions did not affect SBS values. Bond strength ranged from 21.41 to 26.11 MPa. SEM images showed that SGAS modified the surface topography of zirconia and resin cement. The presence of chlorine and silicon (wt%) were higher after SGAS storage than after water storage in both cements used, while barium was higher only for the MDP cement. There was a prevalence of mixed failures for most of the groups. CONCLUSION: The SBS between both types of zirconia and resin cement was not affected by SGAS, although changes in zirconia topography were observed after SGAS exposure. The presence of MDP in the cement layer had no effect on the SBS challenged by SGAS.

Effect of Universal Adhesives on Long-term Bond Strength to Zirconia.

PURPOSE: To evaluate the effect of universal adhesives on the long-term bond strength to yttria-stabilized tetragonal zirconia polycrystal (Y-TZP). MATERIALS AND METHODS: Polyethylene tubes filled with composite cement containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) were adhesively luted to 60 fully sintered Y-TZP slabs (7 x 7 x 2 mm) with or without (control) previous application of a 10-MDP-based adhesive (All Bond Universal, Bisco) - ABU; Clearfil Universal Bond Quick, Kuraray Noritake - CUB; Scotchbond Universal Adhesive, 3M Oral Care - SUA) on the zirconia surface. The bonded specimens were stored in water for 24 h, 6 months, or 1 year and subjected to microshear bond strength testing. The data were analyzed by one-way ANOVA and Tukey's test (p < 0.05). The contact angle was measured after adhesive application to evaluate surface wettability. The adhesive-treated specimens were analyzed with x-ray photoelectron spectroscopy (XPS) and time-of-flight secondary ion mass spectrometry (ToF-SIMS) for chemical characterization. RESULTS: The application of a 10-MDP-based adhesive significantly improved bond strength of composite cement to zirconia when compared to the control group (no adhesive application) (p < 0.05). One-year water storage significantly decreased bond strength for ABU- and CUB-bonded specimens, but not for SUA-bonded specimens. The analysis by XPS and ToF-SIMS showed peaks of carbon, phosphorus, and silicon in all adhesive-treated specimens. CONCLUSIONS: One-year water storage affected the bond strength of composite cement to zirconia when All Bond Universal or Clearfil Universal Bond Quick were used.

Silica deposition on zirconia via room-temperature atomic layer deposition (RT-ALD): Effect on bond strength to veneering ceramic.

PURPOSE: To develop and to characterize a hybrid interface between yttria-stabilized zirconia (Y-TZP) transformed layer and silica-based nanofilm to enable a better bonding between Y-TZP and a veneering ceramic. MATERIAL AND METHODS: Sixty-six fully-sintered rectangular Y-TZP specimens were distributed into 6 groups, according to the surface treatment applied: C (control): no treatment; Al: 27 µm-alumina particle abrasion; Ht: hydrothermal treatment in autoclave for 15h; Si20: 20 cycles of silica deposition using room-temperature atomic layer deposition (RT-ALD); Si40: 40 cycles of RT-ALD; Ht + Si40: hydrothermal treatment followed by 40 cycles of RT-ALD. RT-ALD was performed by the sequential exposure of specimens to vapor of tetramethoxysilane orthosilicate (TMOS) and ammonium hydroxide (NH4OH). Y-TZP surface wettability and shear bond strength (SBS) between Y-TZP and the veneering ceramic were analyzed for all groups after surface treatments. One-way ANOVA and Tukey's HSD test were used for data analysis (p ≤ 0.05). RESULTS: The highest contact angle was observed for the control group (64.46 ± 6.09 θ), while the lowest values (p < 0.001) were presented after Si20 (29.85 ± 4.23 θ) and Si40 (30.37 ± 5.51 θ) treatments. Hydrothermal treatment (49.3 ± 2.69 θ) and alumina abrasion (45.84 ± 4.12 θ) resulted in intermediate contact angle values. The highest SBS values were observed for Al (16.74 ± 1.68 MPa) and Ht (15.27 ± 2.11 MPa) groups (p < 0.018). Groups Si20 (9.66 ± 1.22 MPa), Si40 (9.33 ± 2.11 MPa), Ht + Si40 (9.37 ± 1.02 MPa) and C (12.54 ± 2.64 MPa) all resulted in similar SBS results (p > 0.998). CONCLUSION: The experimental treatments proposed enhanced surface wettability, but shear bond strength between Y-TZP and veneering ceramic was not improved. Alumina particle-abrasion improved SBS values while a decrease in wettability was observed.

