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.

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.

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.

Effects of surface modification techniques on zirconia substrates and their effect on bonding to dual cure resin cement - An in- vitro study.

Aim: This study aims to evaluate the effect of different surface treatments of monolithic zirconia on the bond strength of resin to zirconia and, to explore alternative methods to improve this bonding. Settings and Design: In-Vitro study. Materials and Methods: Fifty rectangular sintered blocks of Yttria-stabilized Tetragonal Zirconia Polycrystal ceramics of dimensions were milled and sintered. These specimens were further divided into five groups (control, air abrasion, etching with primer application, air abrasion with primer application and novel glass infiltrated zirconia surface group), containing 10 samples each. The specimens were analyzed for surface roughness, tensile bond strength to resin cements, and adhesive and cohesive mode of failures. Statistical Analysis Used: ANOVA and Post-Hoc Tukey test was perform to evaluate the significant differences in the mean values of the groups. Results: Air-abraded samples showed the highest surface roughness (4.95 ± 0.65) (P < 0.05). The group with air abrasion followed by primer application showed the highest tensile bond strength (7.12 ± 0.69) (P < 0.05). The lowest surface roughness (0.638 ± 0.8093) and tensile bond strength (2.03 ± 0.58) was seen in samples that were subjected to etchant treatment followed by application of methacryloyloxydecyl di-hydrogen phosphate (MDP) primer. The changes in comparison to the control group were statistically insignificant (P > 0.05). Except Groups A (control) and C (etchant followed by primer), all other groups showed a cohesive failure. Conclusion: Air abrasion of the zirconia surface with 50 µm alumina particles increases the surface roughness without damaging the surface. Air abrasion followed by MDP primer application is the recommended method of surface treatment to achieve superior bonding. Glass infiltration also showed promising results in terms of tensile bond strength.

Novel Fluoride- and Chloride-containing Bioactive Glasses for Use in Air Abrasion.

OBJECTIVES: To investigate the degradation, fluorapatite formation, biological safety and cutting efficiency on dentine of the mixed fluoride- and chloride-containing bioactive glasses (BGs). METHODS: Two series of mixed fluoride- and chloride-containing glasses (GPFCl and GPF2.3Cl series) were synthesized using a melt-quench method. Glass transition temperature (Tg) and the bioactivity in term of glass degradation and fluorapatite formation were evaluated in Tris buffer solution. The cutting efficiency of the powdered BGs (GPF2.3Cl series) on dentine via air abrasion was investigated using white light profilometry and scanning electron microscope. The cytotoxicity of GPF2.3Cl series on human periodontal ligament stem cells (hPLSCs) and oral fibroblasts (OFB) were examined by MTT. RESULTS: These BGs are highly degradable and able to form fluorapatite within 3h of immersion. The formation of CaF2 was also found in the high fluoride-containing BGs. The faster glass degradation was evidenced in the BGs with higher chloride. A significant reduction of Tg from 790°C to 463°C was seen with increasing in calcium halide content. Air abrasion on dentine using the low and intermediate chloride-containing glasses demonstrates clear depressions, while no depression was found using the high chloride-containing glass. Moreover, the studied BGs showed no cytotoxicity to hPLSCs and OFB. CONCLUSIONS: The glasses with mixed fluoride and chloride integrate the benefits from the presence of both, showing rapid glass degradation, fast fluorapatite formation, excellent biocompatibility and controllable hardness to provide a selective cutting efficiency on dentine. CLINICAL SIGNIFICANCE: The developed BGs air abrasive with tunable hardness by varying chloride content can selectively cut different dental tissues. In clinic, a relatively hard BG is of great interest for caries preparation, while a soft glass is attractive for tooth cleaning.

Comparison of decontamination efficacy of two electrolyte cleaning methods to diode laser, plasma, and air-abrasive devices.

