Thermal cycling procedures for laboratory testing of dental restorations

Synergistic effect of graphene oxide/calcium phosphate nanofiller in a dentin adhesive on its dentin bond integrity and degree of conversion. A scanning electron microscopy, energy dispersive X-ray spectroscopy, Fourier transform infrared, micro-Raman, and bond strength study

The objective was to formulate and analyze a dentin adhesive incorporated with graphene oxide (GO) nanoparticle and calcium phosphate (CaP) composite. Methods comprising of scanning electron microscopy (SEM)-energy dispersive X-ray spectroscopy (EDX), micro-Raman spectroscopy, shear bond strength (SBS), and Fourier transform infrared (FTIR) spectroscopy were used to characterize nanoparticle composite, dentin bond toughness, degree of conversion (DC), and adhesive-dentin interaction. Postsynthesis of GO nanoparticles, they were functionalized with CaP using standard process. The GO-CaP composite was not added to experimental adhesive (negative control group, GO-CaP-0%), and added at 2.5 and 5 wt% to yield GO-CaP-2.5% and GO-CaP 5% groups, respectively. Teeth were set to form bonded samples utilizing adhesives in three groups for SBS testing, with and without thermocycling. The homogenous diffusion of GO-CaP composite was verified in the adhesive. Resin tags having standard penetrations were observed on SEM micrographs. The EDX analysis confirmed the occurrence of calcium, phosphorus, and carbon ions in the composite containing adhesives. The SBS test revealed highest mean values for GO-CaP-5% followed by GO-CaP-2.5%. The FTIR spectra verified the presence of apatite peaks and the micro-Raman spectra showed characteristic D and G bands for GO nanoparticles. GO-CaP composite in dentin adhesive may improve its bond strength. The addition of 5 wt% resulted in a bond strength that was superior to all other groups. GO-CaP-5% group demonstrated lower DC (to control), uniform distribution of GO and CaP composite within adhesive, appropriate dentin interaction, and resin tag formation.

3D printing of dental restorations: Mechanical properties of thermoplastic polymer materials

In the seminal field of 3D printing of dental restorations, the time and cost saving manufacturing of removable and fixed dental prostheses from thermoplastic polymer materials employing fused filament fabrication (FFF) is gaining momentum. As of today, the additive manufacturing of the established semi-crystalline polyetheretherketone (PEEK) requires extensive post-processing and lacks precision. In this context, the amorphous polyphenylene sulfone (PPSU) may provide a higher predictability and reliability of the results. The aim of this study was to investigate the mechanical properties of PPSU and PEEK processed by FFF (PPSU1-3D (PPSU Radel) and PPSU2-3D (Ultrason P 3010 NAT)) or extrusion (PPSU1-EX (Radel R-5000 NT) and PEEK-CG (PEEK Juvora)). Three-point flexural strength, two-body wear, and Martens hardness (HM) and indentation modulus (E_IT) were tested after aging. One-way ANOVA, the Kruskal-Wallis and the Pearson's and Spearman's correlation tests were computed (α = 0.05). PPSU1-3D and PPSU2-3D showed lower flexural strength values than PPSU1-EX and PEEK-CG. PPSU1-3D showed the highest, and PEEK-CG and PPSU1-EX the lowest height loss. The highest HM and E_IT results were observed for PEEK-CG and the lowest for PPSU1-3D. Correlations were observed between all parameters except for the application height. In conclusion, the manufacturing process affected the flexural strength of PPSU, with 3D printed specimens presenting lower values than specimens cut from prefabricated molded material. This finding indicates that the 3D printing parameters employed for the additive manufacturing of PPSU specimens in the present investigation require further optimization. For 3D printed specimens, the quality of the filament showed an impact on the mechanical properties, underlining the importance of adhering to high quality standards during filament fabrication. Extruded PPSU led to comparable results with PEEK for flexural strength and two-body wear, indicating this novel dental restorative material to be a suitable alternative to the established PEEK for the manufacturing of both removable and fixed dental prostheses.

Optical analysis of the behavior of sealants under mechanical, thermal and chemical stress

Regarding their resistance five sealants were tested in vitro after experiencing mechanical, thermal and chemical stress. Included for testing were two fluoride varnishes: Fluor Protector [FP] (Ivoclar Vivadent) and Protecto CaF2 Nano One-Step Seal [PN] (BonaDent) and three fluoride-composite filled sealants (with acid etch technique): Clinpro XT Varnish [CP] (3 M Espe), Pro Seal [PS] & Light Bond [LB] (Reliance Orthodontic Products) and a positive control group [CG] Tetric EvoFlow (Ivoclar Vivadent). The sealants were applied on 180 bovine teeth (n = 10/ sealer) in a standardized manner after bracket bonding. Mechanical pressure and its effect by simulating different time points and standardized electric cleaning protocol was tested first. Followed by thermal burden due to varying thermal stress and thirdly change in pH stress imitating chemical exposure were examined separately. A digital microscope and a grid incisal and apical to the brackets (n = 32 fields) was used to standardize the optical analysis. Material loss due to mechanical stress compared to CG (score 0.00) was CP (1.2%), FP (21.5%), LB (22.2%) and PN (81.1%). No significant difference to CG presented PS. Material loss due to thermal stress was CP (0.5%), PS (2%), FP (2.6%), LB (3.1%) and PN (39.9%). Material loss due to chemical stress was FP (1.8%), PS (2.1%), LB (5.5%) and PN (39.6%). No significant difference to CG presented CP. Only PS and CP had optically provable, good resiliance to mechanical, thermal and chemical stress. Significantly poorer outcomes in particular showed PN.

Dentin Bond Integrity of Filled and Unfilled Resin Adhesive Enhanced with Silica Nanoparticles-An SEM, EDX, Micro-Raman, FTIR and Micro-Tensile Bond Strength Study

The objective of this study was to synthesize and assess unfilled and filled (silica nanoparticles) dentin adhesive polymer. Methods encompassing scanning electron microscopy (SEM)-namely, energy dispersive X-ray spectroscopy (EDX), micro-tensile bond strength (µTBS) test, Fourier transform infrared (FTIR), and micro-Raman spectroscopy-were utilized to investigate Si particles' shape and incorporation, dentin bond toughness, degree of conversion (DC), and adhesive-dentin interaction. The Si particles were incorporated in the experimental adhesive (EA) at 0, 5, 10, and 15 wt. % to yield Si-EA-0% (negative control group), Si-EA-5%, Si-EA-10%, and Si-EA-15% groups, respectively. Teeth were set to form bonded samples using adhesives in four groups for µTBS testing, with and without aging. Si particles were spherical shaped and resin tags having standard penetrations were detected on SEM micrographs. The EDX analysis confirmed the occurrence of Si in the adhesive groups (maximum in the Si-EA-15% group). Micro-Raman spectroscopy revealed the presence of characteristic peaks at 638, 802, and 1300 cm^-1 for the Si particles. The µTBS test revealed the highest mean values for Si-EA-15% followed by Si-EA-10%. The greatest DC was appreciated for the control group trailed by the Si-EA-5% group. The addition of Si particles of 15 and 10 wt. % in dentin adhesive showed improved bond strength. The addition of 15 wt. % resulted in a bond strength that was superior to all other groups. The Si-EA-15% group demonstrated acceptable DC, suitable dentin interaction, and resin tag formation.

Influence of Ceramic and Substrate Types on the Microleakage of Aged Porcelain Laminate Veneers

Objective

To evaluate the effects of the type of ceramic, and the influence of the type of cervical substrate on the microleakage of aged Porcelain laminate veneers (PLVs).

Materials and Methods

A total of 48 sound human maxillary premolars were divided randomly into two groups (n=24), Group A: lithium disilicate PLVs; Group B: zirconia reinforced lithium silicate PLVs. The groups were further subdivided into four subgroups (n=12): (A1, B1): finishing line placed in Class V composite filling; (A2, B2): finishing line placed in sound enamel. In subgroups A1 and B1 standardized Class V cavities were prepared and restored with nanocomposite. Standardized PLVs tooth preparation was done for the specimens in all subgroups. Cementation of PLVs was done with a light cured resin cement and specimens were stored in distilled water for 2 weeks. Mechanical load cycling (45,000 cycle, 49 N at 2.5 Hz) and thermocycling procedure (500 cycles, 5–55°C) were done. A microleakage test was done with dye penetration (2% methylene blue) and the microleakage percentage was recorded and calculated using a stereomicroscope and ImageJ program.

Results

Means of microleakage percentage of the subgroups were: A1 (6.6075%), A2 (4.6058%), B1 (7.3158%), and B2 (6.105%), Two-way ANOVA showed a significant effect of ceramic type and cervical composite substrate. According to samples t-test, subgroup A2 was significantly lower than A1 and B2, while subgroup B2 was significantly lower than B1. A P-value≤0.05 was considered as statistically significant.