Effect of universal adhesives and self-etch ceramic primers on bond strength to glass ceramics: A systematic review and meta-analysis of in vitro studies.

STATEMENT OF PROBLEM: To simplify dental procedures, multicomponent products such as universal adhesives and self-etch ceramic primers have been recommended for glass-ceramic bonding; however, studies have shown a wide range of results. PURPOSE: The purpose of this systematic review and meta-analysis was to analyze the in vitro bond strength promoted by hydrofluoric acid+silane-containing universal adhesives and a self-etch ceramic primer to glass-ceramics and compare it with that of conventional treatments. MATERIAL AND METHODS: A systematic search was conducted in the PubMed/Medline, Scopus, LILACS, and ISI Web of Science databases up to April 2021. In vitro studies assessing the resin-mediated bond to glass-ceramics by using a self-etch ceramic primer and hydrofluoric acid+silane-containing universal adhesives and/or compared with traditional hydrofluoric acid+glass-ceramic primers were included. Selection of studies, data extraction, and risk-of-bias analysis were performed. Statistical analysis was performed by using a review management software program using a random effects model (α=.05). RESULTS: A total of 33 studies were included in the qualitative analysis and 26 studies in the quantitative analysis. Bond strength to lithium disilicate ceramic was higher when a hydrofluoric acid+glass-ceramic primer was used than when using a hydrofluoric acid+silane-containing universal adhesive (P<.05), except when 9% to 10% acid concentration was used in combination with static aging (P=.100). A self-etch ceramic primer promoted bond strength values to lithium disilicate that were similar to those of the hydrofluoric acid+glass-ceramic primer (P>.100). CONCLUSIONS: Hydrofluoric acid+silane-containing universal adhesive was not as effective as the hydrofluoric acid+glass-ceramic primer in promoting bond strength to glass-ceramic. Bond strength values generated by a self-etch ceramic primer to glass-ceramic were similar to those generated by the conventional treatment.

Surface characterization of different surface treatments associations with plasma and bonding analysis of Y-TZP and the veneering ceramic.

OBJECTIVES: To characterize the surface of zirconia (Y-TZP) submitted to different surface treatments (with and without plasma associations) and to evaluate the shear bond strength (SBS) between veneering ceramic (VC) and Y-TZP after different aging methods. METHODS: 301 Y-TZP specimens were fabricated and distributed into 7 groups: C (control): no treatment; Al: airborne abrasion with 27 µm Al2O3 particle; L: liner; P: plasma; Al + L: airborne + liner; Al + P: airborne + plasma; P + L: plasma + liner. The Y-TZP surface was characterized by SEM, EDS, AFM, surface profilometry, surface-free energy (SFE), and XRD. SBS between Y-TZP and VC was verified after three aging protocols: initial, after hydrothermal aging (autoclave for 5 h), or thermal fatigue (30,000 baths - 5-55 °C). One- (profilometry, SFE) and two-way ANOVA (SBS), and Tukey's HSD test were used. RESULTS: For the plasma groups, a full globular surface coverage was observed (SEM, AFM). Si was found for Al, L, Al + L, and P + L. Roughness was lower for C, P, and Al + P. For SFE, the highest values were found when the liner was applied (>74.59 nm/Nm). The highest monoclinic content was observed for Al + L (6.96%) and Al + P (5.86%). For the initial period, Al and P + L presented the lowest SBS values (<5.85 MPa; P > 0.331). The highest SBS values were found for L, P, and P + L (hydrothermal aging) and for P, L, Al + L, and Al + P (thermal fatigue). SIGNIFICANCE: Changes in Y-TZP topography and the SBS with the VC were found, according to treatments performed. Plasma treatment improved SBS and did not cause phase transformation.

