Bonding effectiveness of adhesive luting agents to enamel and dentin

Bond strength of two resin cements to dentin after disinfection pretreatment: effects of Er,Cr:YSGG laser compared with chemical antibacterial agent

OBJECTIVE

This study compared the effects of two disinfection procedures (2% chlorhexidine [CHX] solution versus Er,Cr:YSGG laser irradiation) on the shear bond strength of ED primer II/Panavia F2.0 (ED/P) and Excite DSC/Variolink N (Ex/V).

BACKGROUND DATA

Different methods are used for cavity disinfection prior to adhesive cementation, which may influence the bonding ability of resin cements.

METHODS

Flat dentin surfaces were prepared on 100 extracted premolars and randomly divided into 10 groups. In the eight experimental groups, indirect composite samples were cemented with either ED/P or Ex/V under three disinfecting conditions on the dentin surface as follows: (1) CHX application before ED primer II/ after etching, (2) wet laser irradiation (Er,Cr:YSGG laser, 20 Hz, 0.75 W, 15% water +15% air), (3) dry laser irradiation with no water and air cooling. The control groups had no disinfectant application. After 24 h water storage, bond strength test was performed. The data (MPa) were analyzed using two way ANOVA and Tukey tests.

RESULTS

The lowest and highest bond strengths were obtained by dry laser and wet laser (10.18±2.67 and 17.36±2.94 for ED/P, 9.64±2.66 and 20.07±3.36 for Ex/V, respectively). For each cement, two-by-two comparisons of four groups revealed significant differences only for dry laser with others (p<0.001).

CONCLUSIONS

The use of CHX and Er,Cr:YSGG laser at the low fluences with water/air cooling as the antibacterial agents does not adversely influence the bonding ability of the etch-and-rinse and the self-etch cements.

Effects of curing mode and moisture on nanoindentation mechanical properties and bonding of a self-adhesive resin cement to pulp chamber floor

OBJECTIVE

This study aimed to investigate the effect of dentin surface moisture and curing mode on microtensile bond strength (MTBS) and nanoindentation characteristics of a self-adhesive resin cement.

METHODS

Forty-four extracted human molars were distributed into four groups according to dentin surface moisture (dry or wet) and curing mode of the resin cement (light or chemical). Clearfil SA Cement (Kuraray Noritake Dental, Japan) was used for cementation of composite cores to the pulp chamber dentin. The specimens were sectioned into beams for MTBS test at the pulpal floor. Nanoindentation hardness and creep of the cement layer were measured under 100 mN load with 30s hold segment. Data were statistically analyzed using two-way ANOVA and Weibull distribution of MTBS (α=0.05).

RESULTS

Moisture, curing mode or their interaction did not significantly affect mean MTBS values that ranged 17.6-22.6 MPa (p>0.05); however, the lowest characteristic strength was found in moist chemically cured group. Hardness ranged 437-512 MPa, and was not affected by the experimental factors (p>0.05). Nanoindentation creep ranged 9.3-10.9% with the chemically cured groups showing the highest values, indicating lower cross-linking and deformation resistance of their polymer network.

SIGNIFICANCE

Additional moisture on dentin surface did not contribute to adhesion of the anhydrous self-adhesive resin cement to dentin. Light-curing, despite attenuation through the composite core, was beneficial and improved nanoindentation creep resistance of the cement. The difference was not, however, reflected in the mean bond strength or hardness values.

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.

In Vitro Shear Bond Strength of Three Self-adhesive Resin Cements and a Resin-Modified Glass Ionomer Cement to Various Prosthodontic Substrates

Objective

To evaluate the shear bond strength (SBS) of three self-adhesive resin cements and a resin-modified glass ionomer cement (RMGIC) to different prosthodontic substrates.

Materials and Methods

The substrates base metal, noble metal, zirconia, ceramic, and resin composite were used for bonding with different cements (n=12). Specimens were placed in a bonding jig, which was filled with one of four cements (RelyX Unicem, Multilink Automix, Maxcem Elite, and FujiCEM Automix). Both light-polymerizing (LP) and self-polymerizing (SP) setting reactions were tested. Shear bond strength was measured at 15 minutes and 24 hours in a testing device at a test speed of 1 mm/min and expressed in MPa. A Student t-test and a one-way analysis of variance (ANOVA) were used to evaluate differences between setting reactions, between testing times, and among cements irrespective of other factors. Generalized linear regression model and Tukey tests were used for multifactorial analysis.

