The Influence of Contamination and Different Cleaning Methods and the Effect of Plasma Treatment of CoCr Alloy on Tensile Bond Strength to Composite Resin.

PURPOSE: To investigate the influence of contamination and different cleaning methods on resin bonding to cobalt-chro- mium (CoCr) alloy disks. MATERIALS AND METHODS: A total of 160 CoCr disks were divided into 3 groups. The first group (N = 64) was air abraded with alumina particles and contaminated with a silicone disclosing agent and saliva; the second group (N = 64) was air abraded but not contaminated; the third group (N = 32) was neither air abraded nor contaminated. The first two groups were di- vided into 4 subgroups (N = 16) according to the cleaning method: ultrasonic bath in 99% isopropanol, use of a cleaning suspension of zirconium oxide particles, use of a cleaning suspension based on 10-MDP salt, and treatment with atmo- spheric plasma. The third group was divided into 2 subgroups (N = 16): treatment with atmospheric plasma and no treat- ment. All CoCr specimens were bonded to plexiglas tubes filled with a bonding resin that contained phosphate monomer. Tensile bond strength (TBS) was examined by tensile testing after 3 and 150 days of water storage plus 37,500 thermal cy- cles (N = 8). RESULTS: After contamination, TBS was significantly reduced after 150 days of water storage. Groups without air abrasion showed initially low TBS and debonded spontaneously after 150 days of water storage. CONCLUSION: None of the cleaning methods was able to remove saliva and silicone disclosing agent on CoCr-alloy sur- faces. Surface activation by plasma treatment has no long-term effect on the bond strength.

Effects of Surface Textures Created Using Additive Manufacturing on Shear Bond Strength Between Resin and Zirconia.

PURPOSE: This investigation aimed to assess the impact of additive manufacturing-generated surface textures on zirconia bond strength. MATERIALS AND METHODS: Zirconia samples (n = 144) fabricated using digital light-processing (DLP) technology were categorized into 6 groups according to the type of surface conditioning (group NN: no designs, no air abrasion; group NY: no designs, with air abrasion; group GN: groove designs, no air abrasion; group GY: groove designs with air abrasion; group HN: hexagon grid, no air abrasion; group HY: hexagon grid, with air abrasion). Composite resin cylinders were cemented to the treated zirconia surfaces with dual-curing, self-adhesive resin cement (Clearfil SA Luting). The shear bond strength (SBS) was tested after water storage for 3 days or 3 days with an additional 10,000 thermocycles. RESULTS: The zirconia samples fabricated using DLP technology have high accuracy. The SBS of the NY, GY, and HY groups did not significantly differ after 3 days, and neither did the SBS of the NN, GN, and HN groups. The NN, NY, and HY groups exhibited reduced SBS compared to their initial values following artificial aging, while the SBS of the remaining three groups were not diminished. The GY group obtained the highest SBS value after aging. CONCLUSION: Printing grooves with air abrasion can improve the bond strength.

Influence of airborne particle abrasion on dentin bonding effectiveness of a 2-step universal adhesive.

OBJECTIVE: To determine the effect of airborne particle abrasion (APA) on micro-tensile bond strength (µTBS) to dentin using different air-abrasion/polishing powders. METHODS: The bonding effectiveness of G2 Bond Universal (G2B), used in etch-and-rinse (E&R) and self-etch mode (SE), was tested on bur-cut dentin and dentin air abraded/polished using six different powders (aluminum oxide 29 µm (AO29) and 53 µm (AO53), aluminum trihydroxide (AT), sodium bicarbonate (SB), sodium bicarbonate soft (SBsoft) and bioactive glass (BG); Velopex). Adhesive-composite resin specimens were immersed in distilled water at 37 °C for one week and cut into microspecimens. Half of the specimens were subjected to 50,000 thermocycles (aged). Immediate and aged µTBS to dentin were measured. Statistical analysis was performed using linear mixed-effects (LME) modeling (p < 0.05). RESULTS: Comparing the aged bond strengths to air-abraded/polished dentin with bur-cut dentin, pretreatment with SB and SBsoft in combination with G2B used in E&R mode, and BG air polishing in combination with both application modes (E&R, SE), resulted in a significantly higher bond strength. Dentin bond strength was only significantly lower when air abraded with AO29 and using G2B in SE mode. Aging did not significantly influence bond strength for both application modes (E&R, SE), except for AO29 and AT-treated dentin, where bond strengths decrea sed significantly using G2B in SE mode. In general, G2B reached significantly higher bond strengths on air-abraded/polished dentin in E&R mode than in SE mode. CONCLUSION: Air-abrasion/polishing did not impair dentin bond strength using G2B, except when dentin was air abraded with AO29 and using G2B in SE mode. Air polishing positively influenced the bond strength to dentin in specific groups. CLINICAL SIGNIFICANCE: APA is safe concerning bonding to dentin. The E&R application mode is preferred using G2B as adhesive on air-abraded/polished dentin. Air polishing with BG positively influenced dentin bond strength for both application methods.