Mechanical performance of a hybrid zirconia developed through hydrothermal treatment and Room-Temperature Atomic Layer Deposition (RT-ALD).

OBJECTIVE: A silica-based nanofilm has been successfully deposited via Room-Temperature Atomic Layer Deposition (RT-ALD) on the surface of a glass. The purpose of this study was to evaluate the mechanical performance of a hybrid interface created between yttria-stabilized zirconia (Y-PSZ) transformed layer and silica-based nanofilm via RT-ALD. MATERIAL AND METHODS: Fully-sintered Y-PSZ (14 × 4.0 × 1.5 mm) specimens in different translucencies (MO, MT, LT; IPS e.max Zircad, Ivoclar Vivadent) were distributed in 5 groups: control (C - no treatment); hydrothermal treatment (HT- 15h, 134°C, 2 bar); alumina blasting (B - 50 µm Al2O3); RT-ALD silica deposition (S); HT followed by silica deposition (HTS). RT-ALD cycles consisted of the sequential exposure of specimens to tetramethoxysilane orthosilicate (TMOS - 60s) and ammonium hydroxide (NH4OH - 10 min) vapors in 40 cycles. Mechanical performance was analyzed by flexural strength (FS) (n = 10) and fatigue failure load (staircase method; n = 20) tests. Surface hardness (H) and Young's modulus (YM) were analyzed by nanoindentation. For surface chemical and topographical characterization, X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM) were performed. Data from surface H, YM, FS, and fatigue limit (FL) were analyzed by two-way analysis of variance (ANOVA). RESULTS: The interaction between material and treatment had a significant effect on FS (p < 0.001). The FS values ranged from 436.23 MPa to 856.65 MPa. HT resulted in the highest FS (856.65 MPa) for LT and the lowest FS (436.23 MPa) for MO zirconia. For all materials, S and B treatments resulted in similar FS values (p > 0.410). S did not affect FL when compared to the C group (p > 0.277) for any material investigated. HTS resulted in higher FL than S for LT and MO materials (p < 0.001). Surface hardness and modulus were similar between control and S-treated specimens for all materials analyzed. XPS analysis showed homogeneous silica content after 20 and 40 RT-ALD cycles, and SEM did not show significant changes in surface morphology between C and S-treated specimens. CONCLUSION: RT-ALD resulted in effective silica deposition without any deleterious effect on zirconia-based materials mechanical properties. Alumina blasting promoted higher alteration on surface topography. HT prior to S resulted in superior FL (for MO and MT) and flexural strength (MO) for some of the materials investigated.

Effect of handling material on mechanical and optical properties of feldspathic porcelain.

OBJECTIVE: To evaluate the optical, chemical, and mechanical properties of feldspathic porcelain after handling with different instrument materials. MATERIAL AND METHODS: Feldspathic porcelain was manipulated with different spatula compositions: metal spatula (MS), plastic spatula (PS), and glass spatula (GS) for the fabrication of 30 (n = 10) disks. Contrast ratio (CR), translucency parameter (TP), and surface Knoop microhardness (KHN) were measured. The color change (ΔE00 ) was evaluated using the CIEDE2000 system. Scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) were used for surface analysis. Data were analyzed using one-way ANOVA and Tukey test (P < 0.05). RESULTS: All groups presented different morphological surfaces with higher presence of Al on the MS. PS group presented lower Al, Si, K than MS, and GS. Higher CR was observed for PS (0.734; P < 0.043), followed by MS (0.696; P < 0.043) and GS (0.65; P < 0.011). The highest TP (13.06) and KHN (386.27) were presented by GS (P < 0.001). MS and PS presented similar KHN results. The higher ΔE00 were found for plastic/metal comparison. Also, the L* values for the MS group (67.49) were lower than the other groups. CONCLUSION: The use of metal spatula promoted higher color alteration during feldspathic porcelain manipulation than did the other materials. Handling with glass instrument promoted higher microhardness than other spatula materials. CLINICAL SIGNIFICANCE: The effect of the material used for ceramic handling on feldspathic porcelain properties is often ignored. This study shows that the handling spatula material must be carefully chosen to avoid inadvertent changes to the feldspathic porcelain restoration.

