Mechanical properties of dental luting cements

Influence of surface treatment of yttrium-stabilized tetragonal zirconium oxides and cement type on crown retention after artificial aging

STATEMENT OF PROBLEM

Information about the influence of zirconia crown surface treatment and cement type on the retention of zirconia crowns is limited. It is unclear whether zirconia crowns require surface treatment to enhance their retention.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of surface treatment on the retention of zirconia crowns cemented with 3 different adhesive resin cements after artificial aging.

MATERIAL AND METHODS

Ninety extracted human molars were prepared for ceramic crowns (approximately 20-degree taper, approximately 4-mm axial length) and were divided into 3 groups (n=30). Computer-aided design and computer-aided manufacturing zirconia copings were fabricated. Three surface treatments were applied to the intaglio surface of the copings. The control group received no treatment, the second group was airborne-particle abraded with 50 μm Al2O3, and the third group was treated with 30 μm silica-modified Al2O3, The copings were luted with a self-etch (RelyX Unicem 2), a total-etch (Duo-Link), or a self-etch primer (Panavia F 2.0) adhesive cement. They were stored for 24 hours at 37°C before being artificially aged with 5000 (5°C-55°C) thermal cycles and 100,000 cycles of 70 N dynamic loading. Retention was measured on a universal testing machine under tension, with a crosshead speed of 0.5 mm/min. Statistical analysis was performed with 1-way and 2-way ANOVA.

RESULTS

Mean retention values ranged from 0.72 to 3.7 MPa. Surface treatment increased crown retention, but the difference was not statistically significant (P>.05), except for the Duo-Link cement group (P<.05). Analysis of the adhesives revealed that the Duo-Link cement resulted in significantly lower crown retention (P<.05) than the other 2 cements.

CONCLUSION

For zirconia crowns, retention seems to be dependent on cement type rather than surface treatment.

Effects of differing thickness and mechanical properties of cement on the stress levels and distributions in a three-unit zirconia fixed prosthesis by FEA

PURPOSE

This study analyzed the impact of cement layer thickness (CLT) and Young's modulus of the cement on the stress distribution in a three-unit zirconia fixed dental prosthesis (FDP) and in the bonding interfaces by means of finite element method.

MATERIALS AND METHODS

A 3D finite element model was created from a stylized three-unit FDP-cement-tooth/socket system. The pulp and the periodontal ligament were not modeled. Two CLTs (50 and 150 μm) and two values of Young's modulus of the cement (4.9 for simulation of resin cement, 20.1 GPa for glass ionomer cement) were evaluated. A 500 N static vertical load was applied at the central fossa of the pontic to calculate maximum displacement in the framework and maximum principal stresses in both framework and bonding interfaces.

RESULTS

The simulated results showed that the Young's modulus affected stress occurrence only in the cement interface. Lower moduli were associated with less stress. The thickness of the cement layer influenced the maximum principal stress in both the FDP and in the cement layer itself. Thicker cement layers led to higher stresses in the framework but lower stresses in the cement layer. Maximum displacement was less dependent of the investigated variables. During all trials, the location of the maximum principal stress did not change. Maximum stress concentrations were observed at the lower embrasures of the connector areas and in the bonding layer at the cervical margin of the preparation.

CONCLUSIONS

Choosing cements with a preferably low Young's modulus in combination with a CLT as small as possible might increase the clinical survival rate.

Immediate and delayed micro-tensile bond strength of different luting resin cements to different regional dentin

We sought to evaluate immediate and delayed micro-tensile bond strength of Panavia F2.0 and Multilink Sprint resin cement to superficial, deep and cervical dentin. Thirty-six freshly extracted non-carious human molars were sectioned in the mesiodistal direction to expose three different dentin regions including superficial dentin (1 mm below the dentine-enamel junction), deep dentin (1 mm above the highest pulp horn) and cervical dentin (0.5 mm above the cemento-enamel junction and 0.5 mm below the dentine-enamel junction). Resin cements were applied on dentin surfaces and composite blocks were luted under constant seating pressure. Each group was divided into three subgroups according to time intervals. Specimens were sectioned to obtain sticks of 1 mm² in diameter and subjected to microtensile bond strength testing at a cross head speed of 1 mm/min. Both resin cements showed higher micro-tensile bond strength to superficial dentin than that to deep or cervical dentin (P < 0.001). Micro-tensile bond strengths of Panavia F2.0 were higher than those of Multilink Sprint at different dentin regions (P < 0.001). Immediate micro-tensile bond strengths were higher than those of delayed micro-tensile bond strengths for both resin cements (P < 0.001). It was concluded that resin cements with different chemical formulations and applications yield significantly different micro-tensile bond strengths to different dentin regions.

Finite element analysis of stresses in fixed prosthesis and cement layer using a three-dimensional model

Context:

To understand the effect of masticatory and parafunctional forces on the integrity of the prosthesis and the underlying cement layer.

Aims:

The purpose of this study was to evaluate the stress pattern in the cement layer and the fixed prosthesis, on subjecting a three-dimensional finite element model to simulated occlusal loading.