Assessment of a highly-filled flowable composite for the repair of indirect composites.

PURPOSE: To compare the shear-bond-strength (SBS) of a highly-filled-flowable composite (HFFC) and a paste-type composite for indirect composite repair and to evaluate the effect of different surface treatments (ST), concerning the composite repair protocol. METHODS: Eighty-four 5 × 5 × 2 mm cylindrical specimens were prepared using Gradia Plus and SR Nexco indirect composite materials. The samples were thermocycled 5,000 times. According to the ST, the samples were divided into three groups (control, bur, and air-abrasion). After ST, the sample subgroups were divided into two sub-groups according to the repair material: paste-type composite and HFFC (n = 7). Another 5,000 cycles of aging were performed. SBS values were measured with a universal testing machine (Shimadzu, Japan). Shapiro-Wilk, 3-way ANOVA, and Tukey HSD test were used to evaluate data (P < 0.05). RESULTS: ST was considered significant for SBS (P < 0.001). The mean values were (13.9 ± 5.7), (17.0 ± 6.4), (20.4 ± 4.9) MPa for the control, bur and phosphoric acid, and air-abrasion groups, respectively. The surface treatment and repair material interaction was considered significant for SBS (P = 0.044). The highest mean bond strength (24.5 ± 4.5 MPa) was observed for the interaction of SR Nexco, air-abrasion ST, and HFFC repair. CONCLUSION: Repairing with HFFC following air abrasion might enhance the SBS for indirect composite restorations.

Shear bond strength of orthodontic brackets bonded to high-translucent dental zirconia with different surface treatments: An in vitro study.

PURPOSE: The objective of this study was to compare the shear bond strengths of orthodontic brackets bonded to translucent dental zirconia samples which are anatomically accurate and treated with various surface treatments. METHODS: This in vitro study included 156 samples from 3 brands of high-translucent zirconia split into a control group and 4 surface treatment groups: 9.6% hydrofluoric acid etching, 50-micron aluminium oxide particle air abrasion, and 30-micron tribochemical silica coating (TBS) particle air abrasion with and without silane application. After surface treatment, all groups were primed with a 10-MDP primer and bonded to metal orthodontic brackets. Shear bond strength (SBS) was tested and results were compared between all groups. Data analysis consisted of a balanced two-factor factorial ANOVA, a Shapiro-Wilks test, and a non-parametric permutation test. The significance level was set at 0.05. RESULTS: Among all surface treatments, aluminium oxide particle abrasion produced significantly higher SBS (P≤0.002). Lava™ Plus zirconia samples had significantly higher SBS than Cercon® samples (P<0.0001). TBS surface treatment produced significantly higher SBS on Lava™ Plus samples than it did on the other zirconia brands (P=0.032). CONCLUSIONS: This study indicated that mechanical abrasion using aluminium oxide in combination with a 10-MDP primer creates a higher SBS to high-translucent zirconia than the bond created by tribochemical silica coating. Also, there was no significant difference in ARI regardless of zirconia brand or surface preparation.

Particle abrasion as a pre-bonding dentin surface treatment: A scoping review.

