Different adhesive approaches for the bonding of a new universal resin cement to a disilicate glass-ceramic.

This study aimed to evaluate the shear bond strength (SBS) when bonding a universal resin cement to a disilicate glass-ceramic using different adhesive protocols. Sixty specimens were etched with 10% hydrofluoric acid (HF) for 20 s and assigned to one of four treatment protocols (n = 15): The Positive control protocol comprised use of a universal adhesive system + adhesive resin cement; the Test1 protocol comprised use of a new universal adhesive system + universal resin cement; the Test2 protocol comprised use of a silane coupling agent + universal resin cement; and the use of a universal resin cement without adhesive and silane served as the Negative control. One of the two resin cement cylinders built on each specimen in each group was used to test for 24-h SBS, while the other was thermocycled and then tested for SBS. Data were submitted to two-way ANOVA, Tukey's test, and Weibull analysis. The negative control (24 h) showed the lowest SBS mean value. The Test2 protocol resulted in the highest SBS mean value after thermocycling. Adhesive and mixed failures were prevalent in all groups. No statistical difference in m values was observed among the groups at 24 h. After thermocycling, the two Test protocols showed the highest m values. The m values were significantly lower after thermocycling than at 24 h for all groups. After thermal aging, The Test2 protocol resulted in a statistically significantly higher SBS mean value after thermal aging than seen for the other groups.

The impact of inorganic fillers, organic content, and polymerization mode on the degree of conversion of monomers in resin-matrix cements for restorative dentistry: a scoping review.

PURPOSE: The main aim of the present study was to carry out a scoping review on the differences in degree of conversion of monomers regarding several types resin cements, indirect restorative materials, and light-curing procedures used in dentistry. METHOD: A bibliographic review was performed on PubMed using the following search items: "degree of conversion" OR "filler" AND "resin cement" OR "inorganic cement" AND "organic" OR "radiopacity" OR "refractive" OR "transmittance" OR "type" AND "resin composite." The search involved articles published in English language within the last thirteen years. A research question has been formulated following the PICO approach as follow: "How different is the degree of conversion of monomers comparing several types of resin-matrix cements?". RESULTS: Within the 15 selected studies, 8 studies reported a high degree of conversion (DC) of the organic matrix ranging from 70 up to 90% while 7 studies showed lower DC values. Dual-cured resin-matrix cements revealed the highest mean values of DC, flexural strength, and hardness when compared with light- and self-polymerized ones. DC mean values of resin-matrix cements light-cured through a ceramic veneer with 0.4 mm thickness were higher (~ 83%) than those recorded for resin-matrix cements light-cured through a thicker ceramic layer of 1.5 mm (~ 77%). CONCLUSIONS: The highest percentage of degree of conversion of monomers was reported for dual-cured resin-matrix cements and therefore both chemical and light-induced pathways promoted an enhanced polymerization of the material. Similar degree of conversion of the same resin-matrix cement were recorded when the prosthetic structure showed a low thickness. On thick prosthetic structures, translucent materials are required to allow the light transmission achieving the resin-matrix cement. CLINICAL RELEVANCE: The chemical composition of resin-matrix cements and the light-curing mode can affect the polymerization of the organic matrix. Thus, physical properties of the materials can vary leading to early clinical failures at restorative interfaces. Thus, the analysis of the polymerization pathways of resin-matrix cements is significantly beneficial for the clinical performance of the restorative interfaces.

Influence of Natural Dentin Biomodification Agent on Push-Out Bond Strength and Nanoleakage of Self-Adhesive Resin Cement Luting of Glass-Fiber Posts.

OBJECTIVE: To evaluate the plant-derived compound lignin (LIG) as a pretreatment of intraradicular dentin in combination with EDTA on push-out bond strength (PBS) and nanoleakage of the glass fiber posts (GFPs) cemented using adhesive resin cement. MATERIAL AND METHODS: Twenty-eight human incisor roots were prepared for GFP cementation and divided based on dentin pretreatment: (1) CONTROL: no pretreatment, (2) EDTA: 17% EDTA for 3 min, (3) EDTA-LIG: 17% EDTA and 2% lignin for 3 min, (4) EDTA-PAC: 17% EDTA and 2% lignin for 3 min. The GFPs were cemented using the self-adhesive resin cement Multilink Speed. The roots (n = 7) were sectioned into 1 mm-thick discs and subjected to PBS testing after 1 week or 6 months. Nanoleakage was analyzed by SEM. Statistical analysis was performed using two-factor ANOVA and Tukey's test (p < 0.05). RESULTS: Higher PBS was identified for the CONTROL group (p < 0.001). After 6 months, the EDTA-LIG maintained the bond strength with a predominance of mixed failures, while the EDTA-PAC, EDTA, and CONTROL groups showed reduction of bond strength, with a predominance of adhesive failures along with severe silver infiltration in the interface. CONCLUSION: LIG associated with EDTA as a pretreatment for intraradicular dentin shows significant potential for attaining stable bond strength and interfacial integrity of self-adhesive resin cement to intraradicular dentin.

