Microtensile bond strength of composite resin to glass-infiltrated alumina composite conditioned with Er,Cr:YSGG laser

Effect of Dentin and Zirconia Surface Treatments with Laser Irradiation Versus Sandblasting on the Bonding Ability of Zirconia

Objective: This study aimed to investigate the effects of laser irradiation applied to zirconia and tooth surfaces on shear bond strength (SBS) compared with acid etching and sandblasting. Background: The effect of laser irradiation on the bond strength between zirconia and adhesives is a controversial issue for dentin surface treatments. In addition, the effects of different combinations of surface treatments to increase adhesion on both the zirconia and dentin surfaces remain unclear. Materials and methods: A total of 90 tooth samples were assigned into groups according to various pretreatments: control group was left untreated, acid etching, and Erbium, Chromium:Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser irradiation group (15 Hz, 2 W). In addition, the zirconia specimens were separated into three groups (n = 10) according to the different surface treatments performed: sandblasting (120 μm Al2O3), Er,Cr:YSGG laser (15 Hz, 2 W), and as untreated surface. The zirconia samples were cemented to the dentin surface using dual-cure resin cement and subjected to an SBS test at a speed of 0.5 mm/min under a universal testing machine until fractures occurred in the bonding surface. Results: The highest SBS values were observed in Group tooth acid (TA)-zirconia Er,Cr:YSGG laser (ZL), followed by Group tooth Er,Cr:YSGG laser (TL)-zirconia sandblasting (ZS) and Group TA-zirconia control (ZC). The lowest SBS values were found in Group TA-ZS. Significant intergroup difference was noted between Group TA-ZL, Group tooth control (TC)-ZC, Group TL-ZS, and Group TC-ZC. However, no significant difference was noted between Group TA-ZL, Group TL-ZS, and Group TA-ZC. Conclusions: Acid etching and laser treatments applied to the dentin and zirconia surfaces were found to be effective techniques for improving the zirconia-dentin bond, respectively. Clinical Trial Registration number: 33216249-604.01.02-E.24308.

Do different protocols affect the success rate or bond strength of glass-ceramics repaired with composite resin? A systematic review and meta-analysis

STATEMENT OF PROBLEM

Intraoral repair techniques prevent unnecessary replacement of ceramic restorations, thereby increasing the survival rate. However, adhesion between ceramics and the composite resin is challenging and how different protocols influence adhesion is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to analyze the influence of different protocols on repairing glass-ceramic surfaces with composite resins.

MATERIAL AND METHODS

PubMed, Scopus, ISI Web of Science, and Embase electronic databases were searched to select studies comparing bond strength values or survival rates of glass-ceramic repaired with composite resins using different surface treatment protocols. No publication year or language restriction was applied. Data sets were extracted from all included studies, and the mean differences calculated. A 95% confidence interval was calculated by using the random effect model (Rev Man 5.4).

RESULTS

The search identified 5037 studies, and 165 were assessed for eligibility. Finally, 123 in vitro studies were included in the systematic review and 48 in the meta-analysis. Considering different glass-ceramics, bond strength tests, and aged or not aged specimens, 37 meta-analyses found the effect of repair protocols: only adhesive, silane plus adhesive alone or preceded by hydrofluoric (HF) acid, airborne-particle abrasion (APA) with Al2O3 particles, silica-coated APA (SCAPA), diamond rotary instrument (DRI), and laser irradiation (LI).

CONCLUSIONS

For feldspathic porcelain, HF acid, APA, SCAPA, or DRI improved the repair micromechanical retention; applying silane is essential to HF-conditioned surfaces but the use of adhesive is optional when silane is applied. Results for leucite and lithium disilicate were inconclusive in terms of suggesting a treatment other than HF acid plus silane and adhesive applications.

Evaluation of bond strength of glass and resin-ceramics with laser phototherapy: A systematic review and meta-analysis of in vitro studies

STATEMENT OF PROBLEM

Laser phototherapy has been studied as a surface treatment capable of increasing the adhesion of cement to the ceramic surface. However, the bond strength of glass and resin-ceramics after laser phototherapy is unclear.