OBJECTIVE: To compare the in vitro decontamination efficacy of two electrolytic cleaning methods to diode laser, plasma, and air-abrasive devices. MATERIAL AND METHODS: Sixty sandblasted large-grit acid-etched (SLA) implants were incubated with 2 ml of human saliva and Tryptic Soy Broth solution under continuous shaking for 14 days. Implants were then randomly assigned to one untreated control group (n = 10) and 5 different decontamination modalities: air-abrasive powder (n = 10), diode laser (n = 10), plasma cleaning (n = 10), and two electrolytic test protocols using either potassium iodide (KI) (n = 10) or sodium formate (CHNaO2) (n = 10) solution. Implants were stained for dead and alive bacteria in two standardized measurement areas, observed at fluorescent microscope, and analyzed for color intensity. RESULTS: All disinfecting treatment modalities significantly reduced the stained area compared to the untreated control group for both measurement areas (p < 0.001). Among test interventions, electrolytic KI and CHNaO2 treatments were equally effective, and each one significantly reduced the stained area compared to any other treatment modality (p < 0.001). Efficacy of electrolytic protocols was not affected by the angulation of examined surfaces [surface angulation 0° vs. 60° (staining %): electrolytic cleaning-KI 0.03 ± 0.04 vs. 0.09 ± 0.10; electrolytic cleaning-CHNaO2 0.01 ± 0.01 vs. 0.06 ± 0.08; (p > 0.05)], while air abrasion [surface angulation 0° vs. 60° (staining %): 2.66 ± 0.83 vs. 42.12 ± 3.46 (p < 0.001)] and plasma cleaning [surface angulation 0° vs. 60° (staining %): 33.25 ± 3.01 vs. 39.16 ± 3.15 (p < 0.001)] were. CONCLUSIONS: Within the limitations of the present in vitro study, electrolytic decontamination with KI and CHNaO2 was significantly more effective in reducing bacterial stained surface of rough titanium implants than air-abrasive powder, diode laser, and plasma cleaning, regardless of the accessibility of the contaminated implant location. CLINICAL RELEVANCE: Complete bacterial elimination (residual bacteria < 1%) was achieved only for the electrolytic cleaning approaches, irrespectively of the favorable or unfavorable access to implant surface.

An investigation into the cutting efficiency of a novel degradable glass as an alternative to alumina powder in air abrasion cutting of enamel.

OBJECTIVES: To develop and test the cutting efficiency of a novel degradable glass as an alternative media to alumina powder for air abrasion. MATERIALS AND METHODS: A zinc-based glass (QMZK2) was designed, produced, and evaluated with a multi-modality imaging analysis. The glass dissolution study was carried out in three acids, using ICP-OES (inductively coupled plasma optical emission spectroscopy) at 5 different time points: 2.5, 5, 10, 60, and 240 min. The cutting efficiency of both materials was tested under the same parameters on slabs of elephant enamel. A stained fissure of a molar tooth was air abraded with the glass and evaluated with X-ray micro-tomography before and after air abrasion. RESULTS: The particle size distribution of the glass was similar to that of alumina 53 µm but with a slightly greater dispersion of particle size. The shape of the particles was angular, appropriate for cutting purposes. The dissolution study showed that the glass dissolved rapidly in acidic conditions at all time points. Between the two variables, pressure and powder flow, pressure was found to influence the cutting speed to a greater extent than powder flow. CONCLUSIONS: Alumina powder was found to perform significantly better in 4 of the 9 conditions tested on elephant enamel, QMZK2 in one, and no significant differences were found for the rest of the 4 conditions. The QMZK2 seems to offer promising results as an alternative material to alumina. CLINICAL RELEVANCE: QMZK2 glass has the potential for replacing aluminum oxide as a degradable material in air abrasion technology.

Evaluation of the shear bond strength of zirconia to a self-adhesive resin cement after different surface treatment.

OBJECTIVES: The aim of this study was to evaluate the SBS of pre-sintered and sintered zirconia to a selfadhesive resin cement after various treatment (air abrasion and the Nd:YAG laser irradiation at varying power levels -1 W, 2 W and 3 W). MATERIAL AND METHODS: Ninety-nine zirconia specimens were prepared and divided into 3 groups: control (with no surface treatment); and pre-sintered and sintered groups with surface treatment. Surface treatment was applied before sintering in the pre-sintered group and after sintering in the sintered group. After following all protocols, a resin cement was layered on the zirconia surface. Shear bond strength was measured using a universal testing machine. The results were subjected to the statistical analysis. The surface topography and phase transformation of zirconia were evaluated using the atomic force microscopy (AFM), scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyses after surface treatment. RESULTS: The laser irradiation (3 W, 1 W and 2 W) of the pre-sintered zirconia surface resulted in the highest SBS values (p < 0.001), while the lowest SBS values were obtained with airborne particle abrasion of the pre-sintered and sintered zirconia surfaces. CONCLUSIONS: Laser irradiation increased the SBS of pre-sintered zirconia to a resin cement. Surface treatment with air abrasion had a lesser effect on the SBS values.