Evaluation of single-step self-etching ceramic primer and zirconia primer for bonding to zirconia-reinforced lithium silicate ceramic.

The purpose of this study was to evaluate the influence of simplified ceramic surface treatments on the microshear bond strength (µSBS) of 2 resin cements to a zirconia-reinforced lithium silicate (ZLS) material. Blocks of ZLS were sectioned to obtain a total of 90 specimens (1.5 mm thick), which were assigned to 9 different surface treatment protocols (n = 10). Either hydrofluoric acid (HF) surface conditioner or ammonium polyfluoride self-etching ceramic primer (Monobond Etch & Prime [MEP]) was used for surface treatment and then combined with different bonding strategies (Monobond N silane-based universal primer, Prosil silane coupling agent, Ambar Universal APS self-etching adhesive, and/or Signum Zirconia Bond methyl methacrylate-based bonding system [SZB]) and luting agents (Allcem or Multilink Automix dual-curing resin cement). Composite resin cylinders were bonded to ZLS with each of the cementation protocols, and the specimens were subjected to 6000 thermal cycles from 5°C to 55°C prior to the µSBS evaluation. The failure mode was analyzed with the aid of a stereoscopic loupe. Statistical analyses were performed with 1-way analysis of variance and Tukey HSD test (α = 0.05). The HF and MEP protocols resulted in significantly higher µSBS values (P < 0.001), while conditioning with SZB resulted in the lowest µSBS. Multilink Automix groups presented higher µSBS values than Allcem groups (P < 0.01). There was no statistically significant difference in the µSBS values of the MEP + Allcem groups based on whether or not an adhesive layer was applied. The failure mode was predominantly adhesive for all specimens. The results indicate that the ammonium polyfluoride-based material MEP may be used as a substitute for surface treatment with HF and silane, but the use of a zirconia primer alone is not advised for bonding to a ZLS ceramic material.

Shear bond strength of resin cement to a CAD/CAM millable alloy subjected to various surface treatments.

Resin cements are widely used to cement dental restorations; however, limited studies are available on the bond strength of these cements to computer-aided design/computer-aided manufacturing (CAD/CAM) base metal alloys. This study compared the shear bond strength between a self-etching resin cement (Panavia F 2.0) and a millable cobalt-chromium alloy (Ceramill Sintron) following various surface treatments. A total of 40 cylindrical alloy cores (6 mm in diameter × 8 mm in height) were milled and assigned to 1 of 5 groups for different surface treatments (n = 8): control (no surface treatment); sandblasting; metal primer; sandblasting + metal primer; or acid etching. Resin cement was then used to bond cylindrical composite resin specimens to the pretreated core surfaces. The specimens underwent a 1500-cycle thermocycling procedure and shear bond strength testing. The data were analyzed using 1-way analysis of variance, and P < 0.05 was considered statistically significant. The mean (SD) shear bond strength values in the different surface treatment groups were significantly different (P < 0.05): sandblasting, 16.59 (7.10) MPa; acid etching, 15.63 (2.94) MPa; sandblasting + metal primer, 13.28 (1.27) MPa; metal primer, 8.90 (2.08) MPa; and control, 8.86 (3.57) MPa. The mean differences in shear bond strength values were significant between the sandblasting and control groups (P = 0.003) and between the acid-etching and metal primer groups (P = 0.013). Surface roughening procedures--either sandblasting or acid etching of the alloy surface--improved the shear bond strength of resin cement to milled alloy surfaces. The use of metal primer between the alloy surface and resin cement did not significantly increase the bond strength.

Effect of Various Surface Treatments of Zirconia on its Adhesive Properties to Dentin: An In Vitro Study.