Conclusion

The type of ceramic and the type of substrate both affects PLV microleakage. Lithium disilicate PLVs had significantly lower microleakage compared to zirconia reinforced lithium silicate PLVs. Teeth with cervical composite substrate had a significantly higher microleakage compared to teeth with enamel substrate.

Bond strength of conventional, subtractive, and additive manufactured denture bases to soft and hard relining materials

OBJECTIVE

To investigate the tensile and flexural strength of poured, subtractive, and additive manufactured denture base methacrylates bonded to soft and hard relining materials after hydrothermal cycling and microwave irradiation.

METHODS

This study included a conventional (CB), subtractive (SB), and additive (AB) base material as well as a soft (SCR) and hard (HCR) chairside and one hard laboratory-side (HLR) relining material. Reference bodies of the base materials and bonded specimens to the relining materials were produced with a rectangular cross-section. The specimens were either pre-treated by water storage (50 h, 37 °C), hydrothermal cycling (5000 cycles, 5 °C and 55 °C, 30 s each), or microwave irradiation (6 cycles, 640 W, 3 min, wet). A tensile and four-point bending test were performed for a total of 504 specimens. Data were analysed using multivariate analysis of variance (MANOVA) with post-hoc Tukey tests (α = 0.05).

RESULTS

In comparison with the other reference groups SB showed marginally higher tensile and flexural strength (p < 0.047). Bond strength to SCR was affected neither by the base material nor by the pre-treatment (p > 0.085). HCR demonstrated twice the bond strength to AB compared with SB and CB (p ≤ 0.001). HLR showed the highest bond strength to CB (p ≤ 0.001). There was no difference between the specimens after hydrothermally cycling and microwave irradiation (p > 0.318).

SIGNIFICANCE

The bond strength of hard relining materials to subtractive and additive manufactured denture bases differ compared with conventional pouring.

Microtensile Bond Strength of Etch-and-Rinse Adhesives in Different Hydroabrasion Conditionings

The aim of the present study was to in vitro evaluate the effect of dentin conditioning with hydroabrasion on the microtensile bond strengths of three adhesive systems, compared to the standard etch-and-rinse technique. Sixty extracted human third molars were collected, and their midcoronal occlusal dentin was used for the microtensile bond strength test. Teeth were randomly assigned to three groups according to the adhesive system used: ExciTE F DSC, ENA Bond, and Scotchbond Universal. Specimens from each group were further divided into four subgroups: control specimens were treated with standard adhesive procedures; hydroabraded (HA) specimens were subjected to preventive hydroabrasion with three different intensity levels. After bonding procedures, composite crowns were incrementally built up. After thermocycling, specimens were subsequently sectioned into 1 × 1 mm sticks, and microtensile bond strengths were measured. Data were statistically analyzed. Failure mode analysis was performed. There were no significant differences in terms of bond strength between standard adhesion protocols and adhesion with HA preconditionings. On the other hand, the type of adhesive used had a significant effect on the tensile bond strength. Subgroups treated with hydroabrasion at higher intensity showed a slightly increased frequency of cohesive fractures. In conclusion, hydroabrasion can be used for dentin cavity preparation or finishing, since it does not seem to affect the bonding effectiveness.

Evaluation of physical and adhesive properties of enamel after a therapeutic dose of radiation and bonding of orthodontic metal brackets: an in vitro study

Aim:

The study aimed to evaluate the shear bond strength (SBS) of metal brackets and adhesive properties of bonded irradiated and non-irradiated teeth.

Methods:

Sixty-six extracted premolar samples were randomly divided into three groups—(a) Control group consisting of 22 non-irradiated, non-aged teeth (Group 1), (b) 22 non-irradiated, aged samples (Group 2) and (c) 22 irradiated, aged samples (Group 3). Irradiation was done using gamma irradiation with a fractionated dose of 60 Gy for 5 consecutive days per week over 6 weeks. Metal brackets were bonded on all samples with light cure adhesive and subjected to SBS test using universal testing machine. The samples were assessed under the scanning electron microscope to check for the adhesive remnant index (ARI) and tag depth.

Results:

There was a statistically significant decrease in the mean SBS of the irradiated samples compared to the non-irradiated teeth. The non-irradiated, aged samples showed a majority of ARI scoring 1 and 2. Whereas, the irradiated samples showed ARI scoring 2 and 3. Approximately, 77·3% of the non-irradiated samples showed no adhesive present on the tooth surface, and 27·2% of the irradiated samples had more than 50% adhesive present on the enamel surface.

Conclusion:

There is a statistically significant decrease in SBS of irradiated enamel compared to that of non-irradiated teeth. However, the SBS observed in the three groups was well above the ideal SBS for orthodontic bonding, that is, 5·6–6·8 MPa. The adhesive remnant was found on all samples of the irradiated group. Deeper adhesive resin tags were found in the irradiated group in the resin–enamel interface.

A numerical, theoretical and experimental study of the effect of thermocycling on the matrix-filler interface of dental restorative materials

OBJECTIVE

Thermocycling is widely used to age dental composites but with very different results from one study to another, even with apparent similar conditions. This study aims at understanding better the relative damaging speed of matrix and fillers, based on theoretical models.

METHODS

Eight formulations of an experimental dental material were produced. The same organic matrix was used and silanated barium glass particles were added as fillers with different filler ratios. Samples were thermocycled up to 10 000 cycles. Three-point bending tests were carried out at different steps. The yield stress was measured among other mechanical properties.

RESULTS

Composite properties were degraded by thermocycling. The decrease was slight during the first 5 000 cycles whereas it decreased significantly after 10 000 cycles. The Turcsányi model asserts that the interface yield stress is slightly affected in the first 5 000 cycles and then falls down, while the decrease of matrix yield stress is linear.

SIGNIFICANCE

Each component of a composite does not age at the same rate. First, the matrix acts as a protector until the water finds its way to the interphase. The filler silanization treatment is highly sensitive to hydrolysis and is damaged rapidly from that moment. Numerical simulations and surface observations confirmed that cracks appear to propagate in the neighbourhood of the interface but not directly within it.

Effect of thermocycling on the surface properties of resin-matrix CAD-CAM ceramics after different surface treatments

PURPOSE

To evaluate the effect of thermocycling on the water contact angle (WCA), surface roughness (SR), and microhardness (MH) of resin-matrix computer-assisted design and computer-assisted manufacturing (CAD-CAM) ceramics after different surface treatments (conventional polishing or 2 different surface sealants).

MATERIAL AND METHODS

Two different types of resin-matrix CAD-CAM ceramics; a nanoparticle-filled resin (CeraSmart; CS) and a resin nanoceramic (Lava Ultimate; LU) were tested. Rectangular-shaped plates (1 mm-thick) were divided into 3 groups (n = 8) in terms of surface treatment methods applied: conventional polishing (control) or 2 surface sealants (Optiglaze (OG) and Palaseal (PS)). Scanning electron microscope images ( × 1000 and × 700 magnifications) of each material were taken from 2 additional specimens before surface treatments. After surface treatments, WCAs of deionized water, SR, and MH values of specimens were measured. All specimens were subjected to 5000 thermocycling and measurements were repeated. SR, WCA, and MH data before and after thermocycling were compared by using a 2-way ANOVA (α=.05).

RESULTS

A significant interaction was found between the surface treatment and the material for WCA after thermocycling (P < .001), for SR before thermocycling (P = .014), and for MH both before and after thermocycling (P < .001). SEM images before surface treatments revealed that the surface of CS was mechanically rougher with a more microretentive topography compared with the surface of LU. No significant correlation was found between SR and WCA (P > 0.05).

CONCLUSIONS

Thermocycling affected the SR, MH, and WCA of all resin-matrix CAD-CAM ceramics.