PURPOSE

The objective of this systematic review and meta-analysis was to compare the bond strength of glass and resin-ceramics using laser therapy and conventional hydrofluoric acid etching.

MATERIAL AND METHODS

This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the Open Science Framework (OSF) for in vitro studies. A population, intervention, control, and outcome (PICO) question was formulated: "Does phototherapy promote better bond strength in glass and resin-ceramics than conventional hydrofluoric acid etching?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases up to January 2023. The Joanna Briggs Institute critical assessment guidelines for quasi-experimental studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (α=.05).

RESULTS

A total of 6 in vitro studies published between 2007 and 2019 with a total number of 348 specimens were included for qualitative analysis; 1 study had a positive effect. Five of the studies were included in the meta-analysis, which indicated a significant decrease for feldspathic ceramics that received laser phototherapy and lithium disilicate (P=.002; MD: -2.15; 95% CI: -3.53 to -0.77; I²=89%, P<.01) and (P<.01; MD: -2.13; 95% CI: -2.99 to -1.27; I²=82%, P<.01), respectively.

CONCLUSIONS

Laser irradiation as surface etching of glass ceramics does not produce a bond strength equal to that of conventional hydrofluoric acid etching.

Effect of Er:YAG laser pretreatment on glass-ceramic surface in vitro

This study investigated the feasibility of using an Er:YAG laser to pretreat glass-ceramic surface and evaluate the effect of the treatment on the bonding strength and marginal adaptation between glass-ceramic and dentin. Glass-ceramic samples (CEREC Blocs) and third molars were cut into 6 mm × 6 mm × 2 mm plates. Thirty ceramic plates were randomly divided into 5 groups: group A (control), group B (pretreated with 9.6% hydrofluoric acid [HF]), group C (pretreated with the Er:YAG laser at 300 mJ and 15 Hz), group D (pretreated with the Er:YAG laser at 400 mJ and 15 Hz), and group E (pretreated with the Er:YAG laser at 500 mJ and 15 Hz). The surface morphologies of the samples in each group were studied under a scanning electron microscope, and the sample displaying optimal etching parameters was selected for subsequent experiments. Based on the surface treatments, 30 ceramic and dentin plates were randomly allocated into 3 groups: the control, laser, and acid-etching groups. After bonding a ceramic plate to a dentin plate, the microleakage and bonding strength were measured, and the pretreatment effects of the Er:YAG laser and 9.6% HF were compared. Group E exhibited an etching effect that was more pronounced and uniform than that in groups C and D. Microleakage and bonding strength analyses revealed that the laser and acid-etching groups differed significantly from the control group in dye penetration depth and shear strength (P < 0.05), although the laser and acid-etching groups did not differ from each other. Both 9.6% hydrofluoric acid and Er:YAG laser pretreatments can coarsen glass-ceramic surfaces, improve the marginal adaptation and bonding strength between the glass-ceramic and dentin, and decrease microleakage of the materials. The two treatments showed no apparent differences in pretreatment outcomes.

Comparison of Silane Heat Treatment by Laser and Various Surface Treatments on Microtensile Bond Strength of Composite Resin/Lithium Disilicate

In the current study, we evaluated the effects of heat treatment (by Er:YAG or furnace) and various surface treatments on the microtensile bond strength (μTBS) of silanized lithium disilicate ceramic. Seventy lithium disilicate (IPS e. max Press; Ivoclar Vivadent) and composite resin (Tetric N-Ceram; Ivoclar Vivadent) blocks were made and distributed into seven groups (n = 10) at random: S: silanization alone; ALS: airborne particle abrasion (APA) and silanization; SC: APA modified with silica and silanization; SHT1: silanization and heat treatment by Er:YAG; SHT2: silanization and heat treatment performed in the furnace (100 °C, 1 min); HF: etching with HF; and HFS: etching with HF and silanization. Every ceramic specimen was cemented to a composite resin block after surface treatment. Cemented specimens were embedded into acrylic resin and were tested with the μTBS test. Data were analyzed using one-way ANOVA and Tamhane T2 tests (α = 0.05). The SHT1 group had the highest bond of strength compared to the other groups (27.46 MPa). The ALS group had the lowest strength of the groups (15.56 MPa). Between SHT2 and HFS (p = 1), the comparison of the mean µTBS values showed no significant differences. It was concluded that silane heat treatment increased the resin composite–ceramic bond strength; however, within the terms of μTBS, the Er:YAG laser treatment was more successful than other surface treatment applications.