Combined application of femtosecond laser and air-abrasion protocols to monolithic zirconia at different sintering stages: Effects on surface roughness and resin bond strength.

This study aimed to investigate the effects of femtosecond laser (Fs) and/or air-abrasion protocols on surface roughness (Ra) of zirconia and resin bond strength. Eighty zirconia samples were randomly divided into eight subgroups according to surface treatment protocols: Control (C), Air-abrasion before sintering (ABS), Air-abrasion after sintering (AAS), Air-abrasion before and after sintering (ABS + AAS), Fs laser before sintering (FBS), Fs laser before sintering + air-abrasion after sintering (FBS + AAS), Fs laser after sintering (FAS), and Fs laser after sintering + air-abrasion after sintering (FAS + AAS). Measurements of Ra values were obtained using a surface profilometer. Surface morphological properties were evaluated with scanning electron microscopy (SEM), and crystallographic changes were examined by X-Ray diffractometry (XRD). Self-adhesive resin cement was bonded to zirconia samples, and shear bond strength (SBS) tests were performed. The data were statistically analyzed by one-way ANOVA, followed by Tamhane tests. The control group displayed the lowest Ra and SBS values among all groups. The highest Ra and SBS values were found in the FBS and FBS + AAS groups. Air-abrasion applied before sintering significantly increased the Ra of specimens. FAS, FAS + AAS, and ABS + AAS groups exhibited higher SBS values than AAS and ABS (p < .05). Air-abrasion applied after Fs laser did not produce any significant change in the Ra and SBS compared to Fs laser alone (p > .05). Femtosecond laser application may be a promising method to enhance the surface roughness of zirconia and improve resin bond strength. Air-abrasion at pre- and post-sintered stages may also be a viable surface treatment option.

Effect of air-abrasion at pre- and/or post-sintered stage and hydrothermal aging on surface roughness, phase transformation, and flexural strength of multilayered monolithic zirconia.

This study aimed to evaluate the effect of air-abrasion/sintering order and autoclave aging on the surface roughness (Ra), phase transformation, and biaxial flexural strength (BFS) of monolithic zirconia. A total of 104 monolithic zirconia specimens (Katana ML) were divided into eight groups according to airborne-particle abrasion protocols and hydrothermal aging: control (non-aged: C-, aged: C+), air-abrasion before sintering (BS-, BS+), air-abrasion after sintering (AS-, AS+), and air-abrasion before and after sintering (BAS-, BAS+). A steam autoclave was used for accelerated aging, and Ra values were measured with a surface profilometer. All specimens were analyzed by X-ray diffraction to determine any phase transformation on the zirconia surface. BFS was measured by using the piston-on-three-balls method. Scanning electron microscopy and atomic force microscopy were performed on one specimen per group. BS and BAS groups showed higher Ra values compared with groups C and AS. The aging process significantly increased the monoclinic phase content of all specimens. Lower monoclinic levels were found in AS+ and BAS+ compared with other aged groups. The AS groups exhibited higher flexural strength values relative to control groups, whereas BS groups exhibited significantly lower flexural strength values (p < .05). There was no reduction in flexural strength by using the BAS protocol. Air-abrasion of zirconia at the pre-sintered stage only is not recommended in clinical use because of the remarkable decrease in flexural strength.

Influence of alumina air-abrasion for highly translucent partially stabilized zirconia on flexural strength, surface properties, and bond strength of resin cement.