Review of nano-technology applications in resin-based restorative materials.

OBJECTIVE: Nanotechnology has progressed significantly and particles as small as 3 nm are being employed in resin-based restorative materials to improve clinical performance. The goal of this review is to report the progress of nanotechnology in Restorative Dentistry by reviewing the advantages, limitations, and applications of resin-based restorative materials with nanoparticles. MATERIALS AND METHODS: A literature review was conducted using PubMed/Medline, Scopus and Embase databases. In vitro, in vivo and in situ research studies published in English between 1999 and 2020, and which focused on the analysis of resin-based restorative materials containing nanoparticles were included. RESULTS: A total of 140 studies were included in this review. Studies reported the effect of incorporating different types of nanoparticles on adhesive systems or resin composites. Mechanical, physical, and anti-bacterial properties were described. The clinical performance of resin-based restorative materials with nanoparticles was also reported. CONCLUSIONS: The high surface area of nanoparticles exponentially increases the bioactivity of materials using bioactive nanofillers. However, the tendency of nanoparticles to agglomerate, the chemical instability of the developed materials and the decline of rheological properties when high ratios of nanoparticles are employed are some of the obstacles to overcome in the near future. CLINICAL SIGNIFICANCE: In spite of the recent advancements of nanotechnology in resin-based restorative materials, some challenges need to be overcome before new nano-based restorative materials are considered permanent solutions to clinical problems.

Effect of surface treatment on the retention of zirconia crowns to tooth structure after aging.

OBJECTIVE: To evaluate the effect of different surface treatments on the retention between zirconia crowns and tooth structure after in vitro aging. MATERIALS AND METHODS: Human third molars (n = 44) received crown preparations and CAD/CAM zirconia crowns were manufactured. Specimens were divided into two groups: no aging, control (NAC, n = 11) or aging (A, n = 33). NAC were bonded with universal adhesive (UA). Aged specimens were divided into three subgroups (n = 11) according to surface treatment: Control: no abrasion + UA; Alumina: alumina abrasion + UA; Silica: tribochemical silica coating + UA. The crowns were cemented with dual-cure resin cement. Specimens in group A were aged by a combination of mechanical, thermal, and pH cycling. Retention strength values were obtained by tensile tests and results were analyzed by one-way analysis of variance (ANOVA) and Tukey test (P < .05). RESULTS: Aging decreased the retention strength in control specimens (P < .001). Surface treatment improved the retention strength of aged specimens (P < .001), with similar results between alumina and tribochemical silica coating. CONCLUSION: The chemical interaction between the universal bonding system and zirconia's surface was not sufficient to withstand artificial aging. Tribochemical silica coating did not promote additional retention in comparison to alumina blasting. CLINICAL SIGNIFICANCE: The long-term retention of translucent zirconia crowns to tooth structure using phosphate-based materials is improved by means of mechanical surface treatments such as alumina blasting and tribochemical silica coating.

Effect of hydrothermal aging on the properties of zirconia with different levels of translucency.