Evaluation of Efficacy of Various Surface Conditioning Methods on the Repair Bond Strength of Composite to Different Fracture Types of Zirconia Ceramics

The aim of this study was to investigate the effects of different surface treatment methods on shear bond strength between composite resin and different levels of zirconia ceramic. Laser surface-conditioning procedures have been reported as effective method to increase repair bond strength of composite to zirconia ceramics. Detailed information of effects of Er,Cr:YSGG laser treatment with different pulse rates on the zirconia ceramics is lacking in the literature. 120 disc-shaped specimens were prepared including zirconia, veneering ceramic, and 50% veneering ceramic-50% zirconia surfaces. Four different surface treatments were applied to the specimens. These were grinding with diamond bur, sandblasting, and short and long pulse rates of Er,Cr:YSGG laser irradiation. An intraoral ceramic repair kit was used to repair specimens, and shear bond strength was performed on the composite resin to each specimen. The highest mean bond strength was seen in the veneering ceramic surface that was ground using a diamond bur, and the lowest mean bond strength value was observed in the same surface that was treated with long pulse laser irradiation. The sandblasting with alumina particles exhibited lower mean repairing bond strength among the rest of used methods in this study for the group which contained half of the veneering ceramic and half of the zirconia. Sandblasting and Er,Cr:YSGG laser using surface treatment procedures obtained appropriate bond strength for the group that included 50% veneering ceramic-50% zirconia, because of no significant differences observed among the applied surface conditioning methods in this group.

Influence of Er:YAG laser surface treatment on flexural and bond strengths to glass-infiltrated zirconia-reinforced ceramic

To evaluate the effect of Er:YAG laser conditioning of a glass-infiltrated alumina-based zirconia-reinforced ceramic on its flexural strength and on bonding to a resin cement. Sixteen blocks (5 × 5 × 4 mm) and 50 discs (Ø 12 mm, 1 mm thickness) of In-Ceram Zirconia (ICZ) obtained from CAD-CAM blocks were infiltrated with glass. For the microtensile bond strength (μTBS) test, all blocks were treated with aluminum oxide (AOX) and divided into 4 groups (n = 4): G1 (AOX), no combined surface treatment; G2 (ROC), tribochemical silica-coating; G3 (EY200), Er:YAG laser 200 mJ/15 Hz; and G4 (EY250), Er:YAG laser 250 mJ/10 Hz. The ceramic blocks were silanated and cemented with a resin cement (Panavia F2.0/Kuraray) to composite resin blocks and subjected to the μTBS test. For the flexural strength evaluation, the discs were divided into 5 groups (n = 10) as described above, in addition to a control group (G5 - CTRL, mirror-polished without further treatment). Each surface treatment was submitted to qualitative evaluation under SEM. One-way ANOVA (α = 5%) revealed the highest bond strength value for EY200 with no significant difference from ROC. The groups AOX and EY250 showed similar μTBS values that were statistically lower than those of EY200. For flexural strength, ROC was the only group with significantly lower values when compared with the CTRL. The use of Er:YAG laser at 200 mJ/15 Hz can be considered an innovative and effective alternative for surface conditioning of ICZ since it did not reduce the flexural strength of the ceramic and improved the resin cement bond to this substrate.