AIM: To assess the effectiveness of various surface treatments and adhesives on the bond strength of zirconia-based ceramic to dentin. MATERIALS AND METHODS: Eighty samples of zirconia were subjected to the four-surface treatment protocols (sandblasting, 48% hydrofluoric acid (HF), 48% hydrofluoric acid + 70% nitric acid (HNO3) and no treatment (control) following which the samples from each group were subdivided into two subgroups (n = 10) based on the resin cement employed for cementation (RelyX U200 and G-Cem Linkforce). The bonded specimens were subjected to shear stress to measure the bond strength using Universal testing machine. To test the difference in bond strength among the eight study groups, the Kruskal-Wallis ANOVA test was applied and for comparison between cements in each group, Mann-Whitney U test was applied. RESULTS: The highest bond strength values were observed for 48% HF group cemented with G-Cem Linkforce resin cement (16.220 ± 1.574) and lowest for control group-RelyX (4.954 ± 0.972). G-Cem cement showed higher bond strength than RelyX for all surface treatments except 48% HF + 70% nitric acid. CONCLUSION: It can be inferred that 48% HF can etch zirconia and generate a porous structure that proves to be beneficial for bonding. CLINICAL SIGNIFICANCE: The increasing demand for esthetics has led to the replacement of metal-ceramic materials with zirconia-based ceramics. However, the chemical inertness of zirconia to various conventional surface treating agents has continuously challenged researchers to discover a new surface treatment protocol that could enhance the bond strength of zirconia. How to cite this article: Yenamandra MS, Joseph A, Singh P, et al. Effect of Various Surface Treatments of Zirconia on its Adhesive Properties to Dentin: An In Vitro Study. J Contemp Dent Pract 2024;25(3):226-230.

Influence of the Use of Irrigation Solution Inhibitors in Improving Dentine Adhesion: A Systematic Review and Meta-Analysis.

INTRODUCTION: This systematic review examined the effect of neutralizing agents on bond strength after irrigation with sodium hypochlorite and their existing protocols in literature. METHODS: This present study adhered to the PRISMA guidelines and was registered at PROSPERO. Five electronic databases were searched (sept-2020/jan-2021) in English, Spanish, and Portuguese, without any restrictions on publication date. Cases reports, editorials and literature reviews were not included. The risk of bias was assessed using the Cochrane Collaboration tool. From the initial 7,147 studies, 2,745 were removed as duplicates and 4,382 were excluded after a title/abstract screen. RESULTS: Seventeen in vitro studies were included. The results showed that the higher the concentration of sodium hypochlorite, the lower the bond strength at dentine/restoration interface (p⟨0.01). Among the studies, sodium ascorbate was the most widely used neutralizer and showed the most significant results in increasing bond strength (p⟨0.01). The bond strength values were found to increase with longer application time of the neutralizing substances (p⟨0.01). CONCLUSIONS: The use of sodium ascorbate as a neutralizing agent can reverse the negative effects of the sodium hypochlorite and improve the bond strength between dentine and resin cement, however, it isn't possible to determine the best protocol for use.

Influence of Thickness and Translucency of Lithium Disilicate Ceramic on the Degree of Conversion of Resin Cements with Different Initiators.

INTRODUCTION: The degree of conversion (DC) of resin cements can be affected by ceramics, and by the type of resin cement. The purpose was to evaluate the influence of thickness and translucencies of lithium disilicate ceramic on the DC of resin cements: two light-cure (Variolink LC; NX3 LC) and one dual-cure (NX3 Dual). METHODS: IPS e.max Press ceramic (A2) discs were prepared in 4 thicknesses (0.3, 0.5, 1.0, and 1.5 mm) and in 3 translucencies: HT (high translucency), LT (low translucency), and MO (medium opacity). Subsequently, 234 samples of resin cement (5 x 1 mm) were light-cured through those ceramic discs. The DC was assessed by Fourier Transform Infrared Spectroscopy (FTIR). RESULTS: Ceramic thicknesses decreased DC of NX3 Dual through HT-1.0 and HT 1.5 (p=0.005). Between translucencies, only MO-0.3 affected Variolink LC DC (p=0.018). There was difference among light- and dual-cured resin cements (p=0.001). CONCLUSION: Increasing thickness and opacity lead to a decrease in the DC of all resin cements, with a significantly lower DC value in NX3 Dual (HT-1.0; HT-1.5), and in Variolink LC (MO- 0.3). Light- and dual-cured resin cements were different among each other. NX3 Dual achieved a significantly lower value than its counterpart NX3 LC.

Four-point flexural strength and microtensile bond strength of digitally and conventionally veneered zirconia.