OBJECTIVES: The aim of this study was to evaluate the effect of hydrothermal aging on the mechanical properties and translucency of dental zirconia with different levels of translucency. METHODS: Three different types of dental yttria-stabilized zirconia were used: 3Y-TZP (ZrO2 - 3 mol.% Y2O3) of medium opacity (designated Z3OP), 3Y-TZP of medium translucency (Z3MT), and 5Y-PSZ (ZrO2 - 5 mol.% Y2O3) of high translucency (Z5HT). A total of 120 specimens were sintered (n = 40 specimens/group). The control group (sintered→polished→heat-treated) and the aged group (sintered→polished→heat-treated→hydrothermally degraded at 134 °C, 2 bar, 5h) were characterized by relative density, quantitative phase analysis by X-ray diffraction using the Rietveld method, microstructural analysis by scanning electron microscopy, surface roughness and translucency. All groups were submitted to a biaxial flexural strength test. Data analysis using Kruskal-Wallis, Nemenyi (p-value = 0.05), and Weibull statistics were used. RESULTS: All sintered specimens presented full densification. After aging, an increase of the m-ZrO2 phase content was observed for the Z3OP group. On the other hand, Z3MT and Z5HT did not show any m-ZrO2 phase, indicating resistance to the hydrothermal degradation. Smaller grains were observed in the Z3MT group in relation to Z3OP group and the Z5HT group presented a bimodal grain distribution, where the largest grains were associated to cubic ZrO2. Z3OP exhibited a slight increase in roughness as a function of degradation, while the roughness remained statistically stable in the other groups. Translucency was little influenced by degradation, but considerably affected by increasing thickness. The Z5HT samples were the group with the highest translucency among the control groups. Z3OP exhibited the highest flexural strength, while being the most susceptible to hydrothermal degradation. The lowest values were presented by Z5HT in all groups, due to the high concentration of c-ZrO2 grains. CONCLUSION: Hydrothermal aging is less critical to the flexural strength of zirconia-based materials than the materials' composition and microstructure. Z5HT zirconia showed the highest translucency, however the measured difference is not visually perceptible. Z5HT was considered the most resistant to hydrothermal degradation.

Effect of cleaning protocol on silica deposition and silica-mediated bonding to Y-TZP.

OBJECTIVES: To evaluate the effect of cleaning methods on the deposition of silica on yttria-stabilized zirconium dioxide (Y-TZP) surface and on the silane-silica mediated bond strength between Y-TZP and resin cement. METHODS: Y-TZP slabs were air-abraded with 30µm silica-coated alumina particles and distributed in three groups: no cleaning, cleaning with a stream of oil-free air/water spray for 5s and cleaning with an ultrasonic bath in water for 10min. The distribution of Si on the Y-TZP surfaces was recorded using energy dispersive spectroscopy (EDS). After the treatment was applied, Y-TZP slabs (n=20) received a primer application and resin cement cylinders were built on the surface. After storage (24h) in water storage or 3 months plus thermocycling; n=10), microshear bond strength test (µSBS) was performed. X- ray Photoelectron Spectroscopy (XPS) characterized the chemical bonds between the silica layer and the silane-containing primer. Data were analyzed using ANOVA and Tukey test, as well as Weibull analysis (α=0.05). RESULTS: Cleaning method had a significant effect on the amount of Si deposited on zirconia surface (p<0.001) and, consequently, on bond strength (p<0.001). Storage/aging also had a significant effect on bond strength (p<0.001). Low values of Weibull moduli for bond strength were observed for all groups after aging. XPS showed silane-silica chemical interaction for all groups. SIGNIFICANCE: The silica deposited by tribochemical coating to Y-TZP was removed by the cleaning methods evaluated, compromising bond strength. Stability of the bonding is also a concern when no cleaning method is applied.

Effect of silane and MDP-based primers on physico-chemical properties of zirconia and its bond strength to resin cement.

OBJECTIVE: To evaluate the effect of surface treatments on yttria-tetragonal zirconia polycrystal (Y-TZP) characteristics and on resin-mediated zirconia bond. METHODS: Y-TZP slabs were grit blasted with 45µm alumina or with 30µm silica-coated alumina particles. The chemical treatments were: no-chemical treatment (NC), silane-containing primer (SP), MDP (10-Methacryloyloxydecyl dihydrogen phosphate) and silane-containing primer (MPS), MDP-containing primer (MP) and MDP and silane-containing adhesive (MPA). Contact angle as a function of surface roughness (θm) and surface roughness parameter (Sdr) were measured using Fringe Projection Phase Shifting (FPPS). Surface free energy (γsTOT) was calculated with a goniometer. Chemical interaction between primers/adhesive and zirconia was analyzed using time-of-flight secondary ion mass spectrometry (ToF-SIMS). Resin cement microshear bond strength (µSBS) was analyzed at either 24-h or 8-months water storage (37°C). θm values, Sdr values, γsTOT and µSBS values were analyzed using Analysis of variance (ANOVA) and post hoc Tukey test (α=0.05). RESULTS: Chemical treatment had an effect (p<0.001) on all surface parameters analyzed: θm, γsTOT and Sdr. MP-treated group showed higher incidence of P-O-Zr bonds than the other groups, indicating more chemical linkages. Grit blasting (p<0.001) and the interaction chemical treatment*storage (p<0.001) did not affect µSBS; all silane-containing primers showed significant drop in µSBS after aging. SIGNIFICANCE: MDP and/or silane-based solutions affect the physicochemical properties of blasted-zirconia. An MDP-based primer is fundamental to achieve a stable resin-zirconia bonding, but the chemical reactivity of MDP is impaired when this molecule is present in a multicomponent system.