OBJECTIVE: This study aims to evaluate the influence of different air-abrasion pressures and subsequent heat treatment on the flexural strength, surface roughness, and crystallographic phases of highly translucent partially stabilized zirconia (Y-PSZ), and on the tensile bond strength of resin cement to Y-PSZ. METHODOLOGY: Fully sintered zirconia specimens were ground with SiC paper (control) and/or air-abraded with 50 µm particles of alumina at 0.1, 0.15, 0.2, or 0.3 MPa or left as-sintered. After air-abrasion at 0.2 MPa (0.2AB), additional specimens were then heated to 1500°C, and held for one hour at this temperature (0.2AB+HT1h). Flexural strength and surface roughness were evaluated. Crystalline phase identification was also carried out using X-ray diffraction. Bonded zirconia specimens with self-adhesive resin cement were stored in distilled water at 37°C for 24 h, either with or without aging (thermal cycling 4-60°C/20000). Results were analyzed statistically by ANOVA and Tukey-Kramer tests. RESULTS: The flexural strength decreased with the increase in air-abrasion pressure, while in contrast, the surface roughness increased. The lowest flexural strength and the highest roughness value were found for the 0.2AB and 0.3AB groups, respectively. All groups contained cubic-, tetragonal ( t )-, and rhombohedral ( r )-ZrO2 phases with the exception of the as-sintered group. Upon increasing the air-abrasion pressure, the relative amount of the r -ZrO2 phase increased, with a significant amount of r -ZrO2 phase being detected for the 0.2AB and 0.3AB groups. The 0.2AB+HT1h group exhibited a similar flexural strength and t -ZrO2 phase content as the as-sintered group. However, the 0.2AB group showed a significantly higher tensile bond strength (p<0.05) than the 0.2AB+HT1h group before and after aging. CONCLUSION: Micromechanical retention by alumina air-abrasion at 0.2 MPa, in combination with chemical bonding of a resin to highly translucent Y-PSZ using a MDP-containing resin cement may enable durable bonding.

In vitro comparison of shear bond strengths of ceramic orthodontic brackets with ceramic crowns using an aluminium oxide air abrasion etchant.

OBJECTIVE: The aim of this study was to determine if there are differences between the shear bond strengths of 3 types of ceramic brackets when bonded to different ceramic substrates using an aluminium oxide air abrasion etchant protocol. MATERIALS AND METHODS: Substrate groups consisting of thirty-six lithium disilicate (e.max® CAD) samples and thirty-six lithium silicate infused with zirconia (CELTRA® DUO) samples were fabricated to replicate the facial surface of a left maxillary central incisor. The surface of all samples was prepared with an aluminium oxide air abrasion etchant protocol. Each substrate group was split into three test groups (n=12). Each test group was bonded using a different brand of ceramic orthodontic bracket. Shear bond strength (SBS) testing was conducted and the mean SBS values for each group were calculated and recorded in MPa. An Adhesive Resin Index (ARI) score was also assigned to each sample to assess the location of bond failure. RESULTS: Mean SBS of the e.max® CAD groups were significantly less than the CELTRA® DUO groups. Symetri brackets showed significantly higher shear bond strengths to both substrates than both of the other brackets tested. ARI scores of the e.max® CAD groups were significantly less than the CELTRA® DUO groups. CONCLUSION: The Symetri bracket was the only bracket that was effective for both substrates (mean SBS>6mPa). The Etch Master protocol does not appear effective for e.max® CAD.

Influence of alumina air-abrasion for highly translucent partially stabilized zirconia on flexural strength, surface properties, and bond strength of resin cement