In Vitro Evaluation of the Effect of Different Surface Treatments of a Hybrid Ceramic on the Microtensile Bond Strength to a Luting Resin Cement

Introduction: The aim of the present study was to investigate the effect of different surface treatments of a hybrid ceramic, Vita Enamic, on the micro-tensile bond strength (µ-TBS) to resin cement. Methods: Ten blocks (3×10×8 mm) were retrieved from the original blocks and divided into 5 groups according to the different surface treatments performed: Groups 1: 35% acid phosphoric for 60 seconds (PA); group 2: Sandblasting with 50 µm Al₂ O₃ particles for 10 seconds (SB); groups 3: 9.5% hydrofluoric acid for 60 seconds (HF), group 4: The Er:YAG laser (2 W, 10 Hz) (ER1), group 5: The Er:YAG laser (3 W, 10 Hz) (ER2). All treated surfaces were salinized and the blocks with similar surface treatments were bonded together using a dual-cured resin cement and light-cured. After 24-hour storage in water, the blocks were cut into beams (1 mm²). Half of the specimens in each group (n=16) were tested immediately and the rest were subjected to thermocycling between 5°C and 55°C for 6000 cycles before the µ-TBS test at a crosshead speed of 0.5 mm/min. The data were analyzed using two-way analysis of variance (ANOVA) and Tukey HSD tests and the significance level was set at 0.05. The failure mode was evaluated by using a stereomicroscope. Results: The µ-TBS was clearly influenced by surface treatment methods (P < 0.001) and thermocycling significantly decreased the bond strength values in all groups (P = 0.007). The highest value (66.07 MPa ± 11.3) was obtained for the HF groups with no thermocycling and the lowest values were observed in the laser groups with no significant difference among different irradiation parameters. Adhesive failure was mainly observed in the PA and SB groups while mixed failure was predominantly shown in the laser and HF groups. Conclusion: This study demonstrated that surface treatment of VE with HF and salinization could improve the bond strength to a dual-cured resin cement, and Er:YAG laser irradiation with the evaluated parameters did not promote the adhesion of the resin cement to VE.

Repair bond strength of composite to Er,Cr:YSGG laser irradiated zirconia and porcelain surfaces

BACKGROUND

Fracture or chipping are major concerning failures of an all-ceramic restoration. Repairing of the failure restoration using intra-oral technique is time saving and cost effective treatment modality. The present study was proposed to evaluate effect of Er,Cr:YSGG laser irradiation on shear bond strength between zirconia/porcelain and composite resin.

METHODS

Thirty zirconia and thirty zirconia based porcelain disc shape specimens were prepared. Three different surface treatment procedure were applied the specimens. For control groups (Group ZC and PC), instruction manual of an intra-oral porcelain repair system was followed. Different pulse rates of Er,Cr:YSGG laser irradiation (short and long pulses) were applied to zirconia and porcelain surfaces for other groups (Group ZS, ZL, PS, and PL). Porcelain repair kit was used to repair specimens using standard cylindrical teflon mold (2 × 2 mm). Repair bond strength of the repaired specimens was tested using a universal testing machine.

RESULTS

Highest mean bond strength value was observed at Group PC that was significantly higher than laser applied porcelain groups. Long pulse laser irradiation illustrated that increased mean bond strength compared to short pulse application on to the porcelain surface. Laser applied zirconia groups showed better mean bond strength than Group ZC, but differences between the groups were not statistically significant.

CONCLUSION

Different modes of Er,Cr:YSGG laser irradiation enhanced repair bond strength of the composite resin to zirconia, but these were not significant. Following the instruction manual for surface treatment on the porcelain surface was better method than Er,Cr:YSGG laser surface conditioning.

Shear Bond Strength Between Zirconia and Veneer Ceramic: Effect of Thermocycling and Laser Treatment