Simulated occlusal adjustments and their effects on zirconia and antagonist artificial enamel.

PURPOSE: The aim of this study was to evaluate the effect of occlusal adjustments on the surface roughness of yttria-tetragonal zirconia polycrystal (Y-TZP) and wear of opposing artificial enamel. MATERIALS AND METHODS: Twenty-five Y-TZP slabs from each brand (Lava, 3M and Bruxzir, Glidewell Laboratories) with different surface conditions (Control polished - CPZ; Polished/ground - GRZ; Polished/ground/repolished - RPZ; Glazed - GZ; Porcelain-veneered - PVZ; n=5) were abraded (500,000 cycles, 80 N) against artificial enamel (6 mm diameter steatite). Y-TZP roughness (in µm) before and after chewing simulation (CS) and antagonist steatite volume loss (in mm3) were evaluated using a contact surface profilometer. Y-TZP roughness was analyzed by three-way analysis of variance (ANOVA) and teatite wear by two-way ANOVA and Tukey Honest Difference (HSD) (P=.05). RESULTS: There was no effect of Y-TZP brand on surface roughness (P=.216) and steatite loss (P=.064). A significant interaction effect (P<.001) between surface condition and CS on Y-TZP roughness was observed. GZ specimens showed higher roughness after CS (before CS - 3.7 ± 1.8 µm; after CS - 13.54 ± 3.11 µm), with partial removal of the glaze layer. Indenters abraded against CPZ (0.09 ± 0.03 mm3) were worn more than those abraded against PVZ (0.02 ± 0.01 mm3) and GZ (0.02 ± 0.01 mm3). Higher wear caused by direct abrasion against zirconia was confirmed by SEM. CONCLUSION: Polishing with an intraoral polishing system did not reduce the roughness of zirconia. Wear of the opposing artificial enamel was affected by the material on the surface rather than the finishing technique applied, indicating that polished zirconia is more deleterious to artificial enamel than are glazed and porcelain-veneered restorations.

Surface analysis and shear bond strength of zirconia on resin cements after non-thermal plasma treatment and/or primer application for metallic alloys.

There is no established protocol for bonding zirconia (Y-TZP) with resin cements. Non-thermal plasma (NTP) may be an alternative for the clinical problems related to adhesion. The purpose of the present study was to characterize the surface of Y-TZP exposed to methane (CH4) NTP or coated with a layer of primer for metal alloys and the association between the two methods and to evaluate the effect of NTP treatment on bond strength between Y-TZP and two resin cements. A total of 235 Y-TZP discs (8×2mm) were distributed into five groups: Co (no surface treatment), Pr (primer), NTP (methane plasma), Pr+NTP and NTP+Pr. The effect of the treatment type on the surface free energy, morphology, topography and chemical composition of the Y-TZP discs was investigated. The discs were cemented to composite resin substrates using Panavia F2.0 or RelyX U200. Shear bond strength (n=10) analyses were performed (1mm/min) before and after thermocycling (5-55°C, 2000cycles) on the bonded specimens. The data were analyzed with one and three-way ANOVAs and Bonferroni tests (α=0.05). NTP reduced the surface energy and roughness of the Y-TZP discs. SEM-EDS and XPS analyses showed the presence of the organic thin film, which significantly improved the bond strength results when Rely X U200 was used, whereas the primer treatment was more effective with Panavia F2.0. Thermocycling significantly reduced the bond strength results of the NTP and Pr+NTP groups cemented with Rely X U200 and the Pr and NTP+Pr groups cemented with Panavia F2.0. Nonthermal plasma improves the bond strength between Rely X U200 and Y-TZP and also seems to have water-resistant behavior, whereas Panavia F2.0 showed better results when associated with primer.