Photon-Induced Photoacoustic Streaming Activation of the Postbleaching Antioxidant Application Rapidly Improves Bonding to Pulp Chamber Dentin

Objective: This study explored whether the erbium/yttrium/aluminum/garnet (Er:YAG) laser irradiated through the photon-induced photoacoustic streaming (PIPS) method would impact on the resin bonding to pulp chamber dentin when used to activate bleaching and/or postbleaching antioxidant treatment. Materials and methods: One hundred five dentin samples prepared from freshly extracted human incisors were randomly assigned to seven groups (n = 15): control (no bleaching/antioxidant); CB (conventional bleaching only); MB (modified bleaching only); CB-NI (conventional bleaching+antioxidant with needle irrigation); MB-NI (modified bleaching+antioxidant with needle irrigation); CB-PIPSI (conventional bleaching+antioxidant with PIPS-activated irrigation); and MB-PIPSI (modified bleaching+antioxidant with PIPS-activated irrigation). Bleaching (40% hydrogen peroxide) lasted for 20 min. Modified bleaching groups were irradiated with Er:YAG laser using the PIPS tip (2940 nm, 0.90 W, 30 Hz, 30 mJ/pulse, 50-μsec pulse duration) during the first 60 sec of the procedure. The antioxidant treatment with 10% sodium ascorbate lasted for 60 sec. PIPS-activated antioxidant groups were irradiated with Er:YAG laser using the PIPS tip (2940 nm, 0.30 W, 15 Hz, 20 mJ per pulse, 50-μsec pulse duration) throughout the procedure. After completing the composite restorations, all samples were subjected to 5000 thermocycling and the shear bond strength (SBS) test at a crosshead speed of 1 mm/min. SBS data were analyzed using the Kruskal-Wallis test with Bonferroni correction (α& 0.05). Results: No significant difference was detected among the control, CB-PIPSI, and MB-PIPSI (p > 0.05), which presented a significantly higher SBS compared with the other groups (p < 0.05). Conclusions: Irrespective of the application mode of the initial bleaching, PIPS-activated irrigation of the antioxidant improved SBS to bleached dentin to the level of the control in 1 min. Postbleaching antioxidant treatment combined with the PIPS method might be a promising approach to enable immediate resin restoration of bleached dentin.

Edge chipping resistance of veneering composite resins

OBJECTIVES

To investigate the edge chipping resistance (ECR) of six veneering composite resins after different treatment protocols.

MATERIALS AND METHODS

Rectangular bar specimens were manufactured from Ceramage Incisal (CER; Shofu), dialog Vario Occlusal (DIA; Schütz Dental), Gradia Plus Heavy Body Enamel (GRA; GC Europe), in:joy incisal (INJ; Dentsply Sirona Deutschland), SR Nexco Paste Incisal (SRN; Ivoclar Vivadent), and Signum composite enamel (SIG; Kulzer). ECR was determined after five treatment protocols: (1) no treatment, (2) after storage in distilled water at 37 °C for 7 days, (3) storage in distilled water with an additional 10 000 thermal cycles (5 °C/55 °C), and hydrothermal treatment at 134 °C at a water vapor pressure of 0.2 MPa for a duration of (4) 3.5 min or (5) 23.5 min. Force was applied with the universal testing machine ZHU 0.2 (Zwick Roell) mounted with a Vickers diamond indenter until the chip fractured off the specimen and ECR values were computed by dividing the applied maximum force by the distance to the center of the applied force. Fracture analysis was performed employing light microscope imaging. Univariate and one-way ANOVA, Scheffé and Tukey-B post hoc, and partial eta squared (ƞ_p²) were computed (p < 0.05).

RESULTS

DIA presented consistently high ECR values, while CER showed low results. For some groups, seven days' storage in water and hydrothermal treatment for 3.5 min led to higher ECR results than observed in the initial state, while an additional 10 000 thermal cycles and hydrothermal treatment for 23.5 min resulted in lower ECR values.

CONCLUSIONS

The examined veneering composite resins differed in regard to their mechanical properties, with DIA possessing the highest resistance to chipping. While post-processing can initially increase a material's edge chipping resistance, intensified treatment protocols reduced the mechanical properties of veneering composite resins.

Aging Methods-An Evaluation of Their Influence on Bond Strength

Objectives  To evaluate the effect of different artificial aging methods on the bond strength of a resin composite associated with a universal adhesive (Scotchbond Universal) used under two etching approaches (self-etch [SE] or etch-and-rinse [ER]) to enamel and dentin substrates.

Materials and Methods  A total of 96 noncarious human third molars were prepared and randomly divided according to three factors ( n = 6): substrate (enamel and dentin), adhesive approach (SE and ER), and aging method (water storage for 24 hours, 6 months, or 1 year; subjected to 10,000, 20,000, or 30,000 thermal cycles; and sodium hypochlorite [NaOCl] storage for 1 or 5 hours).

Statistical Analysis  Microshear bond strength tests were conducted, and the collected data (MPa) were subjected to three-way analysis of variance (ANOVA) with post hoc Bonferroni tests ( p < 0.05) and Weibull analysis. The failure pattern was also evaluated.

Results  Three-way ANOVA revealed that the factors “substrate” ( p = 0.00) and “aging method” ( p = 0.00) had a significant effect on the bond strength, but the factor “adhesive approach” did not ( p = 0.84). The bond strength in the enamel group for the SE approach was negatively affected under 20,000 and 30,000 thermal cycles. Weibull presented the highest m in the NaOCl storage for the 5 hours group to enamel using the SE and to dentin using ER approaches. Adhesive/mixed failures were predominant for all groups.

Conclusion  Thermocycling aging (20,000 and 30,000 cycles) significantly reduced the bond strength to enamel using the SE approach. On the contrary, storage with the NaOCl method proved to increase bond strength under the evaluated conditions.

Effect of in vitro aging and acidic storage on color, translucency, and contrast ratio of monolithic zirconia and lithium disilicate ceramics

STATEMENT OF PROBLEM

How the translucency and color of ceramic restorations are affected by surface changes from the corrosive environment in the oral cavity and aging of materials is unclear.

PURPOSE

The purpose of this in vitro study was to compare the impact of acidic exposure and aging on the color and translucency of monolithic zirconia and lithium disilicate ceramics.

MATERIAL AND METHODS

Twenty computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic zirconia specimens and 20 pressed lithium disilicate specimens were fabricated. Half of the specimens of each group were aged in an autoclave (7.5 hours, 134 °C, 0.2 MPa), and the rest were immersed in hydrochloric acid to simulate the acidic conditions in the oral cavity from gastric reflux. The color coordinates L∗, a∗, and b∗ were measured with an ultraviolet spectrophotometer before and after aging or acidic storage. The translucency parameters and contrast ratios were calculated, and the CIEDE2000 color difference formula was used to determine color differences before and after each treatment. ANOVA and ANCOVA test models were used for data analysis (α=.05), while differences of color parameters in respect to acceptability and perceptibility thresholds were evaluated with the 1-sample t test (α=.05).

RESULTS

Lithium disilicate presented a significantly higher translucency parameter and lower contrast ratio at baseline compared with monolithic zirconia specimens (P<.001). Acidic storage significantly impacted all parameters compared with aging, especially for the lithium disilicate group. Color differences were above the acceptability ΔΕ₀₀ threshold for lithium disilicate after acidic storage (P=.001) and below for monolithic zirconia after acidic storage (P=.003).

CONCLUSIONS

The performance of lithium disilicate was slightly inferior compared with that of monolithic zirconia specimens, as they presented significant and clinically observable differences for the translucency parameter and ΔΕ₀₀ after acidic storage and aging.

In vitro investigation of the influence of printing direction on the flexural strength, flexural modulus and fractographic analysis of 3D-printed temporary materials

The aim of this in vitro study was to evaluate the effect of printing direction and aging on the mechanical strength of 3D-printed temporary resin-based composites. Three hundred and sixty specimens (2×2×25 mm³) out of three materials were DLP printed. Specimens were either stored in distilled water for 24 h at 37°C or additionally subjected to thermocycling. Flexural strength (FS) and flexural modulus (FM) were evaluated in a three-point bending test considering three printing directions. Fractography was carried out by light microscopy, surfaces were categorized according to fracture origin. FS ranged from 93.2 to 159.9 MPa and 76.8 to 135.1 MPa in nonaged and aged specimens in the material sequence: Freeprint temp<Nextdentc&b<3Delta temp. Printing direction exerted a strong influence on 3Delta temp (ηp²=0.407) and had an influence on fracture origin in Freeprint temp aged (p=0.009) and 3Delta temp (p=0.042) nonaged specimens. The effects of printing direction on FS were material dependent and lower than the effects of aging.

Durable Oral Biofilm Resistance of 3D-Printed Dental Base Polymers Containing Zwitterionic Materials

Poly(methyl methacralyate) (PMMA) has long been used in dentistry as a base polymer for dentures, and it is recently being used for the 3D printing of dental materials. Despite its many advantages, its susceptibility to microbial colonization remains to be overcome. In this study, the interface between 3D-printed PMMA specimens and oral salivary biofilm was studied following the addition of zwitterionic materials, 2-methacryloyloxyethyl phosphorylcholine (MPC) or sulfobetaine methacrylate (SB). A significant reduction in bacterial and biofilm adhesions was observed following the addition of MPC or SB, owing to their protein-repellent properties, and there were no significant differences between the two test materials. Although the mechanical properties of the tested materials were degraded, the statistical value of the reduction was minimal and all the properties fulfilled the requirements set by the International Standard, ISO 20795-2. Additionally, both the test materials maintained their resistance to biofilm when subjected to hydrothermal fatigue, with no further deterioration of the mechanical properties. Thus, novel 3D-printable PMMA incorporated with MPC or SB shows durable oral salivary biofilm resistance with maintenance of the physical and mechanical properties.