Materials and Methods:

Three-dimensional finite element model was simulated to replace missing mandibular first molar with second premolar and second molar as abutments. The model was subjected to a range of occlusal loads (20, 30, 40 MPa) in two different directions – vertical and 30° to the vertical. The cements (zinc phosphate, polycarboxylate, glass ionomer, and composite) were modeled with two cement thicknesses – 25 and 100 μm. Stresses were determined in certain reference points in fixed prosthesis and the cement layer.

Statistical Analysis Used:

The stress values are mathematic calculations without variance; hence, statistical analysis is not routinely required.

Results:

Stress levels were calculated according to Von Mises criteria for each node. Maximum stresses were recorded at the occlusal surface, axio-gingival corners, followed by axial wall. The stresses were greater with lateral load and with 100-μm cement thickness. Results revealed higher stresses for zinc phosphate cement, followed by composites.

Conclusions:

The thinner cement interfaces favor the success of the prosthesis. The stresses in the prosthesis suggest rounding of axio-gingival corners and a well-established finish line as important factors in maintaining the integrity of the prosthesis.

Evaluation of bond strength of resin cements using different general-purpose statistical software packages for two-parameter Weibull statistics

OBJECTIVES

This study evaluated and compared Weibull parameters of resin bond strength values using six different general-purpose statistical software packages for two-parameter Weibull distribution.

METHODS

Two-hundred human teeth were randomly divided into 4 groups (n=50), prepared and bonded on dentin according to the manufacturers' instructions using the following resin cements: (i) Variolink (VAN, conventional resin cement), (ii) Panavia21 (PAN, conventional resin cement), (iii) RelyX Unicem (RXU, self-adhesive resin cement) and (iv) G-Cem (GCM, self-adhesive resin cement). Subsequently, all specimens were stored in water for 24h at 37°C. Shear bond strength was measured and the data were analyzed using Anderson-Darling goodness-of-fit (MINITAB 16) and two-parameter Weibull statistics with the following statistical software packages: Excel 2011, SPSS 19, MINITAB 16, R 2.12.1, SAS 9.1.3. and STATA 11.2 (p≤0.05). Additionally, the three-parameter Weibull was fitted using MNITAB 16.

RESULTS

Two-parameter Weibull calculated with MINITAB and STATA can be compared using an omnibus test and using 95% CI. In SAS only 95% CI were directly obtained from the output. R provided no estimates of 95% CI. In both SAS and R the global comparison of the characteristic bond strength among groups is provided by means of the Weibull regression. EXCEL and SPSS provided no default information about 95% CI and no significance test for the comparison of Weibull parameters among the groups. In summary, conventional resin cement VAN showed the highest Weibull modulus and characteristic bond strength.

SIGNIFICANCE

There are discrepancies in the Weibull statistics depending on the software package and the estimation method. The information content in the default output provided by the software packages differs to very high extent.

The all-ceramic, inlay supported fixed partial denture. Part 3. Experimental approach for validating the finite element analysis

In a previous study, the authors used a finite element analysis (FEA) to evaluate the stresses developed during the loading of an all-ceramic, inlay supported fixed partial denture and compared it with the more traditional full crown supported prosthesis. To date there has been little research into correlating the responses of the numerical model against physical mechanical tests; such validation analysis is crucial if the results from the FEA are to be confidently relied upon. This study reports on the experimental methods used to compare with the FEA and thereby to validate the predictive fracture behaviour of the numerical model. This study also outlines the methods for manufacture and testing of the ceramic structure along with observations of the fracture tests. In addition the procedure used for developing the FEA model for the test system is outlined.

Advances in dental veneers: materials, applications, and techniques

Laminate veneers are a conservative treatment of unaesthetic anterior teeth. The continued development of dental ceramics offers clinicians many options for creating highly aesthetic and functional porcelain veneers. This evolution of materials, ceramics, and adhesive systems permits improvement of the aesthetic of the smile and the self-esteem of the patient. Clinicians should understand the latest ceramic materials in order to be able to recommend them and their applications and techniques, and to ensure the success of the clinical case. The current literature was reviewed to search for the most important parameters determining the long-term success, correct application, and clinical limitations of porcelain veneers.

An In Vitro Evaluation of the Microleakage under Complete Metal Crowns Using Three Adhesive Luting Cements

Despite the material advancements and precise laboratory techniques, cement lines are inevitable in fixed prosthodontics which leads to increased dependence on the integrity of the cement to maintain the marginal seal. The material class of luting agent is known to influence microleakage. Studies of cement dissolution and disintegration have produced varying results. Hence, this study was done to evaluate marginal leakage under complete metal crowns using three adhesive cements, two resin cements (one self cure, one dual cure) and a glass ionomer cement. Metal crowns were prepared on sixty intact extracted premolars and were randomly divided into three groups of twenty each, with each group using a different cement for luting. All the samples were then subjected to thermocycling and were sectioned using a diamond saw. Reflected Binocular Stereomicroscope at 100× magnification was used to study the extent of microleakage at both metal cement (MC) and tooth cement (TC) interface, at two opposite margins of each sectioned specimen. Data was analyzed with a one way analysis of variance. For comparison among the groups multiple comparison Bonferroni test was done. Within group data was analysed with independent student t test. Between three groups, metal crowns cemented with multilink cement showed significantly less microleakage at both the interfaces. Glass ionomer cement recorded maximum combined microleakage amongst three cements irrespective of the interfaces. Within group, glass ionomer and multilink cement showed more microleakage at MC interfaces than at TC interface. A complex interaction between variables related to dental restoration, luting agent and tooth structure probably influence microleakage. In vitro studies must always be followed by in vivo studies before definite conclusion can be drawn.

