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

The efficacy of Er,Cr:YSGG laser and contemporary universal adhesive systems on composite resin repair bond strength: an in vitro study

The aim of this study is to investigate the repair bond strength of composite resin following three different surface treatments (bur-grinding, silanization, and Er,Cr:YSGG laser irradiation) using various universal adhesives. A total of 160 resin composite specimens, produced in cylindrical form (6 × 2 mm) with a nanohybrid composite resin within metal molds, were subjected to 5000 cycles of aging in a thermocycler. The aged samples were categorized into four groups based on surface treatments: control, bur, silane, and Er,Cr:YSGG laser. Following surface treatments, the specimens underwent repair using the same resin composite and four different adhesive systems: Tokuyama Universal Bond (TUB), Prime Bond Universal (PBU), Gluma Bond Universal (GBU), and Clearfil SE Bond (CSB). Subsequently, the specimens were subjected to shear forces, and statistical analysis was performed using two-way ANOVA and Tukey tests (p < 0.05). The failure modes were examined using a stereomicroscope, and the surface topography of the roughened resin composite was assessed through scanning electron microscopy (SEM). Results indicated that silane + GBU exhibited the highest shear bond strength (SBS) (15.61 MPa) while control + TUB showed the lowest SBS (7.63 MPa). Silane demonstrated significantly higher SBS values (p ≤ 0.05), with no significant difference observed between bur and laser methods (p = 0.998). It is recommended to include an additional silanization step before applying universal adhesive, as it effectively enhances the bond strength of the repaired composite.

The effect of surface treatment and thermal aging on the bonding of clear aligner attachments to provisional resin-based material: shear bond strength analysis

Objectives

The aim of this study is to evaluate the effect of different surface treatments on the shear bond strength (SBS) of clear aligner attachments bonded to Bis-acryl provisional crowns.

Methods

120 cylindrical bisacrylic composite material (ProTemp type) specimens were prepared and divided into six groups (n = 20) based on surface treatment, control: (no treatment); super coarse grit diamond bur, carbide bur, alumina-blasting, non-thermal plasma treatment, and Er:YAG laser treatment. The features of treated surfaces were examined using scanning electron microscopy (SEM). A flowable composite resin (Transbond XT; 3M Unitek) was bonded to the specimens forming the attachment. Half of specimens were subjected to thermal cycling (5,000 cycles). SBS was measured before and after thermal cycling. Each specimen was loaded at the attachment/resin interface at a speed of 0.5 mm/min until failure. The nature of the failure was analyzed using the composite remnants index (CRI). Two-way ANOVA and Tukey HSD were used for data analysis α =  0.5. For CRI scores analysis, Kruskal-Wallis test and Dunn's multiple comparison were used as post-hoc test.

Results

SEM analysis showed that all surface treatments altered surface properties and increase surface bonding area. The specimens treated with plasma, Er:YAG laser, and alumina-blasting had higher SBS values before and after thermal cycling. In comparison to control plasma, Er:YAG laser, and alumina-blasting showed a significant increase in SBS (P < 0.001) while carbide and diamond bur groups showed no significant differences (P > 0.05). Thermal cycling significantly decreased the SBS of control, carbide bur, diamond bur, and Er:YAG laser while no significant effect of alumina-blasting and plasma group. Er:YAG laser and plasma groups significantly exhibited more dominance for scores 2 and score 3 and the absence of score 0.

Conclusion

Alumina-blasting, Er:YAG laser, or non-thermal plasma surface treatments increased the shear bond strength between clear aligner attachments and resin-based restorations.

Evaluation of Tensile Strength of Surgically Absorbable Suture Materials Used in Oral Surgery after Immersion in Different Beverages: An In Vitro Study

Suture materials are natural or synthetic biomaterials used to close tissues together. After surgical procedures in the mouth, the surgical site and the sutures are physically affected by many different factors. This study was conducted to evaluate the effects of frequently consumed beverages on the tensile strength of monofilament PGLA (polyglycolide-co-l-lactide) and multi-filament PGCL (polyglycolide-co-caprolactone) absorbable sutures. In particular, PGLA and PGCL absorbable sutures, which are frequently used in oral surgery, were used to evaluate the change in the strength of suture materials. The suture materials were soaked in tea, coffee, and cola drinks five times a day for 5 min each and the rest of the time in artificial saliva. All suture materials were aged via thermal cycling. Tensile strengths were tested at 0, 3, 7, and 14 days. Mixed ANOVA (four replicates: within-group comparison and two factors: between-group comparison) was performed to evaluate the effects of groups and time on the tension levels of the Tekmon and Vicryl suture materials. Analysis of Variance was used for the within- and between-group comparisons, with the Bonferroni corrected t-test for multiple comparisons. For the PGCL suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2, and at T1 and T2 compared to T0. For the PGLA suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2. There was also a significant decrease in tension level at time T2 in cola compared to T0. The present study demonstrates that beverages significantly decrease the strength of suture materials for 14 days after surgery. In particular, cola decreased the resistance of the PGCL suture material more significantly in the first week when compared to other beverages.