Effect of silorane-based adhesive system on bond strength between composite and dentin substrate.

CONTEXT: The complexities of the oral environment, the dentin substrate, and the different bond and composite resin systems represent a challenge to the maintenance of reasonable bond between the composite resin and the tooth structure. AIMS: To evaluate the effect of the adhesive system on bond strength between silorane-based composite resin and dentin. MATERIALS AND METHODS: Fourteen human molars extracted were selected and vertically cut into 3 dentin fragments, randomly divided among the experimental groups and restored with Z250 and P90 composite resin using different adhesive protocols (Adper Single Bond 2, Silorano primer, Adper SE Plus, and Scotchbond Multiuse). Two composite resin cylinders were built up on each dentin surface (n = 10) and subjected to a micro-shear bond strength test. STATISTICAL ANALYSIS USED: Kruskal-Wallis one-way analysis of variance and Tukey test (P = 0.05). RESULTS: According to the results, Kruskal-Wallis test evidenced at least one statistical significant difference (P = 0.001). The Tukey test showed statistically significant differences among the group (P < 0.05). Group PSM8 (P90 + SM) showed statically significant higher results when compared with groups PSP4 (P90 + SP), PSB2 (P90 + SB), and ZSE5 (Z250 + SE). CONCLUSION: The results evidenced that the monomer of the adhesive system has an effect on bond strength between the composite resin and dentin.

Influence of additional adhesive application on the microtensile bond strength of adhesive systems.

This study evaluated microtensile bond strength (pTBS) when an additional adhesive layer was applied to the dentin surface. Thirty-five human third molars were flattened to expose the occlusal dentin surface. The teeth were randomly assigned to 7 experimental groups: G1-Single Bond (SB); G2-additional layer of SB; G3--a layer of Scotchbond Multi-purpose (SMP) adhesive applied over SB; G4-Clearfil SE Bond (CE); G5-additional layer of CE; G6-Adper Prompt (AP) and G7-additional layer of AP. For the G2, G3, G5 and G7 groups, the first adhesive layer was light-cured before application of the additional layer. After bonding procedures, 5-mm high composite crowns were incrementally built up. The samples were sectioned to obtain 0.9 x 0.9 beams, which were tested under tension at a crosshead speed of 0.5-mm/minute until failure. The failure mode and adhesive thickness were evaluated under SEM. The pTBS data were analyzed by 1-way ANOVA and post-hoc Ducan's Test (a=0.05). Mean adhesive thickness was analyzed by 1-way ANOVA and post-hoc Tukey's test (a=0.05). The results indicated that G3 presented the highest microTBS and the thickest adhesive layer. G6 and G7 presented the lowest microTBS values. When solvent-free adhesives systems were used, microTBS values were not affected by the thicker layer.

Contorno cosméstico: uma alternativa simples para a reformulaçäo estética dos dentes naturais / Esthetic contour: a simple alternative to natural teeth's aesthetic

Em um universo globalizado, a Odontologia cosmética apresentava-se como um dos fatores primordiais no planejamento odontológico. Este fato deve-se principalmente à necessidade, por parte dos pacientes, de obter restauraçöes imperceptíveis que proporcionam sorrisos agradáveis e com sinais de saúde. Neste contexto, a reformulaçäo dos dentes naturais, através das técnicas de contorno cosmético, representa uma alternativa simples e eficaz na recuperaçäo de uma aparência mais harmônica, adequando o sorriso a padröes estéticos desejáveis. Este trabalho tem como objetivo discutir as vantagens e limitaçöes da técnica do contorno cosmético na criaçäo de ilusöes ópticas, com ou sem auxílio da utilizaçäo de compósitos