The all-ceramic, inlay supported fixed partial denture. Part 2. Fixed partial denture design: a finite element analysis

The clinical use of all-ceramic crowns and fixed partial dentures has seen widespread adoption over the past few years due to their increasing durability and longevity. However, the application of inlays as an abutment design has not been as readily embraced because of their relatively high failure rates. With the use of an idealized inlay preparation design and prosthesis form which better distributes the tensile stresses, it is possible to utilize the inlay as support for an all-ceramic fixed partial denture. Utilizing a three-dimensional finite element analysis, a direct comparison of the inlay supported all-ceramic bridge against the traditional full crown supported all-ceramic bridge is made. The results demonstrate that peak stresses in the inlay bridge are around 20% higher than in the full crown supported bridge with von Mises peaking at about 730 MPa when subjected to theoretical average maximum bite force in the molar region of 700 N, which is similar to the ultimate tensile strengths of current zirconia based ceramics.

The effect of dentin desensitizer on shear bond strength of conventional and self-adhesive resin luting cements after aging

This study tested the impact of Gluma Desensitizer on the shear bond strength (SBS) of two conventional (RelyX ARC, Panavia 21) and two self-adhesive (RelyX Unicem, G-Cem) resin luting cements after water storage and thermocycling. Human third molars (N=880) were embedded in acrylic resin. The buccal dentin was exposed. Teeth were randomly divided into four main groups, and the following cements were adhered: 1) RelyX ARC, 2) Panavia 21, 3) RelyX Unicem, and 4) G-Cem. In half of the teeth in each group, dentin was treated with Gluma Desensitizer. In the conventional cement groups, the corresponding etchant and adhesive systems were applied. SBS of the cements was tested after 1 hour (initial); at 1, 4, 9, 16, and 25 days of water storage; and at 1, 4, 9, 16, and 25 days of thermocycling. SBS data were analyzed by one-way analysis of variance (ANOVA); this was followed by the post hoc Scheffé test and a t-test. Overall, the highest mean SBS (MPa) was obtained by RelyX ARC (ranging from 14.6 ± 3.9 to 17.6 ± 5.2) and the lowest by Panavia 21 in combination with Gluma Desensitizer (ranging from 0.0 to 2.9 ± 1.0). All tested groups with and without desensitizer showed no significant decrease after aging conditions compared with baseline values (p>0.05). Only the Panavia 21/Gluma Desensitizer combination showed a significant decrease after 4 days of thermocyling compared with initial values and 1 day thermocycling. Self-adhesive cements with Gluma Desensitizer showed increased SBS after aging conditions (ranging from 7.4 ± 1.4 to 15.2 ± 3) compared with groups without desensitizer (ranging from 2.6 ± 1.2 to 8.8 ± 2.9). No cohesive failures in dentin were observed in any of the test groups. Although self-adhesive cements with and without desensitizer presented mainly adhesive failures after water storage (95.8%) and thermocyling (100%), conventional cement (RelyX ARC) showed mainly mixed failures (90.8% and 89.2%, after water storage and thermocyling, respectively). Application of the Gluma Desensitizer to dentin before cementation had a positive effect on the SBS of self-adhesive cements.

Fracture resistance of premolars restored with inlay and onlay ceramic restorations and luted with two different agents

PURPOSE

The purpose of this study was to evaluate the fracture resistance of human maxillary premolars restored with 2 ceramic systems (Vitadur Alpha and In Ceram) comparing 3 preparation designs and 2 luting agents.

METHODS

Seventy sound teeth were prepared to receive ceramic restorations (Vitadur Alpha; n=14) as follows: (1) control, sound premolars, with no preparation, (2) inlays, (3) partial onlays (palatal cuspid coverage), (4) total onlays (both cuspids coverage), and (5) total onlays with an In Ceram core. The ceramic restorations were cemented using Enforce or RelyX ARC (half restorations with each cement), placed into the cavity and held under pressure, except for the control group. The teeth were subjected to compressive axial loading at 0.5 mm min⁻¹ using a 9 mm steel ball until fracture. Data were analyzed by 3-way ANOVA and post hoc Tukey's test (α=.05).

RESULTS

There was a significant difference between cements and among preparation designs (P<.05). All restorations cemented with Enforce exhibited significantly higher fracture resistance (P<.05). Inlay restorations showed similar fracture resistance when compared to control group (P>.05). Partial and total onlays did not statistically differ and showed the weakest performance. The use of an In Ceram core did not produce higher fracture resistance.

CONCLUSIONS

Within the limitations of this study, the cements tested had different mechanical properties, while cuspid coverage did not result in improved fracture resistance of the restored teeth.

Conventional and contemporary luting cements: an overview

Long-term clinical success of fixed prosthodontic restorations is influenced by many factors, one important factor being the selection of an appropriate luting agent. No single luting agent is capable of meeting all the stringent requirements, which is one reason why there is such a wide choice of luting agents currently available from conventional water-based to contemporary adhesive resin cements. Introduction of adhesive resin systems has completely changed the face of fixed prosthodontic practice leading to an increased use of bonded all-ceramic crowns and resin-retained fixed partial dentures. This article makes an effort to review various conventional and contemporary luting agents, their properties & associated clinical implications thereby trying to help the clinician select an appropriate luting agent for a given clinical situation.