Real-time imaging and quantitative analysis of internal gap formation in bulk-fill and conventional resin composites: An OCT evaluation

BACKGROUND

This study used optical coherence tomography (OCT) to observe real-time internal gap formation in both bulk-fill and conventional resin composites. It aimed to provide a quantitative analysis of variations, addressing the inconclusive nature of microleakage assessment caused by differences in testing methods.

METHODS

Fifty extracted third molars prepared with Class I cavities, were divided into five groups (n = 10). Conventional resin Filtek Z350 XT (FZX) was applied with a double-layer filling of 2 mm per layer. Bulk-fill resins X-tra fil (XTF), Filtek Bulk Fill Posterior Restorative (FBP), Surefil SDR Flow + (SDR), and Filtek Flowable Restorative (FFR) were applied with a single-layer filling of 4 mm. Real-time OCT imaging was conducted during light curing. Post-curing, the entire sample was OCT-scanned. Following this, ImageJ software was used to measure the gap (G1 %). Subsequently, thermal cycling (TC) (5000 times, 5 °C-55 °C) was applied, followed by OCT scanning to calculate the gap (G2 %) and ΔG%. Data were analyzed using two-way repeated measures ANOVA, Kruskal-Wallis test, and Duncan's test (α=0.05).

RESULTS

There was no significant difference in G1 % among the groups (p > 0.05). Following TC, FZX exhibited the highest G2 %, succeeded by FFR, FBP, XTF, and SDR, with SDR demonstrating the lowest G2 % (p < 0.05). FZX showed the highest ΔG% (p < 0.05), while SDR exhibited the lowest ΔG% (p < 0.05).

CONCLUSION

OCT proves to be a promising tool for detecting microleakage. TC exerted a more significant negative impact on conventional resin. Surefil SDR Flow + displayed the least microleakage, both before and after TC.

Effects of dentin bonding agents and silanization on bond strength between 3D printed resin and composite resin

This study aimed to evaluate the effects of dentin bonding agents and silanization on the bond strength between 3D printed resin and composite resin and compare it with a conventional composite resin. 3D printed resin cylinders (PCB) and composite resin substrates (Z250) were prepared and divided into eight subgroups based on the bonding agents used (n=12). The shear bond strength was measured using a universal testing machine, and the failure modes were evaluated. The bond strength was found to vary significantly among the bonding agents and substrate types. Silane application did not significantly improve the bond strength. Among the bonding agents, the universal adhesives exhibited the highest bond strengths for both substrates. Compared to PCB, Z250 demonstrated stronger bonds and exhibited more cohesive failures. Further research is needed to optimize the surface treatments and resin formulations for enhanced bond strength and durability between 3D printed and composite resins.

Comparative evaluation of three materials used for fragment reattachment in uncomplicated crown fracture-An in vitro study using bovine teeth

BACKGROUND/AIMS

The recommended treatment for uncomplicated crown fractures is bonding the fractured fragment or the fragment reattachment. A paucity was identified regarding the studies comparing the efficacy of micro-hybrid and nanohybrid composites in fragment reattachment. Hence, the present study aimed to evaluate and compare three materials for bonding of fragments rehydrated by humidification in teeth with uncomplicated crown fractures.

MATERIAL AND METHODS

Eighty mandibular bovine incisors with similar dimensions and free of any structural deformities were fractured similar to the technique followed in previous studies. Fracture was simulated, fragments, and stumps were coded, stumps were stored in artificial saliva and the fragments were dehydrated at room temperature and pressure. They were randomly assigned to Group-1 (no rehydration), Group-2 (rehydrated and bonded by flowable nanohybrid composite-3M Filtek Supreme Syringe Flowable Composite Resin-A2, Sao Paulo, Brazil), Group-3 (rehydrated and bonded by flowable micro-hybrid composite- Ruby Flow, InciDental, England, United Kingdom), and Group-4 (rehydrated and bonded by light-cured Glass-Ionomer-Cement-Voco Ionoseal, Cuxhaven, Germany). The samples were subjected to a universal testing machine to evaluate the force required to fracture the bonded fragments.