Abstract Objective This study aims to evaluate the influence of different air-abrasion pressures and subsequent heat treatment on the flexural strength, surface roughness, and crystallographic phases of highly translucent partially stabilized zirconia (Y-PSZ), and on the tensile bond strength of resin cement to Y-PSZ. Methodology Fully sintered zirconia specimens were ground with SiC paper (control) and/or air-abraded with 50 µm particles of alumina at 0.1, 0.15, 0.2, or 0.3 MPa or left as-sintered. After air-abrasion at 0.2 MPa (0.2AB), additional specimens were then heated to 1500°C, and held for one hour at this temperature (0.2AB+HT1h). Flexural strength and surface roughness were evaluated. Crystalline phase identification was also carried out using X-ray diffraction. Bonded zirconia specimens with self-adhesive resin cement were stored in distilled water at 37°C for 24 h, either with or without aging (thermal cycling 4-60°C/20000). Results were analyzed statistically by ANOVA and Tukey-Kramer tests. Results The flexural strength decreased with the increase in air-abrasion pressure, while in contrast, the surface roughness increased. The lowest flexural strength and the highest roughness value were found for the 0.2AB and 0.3AB groups, respectively. All groups contained cubic-, tetragonal ( t )-, and rhombohedral ( r )-ZrO2 phases with the exception of the as-sintered group. Upon increasing the air-abrasion pressure, the relative amount of the r -ZrO2 phase increased, with a significant amount of r -ZrO2 phase being detected for the 0.2AB and 0.3AB groups. The 0.2AB+HT1h group exhibited a similar flexural strength and t -ZrO2 phase content as the as-sintered group. However, the 0.2AB group showed a significantly higher tensile bond strength (p<0.05) than the 0.2AB+HT1h group before and after aging. Conclusion Micromechanical retention by alumina air-abrasion at 0.2 MPa, in combination with chemical bonding of a resin to highly translucent Y-PSZ using a MDP-containing resin cement may enable durable bonding.

Effect of different surface treatment methods on the shear bond strength of orthodontic brackets to temporary crowns.

INTRODUCTION: The number of adult patients seeking orthodontic treatment has been consistently increasing. Since the placing of the final restoration must be postponed until the completion of the orthodontic treatment, provisional restoration is recommended for the duration of the orthodontic treatment. These surfaces have special chemical properties, which necessitate the orthodontists to prepare the bonding area with special measures. METHODS: Polycarbonate and polymethylmethacrylate (PMMA) crowns (n=80) were randomly subdivided into 4 groups. Conditioning methods were grinding, sandblasting, CO2 laser and methyl methacrylate application. Samples underwent SBS testing. A scanning electron microscope (SEM) analysis was carried out. The data was analysed with ANOVA, Student t-test and Post-hoc test. Adhesive remnant index (ARI) was analysed with Chi2 test. RESULTS: In all surface treatments, the mean Shear Bond Strength (SBS) of PMMA was significantly higher than that of polycarbonate (P<0.001). In the polycarbonate groups, there was a significant difference between the mean SBS of the four treatment methods (P<0.001). However, there were no significant differences in PMMA group (P=0.076). In both crown materials, the mode of the failure was adhesive type, regardless of the conditioning method (P>0.05). CONCLUSIONS: PMMAs rendered higher bond strength than polycarbonates. In PMMA, all the surface treatment methods resulted in acceptable bond strength. However, if bonding the brackets to polycarbonate crown is needed, other conditioning methods are preferred over CO2 laser.

Evaluation of the effect of different surface conditioning methods on shear bond strength of metal brackets bonded to aged composite restorations.

INTRODUCTION: There are controversies regarding the most reliable conditioning method of the aged composite surface to ensure optimum bond strength. The purpose of this study was to evaluate the shear bond strength of metal brackets to microhybrid composite restorations after different surface preparation techniques. MATERIALS AND METHODS: A total of sixty microhybrid composite samples were prepared using upper right central incisor celluloid crown as a mold. Samples were treated with 4 different surface conditioning methods: (1) etching, (2) sandblasting, (3) grinding, and (4) CO2 laser irradiation. Samples were then bonded with metal brackets and underwent shear bond strength testing. A scanning electron microscope was carried out and the data was analysed by one-way ANOVA and post-hoc Tukey test. Bond failure was examined by stereomicroscope and scored based on adhesive remnant index (ARI). Kruskal-Wallis test was used to compare ARI values (α=0.05). RESULTS: Shear bond strength values in the sandblasting group (17.18±1.53MPa) were significantly higher than the other groups. There was no significant difference between the grinding (12.87±3.38MPa) and laser (11.08±1.37MPa) groups (P=0.09). The lowest values were recorded in the etching group (6.78±1.69MPa). There was a significant difference in ARI scores among the four groups (P<0.001). ARI scores were mostly 2 and 3 in the sandblasting and grinding group, while in the etching and laser groups ARI was mostly 0 and 1. CONCLUSIONS: Surface preparation by sandblasting and CO2 laser provides clinically acceptable results with regards to bond strength and ARI score, however grinding and acid etching failed to produce the same results.

The Effect of Temporary Cement Cleaning Methods on the Retention of Crowns.