OBJECTIVE: This scoping review aims to assess the influence of air abrasion with aluminum oxide and bioactive glass on dentin bond strength. MATERIALS AND METHODS: An electronic search was conducted in three databases (PubMed, Cochrane Library, and Embase), on March 3rd, 2023, with previously identified MeSH Terms. A total of 1023 records were screened. Exclusion criteria include primary teeth, air abrasion of a substrate other than sound dentin, use of particles apart from aluminum oxide or bioactive glass, and studies in which bond strength was not assessed. RESULTS: Out of the 1023 records, title and abstract screening resulted in the exclusion of 895 and 67 studies, respectively, while full-text analysis excluded another 25 articles. In addition, 5 records were not included, as full texts could not be obtained after requesting the authors. Two cross-references were added. Thus, 33 studies were included in this review. It is important to emphasize the absence of standardization of air abrasion parameters. According to 63.6% of the studies, air abrasion does not influence dentin bond strength. Moreover, 30.3% suggest improving bonding performance, and 6.1% advocate a decrease. CONCLUSIONS: Air abrasion with aluminum oxide does not enhance or impair dentin bond strength. The available data on bioactive glass are limited, which hinders conclusive insights. CLINICAL SIGNIFICANCE: Dentin air abrasion is a widely applied technique nowadays, with numerous clinical applications. Despite the widespread adoption of this procedure, its potential impact on bonding performance requires a thorough analysis of the existing literature.

Influence of different surface treatment on bonding of metal and ceramic Orthodontic Brackets to CAD-CAM all ceramic materials.

BACKGROUND: Developing efficient bonding techniques for orthodontic brackets and all-ceramic materials continues to pose a clinical difficulty. This study aimed to evaluate the shear bond strengths (SBS) of metal and ceramic brackets to various all-ceramic CAD-CAM materials, such as lithium disilicate CAD (LDS-CAD), polymer-infiltrated ceramic (PIC), zirconia-reinforced lithium silicate glass ceramic (ZLS), and 5YTZP zirconia after different surface treatments and thermal cycling. MATERIALS AND METHODS: The samples were divided into two groups to be bonded with ceramic and metal lower incisor brackets. Each group was subdivided into a control group devoid of any surface treatment, 10% HF acid (HFA) etching, ceramic etch & prime (MEP), Al2O3 air abrasion, and medium grit diamond bur roughening. After surface treatment, brackets were bonded with composite resin cement, thermal cycled, and tested for shear bond strength. The failed surfaces were evaluated with a digital microscope to analyse the type of failure. The data were statistically analysed using a one-way ANOVA and Tukey HSD tests at p < 0.05. RESULTS: The highest mean bond strengths were found with HFA etching in LDS-CAD (13.17 ± 0.26 MPa) and ZLS (12.85 0.52 MPa). Diamond bur recorded the lowest mean bond strength roughening across all the ceramic groups. There were significant differences in mean shear bond values per surface treatment (p < 0.001) and ceramic materials. CONCLUSION: Among the surface treatment protocols evaluated, HFA etching and MEP surface treatment resulted in enhanced bond strength of both ceramic and metal brackets to CAD-CAM all ceramic materials.

Effects of tetrabutylammonium dihydrogen trifluoride etchant on bond strengths of resin composites with Ti-6Al-4V and Co-Cr alloys.

PURPOSE: This study aimed at evaluating the effects of surface treatments with tetrabutylammonium dihydrogen trifluoride (TDTF) on the bond strengths of indirect resin composites with titanium-aluminum-vanadium (Ti-6Al-4V) and cobalt-chromium (Co-Cr) alloys. METHODS: Disk-shaped Ti-6Al-4V and Co-Cr alloy specimens were air-abraded with alumina, treated with an etchant (MEP) containing TDTF for 10 s (MEP10) or 30 s (MEP30), and rinsed with water. Subsequently, a primer containing 6-methacryloyloxyhexyl phosphonoacetate was applied to the surfaces, and the specimens were veneered with a light-curing indirect resin composite. Specimens without MEP were prepared as controls (no-MEP). Shear bond strengths were determined before or after 100,000 thermocycles, and the data were analyzed using the Steel-Dwass test (α = 0.05, n = 10). RESULTS: No significant difference was found in the bond strengths between the Ti-6Al-4V and Co-Cr alloys. In each metal alloy, the MEP10 and MEP30 specimens exhibited higher bond strengths than the no-MEP controls after 100,000 thermocycles. Scanning electron microscopy observations revealed that submicron-pits and crevices were formed on both the metal alloys upon applying the MEP etchant. CONCLUSION: Surface treatments with TDTF following air abrasion are useful for improving bonding durability while veneering resin composites on Ti-6Al-4V or Co-Cr alloy frameworks.