RESULTS

The highest median value of the force required to fracture was recorded for Group 2 (208.4 N) followed by Group 3 (195.2). The force required to fracture the bonded fragments was lowest in Group 4 (67.2 N) which was lower than the negative control (131.4 N). The differences between the observations in Groups 2 and 3 were not found to be statistically significant.

CONCLUSION

The nano and micro-hybrid composites showed greater force required to fracture than fragments bonded by LC-GIC. Dehydrated fragments bonded using nanocomposites performed better than rehydrated fragments bonded by using LC-GIC.

Scoping review: Effect of surface treatments on bond strength of resin composite repair

OBJECTIVE

to evaluate the existing evidence on surface treatment techniques employed in resin composite repair and their effect on the repair short- and long-term bond strength.

DATA AND SOURCE

This scoping review was performed under the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform.

STUDY SELECTION

A systematic search was conducted in PubMed, Embase, and Scopus and grey literature up to September 2022 without language or date restriction. In vitro studies comparing mechanical surface and/or chemical treatments on repair bond strength of resin composite were included. Studies evaluating experimental adhesive systems or resin composites were excluded. Selection of studies and data extraction were performed. Data from selected studies was qualitatively analyzed.

RESULTS

A total of 76 studies were included in the qualitative analysis. Among the mechanical treatments, alumina blasting was the most frequently used, followed by silica coating and diamond bur. As for chemical treatments, dentin bonding systems were the most frequently evaluated, followed by universal adhesive systems and silane/ceramic primer. The combination of mechanical and chemical pre-treatments increased the repair bond strength of resin composite in both short- and long-term simulated aging scenarios. The evidence obtained from the included studies was classified as moderate quality, mainly due to the medium risk of bias observed across most of the studies.

CONCLUSION

The techniques used to treat the surface of resin composites for repair are diverse. Incorporating a combination of mechanical and chemical pre-treatments resulted in superior repair bond strength of resin composite materials under both short- and long-term simulated aging conditions.

CLINICAL SIGNIFICANCE

The analysis of evidence revealed significant variability among protocols for repairing resin composites. Utilizing both mechanical and chemical pre-treatment methods is important for enhancing the bond strength of resin composites during both short- and long-term simulated aging situations.

Mechanical properties, biosafety, and shearing bonding strength of glass fiber-reinforced PEEK composites used as post-core materials

OBJECTIVE

To investigate the mechanical properties, biosafety, and shearing bonding strength of glass fibers-reinforced polyether-ether-ketone (PEEK-GF) for post-core materials.

METHODS

PEEK-GF composites with different glass fiber contents were prepared by extrusion injection and named PEEK-GF30, PEEK-GF40, and PEEK-GF50. Mechanical properties including flexural modulus, flexural strength, Vickers hardness, and compression strength were tested. The cross-sectional morphology was examined using scanning electron microscopy (SEM). Cytotoxicity was studied in vitro with Cell-counting kit-8 (CCK-8). Cell morphology was observed under a microscope. Cell growth on the composites' surfaces was analyzed with DAPI staining. The shearing bonding strength (SBS) of PEEK-GF50 was assessed after applying different pretreatments. Failure modes were evaluated by microscopy. SEM and contact-angle measurements were performed on the surfaces. Statistical analysis was conducted using one-way ANOVA (P < 0.05).

RESULTS

The mechanical properties of PEEK-GF composites improved with increased GF content. The PEEK-GF50 group exhibited flexural modulus (17.4 ± 0.5 GPa) close to that of dentin (18.6 GPa) and showed the highest flexural strength (350.0 ± 2.9 MPa), Vickers hardness (47.6 ± 4.5 HV), and compressive strength (264.0 ± 18.0 MPa). The SEM analysis demonstrated that the PEEK matrix combined well with glass fibers. The CCK-8 results confirmed the biosafety of all groups. DAPI staining indicated that cells were growing well on the composites' surface. The sample that was pretreated with sandblasting and plasma showed the highest SBS (16.0 ± 1.7 MPa).

SIGNIFICANCE

The PEEK-GF composites demonstrated excellent mechanical properties, biosafety, and SBS, and have great potential to serve as post-core materials.