Shear bond strength of the adhesive/dentin interface after different etching protocols

Background:

Aim:

Materials and Methods:

Results:

Conclusion:

Aging behavior of high-translucent CAD/CAM resin-based composite blocks

OBJECTIVE

The aim of this study was to investigate the influence of artificial aging on the mechanical properties and fracture patterns of novel CAD/CAM resin-based composite blocks (RCB).

METHODS

Flexural strength and modulus of RCBs from seven manufacturers (Voco, Grandio Blocs, GB; Ivoclar Vivadent, Tetric®CAD, TC; DMG, Luxacam Composite, LC; Shofu Block HC, SF; 3M, Lava™ Ultimate, LU; GC, Cerasmart®, CS; Coltene, BRILLIANT Crios, CB) were assessed in a three-point-bending test after an aging process consisting of three sequential steps (14 days storage in artificial saliva, 10,000 thermo-cycles in distilled water between 5/55 °C, 48 h storage in ethanol 75%). Fracture origins were determined in a fractographic examination using reflected light stereomicroscopy combined with transillumination and scanning electron microscopy. Effects of aging were statistically analysed using one-way ANOVA with Tukey's HSD post hoc test (α = 0.05) and Weibull statistics. Correlations regarding filler amount were analysed using linear regression analysis.

RESULTS

The strongest influence on the flexural modulus and strength was exerted based on the parameter material (p < 0.001, ɳ_P² = 0.957; ɳ_P² = 0.770), but the influence of in vitro aging was also significant (p < 0.001, ɳ_P² = 0.623; ɳ_P² = 0.407). Storage in artificial saliva decreased the flexural modulus and flexural strength of all materials, apart from CS, significantly (p < 0.05). The Weibull moduli varied from 5.8 to 22.4. Filler amount correlated significantly with flexural modulus (p < 0.001; R² = 0.739). Fractography revealed four different fracture patterns with fracture origins from the corner, edge or sub-surface and a smooth fracture surface with non-identifiable fracture origin. Specimens with smooth fracture surface showed the significantly lowest flexural strength (p < 0.001). Pores, agglomerates and inclusions were identified as fracture origins.

CONCLUSIONS

Storage in artificial saliva mainly reduced the mechanical properties significantly while additional thermal aging mostly maintained the results. Aging in ethanol mostly maintained the results for flexural modulus but led to an increase in flexural strength values to the level of the unaged specimens. Fractographic analysis revealed a significant accumulation of sub-surface fracture origins after storage in ethanol arising from inherent flaws.

Influence of Sandblasting Particle Size and Pressure on Resin Bonding Durability to Zirconia: A Residual Stress Study

The influence of residual stress induced by sandblasting the zirconia ceramic surface on the resin bonding to the ceramic is still unclear. The effect of four different sandblasting conditions (with 50 and 110 μm alumina at pressures of 0.2 and 0.4 MPa) on the bonding of adhesive resin cement (Panavia F 2.0) to zirconia (Cercon^® ht) was investigated in terms of residual stress. The surface roughness and water contact angle of the zirconia surfaces were measured. The tetragonal-to-monoclinic (t-m) phase transformation and residual stresses (sin²ψ method) were studied by X-ray diffraction. The resin-bonded zirconia specimens were subjected to shear bond strength (SBS) tests before and after thermocycling (10,000 and 30,000 cycles) (n = 10). As the particle size and pressure increased, the roughness gradually and significantly increased (p = 0.023). However, there were no significant differences in roughness-corrected contact angle among all the sandblasted groups (p > 0.05). As the particle size and pressure increased, the m-phase/(t-phase + m-phase) ratios and compressive residual stresses gradually increased. After thermocycling, there were no significant differences in SBS among the sandblasted zirconia groups (p > 0.05). In conclusion, increased surface roughness and residual stress do not directly affect the resin bonding durability.

Interface between calcium silicate cement and adhesive systems according to adhesive families and cement maturation

Objectives

This study aimed to evaluate the interface between a calcium silicate cement (CSC), Biodentine and dental adhesives in terms of sealing ability.

Materials and Methods

Microleakage test: 160 standardized class II cavities were prepared on 80 extracted human molars. The cavities were filled with Biodentine and then divided into 2 experimental groups according to the time of restoration: composite resin obturation 15 minutes after Biodentine handling (D0); restoration after 7 days (D7). Each group was then divided into 8 subgroups (n = 5) according to the adhesive system used: etch-and-rinse adhesive (Prime & Bond); self-etch adhesive 2 steps (Optibond XTR and Clearfil SE Bond); self-etch adhesive 1 step (Xeno III, G-aenial Bond, and Clearfil Tri-S Bond); and universal used as etch-and-rinse or self-etch (ScotchBond Universal ER or SE). After thermocycling, the teeth were immersed in a silver nitrate solution, stained, longitudinally sectioned, and the Biodentine/adhesive percolation was quantified. Scanning electron microscopic observations: Biodentine/adhesive interfaces were observed.

Results

A tendency towards less microleakage was observed when Biodentine was etched (2.47%) and when restorations were done without delay (D0: 4.31%, D7: 6.78%), but this was not significant. The adhesives containing 10-methacryloyloxydecyl dihydrogen phosphate monomer showed the most stable results at both times studied. All Biodentine/adhesive interfaces were homogeneous and regular.

Conclusions

The good sealing of the CSC/adhesive interface is not a function of the system adhesive family used or the cement maturation before restoration. Biodentine can be used as a dentine substitute.

Repair bond strength and surface topography of resin-ceramic and ceramic restorative blocks treated by laser and conventional surface treatments

This study intended to compare the repair bond strength of computer-aided design/computer-aided manufacturing (CAD/CAM) blocks consisting of resin and feldspathic ceramics following different surface treatments using the microtensile bond strength (μTBS) test. Ten specimens were prepared with 4 mm height for Vita Enamic (VE), Lava Ultimate (LU), Vita Mark II (VM), and thermocycled (10,000 cycle, 5-55°C). Each material was categorized into one of five subgroups according to following surface treatments: (a) bur grinding (BG), (b) hydrofluoric acid etching (HF), (c) neodymium-doped yttrium aluminum garnet (Nd:YAG or NY), (d) erbium-doped yttrium aluminum garnet (Er:YAG or EY), and (e) erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG or ECY) laser conditioning. After surface treatment procedures, specimens were properly restored to 4 mm high with a micro-hybrid composite resin. Bar specimens (1 × 1 × 8 mm) were obtained using a low-speed cutting machine and then thermocycled (10,000 cycle, 5-55°C). The μTBS was tested at 1 mm/min crosshead speed, and failure modes were evaluated. Data were analyzed with two-way ANOVA and post hoc Tukey tests. LU-BG showed significantly higher μTBS (32.94 ± 5.80 MPa) compared to LU-laser groups (p < .05). VE-BG showed significantly higher μTBS (22.06 ± 4.26 MPa) compared to other VE groups (p < .05). Among the laser groups, the NY laser produced the lowest (p < .05) μTBS for LU (13.42 ± 3.44 MPa) and VE (2.27 ± 0.85 MPa), while EY showed the highest (p < .05). Laser-treated VM groups were all prefailured. VM-HF produced a higher μTBS (18.73 ± 3.75 MPa) than VM-BG (5.05 ± 1.76 MPa) (p < .05).

Effect of different surface treatments and multimode adhesive application on the Weibull characteristics, wettability, surface topography and adhesion to CAD/CAM lithium disilicate ceramic

This paper aims to evaluate the effect of different surface treatments on surface topography, wettability, and shear bond strength of resin cement to glass ceramic.

Effect of Methacryloyloxydecyl Dihydrogen Phosphate–Containing Silane and Adhesive Used Alone or in Combination on the Bond Strength and Chemical Interaction With Zirconia Ceramics Under Thermal Aging

Clinical Relevance

Achieving durable bonding to zirconia is fundamental for the application of a methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane solution or an MDP-containing silane solution associated with an MDP-containing universal adhesive.

SUMMARY

Objectives: To evaluate the effect of a methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane coupling agent and universal adhesive, used alone or in combination, on the microshear bond strength (μSBS) to zirconia after 24 hours of water storage (24h) and after 10,000 thermocycles (TC), complemented with chemical analysis of the surface to establish the presence of MDP on the surface of the zirconia after bonding procedures.