Influence of a Novel Lithium Disilicate Coating on Composite-Zirconia Bonding and Bond Characterization.

PURPOSE: To investigate microtensile bond strength and characterization with the novel lithium disilicate coating technique compared to conventional air abrasion. MATERIALS AND METHODS: Eight zirconia blocks were fabricated and assigned to two groups (n = 4 each): (1) Lithium disilicate coating followed by hydrofluoric acid etching and Monobond N Primer (LiDi group); and (2) alumina air abrasion (MUL group). For each group, two identically pretreated zirconia blocks were bonded together with Multilink Speed Cement and cut into 30 stick-shaped specimens (1 × 1 × 9 mm3). The 120 specimens were stored in water for 24 hours and assigned to one of three groups (n = 20/group): (1) short-term storage for 24 hours; (2) thermocycling for 5,000 cycles; and (3) thermocycling for 10,000 cycles. A microtensile bond strength test was performed and evaluated. The bond strength results were analyzed using two-way ANOVA followed by one-way ANOVA and Tukey HSD (α = .05). Energy-dispersive x-ray spectroscopy (EDS), Fourier-transform infrared (FTIR), x-ray diffraction (XRD), focused ion beam scanning electron microscopy (FIB-SEM), and scanning electron microscopy (SEM) were used for chemical, crystalline phase, and failure mode analyses. RESULTS: The MUL groups recorded higher bond strength than the LiDi groups. Thermocycling significantly decreased the bond strength in both groups. Chemical analyses suggested that the lithium disilicate layer underwent hydrolysis, which compromised long-term bond strength. CONCLUSION: The bond between composite cement and alumina-abraded zirconia performed better than that with the lithium disilicate coating technique. Int J Prosthodont 2023;36:172-180. doi: 10.11607/ijp.6744.

Effect of Material and Pad Abrasion on Shear Bond Strength of 3D-Printed Orthodontic Brackets.

OBJECTIVE: To investigate the effect of printing material and air abrasion of bracket pads on the shear bond strength of 3D-printed plastic orthodontic brackets when bonded to the enamel of extracted human teeth. MATERIALS AND METHODS: Premolar brackets were 3D-printed using the design of a commercially available plastic bracket in two biocompatible resins: Dental LT Resin and Dental SG Resin (n = 40/material). 3D-printed brackets and commercially manufactured plastic brackets were divided into two groups (n = 20/group), one of which was air abraded. All brackets were bonded to extracted human premolars, and shear bond strength tests were performed. The failure types of each sample were classified using a 5-category modified adhesive remnant index (ARI) scoring system. RESULTS: Bracket material and bracket pad surface treatment presented statistically significant effects for shear bond strengths, and a significant interaction effect between bracket material and bracket pad surface treatment was observed. The non-air abraded (NAA) SG group (8.87 ± 0.64 MPa) had a statistically significantly lower shear bond strength than the air abraded (AA) SG group (12.09 ± 1.23 MPa). In the manufactured brackets and LT Resin groups, the NAA and AA groups were not statistically significantly different within each resin. A significant effect of bracket material and bracket pad surface treatment on ARI score was observed, but no significant interaction effect between bracket material and pad treatment was found. CONCLUSION: 3D-printed orthodontic brackets presented clinically sufficient shear bond strengths both with and without AA prior to bonding. The effect of bracket pad AA on shear bond strength depends on the bracket material.

Evaluation of shear bond strength and translucency of zirconia-reinforced lithium silicate and lithium disilicate: An in vitro study.

