Impact of CAD/CAM Material and Bonding Protocol on the Bond Strength Between Denture Bases and Artificial Teeth: A Systematic Review and Meta-analysis

PURPOSE: To identify the most effective protocol for bonding denture bases and artificial teeth made with different computer-aided design and manufacturing (CAD/CAM) materials (milled and 3D-printed) and conventional heat-polymerized resins. MATERIALS AND METHODS: This review was performed according to the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA) criteria and registered in the International Prospective Registry of Systematic Reviews PROSPERO (CRD42021276084). An electronic search was performed independently by two examiners in PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science, ProQuest, and OpenGrey databases for articles published up to and including December 2021. RESULTS: The electronic search returned 806 articles, and after duplicates were removed, 589 articles remained. Four articles met the eligibility criteria to be included in this study. After evaluating the different combinations of denture base materials and artificial teeth, it was found that IvoBase CAD Bond (Ivoclar Vivadent) was effective for bonding CAD/CAM denture bases to prefabricated acrylic resin teeth, which showed no differences compared to the heat-polymerized resin denture base bonded to prefabricated acrylic resin teeth (χ2: 68.56; I2: 96%; P < .001). CONCLUSIONS: The IvoBase CAD Bond bonding system can be used for the fabrication of CAD/CAM denture bases with prefabricated acrylic resin teeth.

Which metal surface treatment improves the bond strength between metal alloys and acrylic resin in removable partial dentures? A systematic review.

STATEMENT OF PROBLEM: The union of the metal removable partial denture framework to the heat polymerized acrylic resin is related to prosthesis longevity. However, methods to enhance this bond are not clear to clinicians and dental laboratory technicians. PURPOSE: The purpose of this systematic review was to identify which metal surface treatments best increase the bond strength between heat polymerized acrylic resin and removable partial denture alloys. MATERIAL AND METHODS: This review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Registry of Systematic Reviews (PROSPERO) database (CRD42022384926). Electronic searches were carried out independently, by 3 examiners in Medline/PubMed, Scopus, and Web of Science databases, and in the nonpeer-reviewed literature via ProQuest. RESULTS: The electronic searches resulted in 4143 articles, with 4055 after removing duplicates. After reading the titles and abstracts, 37 articles were selected for reading in full-text version, from which 6 articles were included. All studies evaluated materials for conventional acrylic resin denture base (heat polymerized), processed by water bath, bonded to metal. For the metal framework alloys, cobalt chromium (Co-Cr) alloys were used in 2 studies, titanium (Ti) in 2 studies, and Co-Cr and Ti in the other 2 studies. Different metal surface treatments were used as airborne-particle abrasion with aluminum oxide (particle sizes of 50 µm, 110 µm, and 250 µm) followed by the primer application and the isolated use of the primer, compared to the absence of isolated intervention or airborne-particle abrasion of the metal surface. Among the different primers used, those based on 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) showed the highest acrylic resin-to-metal bond strength values. CONCLUSIONS: Airborne-particle abrading the metal with Al2O3 followed by applying a 10-MDP-based primer, increased the bond strength between metal framework alloys and heat polymerized acrylic resin denture base material.

Bond strength between denture lining material and CAD-CAM denture base resin: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: An effective bond between a denture lining material and the denture base resin is necessary for proper function. Regarding the new technologies for manufacturing denture bases, a systematic search of the literature on this topic is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the bond strength between denture lining material and computer-aided design and computer-aided manufacturing (CAD-CAM) denture base resin (milled and 3-dimensionally printed) versus conventional denture base resin. MATERIAL AND METHODS: Electronic databases (PubMed/MEDLINE, Scopus, and Web of Science) were independently searched by 4 researchers for relevant studies published up to April 2023. The population, intervention, comparison, and outcome (PICO) question was: "Comparing conventional and CAD-CAM (milled and 3-dimensionally printed) denture base materials, which promote greater bond strength when associated with denture lining material?" A meta-analysis was performed based on mean ±standard deviation bond strength values between denture base resins and denture lining material with 95% confidence intervals. RESULTS: Five in vitro studies were included. For bond strength, no difference was noted between conventional and milled denture base resin (confidence interval: -0.99 [-2.17 to 0.20]; heterogeneity: t2=0.57; Chi2:4.57; I2=78%; P=.10), and conventional resin had better values compared with those of 3-dimensionally (3D) printed (confidence interval: 3.03 [2.40-3.66]; heterogeneity: t2=0.00; Chi2:0.56; I2=0%; P<.001) when relined with soft materials. The milled denture base resin was better than the conventional (confidence interval: -0.85 [-1.33 to -0.38]; heterogeneity: Chi2:28.87; I2=93%; P<.001), with no difference between 3D printed and conventional (confidence interval: 0.18 [-4.23 to 4.59]; heterogeneity: t2=16.51; Chi2:130.99; I2=98%; P=.94) for hard liners. CONCLUSIONS: The bond strength between resins for milled CAD-CAM denture bases and denture lining material was similar to that of conventional denture base resin, regardless of the consistency of the denture lining material. The bond strength to 3D printed CAD-CAM resin was lower than that of the milled version.