Nonlinear visco-elastic finite element analysis of different porcelain veneers configuration

This study is aimed at evaluating the biomechanical behavior of feldspathic versus alumina porcelain veneers. A 3D numerical model of a maxillary central incisor, with the periodontal ligament (PDL) and the alveolar bone was generated. Such model was made up of four main volumes: dentin, enamel, cement layer and veneer. Incisors restored with alumina and feldspathic porcelain veneers were compared with a natural sound tooth (control). Enamel, cementum, cancellous and cortical bone were considered as isotropic elastic materials; on the contrary, the tubular structure of dentin was designed as elastic orthotropic. The nonlinear visco-elatic behavior of the PDL was considered. The veneer volumes were coupled with alumina and feldspathic porcelain mechanical properties. The adhesive layers were modeled in the FE environment using spring elements. A 50N load applied at 60 degrees angle with tooth longitudinal axis was applied and validated. Compressive stresses were concentrated on the external surface of the buccal side of the veneer close to the incisal margin; such phenomenon was more evident in the presence of alumina. Tensile stresses were negligible when compared to compressive ones. Alumina and feldspathic ceramic were characterized by a different biomechanical behavior in terms of elastic deformations and stress distributions. The ultimate strength of both materials was not overcome in the performed analysis.

Retention of zirconia copings on zirconia implant abutments cemented with provisional luting agents

The purpose of this study is to measure and compare the retentive force of zirconia-based all-ceramic crowns cemented on zirconia abutments using five provisional luting agents. In addition, the effect of sandblasting and thermocycling on the retentive force was evaluated. Two hundred zirconia abutments and copings were fabricated (Procera system; Nobel Biocare) and divided into five groups. Hy bond temporary cement hard (Hard), Hy bond temporary cement soft (Soft), experimental temporary cement (New), Tempbond NE (Temp) and Freegenool temporary pack (Pack) were used according to the manufacturers' instructions. Each group was divided into two groups, one with and one without sandblasting. Furthermore, thermocycling up to 2000 cycles was conducted on half of each group. After 24 h and thermocycling, the retentive force was measured using a universal testing machine. The data were subjected to analysis of variance, and comparisons of the means were performed with a Games-Howell test at a level of 95%. As a result, Hard showed the highest retentive force, sandblasting was effective for improving the durability, and no effect of sandblasting was detected in the others. New showed stability of the retentive force even after thermocycling. The retentive force of Temp and Pack decreased significantly after thermocycling even with sandblasting. The retentive forces were different from the provisional cement and sandblasting, and Temp and Pack may not be appropriate for the retention of single-tooth zirconia abutments and coping restorations.

In vitro exploration and finite element analysis of failure mechanisms of resin-bonded fixed partial dentures

PURPOSE

The purpose of this study was to explore the debonding mechanisms of two-unit cantilevered and straight and bent three-unit fixed-fixed resin-bonded fixed partial dentures (RBFPDs) and to measure the failure loads needed for debonding.

MATERIALS AND METHODS

Failure load tests were performed using Bondiloy beams simulating both cantilevered and fixed-fixed RBFPDs, luted onto flat-ground buccal surfaces of bovine teeth with RelyX ARC, Panavia F2.0, and UniFix resin cements. The failure loads were recorded, and the debonded surfaces of both the enamel and the restorations were examined for details of interest. Finite element analysis (FEA) was used to calculate the stress concentrations within the cement layers at failure.

RESULTS

Simulated two-unit cantilevered and straight three-unit fixed-fixed RBFPDs showed a significantly higher failure load than the simulated three-unit fixed-fixed RBFPDs with a curved appearance. The FEA models revealed the magnitude and stress locations within the cement layer, resulting in an explanation of the different failure modes.

CONCLUSIONS

The low failure loads for the three-unit bent fixed-fixed RPFPDs, compared with their straight counterparts and the two-unit cantilevered RBFPDs, indicate that clinically a reserved attitude needs to be maintained with regard to three-unit fixed-fixed RBFPDs spanning a clearly curved part of the dental arch. The FEA results make it clear which part of the tooth restoration interface is subject to the highest stress levels, making it possible to design abutment preparations that avoid high interfacial stresses to help prevent debonding.

Effect of cement selection and finishing technique on marginal opening of cast gold inlays

STATEMENT OF PROBLEM

The standard cement for partial-veneer cast gold restorations has been zinc phosphate. With increasing interest in using resin and resin-modified glass ionomer cements for this purpose, marginal adaptation with use of these newer cements must be assessed.

PURPOSE

The purpose of this in vitro study was to determine if the marginal adaptation of cast gold inlays is comparable for 3 different luting agents and 3 finishing techniques.