Methods and Materials: Thirty computer-aided design/computed-aided manufacturing blocks of zirconia were cut into four sections (6×6×6 mm) and sintered. Zirconia sections (n=96) were assigned to 24 groups according to three factors: 1) silane (no silane, Monobond S [MBS], Monobond P [MB+]), 2) adhesive + resin cement (no adhesive + Enforce [ENF], no adhesive + RelyX Ultimate [REX], Prime&Bond Elect + Enforce [PBE/ENF], Scotchbond Universal + RelyX Ultimate [SBU/REX]), and 3) thermocycling (no thermocycling [24h], 10,000 thermocycles [TC]). Upon silane/adhesive application, cylinder-shaped matrices were filled with resin cement and light cured. Specimens were tested in μSBS (1.0 mm/min) after 24h or TC. The μSBS data were analyzed using twoway ANOVA and Tukey’s post hoc test (α=0.05). In addition, micro-Raman spectroscopy was used to analyze the zirconia surface for immediate chemical interaction analysis (n=24).

Results: For the 24h condition, PBE/ENF resulted in lower mean μSBS than both groups with silane without PBE (MBS and MB+ groups; p&lt;0.001). SBU alone or MB+ alone and MB+ associated with SBU showed the highest mean μSBS (p&lt;0.001). For the TC condition, all groups showed a significant decrease in mean μSBS compared with those of 24h (p&lt;0.001), with the exception of MB+ associated to SBU (p&gt;0.05). However, the application of MB+ alone or MB+ associated to SBU resulted in higher mean μSBS (p&lt;0.001) after TC than the remaining TC groups. In terms of chemical interaction, only the SBU groups, alone or combined with both of the silane agents, were associated with the methacrylate groups after rinsing.

Conclusions: The results of the current study support the use of an MDP-containing silane solution or an MDP-containing silane solution associated with an MDP-containing universal adhesive for bonding to air-abraded zirconia, as a more stable bonding after thermocycling.

Interfacial Stress and Bond Strength of Bulk-Fill or Conventional Composite Resins to Dentin in Class II Restorations

The aim was to evaluate the microtensile bond strength (mTBS) to dentin and interfacial stress in a class II cavity restored with bulk-fill or conventional composite resins and the margin interfaces. Vertical slot class II cavities in the mesial face, with the gingival end in dentin, were prepared in 72 third molars, being divided into groups (n=24): G1-Tetric N-Ceram; G2-Tetric N-Ceram Bulk-Fill; G3-SonicFill. Clearfil SE Bond adhesive system was used in all groups. Half of the teeth in each group (n=12) were submitted to thermo-mechanical cycling (TMC). Restored teeth (n=9) were cut perpendicular to obtain beams, which were submitted to a mTBS test in an EMIC machine. The cervical margins in dentin of the restored teeth (n=3) were assessed using SEM through epoxy resin replicas as well as the section of the restoration. Interfacial stresses after load application were calculated by 2D finite element analysis. The mTBS means-MPa followed by different letters represent statistical difference by ANOVA and Games-Howell's test (p<0.05): Without TMC: G1-15.68±6.10a; G2-10.08±5.21ab; G3-7.98±3.76b. With TMC: G1-9.70±5.52a; G2-5.79±1.42a; G3-4.37±1.87a. Interfacial stress (MPa) was 4.4 for SonicFill, 3.9 for Tetric N-Ceram, and 3.5 for Tetric N-Ceram Bulk-Fill. SEM images showed continuous margins for all composite resin restorations. It was possible to conclude that SonicFill obtained a slightly higher interfacial stress and lower bond strength to dentin in comparison with Tetric N-Ceram and Tetric N-Ceram Bulk-Fill. Continuous margin interfaces were obtained for Tetric N-Ceram, Tetric N-Ceram Bulk-Fill, and SonicFill. However, voids were observed in the SonicFill restorations.

Flexural strength and crystalline stability of a monolithic translucent zirconia subjected to grinding, polishing and thermal challenges

The objective of this study is to investigate the magnitude of structural degradation of a monolithic translucent zirconia caused by clinically relevant grinding and polishing procedures, when associated or not with low temperature degradation (LTD), induced by accelerated hydrothermal aging using autoclave or thermocycling Ninety disks (Ø12 × 1 mm) were prepared from dental zirconia for monolithic restorations (Vipi Block Zirconn Translucent, Vipi). The specimens were divided into 3 groups (n = 30) according to surface treatment: As Sintered (untreated), Grind (diamond bur), Grind + Polish (diamond bur + polish); and then subdivided according to aging method (n = 10): Baseline (no aging), Autoclave (134°C, 2.2 kgf/cm² pressure for 5 h), and Thermocycling (200,000 cycles, 5°C and 55°C, for 15 s each). Roughness, biaxial flexural strength and percentage of monoclinic phase were evaluated. Regarding surface treatment, the Grind group presented higher roughness and greater flexural strength compared to As Sintered group, while Grind + Polish showed intermediate roughness and flexural strength similar to Grind group. Aging had little effect on roughness, but yielded a significant reduction in flexural strength. Tetragonal to monoclinic phase transformation was observed in all groups, caused by both mechanical stresses (grinding and polishing) and LTD, which was similarly induced by the traditional autoclave method, as well as the thermocycling method The use of diamond burs to grind zirconia surface may result in deleterious effects on the surface quality of monolithic zirconia restorations, yet has a potential toughening effect by phase transformation. However, when zirconia is exposed to LTD, regardless of the surface treatment, degradation of the surface quality and strength are observed.

Interfacial Evaluation of CAD/CAM Resin Inlays on the Cavity Floor Using Swept-source Optical Coherence Tomography

CLINICAL RELEVANCE

When a resin nanoceramic inlay is cemented using self-adhesive cement, a universal dentin adhesive can be applied to the prepared cavity. The application of the adhesive before self-adhesive cement placement provides similar or better interfacial adaptation than without the adhesive.

SUMMARY

Purpose: The first objective of this study was to determine whether the luting material used for computer-aided design and computer-aided manufacture resin nanoceramic inlays affected interfacial adaptation. The second objective was to investigate whether application of a universal dentin adhesive before cementation affected interfacial adaptation. The final objective was to compare the inlay-side and dentin-side interfaces in the cement space.Methods and Materials: Seventy-four class I cavities were prepared on extracted human third molars. Cavities were optically scanned, and resin nanoceramic inlays were milled using Lava Ultimate blocks (3M ESPE). For the control groups, the fabricated inlays were cemented using Panavia V5 (Kuraray Noritake) or FujiCem 2 (GC). For the experimental groups, the teeth were randomly divided into groups I and II. Group I contained four subgroups using different luting materials; in all subgroups, the inlays were cemented and dual cured without pretreatment. Group II contained six subgroups in which inlays were cemented and dual cured after application of a universal dentin adhesive. After thermocycling, interfacial adaptation was measured using swept-source optical coherence tomography (SS-OCT) imaging and statistically compared among groups.Results: Interfacial adaptation was different depending on the luting material used (p<0.05). After application of a universal adhesive, some subgroups showed improved interfacial adaptation (p<0.05). In the comparison of inlay-side and dentin-side interfaces, no difference was found in interfacial adaptation (p>0.05).Conclusions: Interfacial adaptation for resin nanoceramic inlays differed with luting material. For some self-adhesive cements, application of a universal adhesive before cementation improved interfacial adaptation.

Retention force of polyetheretherketone and cobalt-chrome-molybdenum removable dental prosthesis clasps after artificial aging

OBJECTIVES

To examine the retention force of removable dental prosthesis (RDP) clasps made from polyetheretherketone (PEEK) and cobalt-chrome-molybdenum (CoCrMo, control group) after storage in water and artificial aging.

MATERIALS AND METHODS

For each material, 15 Bonwill clasps with retentive buccal and reciprocal lingual arms situated between the second pre- and first molar were manufactured by milling (Dentokeep [PEEKmilled1], NT digital implant technology; breCAM BioHPP Blank [PEEKmilled2], bredent), pressing (BioHPP Granulat for 2 press [PEEKpressed], bredent), or casting (remanium GM 800+ [CoCrMo], Dentaurum); N = 60, n = 15/subgroup. A total of 50 retention force measurements were performed for each specimen per aging level (initial; after storage [30 days, 37 °C] and 10,000 thermal cycles; after storage [60 days, 37 °C] and 20,000 thermal cycles) in a pull-off test. Data were statistically analyzed using one-way ANOVA, post hoc Scheffé and mixed models (p < 0.05).

RESULTS

Initial, PEEKpressed (80.2 ± 35.2) and PEEKmilled1 (98.9 ± 40.3) presented the lowest results, while PEEKmilled2 (170.2 ± 51.8) showed the highest values. After artificial aging, the highest retention force was observed for the control group (131.4 ± 56.8). The influence of artificial aging was significantly higher for PEEK-based materials. While PEEKmilled2 and PEEKpressed showed an initial decline in retention force, all other groups presented no impact or an increase in retention force over a repetitive insertion and removal of the clasps.