A Comparative Study of the Repair Bond Strength of New Self-Adhesive Restorative Materials With a Resin Composite Material

AIM

The aim of the present study is to compare the repair bond strengths (RBSs) of Cention-N (light-cure and self-cure modes), Equia Forte HT Fil and a nanohybrid resin composite.

MATERIALS AND METHODS

Equia Forte HT Fil (GC, Tokyo, Japan), Cention-N (Ivoclar Vivadent, Schaan, Liechtenstein) and Filtek Z550 (3M ESPE, St Paul, MN, USA) were used in this study. Equia Forte HT Fil (EQF), Cention-N self-cure (CSC), Cention-N light-cure (CLC) and Filtek Z550 (Z550) groups were formed. A total of 40 samples were prepared; 10 samples in each group (n = 10). After the polymerization was completed according to the manufacturer's instructions, the samples were polished with OptiDisc (Kerr Corporation, Orange, USA) for 5 s each, from extra-course to extra-fine. After all samples were stored in 37°C water for 24 h, 10,000 cycles of brushing simulator and thermal cycles were applied to the samples. The samples were prepared in accordance with the selected repair protocol, and microshear bond strength (µSBS) test was performed. Fracture analysis on debonded surfaces was visualized by scanning electron microscopy. The conformity of the data to normal distribution was analyzed by the Shapiro-Wilk test. Multiple comparisons were performed using Dunn's test.

RESULTS

 Z550 showed significantly higher µSBS as compared to the other three groups. There is no difference between CSC, CLC and EQF.

CONCLUSION

The use of Cention-N's self-cure or light-cure mode did not affect the RBS values. The RBS values of Cention-N and Equia Forte HT Fil materials are lower than those of the composite resin material.

Effect of veneering material type and thickness ratio on flexural strength of bi-layered PEEK restorations before and after thermal cycling

OBJECTIVE

The purpose of this study was evaluating the biaxial strength of bi-layered PEEK restorations before and after aging using different veneering materials in different thickness ratios.

MATERIAL AND METHODS

Ninety specimens of thickness 1.5 mm were divided into three groups according to their veneering material. Group (CAD LD): BioHPP discs veneered with CAD milled lithium disilicate (n=30), group (CAD C): BioHPP discs veneered with CAD milled composite (n=30), and group (LC): BioHPP discs veneered with conventionally layered composite (n=30). Each group was subdivided into 3 subgroups (n=10) according to the different thickness ratios between the core and the veneering material (TC:TV). Subgroup 1: TC:TV=1:0.5, subgroup 2: TC:TV=0.7:0.8, and subgroup 3: TC:TV=0.5:1. Half of the specimens of each subgroup were subjected to thermocycling, and the bi-axial flexural strength of all specimens was tested before and after aging. Three-way ANOVA followed by Bonferroni's post hoc test were used for data analysis. The significance level was set at P ≤ 0.05.

RESULTS

Material, thickness ratio, and aging all had a significant effect on biaxial flexural strength. (LC) group had the highest biaxial flexural strength. TC:TV=0.5:1 showed the lowest biaxial flexural strength. All groups showed significant decrease in biaxial flexural strength after aging.

CONCLUSIONS

Veneering material for PEEK together with the thickness ratio between the core and veneering material greatly affect the flexural strength of bi-layered restorations. Thermocycling negatively impacts the flexural strength of PEEK bi-layered restorations.

CLINICAL SIGNIFICANCE

According to the results of that study, PEEK cores are best veneered with conventionally layered composite with core to veneering thickness ratio being 1:0.5.

The effect of different energy levels of the Er: YAG laser on the repair bond strength of a nanohybrid composite resin

This study evaluates the durability of repair microshear bond strength (µSBS) of nanohybrid composite resins which surfaces are treated with different laser parameters and bur. A total of 240 nanohybrid composite resin disk shaped specimens were prepared. Then, specimens were divided into eight test groups as regards to surface treatment types (Erbium (Er:YAG) laser with seven different parameters and bur). Half of the specimens in each group were subjected to 5000 thermal cycling (TC) and the other half to 20,000 TC. Universal testing machine was used for µSBS test. The data were analyzed with a two-way analysis of variance and Tukey test. Among the specimens treated with ER:YAG laser+5000 TC, we detected the highest mean µSBS test values in the subgroups L200 and L250. Among the specimens treated with ER:YAG laser+20,000 TC, the highest mean µSBS test values were seen in the L200 subgroup. The µSBS values after the 20,000 TC were significantly lower than those after 5000 TC for all different treatment types. Thermal cycling and laser energy levels have effects on repair µSBS. Considering the bond strength and durability it seems more effective to use Er:YAG laser at 200 mJ. To repair an aged nanohybrid composite resin, Er:YAG laser surface treatments may provide some benefits by acquiring a reliable bond strength with durability. This study may give information on which parameters are more suitable to use Er:YAG laser for the repair of nanohybrid composite resins.