Aim: To analyze the effect of various surface treatment protocols on shear bond strength between the ceramic and resin cement (RC) and influence of zirconia on the translucency of LD as compared to zirconia-reinforced lithium silicate (ZLS). Setting and Design: In-Vitro Study. Materials and Methods: Specimens (14 mm × 12 mm × 2 mm) (n = 135) and (14 mm × 12 mm × 1 mm) (n = 45) of ZLS computer-aided design/computer-aided manufacturing glass ceramic block and LD were fabricated, respectively. All the ZLS specimens were crystallized and were tested for the translucency parameter and ceramic-resin shear bond strength. Two different types of surface treatment were used on the ZLS and LD samples. The specimens were treated using the hydrofluoric acid (HF) etching or air abrasion with diamond particles (DPs). The specimens were then bonded using self-adhesive RC to a composite disc of 10 mm and thermocycling was performed. A universal testing machine was used to evaluate ceramic-resin shear bond strength after 24 h. The translucency of the specimens was evaluated using the spectrophotometer by calculating the difference in color between the readings over a black background and a white background. Statistical Analysis Used: Data were statistically analyzed using the independent sample t-test and analysis of variance with Bonferroni's correction and comparison was made between the specimens. Results: Independent sample t-test demonstrated statistically significantly higher translucency for group ZLS (61.44 ± 22) as compared to group LD (20.16 ± 8.39) (P < 0.001). Group ZLS showed statistically significant higher shear bond strength when surface treatment using HF or air abrasion with synthetic DPs was performed as compared to untreated group (3.58 ± 0.45) (P < 0.001). Moreover, air abrasion group (16.79 ± 2.11 megapascal [MPa]) demonstrated statistically significant higher shear bond strength as compared to HF etched group (8.25 ± 0.30 MPa) (P < 0.001). Furthermore, statistically significant higher shear bond strength was noted when air abrasion was done for group ZLS (16.79 ± 2.11 MPa) as compared to group LD (10.82 ± 1.92 MPa) (P < 0.001). However, on surface treatment with HF, a statistically significantly lower shear bond strength was noted for group ZLS (8.25 ± 0.30 MPa) as compared to group LD (11.29 ± 0.58 MPa) (P = 0.001). Conclusion: ZLS demonstrated higher translucency compared to LD restorations. DP abrasion of ZLS is recommended to achieve higher shear bond strength between the ceramic and RC.

Failure behavior of zirconia crowns subjected to air abrasion with different particle sizes.

This study aimed to investigate the failure behavior of 3 mol.% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) prosthetic crowns air-abraded with aluminum oxide (AO) particles of different sizes. Ninety ceramic premolar crowns were produced with 3Y-TZP frameworks veneered with porcelain. Crowns were randomly divided into three groups, according to the size of the air abrasion AO particles (n = 30): (GC) untreated (control); (G53) 53 µm; (G125) 125 µm. Air abrasion was performed with 0.25 mpa pressure, 10-mm distance, for 10 s. Crowns were adhesively cemented to dentin analog abutments. Specimens were loaded in compression to failure, in 37oC distilled water, using a universal testing machine (n = 30). Fractographic analysis was performed using a stereomicroscope and SEM. The roughness of the crown's inner surface was evaluated using an optical profilometer (n = 10). Fracture load data were statistically analyzed with Weibull analysis and roughness data with Kruskal-Wallis (α = 0.05). GC had the lowest characteristic fracture load (L0), while G53 and G125 had higher and statistically similar L0 values. The Weibull modulus (m) was similar among groups. The failure modes observed were catastrophic failure and porcelain chipping. There were no differences between the roughness parameters for the experimental groups (p > 0.05). The size of the AO particles did not affect the fracture load and failure mode of 3Y-TZP crowns. Air abrasion with 53 µm and 125 µm particles resulted in a higher fracture load of ceramic crowns than the untreated group while maintaining their reliability and surface characteristics.

Effect of nonthermal argon plasma treatment on the surface properties and phase transformation of zirconia.

PURPOSE: This study aims to evaluate the effect of applying different parameters of nonthermal argon plasma (NTAP) on the surface roughness and phase transformation of yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramics. METHODS: A total of 60 zirconia samples were prepared and randomly divided into six groups according to their surface treatments (n = 10). Group 1: control group; Group 2: argon plasma with a flow rate of 5 lt/min for 4 min; Group 3: 8 lt/min for 4 min; Group 4: 8 lt/min for 2 min; Group 5: 5 l/min for 2 min; Group 6: air abrasion with Al2O3 particle. The surface roughness was measured with a profilometer, and surface topography was observed using scanning electron microscopy (SEM). X-ray diffraction (XRD) analysis was performed to investigate the phase transformation. RESULTS: The air abrasion group showed the highest surface roughness. The lowest relative monoclinic phase amount (Xm) was observed in the control group (0.4%), and the highest Xm value was observed in group 6 (7.8%). CONCLUSION: While the air abrasion group showed the highest average surface roughness, it also caused the highest phase transformation. With a flow rate of 8 lt/min for 2 min NTAP treatment increased the surface roughness without causing significant phase transformation.