CONCLUSIONS

Within the tested PEEK materials, PEEKmilled2 presented superior results than PEEKpressed. Although CoCrMo showed higher values after artificial aging, all materials exhibited sufficient retention to recommend usage under clinical conditions.

CLINICAL RELEVANCE

As RDPs are still employed for a wide range of indications, esthetic alternatives to conventional CoCrMo clasps are sought.

Effect of matrix metalloproteinase inhibitors on microtensile bond strength of dental composite restorations to dentin in use of an etch-and-rinse adhesive system

Aim

This study assesses the effect of matrix metalloproteinases on microtensile bond strength (μTBS) of an etch‐and‐rinse adhesive system.

Methods

This in vitro study evaluated 88 extracted premolars. The teeth were sectioned to expose dentin and were then randomly divided into four groups (n = 22). In group 1 (control), dentin surface was etched, and Adper Single Bond 2 was applied. In groups 2–4, dentin surface was etched and chlorhexidine (CHX), 1‐ethyl‐3‐(3‐dimethylaminopropyl) carbodiimide (EDC), and dimethyl sulfoxide (DMSO) were applied on the surfaces, respectively, and blotted dry. Next, Adper Single Bond 2 was applied and all teeth were built up with Z350 composite. In each group, half the samples immediately and the other half after 10,000 thermal cycles underwent μTBS test. Data were analyzed using ANOVA and Tukey's test (α = .05).

Results

In thermocycled samples, maximum μTBS was noted in CHX group followed by DMSO, EDC, and control group (p < .001). The thermocycled μTBS of composite to dentin was significantly higher in CHX group compared with EDC, DMSO, and control groups (p < .001) but was not significantly different in EDC and DMSO groups (p = .498).

Conclusion

The thermocycled μTBS obtained by the application of CHX, EDC, and DMSO was significantly higher compared with the value to the control group.

Glycerol Phosphate Dimethacrylate: An Alternative Functional Phosphate Ester Monomer to 10-Methacryloyloxydecyl Dihydrogen Phosphate for Enamel Bonding

The bonding performance of a glycerol phosphate dimethacrylate (GPDM)-based, two-step, self-etch (SE) adhesive was experimentally compared to that of 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based universal adhesives in different application modes for enamel bonding. Microtensile bond strength (μTBS) for adhesives bonded to enamel was measured initially (24 h water storage) and after 10 000 thermocycles plus water storage for 30 days. A GPDM-based, two-bottle, two-step, self-etch adhesive (Optibond Versa, OV) and three one-bottle MDP-based universal adhesives, one self-etching (Tetric N Bond Universal, TNBU) and two with etch-and-rinse (E&R) processing (Single Bond Universal (SBU); Clearfil Universal Bond Quick (CUBQ)), were tested. Scanning electron microscopy (SEM) evaluated nanoleakage at the bonding interfaces. A profilometer determined roughnesses of enamel surfaces after phosphoric acid etching, OV priming, or TNBU conditioning. SEM observed the corresponding surface morphology. NMR and X-ray photoelectron spectroscopy (XPS) characterized chemical bonding in hydroxyapatites (HAps) conditioned with the adhesives. Etch-and-rinse samples had significantly stronger bonding than self-etch samples (p < 0.05) irrespective of aging. The μTBS values for initial and aged OV were significantly higher than those of TNBU (p < 0.05). Aging did not significantly decrease μTBS for any sample except TNBU (p < 0.05), but it significantly aggravated nanoleakage. Etch-and-rinse processing resulted in less nanoleakage than self-etching; the OV samples leaked less than TNBU, both before and after aging. Phosphoric acid etching achieved the highest enamel surface roughness, followed by OV primer. Ca-O-P bonds in hydroxyapatite conditioned with TNBU, SBU, and CUBQ were confirmed by NMR, which showed similar results to XPS observations of conditioned hydroxyapatite powders except OV primer. The GPDM-based, two-step, self-etch adhesive can provide higher micromechanical retention potential, bond strength, and durability than the MDP-based universal adhesive in self-etch mode but lower performance than the MDP-based universal adhesive in etch-and-rinse mode. None of the tested adhesives could avoid nanoleakage after aging.

Effects of Bonding Agents on Metal-Ceramic Bond Strength of Co-Cr Alloys Fabricated by Selective Laser Melting

Bonding agents have been developed to improve bond strength between ceramic and Co-Cr metal. The aim of this study was to investigate the influence of two bonding agents on bond strength of Co-Cr metal fabricated by selective laser melting (SLM). Bond strength was determined by a three-point bending test, and the interfaces of the metal and ceramic, before and after the bending test, were observed by optical microscopy and scanning electron microscopy (SEM) to determine the thickness of the oxide layer and amount of ceramic remaining. To analyze the elemental composition of the bonding agents and fractured surfaces, energy dispersive X-ray spectroscopy (EDS) was used. Co-Cr specimens with bonding agent showed significantly higher bond strength than Co-Cr specimens without bonding agents. The fractured surfaces of most specimens showed mixed failure, but failure mode varied according to bonding agent and fabrication type. Specimens from groups treated with bonding agents had significantly higher remaining ceramic fractions on fractured Co-Cr alloys than specimens from groups that did not receive bonding agent. Mass amounts of silicone (Si) and titanium (Ti) on the fractured alloy surfaces were also different among specimens according to method of fabrication and presence of bonding agent. Together, the results suggest that application of bonding agent to 3D printed Co-Cr metal increases bond strength with ceramics.

Microleakage of resin infiltration in artificial white-spot lesions

This study examined the effectiveness of resin infiltration in inhibiting microleakage from artificial white-spot lesions (AWL) in enamel. Fifty sound extracted premolars were selected and randomly divided into five groups (n = 10 each). Group 1 included sound teeth. In contrast, an AWL was created in all specimens in groups 2 to 5, as follows-Group 2: AWL with no treatment; Group 3: AWL treated with resin infiltration; Group 4: AWL treated with resin infiltration and 5,000 cycles of thermocycling; Group 5: AWL treated with resin infiltration and 10,000 cycles of thermocycling. All specimens were then coated with nail varnish, except for a 4 × 4 mm² area on the buccal surface (the measurement area), immersed in 2% methylene blue solution, and sectioned buccolingually. Microleakage was evaluated with a stereomicroscope. Data were analyzed by using the Kruskal-Wallis test and Bonferroni post-hoc correction. Application of resin infiltrant reduced microleakage in AWL. No microleakage was seen in Group 3, and differences between Groups 3, 4, and 5 were not significant (P > 0.05). The resin infiltration technique appears to aid in sealing enamel AWL and may help provide long-term protection against microleakage in enamel AWL.

Primer-Treated Ceramic Bracket Increases Shear Bond Strength on Dental Zirconia Surface

The purpose of this study is to evaluate the shear bond strength (SBS) of a primer-treated ceramic bracket on dental zirconia and to compare it with conventional ceramic bracket bonding on surface-treated zirconia. Sintered and finished dental zirconia was sandblasted. Samples were divided according to the treated surfaces: no treatment (X), ceramic primer on zirconia (Z), ceramic primer on bracket base (B), and ceramic primer on both zirconia and bracket base (ZB). The ceramic bracket was bonded on zirconia and SBS was measured before (T₀) and after 10,000 cycles of thermocycling (T_f). The failed surfaces were examined under field emission scanning electron microscope (FE-SEM), and adhesive remnant index (ARI) was evaluated. SBS was significantly higher in ZB and significantly lower in X in both T₀ and T_f. There was no significant difference between Z and B. In X and B, adhesive failure occurred while ZB showed mixed failures. There was no apparent change in the zirconia surface except for the existence of some adhesive and resin remnants. The application of ceramic primer on the bracket base increased the bonding strength to the level of conventional bonding with fewer adhesive remnants. The highest bonding strength was obtained when the primer-treated bracket was bonded on the primer-treated zirconia.