Comparison of microleakage and shear bond strength of ribbon and twisted wire retainers bonded on human mandibular incisors with two different types of adhesives with and without primer: An in-vitro study

BACKGROUND AND OBJECTIVES

Shear bond strength and microleakage are the success factors of fixed retainers. Recently, primer-free composites were introduced to reduce chair time. The main objectives of this study were to compare the shear bond strength (SBS) and microleakage of GC Ortho Connect^TM Flow (OF) and Transbond^TM XT (TXT) with two types of common retainer wires (0.0175-inch twisted wire and 0.028×.0.008-inch ribbon dead soft wire retainers). The secondary objectives of the study were to compare enamel-adhesive interface and wire-adhesive interface microleakages.

MATERIALS AND METHODS

This in vitro study was conducted on 132 human mandibular incisors (96 for bond strength and 36 for microleakage). The teeth were randomly divided into four groups for use of ribbon and twisted wires with OF and TXT adhesives. The bond strength was measured by a universal testing machine. Microleakage was evaluated by the dye penetration test using 0.05% fuchsine. Data were analysed by two-way ANOVA (alpha=0.05).

RESULTS

No significant difference was noted in bond strength among the four groups (P>0.05). However, the microleakage of OF was significantly higher than that of TXT at both the enamel-adhesive and wire-adhesive interfaces (P<0.001). The microleakage at the wire-adhesive and enamel-adhesive interface was not significantly different in groups 1 and 4 and was significant in group 2 and 3.

CONCLUSION

Type of adhesive significantly affected the microleakage, and OF resulted in higher microleakage than TXT at both the enamel-adhesive and wire-adhesive interfaces. Type of wire had no significant effect on microleakage. Although OF showed comparable SBS to TXT, its higher microleakage may compromise its successful long-term clinical service.

Effect of different surface pretreatment methods on repair bond strength of resin composite subjected to pH-cycling

Objectives: The aim of this study was to evaluate the effect of two different repair methods (Er:YAG laser and bur) with or without silane application on the microtensile bond strength of a nanohybrid resin composite aged with two different aging methods (pH cycling and thermocycling). Material and Method: Resin composite blocks (Clearfil Majesty Esthetic, Kuraray, Japan) were randomly assigned into two groups for aging process: (a) pH cycling (b) thermocycling (5,000 cycles). After aging, the blocks were assigned to one of the following repair procedures: (1) Er:YAG laser (LightWalker STE-E, Fotona Medical Lasers, Ljubljana, Slovenia) (2) Er:YAG laser+silane (3) bur (4) bur+silane and (5) no-pretreatment group and (6) Cohesive control (cohesive strength of the resin). Resin composite (Clearfil Majesty Esthetic) was bonded to the conditioned substrates incrementally and light polymerized. Repaired samples were thermocycled (5.000 cycles). The microtensile bonding test was performed. The data were analyzed using Scheirer-Ray-Hare, Kruskal-Wallis Mann-Whitney U tests, Chi-square and Z tests with Bonferroni correction (p=0.05). Results: No statistically significant difference was found between the aging methods applied to filling material (p=0.821) and the interaction of applied surface treatments and aging (p=0.289). All repair procedures achieved bond strength values higher than the no-pretreatment group but they did not reach the resin composite’s cohesive bond strength. Failure modes distribution was found statistically different according to repair procedure and also aging methods (p

Comparative Analysis of Three Surface Treatments on the Bond Strength of Zirconia to Resin-luting Agents: An In Vitro Study

AIM

To study the impact of three different surface treatments namely sandblasting, silane-coupling agent, and laser on the retention of zirconia prosthesis and bond strength of zirconia to a resin-luting agent.

MATERIALS AND METHODS

Sixty zirconia crowns were fabricated and were divided into four groups of 15 samples each on the basis of surface treatments. A control group with no surface treatment (group A), laser-treated (group B), treatment with silane-coupling agent (group C), and sandblasting with aluminium oxide (Al₂O₃) particles (group D). Testing was then carried out using a universal testing machine (0.5 mm/min crosshead speed). At a point where the crown got separated from the tooth, the reading in kilogram force (kgF) was recorded. The data were collected and analyzed statistically.