This study intended to evaluate the effect of digital veneering on four-point flexural strength (FS) and microtensile bond strength (µTBS) of veneered zirconia. Two different zirconia blocks, a lithium disilicate and a feldspathic ceramic block, and two different layering ceramics were used. IPS e.max Zir CAD (ZC) and Vita In-Ceram YZ (YZ) with yttria stabilized tetragonal zirconia polycrystals (3Y-TZP) were used as substructures. IPS e.max CAD (LD), Vita Mark II (VMII), IPS e.max Ceram (EC) and Vita VM9 (VM9) were used for veneering. Resin cement and fusion ceramic were placed between veneer and zirconia substructure for digital veneering. A total of one hundred and fifty specimens in five groups (n = 30) were prepared for FS and tested in universal machine at 1.0 mm/min. One hundred specimens in five groups (n = 20) were obtained for the µTBS and tested at 1.0 mm/min. Statistical analysis was made by one way ANOVA and Tukey HSD. Conventional veneering showed statistically significant FS. ZC veneered with EC had the highest mean FS and the lowest was obtained in groups veneered through resin cement. YZ layered with VM9 had the highest mean µTBS. ZC veneered through fusion ceramic and YZ veneered through resin cement showed significantly lower and similar µTBS.

Effect of glass-ceramic coating versus alumina air-abrasion on the bond strength and residual stress of zirconia.

OBJECTIVES: To assess the effect of glass-ceramic coated zirconia versus alumina air-abraded zirconia on the shear bond strength (SBS) of resin cement and investigate the residual stresses present on both mechanically pre-treated surfaces. MATERIALS AND METHODS: A total of 180 zirconia disks, with diameters of 10 mm and 5 mm, were divided into two groups: DCMhotbond glass-ceramic coated, followed by hydrofluoric acid etching (DCM), and alumina air-abraded (AB). All mechanically pre-treated disks were conditioned with G-Multi Primer and bonded using G-Cem Linkforce Cement. Ninety specimens were immersed in distilled water for 24 h and subsequently allocated into three groups based on aging conditions (n = 15/subgroups): immediate testing, 5000 thermal cycles, and 10,000 thermal cycles. Then, the shear bond strength was assessed, and the obtained data were subjected to analysis using a two-way ANOVA, followed by a one-way ANOVA and Tukey's HSD post hoc test (α = 0.05). The residual stresses present on both mechanically pre-treated surfaces were examined using X-ray diffraction analysis. RESULTS: The mean SBS values of the DCM and AB groups showed no significant difference under each aging condition. The SBS of DCM groups was not affected by thermal cycles, whereas the SBS of AB groups exhibited a significant decrease following thermal cycles. Glass-ceramic coated surfaces exhibited higher compressive stresses than alumina air-abrasion. CONCLUSIONS: The DCMhotbond glass-ceramic coated zirconia showed comparable bond strength to the alumina air-abrasion technique. CLINICAL RELEVANCE: The DCMhotbond glass-ceramic coating technique is a promising alternative for zirconia surface pre-treatment. However, further investigations are needed before suggesting its clinical use.

Effect of apical root resection, orthodontic extrusion, and surgical crown lengthening on load capability.

OBJECTIVES: This study aims to investigate the load-to-fracture of procedures changing crown-to-root ratio (RCRR) aimed to restore severely damaged upper central incisors to avoid tooth extraction compared to implant placement. There is no evidence on load capability after apical root resection (AR), orthodontic extrusion (OE), and surgical crown lengthening (SCL) in respect to RCRR, respectively. MATERIAL AND METHODS: Human maxillary central incisors were endodontically treated, decoronated, and divided into 4 groups (n = 48). The following specimen preparation was performed: (I) adhesive core-and-post build-up (control), (II) as (I) and 2 mm apical root resection (AR), (III) before adhesive core-and-post build-up teeth were shortened 2 mm coronally (OE) (IV) as (I), but specimens were embedded 4 mm instead of 2 mm below the CEJ (SCL), group (V) implant-borne restoration with individual all-ceramic abutments (n = 12; ∅4.1/l = 12 mm) (IBR). All specimens received all-ceramic crowns, thermo-mechanical (TML), and subsequent linear loading (LL) until failure. RCRR were calculated and log-rank, Kruskal-Wallis, Mann-Whitney U, ANOVA, and chi-square tests applied (p = 0.05). RESULTS: Fracture loads after subsequent LL differed significantly (p = 0.001) between groups, while implants showed the highest values. Fmax median (min/max) were as follows: (I) 252 (204/542), (II) 293 (243/443), (III) 253 (183/371), (IV) 195 (140/274), and (V) 446 (370/539). Pair-wise comparison showed significant differences (p = 0.001) between group I/IV and group V, I, and IV (p = 0.045), II and IV (p = 0.001), and III compared to IV (p = 0.033), respectively. RCRR below 1 significantly increased load capability compared to RCRR = 1. CONCLUSIONS: OE appears to preferably ensure biomechanical stability of teeth that are endodontically treated and receive core-and-post and crown placement compared to SCL. AR has no adverse biomechanical impact. RCRR < 1 is biomechanically beneficial. CLINICAL RELEVANCE: For endodontically treated and restored teeth, orthodontic extrusion should be preferred compared to surgical crown lengthening prior single-crown restoration. As orthodontic extrusion, apical root resection has no adverse effect on load capability. Single-crown implant-borne restorations are most load capable.