Results

Significantly higher mean SBS were demonstrated for LP mode relative to SP mode (p&lt;0.001) and for 24 hours relative to 15 minutes (p&lt;0.001). Multifactorial analysis revealed that all factors (cement, substrate, and setting reaction) and all their interactions had a significant effect on the bond strength (p&lt;0.001). Resin showed significantly higher SBS than other substrates when bonded to RelyX Unicem and Multilink Automix in LP mode (p&lt;0.05). Overall, FujiCEM demonstrated significantly lower SBS than the three self-adhesive resin cements (p&lt;0.05).

Conclusions

Overall, higher bond strengths were demonstrated for LP relative to SP mode, 24 hours relative to 15 minutes and self-adhesive resin cements compared to the RMGICs. Bond strengths also varied depending on the substrate, indicating that selection of luting cement should be partially dictated by the substrate and the setting reaction.

Degree of conversion of polymer-matrix composite assessed by FTIR analysis

AIMS AND OBJECTIVES

The behavior of polymer-matrix composite is dependent on the degree of conversion. The aim of this study was to evaluate the degree of conversion of two resin cements following storage at 37°C immediately, 24 and 48 hours, and 7 days after light-curing by FTIR analysis.

MATERIALS AND METHODS

The specimens were made in a metallic mold and cured with blue LED with power density of 500 mW/ cm(2) for 30 seconds. The specimens were pulverized, pressed with KBr and analyzed with FTIR following storage times.

STATISTICAL ANALYSIS USED

ANOVA (two-way) and Tukey's post hoc.

RESULTS

To the polymer-matrix composites between 24 and 48 hours does not show a significant increase (p > 0.05), however, the highest values were found after 7 days.

CONCLUSION

The polymer-matrix composites used in this study showed similarity on the degree of conversion and increased of according to the time of storage.

The Effects of Different Adhesive Agents on the Shear Bond Strength of a Self-Adhesive Resin Cement

Purpose

To compare the clinical success of a self-adhesive resin cement used in combination with different adhesive bonding systems with that of a conventional dual-cure resin cement.

Methods

The study was performed with 136 freshly extracted molars embedded in acrylic resin blocks and 136 IPS e.max Press discs. Teeth and discs were randomly divided into four equal groups and cemented together using either RelyX ARC (ARC), RelyX Unicem (Unicem), RelyX Unicem+Adper-Prompt L-pop (L-pop), or RelyX and Unicem+Total-etch (Total-etch). Shear bond strength measurements were obtained before and after thermocycling. Following bond testing, the surfaces of one sample per subgroup (thermocycled and non-thermocycled), were assessed using scanning electron microscopy (SEM).

Results

Among the non-thermocylced subgroups, ARC exhibited the highest bond strength values, followed by Total Etch, Unicem and L-pop. ARC also exhibited the highest bond strength values among the thermocycled subgroups, followed by Unicem, Total-etch, and L-pop. SEM analysis clearly revealed the negative effects of thermo-cycling on the mechanical properties of adhesive agents.

Conclusions

RelyX Unicem may be preferable in many cases because of its simplified application and reduced technique-sensitivity.

Effect of dentin surface modification on the microtensile bond strength of self-adhesive resin cements

PURPOSE

To explore the potential to modify human dentin surface as a means of improving the microtensile bond strength (μTBS) of resin cement to dentin.

MATERIALS AND METHODS

Sound human molars were collected, and their occlusal surfaces were ground flat to expose polished dentin. Indirect composite resin cylinders were cemented to the teeth with RelyX Unicem or G-Cem self-adhesive cements following dentin surface treatments: 6.5% grape-seed extract, 5% glutaraldehyde, or 25% polyacrylic acid and control (no pretreatment). After 24 hours, the teeth were sectioned into beams to produce a cross-sectional area of 1.0 mm(2). Specimens of each group (n = 25) were individually mounted on a jig and placed on a tensile testing machine. A tensile force was applied to failure at a 1 mm/min crosshead speed.