PURPOSE: To evaluate the effect of temporary cement cleaning methods on the retention of cemented crowns using zinc phosphate cement and resin-modified glass ionomer cement. MATERIALS AND METHODS: Forty titanium specimens were fabricated to simulate prepared molars with minimally retentive taper. The Ni-Cr cast crowns were fabricated, temporarily cemented, and separated. The specimens were divided into four groups according to the temporary cement cleaning method (n = 10) as follows: control group (no temporary cementation), orange solvent group, ultrasonic cleaning group, and air-abrasion group. After the cleaning procedures, the specimens were cemented with definitive cements (zinc phosphate cement and resin-modified glass ionomer, RMGI, cement) and subjected to thermocycling (5000 cycles, 5-55°C, dwell time, 10 seconds). The tensile bond strength of each specimen was measured using a universal testing machine, and the results were analyzed using the Kruskal-Wallis and Mann-Whitney U test (α = 0.05). RESULTS: When cemented with zinc phosphate cement, the statistical analysis showed that the value of the air-abrasion group was significantly higher than those of the other groups (p < 0.01). There was no statistically significant difference among the other groups. When cemented with RMGI cement, the air-abrasion group showed the lowest value, and the control group showed the highest value (p < 0.01). The difference between the ultrasonic cleaning group and the orange solvent group was not statistically significant. CONCLUSION: The use of temporary cement did not have a significant influence on retention of permanently cemented crowns when zinc phosphate cement was used for permanent cementation. Airborne-particle abrasion after provisional cementation improved retention of crowns cemented with zinc phosphate cement; however, the use of temporary cement significantly decreased retention of permanently cemented crowns when RMGI cement was used regardless of the temporary cement cleaning method.

Influence of Particle and Air-Abrasion Moment on Y-TZP Surface Characterization and Bond Strength.

PURPOSE: To evaluate the influence of particle and air-abrasion on the surface characterization and shear bond strength (SBS) of a Y-TZP ceramic with a resin cement. MATERIALS AND METHODS: Y-TZP specimens were air-abraded with 50 µm alumina particles; 120 µm alumina particles; 30 µm silica-coated alumina particles (Rocatec Soft); 110 µm silica-coated alumina particles (Rocatec Plus). Air-abrasion was performed before (BS); after (AS); before and after (BAS) zirconia sintering. Surface characterization included roughness (n = 10), wettability (n = 10), morphology (n = 2), and elemental composition (n = 2). For SBS (n = 11), composite resin discs were bonded to the air-abraded and silane-treated zirconia surface, with the resin cement RelyX ARC. Failure mode was determined. Roughness, wettability, and SBS data were analyzed by two-way ANOVA with pairwise interaction and Tukey's test (α = 0.05). RESULTS: Air-abrasion performed with coarser particles at BS and BAS moments provided the highest roughness values, while the lowest roughness values were observed with particles combined with AS moment (p < 0.01). Rocatec Plus provided lower contact angle than the 120 µm alumina particles (p = 0.013), and BAS exhibited lower contact angle than BS (p = 0.002). The combinations 120 µm/BS and the silica-coated alumina particles/AS and /BAS showed the highest SBS (p < 0.05). The combination of each particle/BAS was statistically similar to the same particle/AS. Failure mode was 100% adhesive for all groups. The interaction particle size/air-abrasion moment determined the morphological pattern. Silicon was observed only in the Rocatec groups. CONCLUSIONS: Roughness was influenced by the particle size and was higher when the zirconia was air-abraded in its green stage. The particle composition played an important role in the wettability and both studied air-abrasion moments provided similar wettability than the one in which air-abrasion is usually performed. The highest SBS values were observed in the three moments, by using certain particles for each moment.

The efficacy of air polishing devices in supportive periodontal therapy: A systematic review and meta-analysis.