RESULTS

Group D produced the highest mean bond strength (17.5233 kgF) followed by group B (10.0067 kgF), group C (8.6907 kgF), and group A (3.3773 kgF). One-way ANOVA test showed a p-value more than 0.05, concluding no significant difference among the groups. Tukey's HSD post hoc test gave the p-value corresponding to the F-statistic of one-way ANOVA lower than 0.01 when intergroup comparison was done confirming a significant difference among the groups.

CONCLUSION

The bond strength significantly increased in the samples treated by sandblasting compared with those treated with laser and silane-coupling agents.

CLINICAL SIGNIFICANCE

The success of a zirconia prosthesis lies on its bonding with the tooth structure. Bond failure leads to loss of function and hence ends up in failure. Selection of the proper surface treatment will not only improve the bond strength but also amplify the retention of zirconia-based prosthesis, thereby reducing the failure of the final prosthesis. It also improves the longevity of the prosthesis and restores the lost function which is the basic clinical aim of a prosthodontic treatment.

Penetration and Adaptation of the Highly Viscous Zinc-Reinforced Glass Ionomer Cement on Contaminated Fissures: An In Vitro Study with SEM Analysis

Objective: To evaluate the penetration and adaptation of highly viscous zinc-reinforced glass ionomer cement (ZRGIC), using a scanning electron microscope (SEM), when applied under various contaminated conditions on grooves and fissures of primary second molars. Materials and Methods: A total of 40 extracted human primary second molars were randomly assigned into five groups (8 teeth each), with different surface conditions (conditioned with 40% polyacrylic acid, dry condition, water contamination, saliva contamination, or saliva contamination and air-drying) on the occlusal surface before placement of zinc-reinforced highly viscous glass ionomer cement with the finger-press technique. After sectioning the teeth, they were subjected to SEM analysis, where four in each group underwent aging by thermocycling and the other four were without aging. ANOVA tests, post hoc analysis, and unpaired t-tests were used for statistical analyses. Results: There was a significant statistical difference in the sealant penetration in the non-aging group, but in the aging group, there was no significant statistical difference in the sealant penetration. On other hand, a significant statistical difference was found in the adaptation between all the groups (p < 0.05). Highly viscous zinc-reinforced glass ionomer fissure sealants have better fissure penetration and more intimate adaptation under fissures conditioned with 40% polyacrylic acid and dry surface fissures with no contamination. However, the best penetration and retention after aging were under contaminated fissures with a shiny layer of saliva. Conclusions: The ZRGIC is a highly viscous fluoride-releasing cement, effectively seals fissures by interfering with food lodgment and protecting teeth from caries. It is advisable to restore the fissures with the minimal technique of sensitive fluoride-releasing GIC, particularly in young, uncooperative children, rather than leaving a caries-prone environment.

Microtensile Repair Bond Strength of a Composite After Accelerated Artificial Aging: Effect of the Air Abrasion, Bur, Er:YAG Laser, Two-Step Self-etch Bonding, and Universal Bonding Repair System

Introduction: Repair of old composite restorations is a conservative approach. This study sought to compare the effects of two adhesive systems on the bond strength of repaired composites prepared by three different surface treatments: erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation, air-abrasion, and bur preparation. Methods: Eight microhybrid (Polofil Supra, VOCO, Germany) composite resin blocks were fabricated. The blocks were aged and assigned to four groups as stated by the surface treatment: (I) air-abrasion (50 µ aluminum oxide particles), (II) diamond bur (fine grit), (III) Er:YAG laser (3 W output power, 300 mJ energy) and (IV) control. After surface treatment, the blocks were acid-etched and salinized. Each group was divided two subgroups, and the Clearfil SE Bond or All-Bond Universal was applied on their surface. Composite resin was bonded to the aged composites. The blocks were cut into eight samples, and the microtensile bond strength (MTBS) was measured. Results: The maximum MTBS was noted in the air-abrasion (25.1+6 MPa) group, followed by the Er:YAG laser (21.2+4.7 MPa). The mean MTBS in laser and air-abrasion groups was significantly higher than that in other groups (P<0.05). The mean MTBS was not significantly different between the laser and air-abrasion groups (P>0.05). Composite resin conditioning by All-Bond Universal in laser and air-abrasion groups yielded significantly higher MTBS than the Clearfil SE Bond (P<0.05). Conclusion: All surface treatments created acceptable bond strength. The surface treatment of the aged composite by the Er:YAG laser or air-abrasion along with the application of silane and All-Bond Universal provide high bond strength.