RESULTS

The use of polyacrylic acid on dentin prior to cementation with RelyX Unicem resulted in a statistically significant increase in μTBS compared to the control group (p= 0.0282). Polyacrylic acid (p= 0.0016) or glutaraldehyde (p= 0.0043) resulted in a statistically significant increase in μTBS of G-Cem to dentin when compared to the control group. Treatment with grape-seed extract did not result in a statistically significant increase in μTBS for either cement (p > 0.05).

CONCLUSIONS

Priming dentin surfaces prior to the use of self-adhesive resin cements may be a promising means of improving μTBS. In addition, it was concluded that the results of this study are material dependent as well as being dependent of the type of dentin primer.

Shear bond strength of porcelain laminate veneers to enamel, dentine and enamel-dentine complex bonded with different adhesive luting systems

OBJECTIVES

The aim of this study was to evaluate the shear bond strength of porcelain laminate veneers to 3 different surfaces by means of enamel, dentine, and enamel-dentine complex.

METHODS

One hundred thirty-five extracted human maxillary central teeth were used, and the teeth were randomly divided into 9 groups (n=15). The teeth were prepared with 3 different levels for bonding surfaces of enamel (E), dentine (D), and enamel-dentine complex (E-D). Porcelain discs (IPS e.max Press, Ivoclar Vivadent) of 2mm in thickness and 4mm in diameter were luted to the tooth surfaces by using 2 light-curing (RelyX Veneer [RV], 3M ESPE; Variolink Veneer [VV], Ivoclar Vivadent) and a dual-curing (Variolink II [V2], Ivoclar Vivadent) adhesive systems according to the manufacturers' instructions. Shear bond strength test was performed in a universal testing machine at 0.5mm/min until bonding failure. Failure modes were determined under a stereomicroscope, and fracture surfaces were evaluated with a scanning electron microscope. The data were statistically analysed (SPSS 17.0) (p=0.05).

RESULTS

Group RV-D exhibited the lowest bond strength value (5.42±6.6MPa). There was statistically no difference among RV-D, V2-D (13.78±8.8MPa) and VV-D (13.84±6.2MPa) groups (p>0.05). Group VV-E exhibited the highest bond strength value (24.76±8.8MPa).

CONCLUSIONS

The type of tooth structure affected the shear bond strength of the porcelain laminate veneers to the 3 different types of tooth structures (enamel, dentine, and enamel-dentine complex).

CLINICAL SIGNIFICANCE

When dentine exposure is necessary during preparation, enough sound enamel must be protected as much as possible to maintain a good bonding; to obtain maximum bond strength, preparation margins should be on sound enamel.

1-Year clinical study of indirect resin composite restorations luted with a self-adhesive resin cement: effect of enamel etching

In vitro studies have recommended enamel-etching before luting indirect restorations with self-adhesive resin cement. However, there is no scientific proof that this procedure has any clinical relevance. Thus, the aim of this study was to evaluate the effect of enamel-etching on the marginal quality of indirect composite resin restorations (inlay/onlay) using the self-adhesive cement RelyX Unicem clicker. Forty-two posterior teeth were selected from 25 patients that presented one or two teeth with large restorations in need of replacement. All teeth were prepared by the same operator and impressed with polyvinylsiloxane material. The composite resin restorations were built over plaster casts using the incremental technique with a LED device for light-curing the increments. The inlays/onlays were cemented according to one of the following protocols: 1. Etched group (ETR) - selective enamel phosphoric-acid etching + RelyX Unicem clicker; 2. Non-etched group (NER) - RelyX Unicem clicker alone. Each surface was light-cured for 60 s. Recalls occurred after 1 week (baseline), 6 and 12 months when the teeth were evaluated according to previously established scores (modified USPHS criteria). The clinical analysis showed little or no visible changes in the marginal quality after 1 year, even though a probe could detect all the restorations margins. Statistical analysis (Fisher’s exact test, p<0.05) detected no differences between the groups after 12 months. No restorations failed and no secondary caries were found. Enamel acid etching had no clinical relevance on the marginal quality of indirect composite resin restorations luted with RelyX Unicem clicker after 1 year of follow up.