Influences of Successive Exposure to Bleaching and Fluoride Preparations on the Surface Hardness and Roughness of the Aged Resin Composite Restoratives

Background and Objectives: Surfaces of composite restorations are adversely affected upon bleaching and topical fluoride application. Such a procedure is normally carried out in the presence of restorations already serving in a different oral environment, although previous in vitro studies only considered the freshly-prepared composite specimens for assessment. The current study accordingly aimed to evaluate both the surface hardness and roughness of aged composite restoratives following their successive exposure to bleaching and topical fluoride preparations. Materials and Methods: Disc specimens were prepared from micro-hybrid, nano-filled, flowable and bulk-fill resin composites (groups 1-4, n = 60 each). All specimens were subjected to artificial aging before their intermittent exposure to surface treatment with: none (control), bleach or topical fluoride (subgroups 1-3, n = 20). All surface treatments were interrupted with two periods of 5000 thermal cycles. Specimens' surfaces were then tested for both surface hardness (Vickers hardness number (VHN), n = 10) and roughness (Ra, n = 10). The collected VHNs and Ras were statistically analyzed using two-way ANOVA and Tukey's comparisons at α = 0.05 to confirm the significance of differences between subgroups. Results: None of the tested composites showed differences in surface hardness and roughness between the bleached and the non-treated specimens (p > 0.05), but the bleached flowable composite specimens only were rougher than their control (p < 0.000126). In comparison to the control, fluoride treatment not only reduced the surface hardness of both micro-hybrid (p = 0.000129) and flowable (p = 0.0029) composites, but also increased the surface roughness of all tested composites (p < 0.05). Conclusion: Aged composite restoratives provide minimal surface alterations on successive bleaching and fluoride applications. Flowable resin composite is the most affected by such procedures. Although bleaching seems safe for other types of composites, the successive fluoride application could deteriorate the aged surfaces of the tested resin composites.

The Retentive Strength of Zirconium Oxide Crowns Cemented by Self-Adhesive Resin Cements before and after 6 Months of Aging

The aim of this study was to evaluate the retentive strength of zirconium oxide (yttria-stabilized tetragonal zirconia polycrystals (Y-TZP)) crown-copings treated by combined mechanical and chemical treatments and cemented by four types of self-adhesive resin cements (SARCs) to human prepared teeth, before and after six months of aging in water and thermocycling. A total of 120 molar teeth were mounted, prepared using a standardized protocol and digitally scanned, and Y-TZP copings were produced. Teeth were randomly assigned to four SARC groups. Prior to cementation, the intaglio surfaces of all crowns were sandblasted and then coated with Z-Prime™ Plus (Bisco Dental, Schaumburg, IL, USA). Post cementation, each cement group was subdivided into aged and non-aged groups. After aging, the cemented assemblies were tested for retentive strength using a universal testing machine. Failure analysis was conducted by inspecting all matched debonded surfaces of the teeth and crowns at 3× magnification. Aging treatment did not affect the retentive strength of the Y-TZP crown-copings (p = 0.918). The interaction between cement and aging was statistically significant (p = 0.024). No significant differences in the retentive strengths between the different SARCs were observed pre-aging (p = 0.776), whereas post-aging, Panavia SA (PAN; Kuraray Dental Co Ltd., Osaka, Japan) showed significantly higher strength than RelyX U-200 (RU200; 3M ESPE, Seefeld, Germany). The predominant failure mode was adhesive between the cement and dentin, followed by mixed mode failure.

Evaluation of the Bond Strength and Cytotoxicity of Alkasite Restorative Material

Cention N (CN; Ivoclar Vivadent, Schaan, Liechtenstein), advertised as an alkasite, is a bioactive bulk-fill resin-based composite (BF-RBC) with alkaline fillers. This study evaluated the resin-dentin micro-tensile bond strength (μTBS) and cytotoxicity of CN. Methods: Flat dentin surfaces were obtained, bonded with a universal adhesive, and randomly distributed into two groups. CN (group I) and a flowable BF-RBC, namely, Tetric N-Flow Bulk Fill, Ivoclar Vivadent, Schaan, Liechtenstein (group II), were used. After thermocycling, bonded samples were sectioned into micro-beams for μTBS evaluation. Resin-based composite (RBC) discs with a thickness of 2 and 4 mm were tested on human gingival fibroblast cells (HGFCs). Cytotoxicity was assessed by cell viability and growth using AlamarBlue® (Biosource, Camarillo, CA, USA) over a seven-day period. Independent t-test was utilized to statistically analyze μTBS data, while one- and two-way analysis of variance (ANOVA) and Tukey’s post-hoc tests were utilized to analyze the cell viability data. Results: There was no statistically significant difference (p > 0.05) in the μTBS between the flowable BF-RBC and CN. For both materials, the HGFCs were viable, with constant growing over the seven-day period. Conclusion: CN provided a resin-dentin μTBS that was comparable to that provided by the flowable BF-RBC. Both materials showed acceptable cytotoxicity over the seven-day period at a thickness of both 2 and 4 mm.

Frame Coating of Single-Walled Carbon Nanotubes in Collagen on PET Fibers for Artificial Joint Ligaments

The coating formation technique for artificial knee ligaments was proposed, which provided tight fixation of ligaments of polyethylene terephthalate (PET) fibers as a result of the healing of the bone channel in the short-term period after implantation. The coating is a frame structure of single-walled carbon nanotubes (SWCNT) in a collagen matrix, which is formed by layer-by-layer solidification of an aqueous dispersion of SWCNT with collagen during spin coating and controlled irradiation with IR radiation. Quantum mechanical method SCC DFTB, with a self-consistent charge, was used. It is based on the density functional theory and the tight-binding approximation. The method established the optimal temperature and time for the formation of the equilibrium configurations of the SWCNT/collagen type II complexes to ensure maximum binding energies between the nanotube and the collagen. The highest binding energies were observed in complexes with SWCNT nanometer diameter in comparison with subnanometer SWCNT. The coating had a porous structure-pore size was 0.5-6 μm. The process of reducing the mass and volume of the coating with the initial biodegradation of collagen after contact with blood plasma was demonstrated. This is proved by exceeding the intensity of the SWCNT peaks G and D after contact with the blood serum in the Raman spectrum and by decreasing the intensity of the main collagen bands in the SWCNT/collagen complex frame coating. The number of pores and their size increased to 20 μm. The modification of the PET tape with the SWCNT/collagen coating allowed to increase its hydrophilicity by 1.7 times compared to the original PET fibers and by 1.3 times compared to the collagen coating. A reduced hemolysis level of the PET tape coated with SWCNT/collagen was achieved. The SWCNT/collagen coating provided 2.2 times less hemolysis than an uncoated PET implant. MicroCT showed the effective formation of new bone and dense connective tissue around the implant. A decrease in channel diameter from 2.5 to 1.7 mm was detected at three and, especially, six months after implantation of a PET tape with SWCNT/collagen coating. MicroCT allowed us to identify areas for histological sections, which demonstrated the favorable interaction of the PET tape with the surrounding tissues. In the case of using the PET tape coated with SWCNT/collagen, more active growth of connective tissue with mature collagen fibers in the area of implantation was observed than in the case of only collagen coating. The stimulating effect of SWCNT/collagen on the formation of bone trabeculae around and inside the PET tape was evident in three and six months after implantation. Thus, a PET tape with SWCNT/collagen coating has osteoconductivity as well as a high level of hydrophilicity and hemocompatibility.

Effect of Tribochemical Coating on Composite Repair Strength

Clinical Relevance

Tribochemical treatment of existing composite surfaces is highly effective for composite repair. When repairing an old composite restoration, the clinician should try to use the same composite originally used for the restoration. If the information about the original restoration is not known, a composite with strong mechanical properties should be used for the repair restoration.

SUMMARY

This study evaluated the effect of tribochemical coating on composite-to-composite repair interfacial fracture toughness (iFT). Sixty beam-shaped specimens (21×4×3 ± 0.2 mm) were prepared with a nanofill composite (Filtek Supreme Ultra [FSU]) and a nanohybrid composite (Clearfil Majesty ES-2 [CME]) and aged for 50,000 thermocycles (5°C-55°C, 20-second dwell time) and then sectioned in half. The resulting 120 hemispecimens (60 for each composite) were randomly assigned to different repair methods (n=10): universal adhesive (Clearfil Universal Bond Quick [CUB]), sand-blasting followed by CUB, or tribochemical coating (CoJet, CoJet sand, Espe-Sil, and Visio-Bond). The repair surface was prepared with a diamond bur (Midwest #471271), rinsed, and dried. Each aged composite brand (FSU, CME) was repaired with either the same composite or the opposite composite. All adhesives and composites were light cured with a high-irradiance LED curing light (Elipar DeepCure-S). After postrepair storage in 100% humidity and at 37°C for 24 hours, iFT was measured as KIc (MPa m½). Data were analyzed for statistical significance using two-way analysis of variance (ANOVA) and the Tukey honest significant difference post hoc test (α=0.05). Regardless of the substrate composite, ANOVA showed significant differences for surface treatment (p&lt;0.0001) and repair composite (p&lt;0.0001). Mean iFT values (SD) ranged from 0.91 (0.10) MPa·m½ to 2.68 (0.12) MPa·m½. Repairs made with FSU after CoJet resulted in significantly higher iFT (FSU: 2.68 MPa·m½; CME: 2.21 MPa·m½) when compared to the other experimental groups. The repair iFT was higher with CoJet treatment and when the nanofill composite FSU was used as the repair composite.