OBJECTIVE: This systematic review analyzes existing literature on the clinical efficacy of air polishing devices (APDs), discussing the evidence-based data available for justifying their use as an alternative to conventional periodontal debridement in supportive periodontal therapy. The main objective of the review was to assess whether APD was as equally efficient or superior in obtaining successful treatment outcomes when compared with conventional methods. DATA SOURCES: Following PRISMA guidelines, a systematic literature search of articles in English, up to December 2016, was conducted using PubMed, Cochrane, and Medline. Relevant articles were selected based on specific criteria. Seven studies were selected for the final assessment. One more study was added after a manual search of the literature. Due to considerable heterogeneity in study designs and outcome variables measured, only clinical parameters (probing depth, bleeding on probing, and clinical attachment level) were selected for meta-analysis. CONCLUSION: The studies selected for this systematic review provide some evidence that APDs as monotherapy could be an alternative to conventional debridement of single- and multi-rooted teeth with no furcation involvement, during supportive periodontal therapy. Comparing clinical and microbiologic outcomes, APDs seem to be as effective as conventional treatments. The primary advantage for the use of APDs in supportive periodontal therapy seems to be their ability to efficiently remove biofilm, without causing damage to the periodontal soft tissues or tooth and root structure. There may also be an advantage regarding patient comfort and time consumed.

Effect of Resin Luting Systems and Alumina Particle Air Abrasion on Bond Strength to Zirconia.

This study aimed to evaluate the effect of different primer/resin luting agent combinations and alumina air abrasion on the adhesion to zirconia. Eighty blocks (4×4×3 mm) of Lava Frame Zirconia (3M ESPE) were produced and randomly assigned into eight groups (n=10) according to two zirconia surface treatments (untreated or air abrasion with 50-µm alumina particles) and four luting systems (SU: Scotchbond Universal/RelyX Unicem 2; ZP: Z-Prime Plus/Duo-link Universal; MB: Monobond Plus/Variolink II; and AP: Alloy Primer/ED Primer II/Panavia F 2.0). After the conditioning and primer applications, resin luting agents were manipulated and applied on the zirconia, using a matrix, to form a cylinder (2 mm in diameter×2 mm high), followed by photoactivation for 40 seconds. After that, the specimens were stored in distilled water (37 °C) for 120 days and then submitted to shear bond strength testing, followed by failure mode evaluation under an optical microscope (30×). A two-way analysis of variance and Tukey test (α=0.05) were used for data analysis. Alumina air abrasion (Al) promoted higher bond values for the three luting systems, except for SU, which showed the best results without air abrasion, while with air abrasion, Al-SU, Al-ZP, and Al-MB presented higher values compared to Al-AP. We concluded that the alumina air abrasion of zirconia surfaces seemed to be dispensable for the SU group, while air abrasion (topographical alterations) enhanced the adhesion of the ZP, MB, and AP groups.

Effect of Different Surface Treatments on Biaxial Flexural Strength of Yttria-stabilized Tetragonal Zirconia Polycrystal.

INTRODUCTION: Ceramics are widely applied in dentistry owing to their excellent mechanical and physical attributes. The most popular ceramics are Lava™, KaVo Everest, and Cercon. However, it is unclear whether or not a different surface treatment along with low-temperature aging and mechanical loading (ML) affects the physical properties of computer-aided design (CAD)/computer-aided manufacturing (CAM)-machined yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic. AIM: The objective of this research was to assess the impact of various surface treatments as air-particle abrasion, ML, low-temperature degradation (LTD), and their cumulative effects on biaxial flexural properties of Y-TZP. MATERIALS AND METHODS: Totally, 50 specimens were fabricated by CAD-CAM machining from Cercon® and divided into five groups following different surface treatments as control (C), air-particle abrasion (Si), ML, LTD, and cumulative treatment (CT) group. Results were investigated by two-way analysis of variance (ANOVA) and Tukey honest significant difference (HSD) test. RESULTS: The highest biaxial flexural strength was observed in the Si group (950.2 ± 126.7 MPa), followed by the LTD group (861.3 ± 166.8 MPa), CT group (851.2 ± 126.5 MPa), and the least with ML (820 ± 110 MPa). A significant difference was observed in the two-way ANOVA test. X-ray diffraction (XRD) analysis showed that the control group consists of 100% tetragonal zirconia and the maximum amount of monoclinic phase was obtained after LTD. CONCLUSION: No negative effect on biaxial flexural strength was observed; indeed, it increases the biaxial strength. Hence, these surface treatments can be done in routine clinical practice to improve the performance of ceramic restoration.