Influence of matrix metalloproteinase synthetic inhibitors on dentin microtensile bond strength of resin cements

This study evaluated the effect of dentin pretreatment with 2% chlorhexidine (CHX) or 24% ethylenediamine tetra-acetic acid gel (EDTA) on the dentin microtensile bond strength (μTBS) of resin cements. Composite blocks were luted to superficial noncarious human dentin (n=10) using two resin cements (RelyX ARC [ARC] and RelyX U100 [U100]) and three dentin pretreatments (without pretreatment-control, CHX, and EDTA). CHX was applied for 60 seconds on the acid-etched dentin in the ARC/CHX group, and for the same time on smear layer-covered dentin in the U100/CHX group. EDTA was applied for 45 seconds on smear-covered dentin in the U100/EDTA group, and it replaced phosphoric acid conditioning in the ARC/EDTA group for 60 seconds. After storage in water for 24 hours, specimens were prepared for microtensile bond strength testing. The results were submitted to two-way analysis of variance (ANOVA) followed by Tukey test. ARC produced significantly higher μTBS (p<0.05) compared to the U100, except when EDTA was used. For ARC, no pretreatment and CHX produced higher μTBS than EDTA. For U100, EDTA produced higher μTBS; no statistical difference occurred between CHX pretreatment and when no pretreatment was performed. While CHX did not affect immediate dentin bond strength of both cements, EDTA improved bond strength of U100, but it reduced dentin bond strength of ARC.

Effect of oxalate desensitizer on the bonding durability of adhesive resin cements to dentin

PURPOSE

This study investigated whether the tubular occluding effect of oxalate desensitizer (OX) during adhesive cementation improved bonding of a self-etch and two etch-and-rinse resin cements to dentin after 6 months.

METHODS

A flat dentin surface was prepared on 120 extracted premolars, which were randomly divided into six groups of 20 teeth each according to the adhesive resin cement system used: ED primer II/Panavia F2.0, Excite DSC (Ex DSC)/Variolink II, and One-Step Plus (OS Plus)/Duolink, with or without OX (BisBlock) application. After cementation of an indirect composite rod, two subgroups (n=10) were tested after 24 h and 6 months of water storage plus thermocycling, and shear bond strengths were recorded in MPa.

RESULTS

Statistical tests showed that although oxalate had a borderline significant negative effect on initial bonding of ED primer II/Panavia F2.0, it significantly improved bonding durability (p<0.05). OX severely compromised the initial bond strength of Ex DSC/Variolink II (p<0.001) but had no effect on the reduction in bonding after aging. OX was compatible with OS Plus/Duolink and did not affect the loss of bonding strength after 6 months (p>0.05).

CONCLUSION

Combining an oxalate desensitizer with three types of resin cements had different effects on bond strength to dentin after aging, depending on the interaction of oxalate with the adhesive system associated to the resin cement.

Bond Strength Evaluation of Three Self-adhesive Luting Systems Used for Cementing Composite and Porcelain

Although all self-adhesive systems give improved handling and ease of use compared to traditional multi-step adhesive cements, clinicians should still consider self-adhesive cements as a heterogeneous category of luting agents that need to be better classified in terms of bond strength and chemical/mechanical properties.

Frequently asked questions in composite restorative dentistry

With an increasing number of dental practitioners using composite resins as the restorative material of choice, knowledge of terminology, handling properties and restorative techniques are important.

CLINICAL RELEVANCE

This paper addresses many of the questions raised by participants at lectures and courses given by the authors across Europe.

Effect of Dentin-cleaning Techniques on the Shear Bond Strength of Self-adhesive Resin Luting Cement to Dentin

Objective

This in vitro study evaluated the influence of different cleansing techniques on the bond strength of self-adhesive cement to dentin.

Methods and Materials

A total of 33 noncarious human molars were sectioned mesiodistally and embedded in chemically cured resin with the buccal or lingual surfaces facing upward. Superficial dentin was exposed and resin disk provisional restorations were cemented to the dentin surfaces with noneugenol provisional cement and were stored in distilled water at 37°C. After seven days, the provisional restorations were removed and 13 specimens were randomly assigned to each of the five groups (n=13), according to the following cleansing treatments: G1—excavator (control); G2—0.12% chlorhexidine digluconate; G3—40% polyacrylic acid; G4—mixture of flour pumice and water; and G5—sandblasting with 50 μm aluminum oxide particles at a pressure of 87 psi. Resin composite disks (Filtek Supreme Plus, 3M ESPE Dental Products, St Paul, MN, USA) 4.7 (±0.1) mm in diameter and 3.0 (±0.5) mm in height were cemented with self-adhesive cement (RelyX Unicem, 3M ESPE), photocured, and stored in distilled water at 37°C for 24 hours. Shear bond strength testing was conducted using a universal test machine at a crosshead speed of 0.5 mm/min until failure.