Effects of remaining dentin thickness on the bond strength of bleached dentin

Background

The bond strength of resin composites to dentin was reported to be related to either the remaining dentin thickness (RDT) or bleaching treatment. However, information is limited regarding the effects of RDT on the bond strength of bleached dentin. The present study aimed to investigate the effects of RDT on the microshear bond strength (μSBS) of resin cement to bleached dentin.

Methods

A total of 120 dentin specimens were prepared and randomly divided into 2 groups: a bleaching group (group B) and a control group (group C). Hydrogen peroxide with a concentration of 35% (Ultradent, USA) was applied on the dentin surface for 2 × 1 d for group B, while no bleaching treatment was performed for group C. After the treatment, the specimens were finished and polished to obtain different RDTs (2, 1, and 0.5 mm) and divided into 3 groups of 20 specimens each. The bonding procedure was performed using Panavia V5 (Kuraray, Japan) with a bonding area of 0.785 mm². For each group, half of the specimens were subjected to 5000 thermal cycles (subgroup T), while the other half did not receive thermocycling (subgroup N) (n = 10). The specimens were then subjected to the μSBS test using a universal testing machine. Data were analyzed by a three-way analysis of variance (α = 0.05). The fracture modes of the specimens were confirmed with a measuring microscope. Representative specimens with different fracture modes were observed with scanning electron microscopy (SEM).

Results

The μSBS values were significantly affected by bleaching treatment (p < 0.001), whereas no significant effect was observed for thermocycling (p = 0.293). In terms of RDT, a significantly different μSBS value was found among the subgroups with different RDTs in group C (p = 0.003). However, the RDT did not significantly affect the μSBS values of bleached dentin in group B (p = 0.779). The μSBS values were significantly lower in group B than in group C (p < 0.001). A higher percentage of adhesive failure was observed in group B than in group C.

Conclusion

Based on the present findings, it can be concluded that the RDT did not affect the bond strength of resin cement to bleached dentin.

Clinical significance

Since RDT did not affect the bond strength of resin cement to bleached dentin, bonding procedures should not be performed immediately after intracoronal bleaching, even if the dentin is planned to be removed due to a tooth preparation process.

Do hydrothermal aging and microwave sterilization affect the trueness of milled, additive manufactured and injection molded denture bases?

Concepts for digital denture manufacturing are market-available but studies comparing the trueness of such dentures, either milled (MIL) or additive manufactured, compared to injection molded (IM) ones are still limited. Regarding the impact of artificial aging and microwave sterilization on this parameter, no data are available. Therefore, the purpose of this investigation was to assess the trueness of IM, MIL, and stereolithography (SLA) printed denture bases after manufacturing, hydrothermal cycling, and microwave sterilization. Sixteen edentulous maxillary plaster models were poured using a silicone mold and digitized by means of a desktop scanner. For group IM, 16 denture bases were injection molded using these models. For group MIL and SLA, the denture bases were virtually designed and manufactured referring to the digitized data. A total of 48 samples were scanned 1) after manufacturing, 2) after hydrothermal cycling (5-55 °C, N = 5,000), and after 3) three as well as 4) six cycles of microwave sterilization for 6 min each at 640 W. The 3D surface deviation of the total intaglio surface, the palate, the alveolar ridge, and the border seal region was evaluated on the basis of the root mean square estimation (RMSE) and positive and negative mean deviations with an inspection software. For statistical analysis, ANOVA and post hoc Tukey tests were performed (α = 0.05). MIL showed the lowest deviations of the total RMSE (P ≤ .006) compared with the scans of the plaster models. In comparison, IM showed increased, mainly positive, deviations (P = .006) at the border seal. SLA presented the highest total RMSE (P = .001) with increased negative deviations, likewise at the border seal. In contrast to SLA (P = .001), no differences between IM and MIL (P = .816) were measured after hydrothermal cycling. Following microwave sterilization, the trueness of SLA was higher compared to IM and MIL (P = .001), with no differences between MIL and IM (P = .153). Distortion of IM and MIL was measured after the 3rd cycle with no further changes observed thereafter (P ≥ .385). It can be concluded, that subtractive manufacturing of denture bases results in the highest trueness, followed by IM and SLA. In contrast to IM and SLA, hydrothermal cycling did not affect MIL. Solely SLA printed denture bases remained dimensionally stable after microwave sterilization.

Evaluation of Two Resin Composites Having Different Matrix Compositions

This study compared two resin composites with similar filler systems and different matrix compositions. The depth of cure (DoC), polymerization shrinkage, and marginal leakage were evaluated. A Filtek Bulk Fill resin composite (FB) and a Filtek Supreme resin composite (FS) were used. For the DoC and polymerization shrinkage, cylindrical specimens with different thicknesses were prepared. The DoC was attributed to the bottom/top ratios of Vickers microhardness numbers. For polymerization shrinkage, each specimen was firstly scanned using micro-computed tomography (µCT) then cured for 20 s, then for 10 s, and then for 10 s, and they were rescanned between each curing time. Data were processed using the Mimics software. For marginal leakage, standardized 5 mm cavities were prepared in 90 molars. After etching and bonding, materials were packed according to groups: FB-bulk, FB-incremental, and FS-incremental, which were cured for 20, 30, and 40 s, respectively. After thermo-cycling, teeth were stored in 1% methylene blue dye for 24 h and then sectioned and observed for dye penetration. The results showed insignificant differences in the shrinkage and leakage between the different packing techniques and curing times of both materials. In conclusion, the introduction of a novel matrix into resin composite composition enabled bulk-filling in one layer up to 5 mm deep while keeping a tolerable polymerization shrinkage.

Interfacial Fracture Toughness Comparison of Three Indirect Resin Composites to Dentin and Polyether Ether Ketone Polymer

OBJECTIVES

 Advances in laboratory composites and their high wear resistance and fracture toughness have resulted in their growing popularity and increasing use for dental restorations. This study sought to assess the fracture toughness of three indirect composites bonded to dental substrate and polyether ether ketone (PEEK) polymer.

MATERIALS AND METHODS

 This in vitro study was conducted on two groups of dental and polymer substrates. Each substrate was bonded to three indirect composite resins. Sixty blocks (3 × 3 × 12 mm) were made of sound bovine anterior teeth and PEEK polymer. Sixty blocks (3 × 3 × 12 mm) were fabricated of CRIOS (Coltene, Germany), high impact polymer composite (HIPC; Bredent, Germany), and GRADIA (Indirect; GC, Japan) composite resins. Composites were bonded to dentin using Panavia F 2.0 (Kuraray, Japan). For bonding to PEEK, Combo.lign (Bredent) and Visio.Link (Bredent) luting cements were used. In all samples, a single-edge notch was created by a no. 11 surgical blade at the interface. The samples were subjected to 3,500 thermal cycles, and their fracture toughness was measured in a universal testing machine (Zwick/Roell, Germany) by application of four-point flexural load.

STATISTICAL ANALYSIS

 Data were analyzed using one-way analysis of variance, Kruskal-Wallis.

RESULTS

 The fracture toughness of CRIOS-PEEK interface was significantly higher than HIPC-PEEK. The fracture toughness of GRADIA-PEEK was not significantly different from that of HIPC and CRIOS. The fracture toughness of GRADIA-dentin was significantly higher than HIPC-dentin.

CONCLUSION

 Considering the limitations of this study, GRADIA has the highest bond strength to dentin, while CRIOS shows the highest bond strength to PEEK.

Effect of surface treatment on the retention of zirconia crowns to tooth structure after aging

OBJECTIVE

To evaluate the effect of different surface treatments on the retention between zirconia crowns and tooth structure after in vitro aging.

MATERIALS AND METHODS

Human third molars (n = 44) received crown preparations and CAD/CAM zirconia crowns were manufactured. Specimens were divided into two groups: no aging, control (NAC, n = 11) or aging (A, n = 33). NAC were bonded with universal adhesive (UA). Aged specimens were divided into three subgroups (n = 11) according to surface treatment: Control: no abrasion + UA; Alumina: alumina abrasion + UA; Silica: tribochemical silica coating + UA. The crowns were cemented with dual-cure resin cement. Specimens in group A were aged by a combination of mechanical, thermal, and pH cycling. Retention strength values were obtained by tensile tests and results were analyzed by one-way analysis of variance (ANOVA) and Tukey test (P < .05).

RESULTS

Aging decreased the retention strength in control specimens (P < .001). Surface treatment improved the retention strength of aged specimens (P < .001), with similar results between alumina and tribochemical silica coating.

CONCLUSION

The chemical interaction between the universal bonding system and zirconia's surface was not sufficient to withstand artificial aging. Tribochemical silica coating did not promote additional retention in comparison to alumina blasting.

CLINICAL SIGNIFICANCE

The long-term retention of translucent zirconia crowns to tooth structure using phosphate-based materials is improved by means of mechanical surface treatments such as alumina blasting and tribochemical silica coating.