MATERIAL AND METHODS

Cast gold inlays were cemented into triangular preparations on the buccal surface of 45 extracted human molars. Three operators each used a different technique for finishing margins: finishing during cementation (FD), finishing before cementation (FB), and finishing before and during cementation (FBA). The 15 teeth for each operator were divided into 3 subgroups of 5 each to accommodate 3 cements: zinc phosphate (Fleck's zinc phosphate: ZP), resin-modified glass ionomer (RelyX Luting: RXL), and self-adhesive modified resin (RelyX Unicem: RXU). For all specimens, fine sandpaper disks followed by fine cuttle disks were used for finishing the castings. The marginal gap was measured using a Nikon measuring microscope at x50 magnification. Data were analyzed with a 1-way ANOVA for each cement (alpha=.05).

RESULTS

There were significant differences among finishing techniques for each cement (P<.05). For ZP, the smallest mean marginal gaps were for FD (31 microm) and FBA (42 microm). For RXL, FBA produced the smallest gap (19 microm). For RXU, FB (23 microm) and FBA (22 microm) were optimal.

CONCLUSIONS

Within the limitations of this in vitro study, the marginal gap attained with cementation of partial-veneer cast gold restorations with ZP (31 microm) can also be obtained using RXL or RXU. The techniques of FD or FBA are best used for ZP, whereas the FBA technique is best for RXL, and either FB or FBA is optimal for RXU. The FBA technique yielded a small gap; this was common to all 3 cements.

A study of the fracture resistance of nyyar cores of three restorative materials

Despite the successful use of dental amalgam for coronal-radicular dowel and core build-up in endodontically-treated posterior teeth, newer materials offer many potential advantages over amalgam and have better patient acceptance. This study compared the fracture resistance of coronal-radicular restorations made from three different direct restorative materials. Sixty human premolars were selected, 45 of which were root treated and decoronated. Fifteen of these premolars were restored using amalgam, 15 with composite and 15 using resin-modified glass ionomer. The 15 unrestored teeth were used as a control group. All the teeth were mounted in acrylic within steel containers and subjected to compressive loading to failure on a universal testing machine. The force required to fracture each core specimen was recorded as well as the proportion of core lost due to failure. The results showed dental amalgam as having the highest fracture resistance (mean 1.93kN, sd 0.22) followed by resin-modified glass ionomer (mean 1.05kN, sd 0.20), sound tooth (mean 0.79kN, sd 0.20) and composite (mean 0.75kN, sd 0.11). The differences among all groups were significant. These results demonstrate that, although resin-modified glass ionomer is significantly weaker than amalgam, these restorations were stronger than unrestored teeth and failed at forces in excess of those encountered in normal mastication. Amalgam cores, along with resin-modified glass ionomer, tended to fail less catastrophically than the other materials and, given their strength, would remain the material of choice in situations where abnormally high forces are expected.

Tensile Bond Strength and Flexural Modulus of Resin Cements—Influence on the Fracture Resistance of Teeth Restored with Ceramic Inlays

The mechanical properties of resin cement can influence the fracture resistance of teeth restored with ceramic inlays. In general, cement with a higher elastic modulus resulted in a tooth/ceramic inlay that had a higher fracture resistance.

Dental cements for definitive luting: a review and practical clinical considerations

Dental cement used to attach an indirect restoration to a prepared tooth is called a luting agent. A clinically relevant discussion of conventional and contemporary definitive luting agents is presented in this article. Physical properties are listed in table form to assist in comparison and decision-making. Additional subtopics include luting agent requirements, classifications, retention and bonding, cement considerations for implant-supported teeth, and fatigue failure.

An evaluation of the performance of cast gold bonded restorations in clinical practice, a retrospective study

OBJECTIVES

To evaluate the performance of cast gold bonded restorations in clinical practice.

MATERIALS AND METHODS

The records of all patients treated with cast gold bonded restorations between 1997 and 2004 of The Dental Hospital of Newcastle upon Tyne were reviewed. The following data were recorded: sex of patient, location of teeth (anterior or posterior), position of teeth (upper or lower) and type of cement (glass ionomer, zinc phosphate or resin cement). The survival time was calculated for each restoration; and the reason for failure (either debond or change of treatment plan) identified for each case. The restorations were stratified according to the age of the patient into 10-year age bands and survival analysis was used to identify variables associated with increased risk of failure.

RESULTS

Restorations luted with resin cement showed the highest rate of survival after 7 years of follow-up. The alternative lutes had significantly worse survival (p<0.05). Restorations on anterior teeth had poorer survival than on posterior teeth but there were no differences between those placed in the mandible and the maxilla.

CONCLUSIONS

Within the limitations of this study resin cements are most appropriate for this type of restoration with 80% survival at 7 years. Restorations placed on posterior teeth survived better.

Comparison of the Flexural Strength of Five Adhesive Resin Cements

STATEMENT OF PROBLEM

The increased use of adhesive resin cements in bonded prosthetic restorations has led to restorations debonding under function.

PURPOSE

This investigation evaluated the differences in the flexural strength of new adhesive resin cements as a function of specimen age and storage condition.

MATERIALS AND METHODS

Four new dual-cure cements were compared to C/B Metabond. Twenty specimens of each of the five cements were prepared in a rectangular glass mold (25 x 2 x 2 mm). The new cements were light-activated with a 550 mW/cm(2) lamp for 80 seconds on both the top and bottom surfaces. The auto-cured cement was allowed to set according to manufacturer's directions. Half the specimens were tested immediately after curing while the other half were stored in distilled water at 37 degrees C for 30 days. A three-point bending test was performed using an Instron at a crosshead speed of 1 mm/min. The results were analyzed by analysis of variance and Scheffé tests ( p < 0.05) to examine the effect of specimen age and storage condition.