Results

Data were analyzed using analysis of variance (ANOVA) and the Tukey-B rank order test. Sandblasting with aluminum oxide (11.32 ± 1.70 MPa) produced significantly higher shear bond strength values compared with any other treatment groups (p&lt;0.05). No significant differences were found between G1-control (7.74 ± 1.72 MPa), G2-chlorhexidine (6.37 ± 1.47 MPa), and G4-pumice (7.33 ± 2.85 MPa) (p&lt;0.05).

Influence of the curing mode on fluoride ion release of self-adhesive resin luting cements in water or during pH-cycling regimen

This study evaluated the effects of curing modes and storage conditions on fluoride release of resin cements. In phase 1, the cumulative fluoride release rate from samples of the resin cements (Panavia F 2.0, RelyX Unicem, MaxCem, and BisCem) was quantified after 15 days storage in water (n=4). In phase 2, the fluoride release profiles from the same materials were analyzed during pH cycling (n=4). In this second phase, fluoride was measured at specific times (one, two, three, five, eight, and 15 days). Disk-shaped specimens were prepared (10 mm × 0.5 mm), and the materials were either light activated or allowed to autopolymerize. For both phases, the fluoride release was measured using a fluoride ion-specific electrode. The fluoride release in water was not affected by the curing mode of RelyX Unicem and Maxcem resin cements. Panavia F. 2.0 and BisCem resin cements, either light cured or autopolymerized modes, released higher amounts of fluoride in water than the other self-adhesive cements. In phase 2, the concentration of fluoride released decreased from the first day of pH cycling until the 15th day for all resin cements, for both curing modes, regardless of the storage solution used (demineralizing/remineralizing). The fluoride release rate during pH cycling by Panavia F 2.0 and MaxCem was not affected by the curing mode. The effect of the curing mode on fluoride ion release in water or during pH cycling was product dependent.

Dual and self-curing potential of self-adhesive resin cements as thin films

In this study, the dual- and self-curing potential of self-adhesive resin cements (SARCs) as thin, clinically-relevant cement films was investigated. The SARCs tested were: BisCem (BSC; Bisco), Maxcem Elite (MXE; Kerr), RelyX Unicem clicker (UNI; 3M ESPE), seT capsule (SET; SDI), and SmartCem 2 (SC2; Dentsply Caulk). The conventional cement RelyX ARC (3M ESPE) was tested as a reference. The degree of conversion (DC) as a function of time was evaluated by real-time Fourier transform infrared spectroscopy with an attenuated total reflectance (ATR) device. The cements were either photoactivated for 40 seconds (dual-cure mode) or not photoactivated (self-cure mode). The cement film thickness was 50 ± 10 μm. The DC (%) was evaluated 1, 5, 10, 15, 20, 25, and 30 minutes after placing the cement on the ATR cell. Data for DC as a function of time were analyzed by two-way repeated measures analysis of variance (ANOVA). DC values at 30 minutes for the self- and dual-cure modes were submitted to one-way ANOVA. Post hoc comparisons were performed using the Student-Newman-Keuls test (p<0.05). The rate and the extent of conversion were lower for the SARCs compared with the conventional cement. Means ± standard deviations (SD) for the dual-cure mode at 30 minutes were: 75 ± 5 (ARC)a, 73 ± 8 (SET)a, 61 ± 4 (MXE)b, 51 ± 9 (BSC)c, 51 ± 4 (UNI)c, and 48 ± 3 (SC2)c, while in the self-cure mode means and SD were 62 ± 6 (ARC)a, 54 ± 3 (MXE)b, 40 ± 6 (SC2)c, 35 ± 2 (UNI)c, 35 ± 3 (SET)c, and 11 ± 3 (BSC)d. The DC for the dual-cure mode was generally higher than the self-cure, irrespective of the time. Discrepancies in DC between the dual- and self-cure modes from 11% to 79% were observed. In conclusion, SARCs may present slower rate of polymerization and lower final DC than conventional resin cements, in either the dual- or self-cure mode.