Bond strength of selfadhesive flowable resin composites to tooth structure: a systematic review

Aim: To review the current literature regarding the bond strength of self-adhesive flowable resin composites (SAFRCs) to tooth structure, comparing the outcomes with conventional flowable resin composites (CFRCs). Methods: PubMed/Medline, EbscoHost and Scopus databases were screened (last update on November 2020) using related Medical Subject Headings (MeSH) and free terms. We included in vitro studies published in English language comparing the bond strength of SAFRCs and CFRCs to enamel and/or dentin from primary and/or permanent teeth. Results: In total, 23 articles were included. Unlike CFRCs, SAFRCs such as Vertise® Flow and Fusio™ Liquid Dentin exhibited statistically lower bond strength to enamel and dentin from permanent teeth. There were limited studies comparing the enamel bond strength of CFRCs and SAFRCs (prior phosphoric acid etching and/or adhesive system use). Also, we found few studies that evaluated the bonding effectiveness of Constic® and other SAFRCs to primary teeth. Conclusions: Current SAFRCs showed low bond strength to permanent teeth, which impedes to recommend them as a reliable alternative to CFRCs. The bonding performance of Constic® on both hard dental tissues should be evaluated on future studies. Also, more evidence assessing the bond strength of SAFRCs to primary teeth and etched enamel is needed

Global frequency and distribution of head and neck cancer in pediatrics, a systematic review.

BACKGROUND: Incidence and mortality rates of childhood cancer represent a global public health issue, however, the worldwide prevalence of head and neck cancer in pediatric patients (HNCPP) is still unknown. Therefore, this study aimed to describe the frequency and distribution of HNCPP worldwide. METHODS: A specific search strategy was performed using MEDLINE, Scopus, and EMBASE to include studies based on hospital records, national cancer registries, and pathology files. Studies quality was assessed using the risk of bias checklist of the Joanna Briggs Institute Critical Appraisal. RESULTS: Nineteen publications (15,970 cases) were included. Global frequency ranged from 0.25 % to 15 %. Male patients older than 10 years of age were most affected by lymphomas, followed by carcinomas and sarcomas. Non-Hodgkin lymphoma, Hodgkin lymphoma, rhabdomyosarcoma, thyroid carcinoma, and nasopharyngeal carcinoma were the main histopathological subtypes. Neck/lymph nodes were anatomical hotspots. CONCLUSIONS: This HNCPP global overview may guide secondary prevention strategies and future etiological studies.

Depth of cure of bulk fill resin composites: A systematic review.

OBJECTIVE: To evaluate scientific evidence regarding depth of cure of bulk-fill resin composites (BFRCs) and related factors. MATERIAL AND METHODS: PubMed/Medline, Embase, Scopus, and ISI Web of Science databases were accessed from October 2016 to May 2017. Investigations published in English language, assessing depth of cure of BFRCs by microhardness test and/or degree of conversion (DC) were included. Studies using exclusively ISO 4049, employing specimens deepness less than 4 mm, as well as those not reporting exposure time and/or irradiance from light curing units (LCUs) were excluded. RESULTS: In total, 742 studies were found from which 33 were included. From 21 studies evaluating BFRCs microhardness, 10 showed acceptable bottom/top ratios (≥0.8) for all tested materials. However, material-dependent results and non-satisfactory bottom/top microhardness ratios (<0.8) were reported in 9 and 2 investigations, respectively. From 19 studies that assessed DC, 11 showed acceptable results (≥50%) for all tested BFRCs, while 8 studies reported material-dependent outcomes. Overall, irradiance from LCUs ranged from 650 to 1330 mW/cm2 and exposure time from 5 to 60 seconds. Favorable depth of cure results were observed with the use of LCUs emitting irradiance ≥1000 mW/cm2 and exposure times ≥20 seconds. CONCLUSIONS: High depth of cure rates by BFRCs, depends on some factors as material, irradiance and exposure time. Polywave LCUs were useful but not essential on polymerizing alternative photoinitiator-containing BFRC. CLINICAL SIGNIFICANCE: LED curing devices (polywave or monowave) displaying an irradiance ≥1000 mW/cm2 and 20 seconds of exposure time are imperative to accomplish successful polymerization of most BFRCs.