RESULTS

RelyX ARC exhibited a significantly higher flexural strength compared with Calibra and Panavia F when tested immediately. The standard cement, C/B Metabond, deformed and did not fracture at the immediate test time. After storage, the flexural strength had significantly improved from the immediate test time for Calibra, Cement-It, Panavia F, and C/B Metabond. However, there were no significant differences in the flexural strength among the cements when tested after 30 days in water at 37 degrees C.

CONCLUSION

Immediately after curing, these new adhesive resin cements are not equivalent, as evidenced by the significant variability in the measured flexural strength. The distinctions among the cements diminish after aging in water, which may be due to residual polymerization or a plasticizing effect from water absorption.

CLINICAL SIGNIFICANCE

When light-cured, all the new adhesive resin cements have greater early strengths than the auto-cured cement; however, the wide variation in immediate bending strength suggests that some cements may be more appropriate for use in high-stress clinical situations such as resin-bonded fixed partial dentures.

Viscoelastic behavior and fracture toughness of six glass-ionomer cements

STATEMENT OF PROBLEM

Viscoelastic behavior can influence the fracture properties of glass ionomers, which is of clinical relevance. Glass-ionomer cements can display viscoelastic behavior, defined as having displacement rate- or strain rate-dependent mechanical properties. Understanding and describing the viscoelastic behavior of glass ionomers is important to understanding their clinical behavior.

PURPOSE

The purpose of this study was to evaluate the viscoelastic behavior of 6 glass-ionomer cements and determine whether there was a correlation to fracture toughness.

MATERIAL AND METHODS

Three conventional glass-ionomer cements (alpha-Silver, alpha-Fil, and Ketac-Molar) and 3 resin-modified glass-ionomer cements (Vitremer, Fuji II LC, and Photac-Fil Quick) were evaluated using measurements of compressive strength (CS), flexural strength (FS), and diametral tensile strength (DTS) at displacement rates of 0.5, 1.0, 1.5, and 2.0 mm/min. The CS and DTS specimens were cured in glass tubes and cut to 4 x 6-mm and 4 x 2-mm disk-shaped specimens, respectively. The FS specimens were cured in bar molds (2 x 2 x 15 mm). The fracture toughness (FT) specimens were cured in a minicompact mold to obtain precracked specimens. The mechanical testing results were compared statistically using generalized linear model/analysis of covariance and the Ryan-Einot-Gabriel-Welsch multiple range test at the alpha=.05 level.

RESULTS

For all 3 mechanical properties, there was a displacement-rate dependence on the mechanical property. However, there were no differences in the displacement-rate dependence based on the type of material-conventional glass ionomer or resin-modified glass ionomer-for any of the mechanical properties. Only for FS test was there a significant difference based on the brand of material. There was no statistical difference in FT among the glass-ionomer cements tested, although the resin-modified glass ionomers tended to display higher FT.

CONCLUSION

A larger sample size and a much wider range of crosshead speeds are necessary to support a correlation between viscoelastic behavior and FT.

Effect of variations from the recommended powder/liquid ratio on some properties of resin-modified cements

OBJECTIVES

The powder and liquid contents of cements are mixed in accordance with the recommended mixing ratio, but discrepancies occur despite the use of proportioning scoops. Little is known about powder/liquid ratio variations on certain properties of resin-modified cements.

METHODS

Two resin-modified glass ionomer cements (RMGIC) were mixed using various powder/liquid ratios: (a) Recommended ratio: Fuji Plus: powder/liquid 2:1; ProTecCEM p/l 2.25:1. (b) Maximal variation arising using proportioning aids (17% liquid surplus): Fuji Plus 1.66:1, ProTecCEM 1.875:1. Limits of mixing and specimen construction: either (c) both groups with more liquid (1.5:1) or (d) more powder (3:1). Flexural strength was determined using a 3-point bending test (after 24 h) and wear using a 3-body abrasion device. The extent of cure reaction was characterized using differential thermal analysis (DTA).

RESULTS

While higher powder content did not significantly affect the flexural strength of Fuji Plus and ProTecCEM, it considerably reduced wear of Fuji Plus. Increasing liquid content reduced flexural strength. A substantial increase in wear for Fuji Plus 1.5:1, and ProTecCEM 1.875:1 and 1.5:1 mixtures was observed. DTA demonstrated that a higher liquid content resulted in incomplete setting reactions, which could be detected even after 24 h of cure.

CONCLUSIONS

If RMGICs are mixed with powder/liquid variations, given the inaccuracy of proportioning aids the properties of RMGIC will change slightly and may be disregarded. If set with higher powder/liquid variations, a surplus of powder has less influence on the properties than a surplus of liquid.

Dynamometric assessment of the mechanical resistance of porcelain veneers related to tooth preparation: A comparison between two techniques

STATEMENT OF PROBLEM

There is little agreement regarding a palatal extension of the preparation for porcelain veneers, as it represents a more invasive technique than a preparation limited to the facial surface of a tooth.

PURPOSE

The purpose of this study was to detect the stress in maxillary anterior teeth restored with porcelain veneers and compare the resistance to fracture of porcelain veneers prepared using different preparation designs.