The Effect of Different Surface Roughening Systems on the Micro-Shear Bond Strength of Aged Resin Composites

Background

There are controversies regarding the most effective surface treatment method to be applied for the effective repair of resin composites.

Aims

This study aimed to compare the effects of surface roughening processes on repair bond strength of different types of aged composites. Water aging was applied to 60 nanohybrid and 60 micro-hybrid resin composite samples for 1 year. Samples were randomly divided into five groups and four types of roughening processes. Bur, OPTIDISC, SUPERSNAP, and BISCO were applied to the water-aged resin composite samples. Micro-shear test method was used to measure the repair bond strength.

Materials and Methods

Data were analyzed with IBM SPSS V23. Compliance with normal distribution was examined by Kolmogorov-Smirnov test. Two-way analysis of variance (ANOVA) and Tukey HSD test for multiple comparisons were used.

Results

The main effect of the type of resin composites and surface roughening methods were found to be significantly different. The MPa values of surface roughening groups were similar while the lowest mean value was obtained for the untreated group of the nanohybrid resin composite (P < 0.001). The bond strength for both resin composites was generally considered within acceptable limits except for no treatment group of nanohybrid resin composite.

Conclusions

This study showed that surface roughening method is mandatory for effective bond strength and the type of fillers in resin composite affects the micro-shear bond strength.

Microleakage in class II restorations of two bulk fill resin composites and a conventional nanohybrid resin composite: an in vitro study at 10,000 thermocycles

Background

The contraction presented by resin composites causes an increase in stress at the tooth-resin interface, causing micro-gaps that allow microleakage. This study aims to evaluate the degree of in vitro marginal microleakage in class II restorations with two bulk fill resin composites compared to a conventional nanohybrid resin composite.

Methods

The present study was an in vitro experimental design. A total of 30 standardized class II cavities were prepared in 15 human molars (mesially and distally). These cavities were later distributed in 3 groups according to the type of resin. Groups A and B were restored with bulk fill resin composites (Filtek—3 M/ESPE and Tetric N-Ceram—Ivoclar/Vivadent respectively) in a single increment of 4 mm. Group C was restored with the Filtek Z350 XT – 3 M/ESPE resin composite and two increments of 2 mm. Later, the restorations were subjected to 10,000 thermocycles between 5 °C to 55 °C and immersed in a silver nitrate solution (1 M for 24 h). The crowns were then sectioned mesiodistally and observed under the stereomicroscope to determine the degree of marginal microleakage at the occlusal and cervical areas. The results were analyzed with the Kruskal–Wallis and the Mann–Whitney U statistical tests.

Results

There were no statistically significant differences regarding the degree of microleakage between the three types of resin composites in the occlusal and cervical areas (p > 0.05). Similarly, there were no significant differences after comparing each resin type in its occlusal and cervical area (p > 0.05).

Conclusion

Filtek Bulk Fill and Tetric N-Ceram Bulk Fill resin composites showed no statistically significant differences with the conventional nanohybrid resin composite Filtek Z350XT at both occlusal and cervical areas.

Repair of temporary fixed dental prostheses using a flowable resin composite: Effect of material, bonding, and aging

Objectives

Assessment of the effect of aging and bonding on the reparability of different temporary crown and bridge materials using a flowable resin composite.

Methods

The materials used included two bis-acryl and two polymethylmethacrylate materials. The materials were aged either dry, in distilled water, or in a 75% ethanol/water solution. Each group was divided into three subgroups (n = 6) according to the bonding method: application of a universal adhesive, application of a universal primer followed by a universal adhesive, or no bonding. Materials were repaired with a light-cure flowable resin composite; then, they were subjected to thermocycling and tested by shear bond strength. The data were analysed using three-way ANOVA, one-way ANOVA, and Tukey post hoc tests (α = 0.05).

Results

The shear bond strength was significantly higher for bis-acryl compared to polymethylmethacrylate materials (p < 0.001). In terms of aging conditions, shear bond strength was in the order of 75% ethanol/water solution < dry < water. The application of bonding agents significantly increased the shear bond strength of polymethylmethacrylate-based materials (p < 0.001). The difference between water and dry storage was insignificant (p = 0.558); however, storage in a 75% ethanol/water solution showed significantly lower values compared to both dry and water storage in most of experimental groups (p < 0.001). Polymethylmethacrylate-based materials mainly demonstrated adhesive failure, while bis-acryl materials predominantly showed cohesive failure.