Objective: The purpose of this study is to investigate the effect of various presintering and sintered surface treatments and thermocycling on the bond strength between zirconia and veneer ceramics. Background data: Bond stability between zirconia and veneer ceramic is a major concern, and only limited evidence about its longevity is currently available. Moreover, no study has yet evaluated the influence of thermocycling on the bond strength of veneer ceramic to zirconia after Er,Cr:YSGG laser irradiation at different pulse durations and sandblasting. Materials and methods: In this study, 220 nonsintered zirconia specimens were prepared with CAD/CAM and randomly divided into 2 groups; half of the specimens in each group were stored in water for 1 week, and the other half were thermocycled (5000 cycles) between baths of 5°C and 55°C. Specimens were then divided into five subgroups based on the following surface treatments: control (untreated surface), sandblasting (120 μm Al₂O₃), and Er,Cr: YSGG laser irradiations (3 W-8 Hz, 3 W-15 Hz, and 3 W-20 Hz, MGG 6 laser tip, for 20 sec, distance of 10 mm, water/airflow of 55% and 65%). Morphological assessment was done using atomic force microscopy and scanning electron microscopy, and phase transformation was assessed by X-ray diffractometry. All specimens were then veneered with veneering ceramic, and bond strength test using a universal testing device at a 1 mm/min crosshead speed. Data were evaluated by Kruskal-Wallis variance analysis and the Mann-Whitney U test. Results: There was no significant difference in the bonding strength values among the (p > 0.05). Thermocycling reduced the bond strength, but it was not significant (p > 0.05), except for the presintering 20 Hz group (p < 0.02). Conclusions: Application of thermocycling to sintered zirconia specimens may be detrimental to the shear bond strength of zirconia ceramics. Treating the zirconia surface after sintering is not recommended, due to the decrease in bond strength.

Repair bond strength of resin composite to bilayer dental ceramics

PURPOSE

The purpose of this study was to investigate the effect of various surface treatments (ST) on the shear bond strength of resin composite to three bilayer dental ceramics made by CAD/CAM and two veneering ceramics.

MATERIALS AND METHODS

Three different bilayer dental ceramics and two different veneering ceramics were used (Group A: IPS e.max CAD+IPS e.max Ceram; Group B: IPS e.max ZirCAD+IPS e.max Ceram, Group C: Vita Suprinity+Vita VM11; Group D: IPS e.max Ceram; Group E: Vita VM11). All groups were divided into eight subgroups according to the ST. Then, all test specimens were repaired with a nano hybrid resin composite. Half of the test specimens were subjected to thermocycling procedure and the other half was stored in distilled water at 37℃. Shear bond strength tests for all test specimens were carried out with a universal testing machine.

RESULTS

There were statistically significant differences among the tested surface treatments within the all tested fracture types (P<.005). HF etching showed higher bond strength values in Groups A, C, D, and E than the other tested ST. However, bonding durability of all the surface-treated groups were similar after thermocycling (P>.00125).

CONCLUSION

This study revealed that HF etching for glass ceramics and sandblasting for zirconia ceramics were adequate for repair of all ceramic restorations. The effect of ceramic type exposed on the fracture area was not significant on the repair bond strength of resin composites to different ceramic types.

Effect of Silane Heat Treatment by Laser on the Bond Strength of a Repair Composite to Feldspathic Porcelain

PURPOSE

Ceramic restoration fracture may occur in the oral cavity. Intraoral repair of fractured porcelain could be advantageous to both patient and dentist. The aim of this study was to evaluate the effect of heat treatment of the silane coupling agent by Er:YAG and CO₂ lasers on the microshear bond strength of a repair composite to feldspathic porcelain.

MATERIALS AND METHODS

Sixty ceramic blocks were prepared and randomly divided into six groups (n = 10): (i) HF + silane (HS); (ii) silane + CO₂ laser (SC); (iii) CO₂ laser + silane (CS); (iv) silane + Er:YAG laser (SE); (v) Er:YAG laser + silane (ES); (vi) bur + HF + silane (BuHS). An adhesive resin was applied to the prepared ceramic surfaces and light-cured. Two transparent plastic tubes were placed perpendicularly to each ceramic block. The composite resin was then placed on the treated ceramic surface and light-cured for 40 seconds. The bonded blocks were stored in distilled water at 37°C for 24 hours and subjected to 3000 thermocycles. Microshear bond strength (μSBS) tests were performed using a wire and loop method. Data were analyzed using one-way ANOVA and Duncan's multiple range tests (p ≤ 0.05).

RESULTS

The comparison of the mean μSBS values showed no significant differences between the ES and HS groups (p = 0.914). On the other hand, the specimens in these groups exhibited significantly higher bond strengths than those in the other groups (p < 0.01). The mean μSBS of the BuHS group was statistically similar to that of CS and SE groups (p > 0.05). The μSBS for the SC group was significantly lower than that of the other groups (p < 0.01), with the exception of the CS group (p = 0.674).