Fracture resistance of monolithic translucent zirconia crown bonded with different self-adhesive resin cement: influence of MDP-containing zirconia primer after aging.

OBJECTIVES: Successful ceramic restorations depend on the strong bonding with resin cement and even stress distribution. The aim of this study was to evaluate the impact of adding MDP-containing zirconia primer before self-adhesive resin cements with different functional acidic monomers on fracture resistance of monolithic zirconia crown. MATERIALS AND METHODS: Eighty defect-free human maxillary premolars were divided according to the cement type and application of MDP-containing zirconia primer into eight groups (n = 10): Calibra Universal (C), Calibra Universal combined with zirconia primer (CZ), RelyX U200 (R), RelyXU200 combined with zirconia primer (RZ), Panavia SA Cement Plus (P), Panavia SA Cement Plus combined with zirconia primer (PZ), Multilink Speed (M), and Multilink Speed combined with zirconia primer (MZ). After teeth preparation and fabrication of zirconia crowns, each crown was bonded to its corresponding tooth. All specimens were subjected to 10,000 thermocycles between 5 and 55°C, followed by cyclic load (50 N) for 240,000 cycles. Each specimen was subjected to a static axial load until fracture using universal testing machine and the fracture load was recorded. The fracture mode studied and recorded. The fracture load results were analyzed using two-way ANOVA test (α = 0.05). RESULTS: A significant interaction (P = 0.038) of combining MDP-containing zirconia primer and cement type on fracture resistance of monolithic zirconia crown was detected. The mean fracture load values of zirconia crown were significantly influenced by the combined application of the MDP-containing zirconia primer with Calibra Universal (P = 0.01), RelyX U200 (P < 0.001), and Multilink Speed (P = 0.038), while there was no significant difference with Panavia SA Cement Plus (P = 0.660). There was significant difference (F = 20.69, P < 0.001) between the mean fracture loads of groups with self-adhesive cements (C, R, P, and M groups). The highest fracture load was recorded with RZ group (2446.90 ± 126.72 N) while the lowest fracture load was recorded with C group (1623.18 ± 149.86 N). CONCLUSIONS: The self-adhesive resin cement with different acidic functional monomer affects the fracture resistance of monolithic zirconia crown. Application of MDP-containing primer could improve the fracture resistance of monolithic zirconia crown with most self-adhesive cements. The application of an MDP-containing primer had no impact on the fracture resistance of monolithic translucent zirconia crown bonded by MDP-containing self-adhesive resin cement.

Influence of the Fiber Post Length on the Fracture Strength of Endodontically Treated Teeth.

Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular insertion lengths of the fiber posts influence the fracture strength of ETT. Materials and Methods: A total of 10 permanent human lower incisors with straight roots of similar length and volume extracted for periodontal reason were sectioned 2 mm above the cement-enamel junction (CEJ) to a total length of 18 mm and endodontically treated in the same manner, then randomly divided into two groups of five each (Groups 1 and 2, n = 5). Two sound incisors, with no endodontic treatment, were used as the control group (Group 3, n = 2). After one week of storage in a humid environment, spaces for fiber post no. 1 (Reforpost, Angelus, Londrina, PR, Brazil) were prepared in the first two groups at a depth of 5 mm (Group 1) and 7 mm (Group 2), and the fiber posts were adhesively cemented using self-adhesive resin cement (Maxcem Elite, Kerr GmbH, Herzogenrath, Germany). After 7 days, the samples were vertically positioned and fixed in a self-curing transparent acrylic resin, up to 2 mm below the CEJ level, and mechanically tested in compression after another week of storage using a displacement-controlled testing machine up to each sample's fracture. The force-displacement curves were recorded for each sample, the means were calculated for each group and a statistical comparative analysis between groups was conducted. Results: Although no statistically significant differences between groups were observed, the highest mean fracture force (N) was recorded in Group 2 (1099.41 ± 481.89) in comparison to Group 1 (985.09 ± 330.28), even when compared to the sound, non-treated teeth (1045.69 ± 146.19). Conclusions: Within the limitations of this in vitro study, teeth where fiber posts were placed deeper into the root canal (7 mm) recorded slightly higher fracture forces in comparison with shorter lengths (5 mm). However, similar biomechanical performances obtained in the mechanical tests showed no statistical differences between the 7 mm and the 5 mm inserted posts.