Bonding of restorative materials to dentin with various luting agents

The aim was to compare eight types of luting agents when used to bond six indirect, laboratory restorative materials to dentin. Cylinders of the six restorative materials (Esteticor Avenir [gold alloy], Tritan [titanium], NobelRondo [feldspathic porcelain], Finesse All-Ceramic [leucite-glass ceramic], Lava [zirconia], and Sinfony [resin composite]) were ground and air-abraded. Cylinders of feldspathic porcelain and glass ceramic were additionally etched with hydrofluoric acid and were silane-treated. The cylinders were luted to ground human dentin with eight luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], and RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37°C for one week, the shear bond strength of the specimens (n=8/group) was measured, and the fracture mode was stereomicroscopically examined. Bond strength data were analyzed with two-factorial analysis of variance (ANOVA) followed by Newman-Keuls' Multiple Range Test (α=0.05). Both the restorative material and the luting agent had a significant effect on bond strength, and significant interaction was noted between the two variables. Zinc phosphate cement and glass ionomer cements produced the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements. Generally, the fracture mode varied markedly with the restorative material. The luting agents had a bigger influence on bond strength between restorative materials and dentin than was seen with the restorative material.

Tensile bond strength of indirect composites luted with three new self-adhesive resin cements to dentin

Objective

The aims of this study were to evaluate the tensile bond strengths between indirect composites and dentin of 3 recently developed self-adhesive resin cements and to determine mode of failure by SEM.

Material and Methods

Exposed dentin surfaces of 70 mandibular third molars were used. Teeth were randomly divided into 7 groups: Group 1 (control group): direct composite resin restoration (Alert) with etch-and-rinse adhesive system (Bond 1 primer/adhesive), Group 2: indirect composite restoration (Estenia) luted with a resin cement (Cement-It) combined with the same etch-and-rinse adhesive, Group 3: direct composite resin restoration with self-etch adhesive system (Nano-Bond), Group 4: indirect composite restoration luted with the resin cement combined with the same self-etch adhesive, Groups 5-7: indirect composite restoration luted with self-adhesive resin cements (RelyX Unicem, Maxcem, and Embrace WetBond, respectively) onto the non-pretreated dentin surfaces. Tensile bond strengths of groups were tested with a universal testing machine at a constant speed of 1 mm/min using a 50 kgf load cell. Results were statistically analyzed by the Student's t-test. The failure modes of all groups were also evaluated.

Results

The indirect composite restorations luted with the self-adhesive resin cements (groups 5-7) showed better results compared to the other groups (p<0.05). Group 4 showed the weakest bond strength (p>0.05). The surfaces of all debonded specimens showed evidence of both adhesive and cohesive failure.

Conclusion

The new universal self-adhesive resins may be considered an alternative for luting indirect composite restorations onto non-pretreated dentin surfaces.

Microleakage and Marginal Gap of Adhesive Cements for Noble Alloy Full Cast Crowns

Very limited comparative information about the microleakage in noble alloy full cast crowns luted with different types of adhesive resin cements is available. The purpose of this study was to evaluate the microleakage and marginal gap of two self-adhesive resin cements with that of other types of adhesive luting cements for noble alloy full cast crowns. Fifty noncarious human premolars and molars were prepared in a standardized manner for full cast crown restorations. Crowns were made from a noble alloy using a standardized technique and randomly cemented with five cementing agents as follows: 1) GC Fuji Plus resin-modified glass ionomer cement, 2) Panavia F 2.0 resin cement, 3) Multilink Sprint self-adhesive resin cement, 4), Rely X Unicem self-adhesive resin cement with pretreatment, and 5) Rely X Unicem with no pretreatment. The specimens were stored in distilled water at 37°C for two weeks and then subjected to thermocycling. They were then placed in a silver nitrate solution, vertically cut in a mesiodistal direction and evaluated for microleakage and marginal gap using a stereomicroscope. Data were analyzed using a nonparametric Kruskal-Wallis test followed by Dunn multiple range test at a p&lt;0.05 level of significance. The Rely X Unicem (with or with no pretreatment) exhibited the smallest degree of microleakage at both tooth-cement and cement-crown interfaces. The greatest amount of microleakage was found for Panavia F 2.0 resin cement followed by GC Fuji Plus at both interfaces. No statistically significant difference in the marginal gap values was found between the cementing agents evaluated (p&gt;0.05). The self-adhesive resin cements provided a much better marginal seal for the noble alloy full cast crowns compared with the resin-modified glass ionomer or dual-cured resin-based cements.