MATERIAL AND METHODS

Forty-five maxillary anterior teeth were restored with porcelain veneers and divided into 9 groups as follows: Ca, canines with no preparation; Ca-Ch, canines with palatal chamfer preparation; Ca-W, canines with window preparation; LI, lateral incisors with no preparation; LI-Ch, lateral incisors with palatal chamfer preparation; LI-W, lateral incisors with window preparation; CI, central incisors with no preparation; CI-Ch, central incisors with palatal chamfer preparation; CI-W, central incisors with window preparation. Shear-flexural fracture tests were performed. The fractured specimens were subjected to scanning electron microscope (SEM) analysis. Data were statistically analyzed with univariate analysis of variance and the Tukey post hoc test for multiple comparisons (alpha=.05).

RESULTS

The following mean fracture load values (N) were recorded: Ca, 395 +/- 6; Ca-Ch, 310 +/- 8; Ca-W, 322 +/- 8; LI, 309 +/- 8; LI-Ch, 242 +/- 6; LI-W, 225 +/- 8; CI, 298 +/- 8; CI-Ch, 255 +/- 8; CI-W, 221 +/- 6. The SEM analysis showed that both adhesive and cohesive fractures were primarily concentrated at the cervical region. Statistical analysis showed that both the type of tooth and the design of the preparation significantly influenced the resistance to fracture of the restored teeth (P<.001).

CONCLUSION

The chamfer preparation is recommended for central incisors, whereas the window preparation showed better results for canines. Both preparations can be adopted in the restoration of lateral incisors.

Load-fatigue performance of gold crowns luted with resin cements

STATEMENT OF PROBLEM

Resin cements have gained popularity over the past few years because of their improved physical properties. There is a need to test these cements under fatigue loading, as there is growing recognition that fatigue testing is more clinically relevant than traditional monotonic static tests.

PURPOSE

This study investigated the load-fatigue performance of complete gold crowns cemented with 4 types of resin cement.

MATERIAL AND METHODS

Four resin cements (C & B Opaque [CBO], Calibra Esthetic [CE], RelyX Unicem [RU], and Panavia F [PF]) and a control, zinc phosphate cement (HY-Bond [HBZPC]) were tested. Fifty human maxillary premolars were prepared to an occluso-cervical dimension of 4 mm and a convergence angle of 20 degrees. Complete gold crowns were cast (Strator 3) and cemented with 1 of the 5 cements (n=10). A fatigue load of 73.5 N was applied at an angle of 135 degrees to the long axis of each tooth-crown specimen. Preliminary failure was defined as the propagation of a crack in or around the crown luting cement layer. The number of cycles to preliminary failure and the cement failure location were determined. Significant differences in cycles to preliminary failure were assessed by the nonparametric Kruskal-Wallis test, with follow-up Mann-Whitney tests (alpha=.05).

RESULTS

Group CE had the highest rank of cycles to preliminary failure, while HBZPC had the lowest cycles to preliminary failure. Group CE had a significantly higher failure cycle count compared to PF (P=.016), RU (P=.001), and HBZPC (P<.001), but was not significantly different from CBO (P=.112). There was no significant difference in the failure cycle count between RU and HBZPC (P=.070).

CONCLUSION

Not all tested resin cements had a superior fatigue life when compared with zinc phosphate cement. Of the 4 resin cement groups, Groups CE, CBO, and PF were significantly superior to HBZPC.

Influence of activation modes on diametral tensile strength of dual-curing resin cements

In metallic restorations, the polymerization of dual-curing resin cements depends exclusively on chemical activation. The effect of the lack of photoactivation on the strength of these cements has been rarely studied. This study evaluated the influence of activation modes on the diametral tensile strength (DTS) of dual-curing resin cements. Base and catalyst pastes of Panavia F, Variolink II, Scotchbond Resin Cement, Rely X and Enforce were mixed and inserted into cylindrical metal moulds (4 x 2 mm). Cements were either: 1) not exposed to light (chemical activation = self-cured groups) or 2) photoactivated through mylar strips (chemical and photo-activation = dual-cured groups) (n = 10). After a 24 h storage in 37ºC distilled water, specimens were subjected to compressive load in a testing machine. A self-curing resin cement (Cement-It) and a zinc phosphate cement served as controls. Comparative analyses were performed: 1) between the activation modes for each dual-curing resin cement, using Student’s t test; 2) among the self-cured groups of the dual-curing resin cements and the control groups, using one-way ANOVA and Tukey’s test (alpha = 0.05). The dual-cured groups of Scotchbond Resin Cement (53.3 MPa), Variolink II (48.4 MPa) and Rely X (51.6 MPa) showed higher DTS than that of self-cured groups (44.6, 40.4 and 44.5 MPa respectively) (p < 0.05). For Enforce (48.5 and 47.8 MPa) and Panavia F (44.0 and 43.3 MPa), no significant difference was found between the activation modes (p > 0.05). The self-cured groups of all the dual-curing resin cements presented statistically the same DTS as that of Cement-It (44.1 MPa) (p > 0.05), and higher DTS than that of zinc phosphate (4.2 MPa). Scotchbond Resin Cement, Variolink II and Rely X depended on photoactivation to achieve maximum DTS. In the absence of light, all the dual-curing resin cements presented higher DTS than that of zinc phosphate and statistically the same as that of Cement-It (p > 0.05).