Did the Use of Minimum Interventions for Caries Management Change during the COVID-19 Pandemic? A Cross-Sectional Study.

The aim of this study was to evaluate changes in the frequency of use of minimum intervention (MI) techniques for caries management during the COVID-19 pandemic. A questionnaire was applied through the SurveyMonkeyTM platform to evaluate changes in the dentist's frequency of use of noninvasive, microinvasive, minimally invasive, and mixed interventions, nonaerosol or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test, and the effect size (ES) was calculated. An α = 0.05 was adopted. A total of 781 dentists answered the questionnaire; most of them were female (76.4%), with 30s (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the noninvasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p < 0.01; ES = 0.11). The frequency of sealants to repair defective restorations was the only microinvasive technique that increased during the pandemic (p < 0.01; ES = 0.03). Among the minimally invasive techniques, the use of atraumatic restorative treatment increased significantly (p < 0.01; ES = 0.06), while the use of air abrasion decreased (p = 0.02; ES = 0.04) during COVID-19 pandemic. Moreover, nonrestorative cavity control (mixed intervention) increased during pandemic period (p < 0.001; ES = 0.11). Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period.

Effects of fluorosed enamel on orthodontic bracket bonding : An in vitro study.

OBJECTIVE: To investigate the effect of enamel deproteinization and air abrasion on shear bond strength (SBS), adhesive remnant index (ARI) scores, and surface topography when bonding orthodontic brackets to fluorosed enamel. MATERIALS AND METHODS: The sample included 90 fluorosed and 30 normal premolars divided into four groups: group I (fluorosed premolars subjected to air abrasion before acid etching), group II (fluorosed premolars subjected to deproteinization before acid etching), group III (fluorosed premolars; control for groups I and II), and group IV (normal premolars; control for group III). Bonding procedures included etching with 37% phosphoric acid, priming with TransbondTM XT primer (3M Unitek, Monrovia, CA, USA), and application of TransbondTM XT adhesive paste (composite; 3M Unitek, Monrovia, CA, USA). Air abrasion was done using 50 µm aluminum oxide particles under 0.28 MPa pressure for 5 s with the micro-etcher held at a distance of 10 mm. Deproteinization was done for 60 s with 5% sodium hypochlorite (NaOCl). RESULTS: Fluorosed premolars subjected to deproteinization showed the lowest (median = 6.57 MPa) SBS among the four groups, followed by 8.14, 8.90, 8.14 MPa for groups I, III, and IV respectively. ARI scores were significantly different between the four groups (p = 0.006). Fluorosed enamel etched after air abrasion or deproteinization with NaOCl showed a predominance of type 4 etching pattern with some areas appearing unetched. CONCLUSIONS: Shear bond strength of all groups was within the 6-8 MPa acceptable range for orthodontic purposes. Fluorosed premolars subjected to deproteinization showed the lowest values. Further studies are recommended to scrutinize the deproteinization technique.

Comparison of shear bond strength of orthodontic brackets bonded to human teeth with and without fluorotic enamel: A systematic review and meta-analysis of experimental in vitro studies.

The aim of this systematic review was to compare the shear bond strength (SBS) of orthodontic brackets bonded to human teeth with and without enamel fluorosis (EF) using conventional bonding interventions/techniques. An unrestricted search of indexed databases was performed with the following eligibility criteria: (a) human fluorotic teeth (experimental-group); (b) human teeth without fluorosis (control-group); (c) studies using phosphoric acid (PA) etching without air abrasion (AA), PA etching combined with AA, and application of self-etching primer (SEP) alone as bonding interventions/techniques and (d) measuring SBS in megapascals (MPa). Data screening, selection and extraction were performed by two reviewers. The risk of bias (rob) was assessed using the JBI Critical appraisal tool for Quasi-Experimental Studies. Meta-analyses were performed using a random effects model. The quality of available evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Ten in vitro studies were included. Subgroup analyses were performed for each intervention type. The SBS was significantly lower in fluorotic teeth when PA was used without AA (mean difference = 3.26 MPa, confidence interval: [1.00, 5.52]); and there were no significant differences for the PA combined with AA and SEP interventions. All studies had a low rob. The overall level of evidence was at best low. The SBS is lower in teeth with EF when traditional PA is used. No significant differences were found in SBS between teeth with and without EF when PA is used with AA or when SEP is used alone.