Cements and adhesives for all-ceramic restorations

Dental cements are designed to retain restorations, prefabricated or cast posts and cores, and appliances in a stable, and long-lasting position in the oral environment. Resin-based cements were developed to overcome drawbacks of nonresinous materials, including low strength, high solubility, and opacity. Successful cementation of esthetic restorations depends on appropriate treatment to the tooth substrate and intaglio surface of the restoration, which in turn, depends on the ceramic characteristics. A reliable resin cementation procedure can only be achieved if the operator is aware of the mechanisms involved to perform the cementation and material properties. This article addresses current knowledge of resin cementation concepts, exploring the bonding mechanisms that influence long-term clinical success of all-ceramic systems.

Effect of root-canal sealer on the bond strength of fiberglass post to root dentin

OBJECTIVE

To evaluate the effects of different root-canal sealers on the bond strength of a fiberglass post cemented with self-adhesive resin cements.

MATERIAL AND METHODS

Forty extracted maxillary single-rooted canines were prepared with the crown-down technique and randomly divided into four groups according to the tested sealer: Group 1: control group, gutta-percha cone only (no sealer); Group 2: EndoREZ; Group 3: Sealapex; Group 4: Endofill. The roots were obturated with the gutta-percha cone using the cold lateral compaction technique. Fiberglass posts were cemented into the prepared post spaces with the self-adhesive cement RelyX Unicem. Bonded specimens were sectioned into 1-mm thick slabs and a push-out test was performed in a universal machine.

RESULTS

Data were subjected to ANOVA and Tukey tests (α = 0.05). No significant difference was detected between Groups 1-3 (P > 0.05). Group 4 showed a lower bond strength than the other sealers (P < 0.05).

CONCLUSIONS

Endofill negatively interfered with the bond to root dentine; however, EndoRez and Sealapex did not affect the bond strength of the fiberglass post cemented with self-adhesive resin cements.

Effect of surface preparation on bond strength of resin luting cements to dentin

This study examined the effects of using two different burs for dentin surface preparation on the microtensile bond strength (microTBS) of three resin luting cements. Flat, deep dentin surfaces from 45 extracted human third molars were divided into three groups (n = 15) according to bur type: (i) diamond bur and (ii) tungsten carbide bur. The controls were abraded with #600-grit SiC paper. Both burs operated in a high-speed handpiece under water-cooling. Composite blocks were luted onto the dentin using one of three cements: RelyX ARC (ARC, 3M ESPE), Panavia F2.0 (PF, Kuraray) and RelyX Unicem (UN, 3M ESPE) following the manufacturers' instructions. For ARC, the dentin surface was treated with 32% phosphoric acid. The bonded specimens were stored at 37 degrees C for 24 hours and sectioned into 0.9 x 0.9 mm beams for microTBS testing. The data were analyzed using the two-way ANOVA and Student-Newman-Keuls tests. Representative fractured beams from each group were prepared for fractographic analysis under SEM. Two-way ANOVA revealed that the effects of "dentin surface preparation" and "luting cement" were statistically significant (p < 0.001); however, the interaction of these two factors was not significant (p > 0.05). ARC showed no significant difference in microTBS among the three differently prepared dentin surfaces. The microTBS of PF and UN was significantly lower when bonding to dentin prepared with a diamond bur (p < 0.05), compared to the control. For Panavia F2.0, higher bond strengths were achieved on the dentin surface prepared with a tungsten carbide bur. Proper bur selection is essential to optimizing the dentin adhesion of self-etch resin luting cements.