In vitro evaluation of the retention of zirconia-based ceramic posts luted with glass ionomer and resin cements

The retention of zirconia-based ceramic posts (CosmoPost system) luted with glass ionomer and resin cements was evaluated. Thirty-two extracted, caries-free, unrestored teeth were selected and stored in chlorhexidine and water solution. The teeth were endodontically treated and randomly assigned to two groups (n=16). Each tooth was decoronated and prepared to a depth of 10.0 mm from root surface to receive a 1.4 mm diameter zirconium dioxide post. Each group had posts cemented with either glass ionomer cement (Fuji I) or resin cement (Variolink II). The post/teeth specimens were embedded in resin blocks and subjected to tensile testing. The tensile force required to dislodge the cemented posts in a tensile testing machine was recorded. The mean stress values of both groups were analyzed for statistical differences using ANOVA and Student's t-test. Significance level was set at 5%. Mean peak forces at failure (N) and standard deviation for the tested cements were the following: Fuji I = 121.8 (±17.4) and Variolink II = 228.1 (±36.8). Posts luted with the resin cement presented statistically significant higher tensile bond strength than those retained with glass ionomer (p<0.05). It may be concluded that zirconia posts cemented with resin-based cement (Variolink II) failed at statistically significant higher values compared to those cemented with glass ionomer cement (Fuji I). Regardless of the cement type, the posts failed adhesively at the cement/post interface when subjected to a tensile force.

Bonding of ceramic insert to a laboratory particle filler composite

The push-out bond strength of cylindrical ceramic inserts (CI) to particulate filler resin composite (VC) was evaluated in this study. Various surface treatments to improve the adhesion of CI to resin composite were tested. Additionally, the effect of fiber-reinforced composite (FRC) laminate encapsulation around CI was tested. Feldspathic porcelain CI with a diameter of 3.1 mm was bonded to VC. Adhesive resin was used for bonding. In group 1, no surface treatment of CI was done. In group 2, CI was encapsulated with a thin layer of woven glass FRC. In group 3, the surface of the CI was tribochemically silica coated and silanized. In group 4, the surface of the CI was grit-blasted with 50 microm aluminum oxide and etched with hydrofluoric acid. In group 5, the grit-blasted CI was encapsulated with a layer of FRC. The specimens (n = 6/group) were either dry stored or thermocycled in water (6000 x 5-55 degrees C). The push-out test was carried out with a universal material testing machine. The highest push-out strength was achieved in group 5 (20.4 MPa) and the lowest in group 2 (11.5 MPa). ANOVA revealed that both surface treatment and storage condition had a significant effect on push-out strength (p < 0.05). We conclude that the additional glass FRC encapsulation can be used to increase the bond strength of insert to composite.

Comparison of titanium dowel retention using four different luting agents

STATEMENT OF PROBLEM

Luting material, surface properties, and loading conditions affect the retention of prefabricated dowels to varying degrees.

PURPOSE

The purpose of this study was to evaluate the effect of roughening of the dentinal walls and artificial aging on the retention of prefabricated tapered titanium dowels, using 4 different luting materials.

MATERIAL AND METHODS

One-hundred twenty-eight single-rooted teeth were selected, the coronal aspect of each tooth was removed, and the remaining root received endodontic therapy. All specimens were divided into 4 groups (n=32). Dowel spaces were prepared to a depth of 10 mm using ISO 90 rotary cutting instruments. Tapered titanium dowels were luted with the following luting materials: zinc-phosphate cement (Harvard cement), glass-ionomer cement (Ketac Cem EasyMix), resin composite luting agent (Panavia 21) with autopolymerizing dentin primer (ED-Primer), or a self-adhesive composite luting agent (RelyX Unicem). Both composite luting agents were used without acid etching of the canal dentin. Each luting agent was used under 2 conditions: in 1 subgroup (n=16) the dentinal walls were not roughened, and in the other subgroup (n=16), walls were roughened with a diamond rotary cutting instrument. Eight specimens from each subgroup were stored in water at 37 degrees C for 3 days; the other 8 specimens were stored for 150 days and subjected to simulated aging conditions using 37,500 thermal cycles (5 degrees C/55 degrees C) and 300,000 mechanical loading cycles with 30 N. Dowel retention (N) was measured using a universal testing machine with a crosshead speed of 2 mm/min. Data were analyzed using 2- and 3-way ANOVAs and the Tukey HSD test (alpha=.05).

RESULTS

The dislodged dowels were examined microscopically to evaluate mode of failure. The nonroughened dentinal walls showed no significant differences between the different luting agents. Roughening the dentinal walls increased the retention significantly for all groups. This increase was significantly higher for the resin composite groups (P=.0001). Storage for 150 days with thermal cycling and mechanical loading caused a significant decrease in dowel retention (P=.001). The failure mode was purely adhesive at the luting material-dentin interface for all dowels cemented in nonroughened root canals. A mixed failure mode, adhesive at the luting material-dentin interface and cohesive in the luting material, was observed for dowels cemented in roughened root canals.

CONCLUSION

Roughening the dentinal walls and the use of resin luting cements provided statistically significant increases in dowel retention values.