CONCLUSIONS

Treatment with Er:YAG laser prior to silane application can be as effective as HF etching. Heat treatment of silane by CO₂ or Er:YAG lasers does not improve the bond strength between feldspathic porcelain and composite resin.

The Bond Strength of Nanohybrid and Nanoceramic Composites to Feldspathic Porcelain

Background:

Porcelain fracture is the most important problem in fixed prosthetic restorations. The replacement of fractured restoraions isn’t often prefer by patients and dentists. Intraoral repair of fractured porcelain is a big alternative for patient and dentist. For this reason, dentists try to improve different surface treatments to increase the bond strength between porcelain and repair materials such as composite resins.

Aims:

The aim of this study was to evaluate the shear bond strength (SBS) of nano-hybrid (Nh.com) and nano-ceramic composite resins (Nc.com) to this feldspathic porcelains (Vita and Ivoclar).

Settings and Design:

120 ceramic disc were fabricated from feldspathic porcelain.

Materials and Methods:

The following surface treatment was applied on the ceramic surface: 1) Hydrofluoric acid+silane, 2) Air-abrasion+silane, 3) Air-abrasion=Control group. Nh.com and Nc.com was placed on the porcelain surface. Half of the specimens were stored in 37 ± 2oC distilled water and another half were subjected to thermocycling before SBS. The samples placed in an universal testing machine and applied shear force until seperation occured.

Statistical Analysis Used:

The data were analyzed by multi-way analysis of variance (ANOVA) and Duncan test (P <0.05).

Results:

The results show that Ivoclar and Vita had almost equal fracture values. Nh.com showed high bond strength than Nc.com. In the Ivoclar porcelain, hydrofluoric acid etching had highest fracture values than other surface treatments, and in the vita porcelain air-abrasion had a little difference from hydrofluoric acid etching.

Conclusions:

Different surface treatments show different effect on SBS between feldspathic porcelain and composite resins.

Microshear bond strength of self-adhesive composite to ceramic after mechanical, chemical and laser surface treatments

Objectives

This study aimed to assess the microshear bond strength of a repairing self-adhesive flowable composite to ceramic after mechanical, chemical and laser treatment of the ceramic surface.

Materials and Methods

Forty zirconia and forty feldspathic ceramic blocks measuring 8 x 8 x 2 mm were fabricated. Feldspathic blocks were divided into four groups of control (1), laser (2780 nm) (2), sandblasting + hydrofluoric (HF) acid + silane (3) and laser (2780 nm) + HF acid + silane (4). Zirconia blocks were also divided into four groups of control (1), laser (2780 nm) (2), sandblasting + Z-Prime Plus (3) and laser (2780 nm) + Z-Prime Plus (4). Vertise Flow composite was bonded to treated ceramic surfaces as a repairing material, then the samples were subjected to 1000 thermal cycles. Repair bond strength was measured by Instron machine and data were analyzed using one-way ANOVA and post hoc test (P < 0.05).

Results

Maximum and minimum bond strength values were observed in zirconia-control (22.57 ± 4.76 MPa) and feldspathic-control (8.65 ± 6.41 MPa) groups, respectively. There was no significant differences between subgroups within the zirconia or feldspathic groups (P > 0.05), however the bond strength of zirconia subgroups was significantly higher than that of feldspathic subgroups.

Conclusion

Vertise Flow provides relatively good bond strength to ceramic even with no surface treatment.

Surface topography and bond strengths of feldspathic porcelain prepared using various sandblasting pressures

OBJECTIVE

The purpose of this study was to determine the bond strength of composite resin to feldspathic porcelain and its surface topography after sandblasting at different pressures.

METHODS

In this in vitro study, 68 porcelain disks were fabricated and randomly divided into four groups of 17. The porcelain surface in group 1 was etched with hydrofluoric acid. Groups 2, 3, and 4 were sandblasted at 2, 3 and 4 bars pressure, respectively. Surface topography of seven samples in each of the four groups was examined by a scanning electron microscope (SEM). The remaining 40 samples received the same silane agent, bonding agent, and composite resin and they were then subjected to 5000 thermal cycles and evaluated for shear bond strength. Data were analyzed using one-way anova. The mode of failure was determined using stereomicroscope and SEM.