Effect of resin coating and chlorhexidine on the microleakage of two resin cements after storage

PURPOSE

This study evaluated the effect of resin coating and chlorhexidine (CH) on microleakage of two resin cements (Panavia F2.0, Nexus 2) after water storage.

MATERIALS AND METHODS

Class V cavities were prepared on the facial and lingual surfaces of 120 intact human molars with gingival margins placed 1 mm below the cementoenamel junction. Indirect composite inlays were fabricated. The specimens were randomly assigned into six groups (n = 40). Indirect composite inlays (Gradia) were cemented as follows: Group 1 (control): inlays were cemented with Panavia F2.0 according to the manufacturer's instructions. Group 2: the ED-primed (ED Primer, Kuraray Dental, Tokyo, Japan) dentin was coated with a resin layer before cementation of the inlays with Panavia F2.0. Group 3: a 2% CH solution was applied before bonding with Panavia F2.0. Group 4: after CH application, the primed dentin was coated with a resin layer before cementation with Panavia F2.0. Group 5: (control) after applying Optibond Solo Plus, the inlays were cemented with Nexus 2. Group 6: after etching, CH was applied, and cementation was performed similarly to group 5. Half the specimens in each group were stored in distilled water for 24 hours, while the other half were stored in distilled water for 6 months. After storage, the teeth were placed in 1% methylene blue dye for 24 hours, sectioned, and evaluated under a 20× stereomicroscope. Dye penetration was scored using 0 to 3 criteria. Data were analyzed using nonparametric tests.

RESULTS

Resin coating of ED primer for Panavia F2.0 significantly reduced microleakage at the gingival margins after 6 months (p < 0.05). CH application in Panavia F2.0 did not lead to a significant difference in the microleakage at both margins, after 24 hours and 6 months (p > 0.05). The application of CH showed significantly less microleakage than that of the control group at the gingival margins of Nexus 2 after 6 months. In general, gingival margins showed more microleakage than occlusal margins.

CONCLUSION

An additional resin layer applied to a self-etch cement can improve long-term dentinal sealing for indirect restorations, while CH cannot; however, CH reduces gingival microleakage in an etch-and-rinse cement after aging.

The effect of dentin pretreatment on the microtensile bond strength of self-adhesive resin cements

STATEMENT OF PROBLEM

Self-adhesive cements have lower bond strength than conventional resin cements that rely on the application of etch-and-rinse adhesive systems.

PURPOSE

The purpose of this study was to evaluate the effect of tannic and polyacrylic acid on the microtensile bond strength of self-adhesive resin cements to dentin.

MATERIAL AND METHODS

Eighteen molar crowns were flattened to expose dentin and divided into 3 groups according to the dentin pretreatment: (1) control, without surface treatment; (2) 25% polyacrylic acid solution (Ketac Conditioner); (3) 20% tannic acid. Composite resin (Tescera) blocks were luted to dentin surfaces using 2 self-adhesive resin cements (RelyX Unicem or Maxcem Elite) (n=3). All specimens were stored in distilled water for 24 hours, sectioned into beams (1 mm(2)), and tested to failure using a microtensile method at a crosshead speed of 1 mm/min. The data were statistically analyzed using 2-way ANOVA and Fisher's PLSD tests (α=.05).

RESULTS

The polyacrylic acid significantly improved the microtensile bond strength of RelyX Unicem (14.92 ±4.94 MPa) when compared to the control group (8.35 ±1.99 MPa) and tannic acid treatment (8.38 ±2.67 MPa) (P<.001). Dentin surface treatment did not affect the microtensile bond strength of Maxcem Elite cemented groups (control, 8.45 ±3.21 MPa; polyacrylic acid, 9.53 ±9.95 MPa; tannic acid, 6.89 ±4.45 MPa).

CONCLUSIONS

Dentin pretreatment with polyacrylic acid improved the microtensile bond strength of RelyX Unicem.

The Effect of Tooth-preparation Cleansing Protocol on the Bond Strength of Self-adhesive Resin Cement to Dentin Contaminated with a Hemostatic Agent

After contamination with hemostatic agents, tooth-preparation cleansing protocols using either particle abrasion with low-pressure aluminum oxide particles or phosphoric acid-etching restored bond strengths to pre-contamination levels for a self-adhesive resin cement.