Indirect repair of saliva-contaminated materials using veneering ceramics.

PURPOSE: To analyze the in vitro efficacy of a surface conditioning liquid facilitating ceramic repairs of saliva-contaminated metal-ceramic and all-ceramic restorations. MATERIALS AND METHODS: Specimens constructed from nonprecious alloy (NPA), precious alloy (PA), lithium-disilicate (LD), zirconia (ZI), veneering ceramics for zirconia (VZI), veneering ceramics for lithium-disilicate (VLD), and veneering ceramics for metal alloys (VM) were manufactured (total: n = 168; each material n = 24). Veneering ceramic cylinders (thickness: 2 mm) were hand-layered on top of the specimens. Shear bond strength (SBS) tests were performed, measuring the maximum bond strength (MBS) of the cylinders on the specimens. Following this, the specimens were artificially aged and stored in artificial saliva for 30 days at 37°C. After physical cleaning using aluminum oxide air abrasion, a new surface conditioning liquid was applied (test, n = 84) or not (control, n = 84). New ceramic cylinders were hand-layered followed by a second SBS test. Descriptive statistics, linear regression analyses, and a one-sample t-test (α = 0.05) were used to ascertain the differences within (prerepair vs. postrepair) and between the groups. RESULTS: All specimens in the test group could be repaired, whereas 18 repairs in the control group failed. After the repairs, an MBS decrease was observed for the NPA specimens of the control group (-15.5 MPa, p = 0.004) but not among any of the test groups. Comparing the change in MBS between the test and control groups, the reduction was significantly higher in the repaired NPA specimens of the control group (mean difference 11.8 MPa, p = 0.017). CONCLUSIONS: Using the analyzed surface conditioning liquid, metal-ceramic and all-ceramic materials can be repaired, while some repairs failed without the liquid. The initial bond strengths between core and veneering materials could be restored in all specimens when the new surface conditioning liquid was applied.

Influence of eight debridement techniques on three different titanium surfaces: A laboratory study.

OBJECTIVES: Debridement methods may damage implant surfaces. This in vitro study investigated eight debridement protocols across three implant surfaces to assess both biofilm removal and surface alterations. MATERIAL AND METHODS: One hundred sixty commercially pure titanium discs were treated to simulate commercially available titanium implant surfaces-smooth, abraded and abraded and etched. Following inoculation with whole human saliva to create a mixed species biofilm, the surfaces were treated with eight debridement methods currently used for clinical peri-implantitis (n = 10). This included air abrasion using powders of glycine, sodium bicarbonate and calcium carbonate; conventional mechanical methods-piezoelectric scaler, carbon and stainless steel scalers; and a chemical protocol using 40% citric acid. Following treatment, remaining biofilm was analysed using scanning electron microscopy and crystal violet assays. For statistical analysis, ANOVA was applied (p < 0.05). RESULTS: All debridement techniques resulted in greater than 80% reduction in biofilm compared with baseline, irrespective of the surface type. Glycine powder delivered through an air polishing system eliminated the most biofilm. Mechanical instruments were the least effective at eliminating biofilm across all surfaces and caused the greatest surface alterations. Citric acid was comparable with mechanical debridement instruments in terms of biofilm removal efficacy. Titanium surfaces were least affected by air abrasion protocols and most affected by mechanical methods. CONCLUSIONS: Mechanical protocols for non-surgical debridement should be approached with caution. Glycine powder in an air polisher and 40% citric acid application both gave minimal alterations across all implant surfaces, with glycine the superior method in terms of biofilm removal.

Is Ammonium Hydrogen Difluoride a Solution for Zirconia Surface Conditioning?