Bond Strength of a Novel Universal Resin Cement to Dentin with or without an Adhesive Bonding Agent: An In Vitro Study.

AIM: The purpose of this study was to evaluate the bond strength and fracture mode of universal resin cement to dentin compared to self-adhesive and adhesive resin cement with and without an adhesive bonding agent. MATERIALS AND METHODS: Seventy-two molar teeth were sectioned to expose coronal dentin, divided into three groups, and assigned to RelyX Universal (universal), RelyX Ultimate (adhesive), or RelyX Unicem 2 (self-adhesive) cements from 3M. The 3 groups were further subdivided into 2 subgroups of 12 specimens each, with or without the use of an adhesive bonding agent. Lithium-disilicate discs were bonded to the dentin surface using the cements, stored for 24 hours in distilled water, and subjected to 2,000 thermocycles before shear bond strength testing and fracture mode analysis. RESULTS: Significant differences in bond strength and fracture mode were found between groups based on cement or the use of a bonding agent. Both the universal and adhesive cements had significantly greater bond strengths to dentin with the use of a bonding agent versus no bonding agent. With the self-adhesive cement, there was no significant increase in bond strength to dentin with the use of a bonding agent. CONCLUSION: The novel universal resin cement had similar bond strengths to dentin as the adhesive cement with the use of a bonding agent, and similar bond strengths as the self-adhesive cement without the use of a bonding agent. The adhesively bonded universal cement had the greatest percentage of mixed and cohesive fractures. CLINICAL SIGNIFICANCE: When greater adhesion is needed clinically, the novel universal resin cement may be used with an adhesive bonding agent. However, when less adhesion is needed, it could be used without a bonding agent in self-adhesive mode.

Bond Strength of Two Resin Cements with Leucite-reinforced Ceramic Using Different Bonding Agents.

AIM: To compare the bond strength of two resin cements to leucite-reinforced ceramics using three different boding agents and evaluate the compatibility of bonding agents. MATERIALS AND METHODS: Twenty extracted sound human molars were sectioned horizontally 2-3 mm above the cementoenamel junction (CEJ). CAD/CAM ceramic blocks for inLab were also sectioned to create 4 mm thick and bonded to the dentin. The adhesive groups assigned were divided into four adhesive groups: Group I: Variolink II dual-cure resin cement and Scotchbond Multi-Purpose Plus adhesive, group II: Multilink Automix dual-cure resin cement and Multilink primers, group III: Multilink Automix and Clearfil SE bond 2 (CSE2) adhesive, group IV: Multilink Automix and CSE2 with light curing after adhesive application. Five specimens of each group were sectioned perpendicular to obtain six microsticks of 1 × 1 mm width from each sample. Microtensile bond strength data were expressed in MPa. Fracture modes (FrMs) analyzed for the surfaces were divided into six patterns. Microtensile bond strength data were statistically analyzed with one-way ANOVA and Tukey post hoc tests (α = 0.05). T-test was performed at the 5% significance level to analyze groups III and IV with and without light curing. RESULTS: Group I showed the highest µTBS average of 13.67 MPa, group IV showed 12.26 MPa, group III showed 12.15 MPa, and group II showed the lowest average of 10.84 MPa. No significant differences were found between the bonding agents. However, the six types of failure modes, although all observed, were characterized by the adhesive system: Type I: adhesive failure of laminated dentin and ceramic; type II: adhesive failure of laminated ceramic; type III: adhesive failure of laminated dentin; type IV: cohesive failure of luting agent; type V: cohesive failure of dentin, and type VI: mixed failure of adhesion and cohesion. As a result, the FrM most commonly observed was the adhesive failure at the luting cement-ceramic block interface. CONCLUSION: The combination of resin cements and bonding agents did not significantly affect the bond strength of CAD/CAM ceramic restorations and dentin. CLINICAL SIGNIFICANCE: Several universal bonding agents are currently available for direct and indirect bonding, and using the same bonding agent for direct and indirect restorations could simplify inventory and benefit routine clinical practice. How to cite this article: Aida N, Koi K, Amaya-Pajares SP, et al. Bond Strength of Two Resin Cements with Leucite-reinforced Ceramic Using Different Bonding Agents. J Contemp Dent Pract 2023;24(11):859-863.

Impact of access cavity cleaning on the seal of postendodontic composite restorations in vitro.