RESULTS

The highest shear bond strength was seen in group 4. however, statistically significant differences were not seen between the groups (P = 0.780). The most common mode of failure was cohesive in porcelain. The SEM showed different patterns of hydrofluoric acid etching and sandblasting.

CONCLUSION

Increasing the sandblasting pressure increased the surface roughness of feldspathic porcelain but no difference in bond strength occurred.

Microtensile strength of resin cement bond to indirect composite treated by different output powers of Er:YAG laser

The study aimed to evaluate the effect of different output powers of Er:YAG laser on microtensile bonding strength of indirect composite to resin cements.36 indirect composite blocks (GC Gradia DA2, Japan) size 15 × 10 × 10 mm(3) were constructed, and divided into 12 groups, as follows:G1: control group (no treatment); Groups G2 to G6: treated with Er:YAG laser (2,940 nm) in noncontact mode, frequency 20 Hz, pulse duration 470 µs, with output power ranging from 2W to 6W; Groups G7 sandblasting, Groups 8 to G12: as Groups G2 to G 6 with preparatory sandblasting. One specimen from each group was analyzed by SEM; each specimen was fixed to a specialized metal jig using cyanoacrylate (Mitreapel, Beta Kimya San. Ve TIC, Iran) and debonded under tension with a universal testing machine (Zwick, Germany) at a crosshead speed of 0.5 mm min(-1). Sandblasting and laser can improve bond strength above an energy level of 150 mJ. SEM evaluation of laser-treated specimens showed irregularities and deep undercuts. T test analysis showed no significant difference between sandblasted and non-sandblasted group, with laser output power of 0, 100, or 150 mJ (P = 0.666, P = 0.875, and P =  .069); in the specimens irradiated with energy output of 200, 250, or 300 mJ, sandblasted specimens showed higher bond strength than non-sandblasted ones. The results demonstrate that, in composite resin irradiated with laser at energy output of 200-300 mJ, sandblasting might be a suitable procedure to enhance bond strength of resin cement.

Repair bond strength of composite resin to sandblasted and laser irradiated Y-TZP ceramic surfaces

This study investigated the effects of different surface treatments on the repair bond strength of yttrium-stabilized tetragonal zirconia polycrystalline ceramic (Y-TZP) zirconia to a composite resin. Sixty Y-TZP zirconia specimens were prepared and randomly divided into six groups (n = 10) as follows: Group 1, surface grinding with Cimara grinding bur (control); Group 2, sandblasted with 30 µm silica-coated alumina particles; Group 3, Nd:YAG laser irradiation; Group 4, Er,Cr:YSGG laser irradiation; Group 5, sandblasted + Nd:YAG laser irradiation; and Group 6, sandblasted + Er,Cr:YSGG laser irradiation. After surface treatments, the Cimara(®) System was selected for the repair method and applied to all specimens. A composite resin was built-up on each zirconia surface using a cylindrical mold (5 × 3 mm) and incrementally filled. The repair bond strength was measured with a universal test machine. Data were analyzed using a one-way ANOVA and a Tukey HSD test (p = 0.05). Surface topography after treatments were evaluated by a scanning electron microscope (SEM). Shear bond strength mean values ranged from 15.896 to 18.875 MPa. There was a statistically significant difference between group 3 and the control group (p < 0.05). Also, a significant increase in bond strength values was noted in group 6 (p < 0.05). All surface treatment methods enhanced the repair bond strength of the composite to zirconia; however, there were no significant differences between treatment methods. The results revealed that Nd:YAG laser irradiation along with the combination of sandblasting and Er,Cr:YSGG laser irradiation provided a significant increase in bond strength between the zirconia and composite resin.

Effect of different laser surface treatment on microshear bond strength between zirconia ceramic and resin cement

AIM

The purpose of this study was to evaluate the effect of sandblasting, carbon dioxide (CO₂), and erbium,chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers on the microshear bond strength of zirconia to resin cement.