INTRODUCTION: This research investigated the topographical features and phase transformation of high-translucent monolithic zirconia after different surface conditioning methods. METHODS: Zirconia slabs were divided into six groups according to surface treatment method. Group I: etched with hydrofluoric acid (HF); Group II: etched with an experimental acid solution (EAS); Group III: melt-etched with ammonium hydrogen difluoride (AHD); Group IV: air abrasion (AB); Group V: etched with EAS after air abrasion (AB+EAS); Group VI: melt-etched with AHD after air abrasion (AB+AHD). Surface topographies of specimens were documented by scanning electron microscopy (SEM). Tetragonal-to-monoclinic phase transformation was detected by X-ray diffraction and surface evaluation of zirconia specimens; surface roughness and contact angle measurements were performed. The data were statistically analyzed by the Kruskal- Wallis test and post hoc tests (P⟨0.05). RESULTS: The acid-etched zirconia groups (Group I, II, and III) showed the lowest contact angle and surface roughness values (P⟨0.05), while the air abrasion groups (Group IV, V, VI) showed the highest. The SEM images also supported these results. CONCLUSION: Within the limitations of this in vitro study, treating the monolithic zirconia surfaces with EAS or AHD after air abrasion may be recommended to alter the zirconia surfaces.

Effect of novel pre-sintered zirconia surface treatment on shear bond strength between zirconia and veneering porcelain compared to conventional surface treatments: an in-vitro study / Efeito de um novo tratamento de superfície de zircônia pré-sinterizada na resistência ao cisalhamento entre zircônia e porcelana em comparação com os tratamentos de superfície convencionais: estudo in vitro

Objective: to evaluate the effect of novel zirconia surface treatment method on shear bond strength between zirconia and veneering porcelain compared to air abrasion and CoJet surface treatment methods. Material and Methods: twenty-one zirconia ceramic discs were fabricated with diameter of 7mm and 3mm thickness and divided according to surface treatment into three subgroups, control group I: Air Abrasion (n=7), group II: CoJet (n=7) and group III: Z-etch (n=7). Porcelain was built over the zirconia specimens with a customized mold and fired in a ceramic furnace. All specimens were thermocycled (20000 cycles) between 5°C ­ 55 °C with a dwell time of 30 seconds in distilled water and shear bond strength of veneering porcelain to each zirconia specimen was tested using a universal testing machine. Results: numerical data were explored for normality by checking the distribution of data and using tests of normality (Kolmogorov-Smirnov and Shapiro-Wilk tests). One-way ANOVA test was used to compare between the groups. There was a statistically significant difference between the three groups (P-value = 0.002, Effect size = 0.503). Pair-wise comparisons between groups revealed that Z-etch showed the statistically significantly highest mean shear bond strength. Conclusion: zirconia coating using z-etch is showing promising results in promoting higher bond strength than conventional surface treatment methods as air abrasion and silica coating (AU)

Objetivo: avaliar o efeito do novo método de tratamento de superfície de zircônia na resistência ao cisalhamento entre a zircônia e a porcelana de cobertura em comparação com os métodos de abrasão a ar e jateamento com CoJet. Material e Métodos: vinte e um discos de zircônia foram confeccionados com diâmetro de 7mm e espessura de 3mm e divididos de acordo com o tratamento de superfície em três subgrupos, grupo controle I: Abrasão a ar (n=7), grupo II: CoJet (n=7) e grupo III: Z-etch (n=7). A porcelana foi aplicada sobre os espécimes de zircônia com um molde personalizado e sinterizada em forno de cerâmica. Todos os espécimes foram termociclados (20.000 ciclos) entre 5°C - 55°C com um tempo de permanência de 30 segundos em água destilada e a resistência ao cisalhamento da porcelana de cobertura foi testada através de uma máquina de ensaio universal. Resultados: os dados numéricos foram avaliados quanto à normalidade, verificando a distribuição dos dados e utilizando testes de normalidade (testes de Kolmogorov-Smirnov e Shapiro-Wilk). O teste ANOVA de um fator foi utilizado para comparar os grupos. Houve uma diferença estatisticamente significativa entre os três grupos (P-valor = 0,002, tamanho do efeito = 0,503). As comparações pareadas entre os grupos revelaram que o Z-etch apresentou a resistência de união ao cisalhamento estatisticamente significativamente mais alta. Conclusão: o revestimento de zircônia utilizando Z-etch mostrou resultados promissores para o aumento da resistência de união em comparação aos métodos convencionais de tratamento de superfície, como abrasão a ar e revestimento de sílica (AU)