AIM: The aim of the study was to investigate the influence of cavity cleaning and conditioning on marginal integrity of directly placed post-endodontic composite class-I-restorations in vitro. METHODOLOGY: A total of 168 fully intact teeth without caries or fillings received pre-endodontic composite restorations (class-II) after their extraction. Occlusal endodontic access-cavities were prepared, and root canals were instrumented and filled with gutta-percha and an epoxy resin-based sealer. Prior to post-endodontic class-I-restoration, access cavities were completely contaminated with sealer, cleaned with alcohol and pre-treated as follows: cleaner only (alcohol), glycine-polishing, Al2 O3 sandblasting, carbide bur (immediate as well as delayed restoration). A positive control (not contaminated with sealer and adhesive used) and negative control (cleaner used but no adhesive) were established. Half of the teeth from each group were subjected to thermocycling and mechanical loading (TCML). Marginal integrity of post-endodontic restoration was evaluated in oro-vestibular or mesio-distal sections after AgNO3 dye penetration (DP) by standardized photomacroscopic imaging and expressed in per cent of margin length along all segments and separately for enamel, dentine and composite, respectively. Results were analysed non-parametrically (α = .05). RESULTS: No restorations or teeth fractured or debonded completely. Without TCML, the median DP of all segments was significantly higher for the negative control compared with all other groups in oro-vestibular cutting direction (53%; p = .002) and in mesio-distal cutting direction (51%; p ≤ .041). The other groups without TCML revealed 16%-24% DP (oro-vestibular) and 12%-24% DP (mesio-distal). With TCML, the median DP in oro-vestibular cutting direction for all segments ranged between 48% and 62% for all groups, a significant difference was only observed between glycine-polishing and carbide bur (p = .041). In mesio-distal cutting direction, the median DP in negative control was 69% with TCML and significantly higher compared with all other groups (p = .002). For all other groups, the median DP of all segments ranged between 28% and 40% with TCML without significant differences. Error rates method (k = 7) revealed a significant influence of TCML in general on penetration of all segments in both oro-vestibular and mesio-distal cutting directions. CONCLUSION: Additional access cavity pre-treatment after alcohol cleaning did not improve the marginal integrity of post-endodontic composite restorations. Thorough cleaning of the access cavity with alcohol seems to assure an acceptable marginal integrity to the tooth and restorative composite.

Evaluation of pretreatments on intra-radicular dentin bond strength of self-adhesive resin cements.

OBJECTIVES: To evaluate the influence of dentin pretreatments on the push-out bond strength (POBS) of self-adhesive resin cements (SARCs) to radicular dentin. MATERIALS AND METHODS: Two experimental pretreatments (2.5% titanium tetrafluoride (TiF4 ) and 26% polyacrylic acid (PA)) and two SARCs: Maxcem Elite (MAX) and Calibra Universal (CAL) were used. For each cement, a control group was applied as indicated by the manufacturer. Sixty bovine incisors were restored (n = 10) and subjected to POBS evaluation. Failure mode, adhesive interface and surface morphology were analyzed by a Scanning Electron Microscopy (SEM) and resin infiltration was performed by confocal laser scanning microscopy (CLSM). Data for POBS and CLSM were analyzed by three-way ANOVA and Bonferroni post-hoc (α = 0.05). RESULTS: For MAX, both experimental pretreatments resulted in increased POBS in the cervical third, and for CAL, only the PA resulted in higher POBS in the cervical third. The most failures occurred between the dentin and the resin cement, except when TiF4 was applied. For PA, analysis of surface morphology showed open dentinal tubules, while TiF4 presented particle agglomerates. SEM and CLSM images confirmed presence of resin tags for both pretreatments. CONCLUSION: Pretreating radicular dentin with PA and TiF4 solutions improves the bond strength of SARCs.

The resin bond to high-translucent zirconia-A systematic review.

OBJECTIVES: Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP) ceramics. It has been widely discussed, however, that the differing composition and physical properties of new high-translucent zirconia generations (4Y-TZP and 5Y-TZP) may require alternative bonding materials and procedures. This paper reviewed in vitro studies on the success and durability of bonding protocols to high-translucent zirconia. MATERIAL AND METHODS: A systematic search of PubMed and Cochrane Library for in vitro studies on bonding to new zirconia generations published until November 2020 was conducted and complemented by a manual search. Studies selected for review fulfilled the applied inclusion and exclusion criteria. The quality of the included studies was assessed with the Cochrane risk-of-bias tool for randomized trials. RESULTS: Of 629 screened articles, 18 were included in this review. They investigated different surface pretreatment methods, primers, resin cements, aging procedures, and bond strength test protocols. The limited number of the identified studies and the heterogeneity of the extracted data did not allow to conduct a meta-analysis. CONCLUSIONS: The available evidence suggests that resin bonding protocols successfully applied to conventional zirconia are also the most successful for high-translucent zirconia. Airborne particle abrasion and special phosphate monomer-containing primers or composite resin cements provide long-term durable resin bonds. CLINICAL SIGNIFICANCE: Durable bonds can be established between high-translucent zirconia and resin cements. The bonding materials and procedures applied do not compromise their physical properties.