METHODS

Sixty-one sintered yttria stabilized tetragonal zirconia blocks (10 × 5 × 2 mm) were prepared and divided into four experimental groups (n = 15); one sample was retained as a control. The samples were treated by aluminium oxide air abrasion, CO₂4W, Er,Cr:YSGG 3W, and Er,Cr:YSGG 2W, respectively. One sample from each group and the control sample were analyzed by scanning electron microscope. Panavia F2.0 resin microcylinders were prepared and placed on treated surfaces, light cured, and incubated for 48 h. Microshear bond strength testing was done by a microtensile tester machine, and the type of bond failures were determined by stereomicroscope. Data were analyzed by one-way anova and Tukey's test at a significance level of P < 0.05.

RESULTS

Air abrasion showed the highest microshear bond strength (P < 0.05) among all groups. CO₂and Er,Cr:YSGG 3W laser showed significantly higher bond strength than Er,Cr:YSGG 2W (P < 0.05). Apparent micromechanical roughening and irregularities were seen in the air abrasion-treated samples, and the bond failure was mostly mixed type. In the laser-treated surfaces, the roughness was much less than the air abrasion-treated surfaces, and the mode of failure was almost pure adhesive.

CONCLUSION

Air abrasion has a greater effect than CO₂and Er,Cr:YSGG lasers in the treatment of zirconia ceramic surfaces to enhance the bonding strength of resin cement to zirconia. CO₂laser at 4W and Er,Cr:YSGG laser at only 3-W output power can be regarded as surface treatment options for roughening the zirconia surface to establish better bond strength with resin cements.

Lasers in esthetic dentistry: soft tissue photobiomodulation, hard tissue decontamination, and ceramics conditioning

The increasing concern and the search for conservative dental treatments have resulted in the development of several new technologies. Low and high power lasers can be cited as one of these new technologies. Low power lasers act at cellular level leading to pain reduction, modulation of inflammation, and improvement of tissue healing. High power lasers act by increasing temperature and have the potential to promote microbial reduction and ablation of hard and soft tissues. The clinical application of both low and high power lasers requires specific knowledge concerning laser interaction with biological tissues, so that the correct irradiation protocol can be established. The present case report describes the clinical steps of two metal-ceramic crowns development in a 60-year-old patient. Three different laser wavelengths were applied throughout the treatment with different purposes: Nd:YAG laser (1,064 nm) for dentin decontamination, diode (660 nm) for soft tissue biomodulation, and Er:YAG laser (2,940 nm) for inner ceramic surface conditioning. Lasers were successfully applied in the present case report as coadjutant in the treatment. This coadjutant technology can be a potential tool to assist treatment to reach the final success.

Effect of thermocycling on the bond strength of composite resin to bur and laser treated composite resin

The objective of this study was to investigate the effect of two different surface treatments (Er:YAG laser and bur) and three different numbers of thermal cycling (no aging, 1,000, 5,000, and 10,000 cycles) on the micro-shear bond strength of repaired composite resin. Ninety-six composite blocks (4 mm × 4 mm × 1 mm) obtained with a micromatrix hybrid composite were prepared. The composite blocks were then randomly divided into four groups (n = 24), according to the thermal cycling procedure: (1) stored in distilled water at 37°C for 24 h (control group), (2) 1,000 cycles, (3) 5,000 cycles, and (4) 10,000 cycles. After aging, the blocks were further subdivided into two subgroups (n = 12), according to surface treatment. Bur and laser-treated composite surfaces were treated with an etch&rinse adhesive system. In addition, a microhybrid composite resin was bonded to the surfaces via polyethylene tubing. Specimens were subjected to micro-shear bond strength test by a universal testing machine with a crosshead speed of 0 and 5 mm/min. The data were analyzed using one-way analysis of variance and Tukey tests (α = 0.05) for micro-shear bond strengths. After conducting a bond strength test, it was found that the laser and bur-treated specimens had similar results. Aging with 10,000 thermocycles significantly affected the repair bond strength of composite resins.