Luting indirect restorations with resin cements versus composite resins: Effects of preheating and ultrasound energy on film thickness.

OBJECTIVE: This study aims to evaluate and compare the film thickness obtained with a resin cement and two composite resins, preheated and/or ultrasonically vibrated, as luting agents. MATERIALS AND METHODS: One hundred and twenty-six (126) pairs of resin discs were randomly assigned to six experimental groups (n = 21) according to luting agent (Variolink Esthetic LC, IPS Empress Direct or Estelite Omega) and cementation technique (preheating at 68°C and/or ultrasonic vibration). Specimens were luted by applying a controlled force. Following sectioning and film thickness measurement through field emission gun scanning electron microscopy, statistical analysis was carried out considering a 5% significance level. RESULTS: Statistically significant lower film thickness was observed in Variolink Esthetic LC group when compared to all composite resin groups (p < 0.001), except IPS Empress Direct preheated and ultrasonically vibrated group (p = 0.073). IPS Empress Direct with ultrasonic vibration yielded statistically lower film thickness values than Estelite Omega groups, regardless of luting technique (p < 0.05). Ultrasonically vibrated Estelite Omega groups showed statistically lower film thickness values than solely preheated groups (p < 0.05). CONCLUSIONS: Both Variolink Esthetic LC and IPS Empress Direct preheated and ultrasonically vibrated provided the lowest film thickness. The addition of ultrasonic vibration during cementation proved to be effective in reducing film thickness of both tested composite resins. CLINICAL SIGNIFICANCE: The cementation technique will have variable results depending on the luting material. Adhesive cementation protocols with composite resins should mainly consider ultrasonic vibration, but also preheating, as strategies for reducing film thickness. The tested resin cement, alongside with IPS Empress Direct composite resin preheated and ultrasonically vibrated, provided the lowest film thickness among the tested materials and techniques.

Comparative Evaluation of Intrapulpal Thermal Changes during the Polymerization of Different Adhesive Resin Materials: An In Vitro Study.

AIM: Aim of this study was to assess the thermal changes within the pulp at the time of polymerization of three different adhesive resin materials. MATERIALS AND METHODS: Sixty human premolar teeth that had been recently extracted for orthodontic reasons and were devoid of dental caries/flaws were included in this research. Following preparation of the cavities, all 60 samples consisting of 20 premolars in every group, depending on the adhesive resins that were positioned as were assigned at random to one of the following three groups: Group I: RelyX self-adhesive resin cement; Group II: Breeze self-adhesive resin cement; Group III: Pan F self-etch adhesive resin cement. The temperature changes were calculated using a thermocouple wire attached to a digital thermometer. The dissimilarities amid the baseline temperature as well as the temperatures at different time intervals (1, 5, 10, and 15 minutes) were established. RESULTS: The thermal value was higher at first minute (1.84 ± 0.34) and gradually reduced at 5 minutes (1.36 ± 0.29), 10 minutes (0.62 ± 0.11), and 15 minutes (0.06 ± 0.03) in RelyX self-adhesive resin cement. The maximum thermal value was found at the first minute (2.66 ± 0.21) and gradually reduced at 5 minutes (1.42 ± 0.13), 10 minutes (0.86 ± 0.09), and 15 minutes (0.28 ± 0.01) in Breeze self-adhesive resin cement. The higher thermal value was found at the first minute (1.98 ± 0.19) and gradually reduced at 5 minutes (1.49 ± 0.14), 10 minutes (0.76 ± 0.10), and 15 minutes (0.16 ± 0.09) in Pan F self-etch adhesive resin cement and there was a statistically significant difference found between various time points and with all three adhesive resin material groups (p <0.001). CONCLUSION: This current research arrived at a conclusion that each of the three adhesive resin substances showed a safe temperature change within the pulp. However, the lowest heat scores within the pulp were depicted by RelyX self-adhesive resin in pursuit by Pan F self-etch adhesive resin cement as well as the Breeze self-adhesive resin cement in that order. CLINICAL SIGNIFICANCE: The clinical triumph of a restoration is dependent partially on the method of cementation, which is utilized to establish a connection amid the restoration and the tooth. Temporary and permanent pulp inflammation can be avoided by the decreased temperature changes in the adhesive resin cement at the time of polymerization.