Conclusion

The bond strength of a light-cure flowable resin composite is significantly higher with bis-acryl compared to that with polymethylmethacrylate-based substrates. Aging in water does not have a significant effect; however, the 75% ethanol/water solution tends to negatively affect repairability. The application of different bonding agents positively affects the repair strength, especially for polymethylmethacrylate-based substrates.

Repair potential of a bulk-fill resin composite: Effect of different surface-treatment protocols

This study evaluated the effect of different surface-treatment protocols on the repair bond strength of a bulk-fill resin composite. One-hundred and forty specimens (Filtek Bulk-fill) were created (5 mm diameter, 4 mm depth) and allocated to one of 14 groups according to surface treatment (no treatment, tribochemical silica coating, sandblasting with aluminum oxide), adhesive application (no adhesive, total-etch, self-etch), and type of repair resin (bulk-fill, universal resin) (n = 10 per group). Twenty specimens were selected for measuring the cohesive strengths of non-aged resin composites and used as reference. Other specimens were thermocycled. Shear bond-strength testing was performed. Data were analyzed using linear regression of bond strength as a function of the surface treatment, type of adhesive and whether or not adhesive was applied, and type of repair resin. The failure modes were analyzed using logistic regression of failure mode (cohesive failure vs. other types, or adhesive failure vs. other types) on the type of surface treatment, adhesive application, and repair resin used. Surface treatment, regardless of whether this was tribochemical silica coating (mean difference = 5.44 MPa; 95% CI = 4.77-6.11) or sandblasting with aluminum oxide (mean difference = 4.22 MPa; 95% CI = 3.55-4.88), resulted in higher shear bond strength than no treatment. Application of adhesive resulted in a substantial and statistically significant decrease of shear bond strength (by 8.77 MPa, for self-etch and by 7.26 MPa for total-etch) relative to no adhesive. Conversely, the type of repair resin did not influence the shear bond strength to any appreciable extent.

Effect of different surface treatments on shear bond strength of ceramic brackets to old composite

Background

At present, the demand for orthodontic treatment is on the rise. On the other hand, evidence shows that the bond strength of composite resins to old composite restorations is often unreliable. Therefore, the aim of this in vitro study was to assess the effect of different surface treatments on shear bond strength (SBS) of ceramic brackets to old composite restorations.

Methods

In this in vitro experimental study, 60 nano-hybrid composite discs were fabricated. For aging, the discs were incubated in deionized water at 37 °C for 1 month. Next, they underwent 4 different surface treatments namely acid etching with 37% phosphoric acid, sandblasting, grinding, and Er,Cr:YSGG laser irradiation. Ceramic brackets were then bonded to the discs and underwent SBS testing.

Results

The maximum mean SBS value was obtained in the grinding group (9.16 ± 2.49 MPa), followed by the sandblasting (8.13 ± 2.58 MPa) and laser (6.57 ± 1.45 MPa) groups. The minimum mean SBS value was noted in the control group (5.07 ± 2.14 MPa).

Conclusion

All groups except for the control group showed clinically acceptable SBS. Therefore, grinding, sandblasting, and Er,Cr:YSGG laser are suggested as effective surface treatments for bonding of ceramic orthodontic brackets to aged composite.

Comparison of the Bond Strength of Composite Resin to Zirconia and Composite Resin to Polyether Ether Ketone: An In Vitro Study

Aim:

The aim of the study was to compare the shear bond strength of composite resin bonded to polyether ether ketone (PEEK) and zirconia, and also to evaluate the effect of thermocycling on the shear bond strength.

Materials and Methods:

A total of 22 zirconia (Group 1) and 22 PEEK (Group 2) specimens (disks of 10 mm in diameter and 10 mm in thickness) were machine milled using computer-aided design (CAD)/computer-aided manufacturing (CAM) from commercially available zirconia and PEEK. These specimens were air abraded with 110-μm aluminum oxide. Following which these two groups were subdivided into four groups, that is, Group 1A: 11 zirconia specimens before thermocycling, Group 1B: 11 zirconia specimens after thermocycling, Group 2A: 11 PEEK specimens before thermocycling, and Group 2B: 11 PEEK specimens after thermocycling. These four groups of specimens were embedded in an acrylic block, and bonding agent was applied over the upper surfaces of the disks of each of these specimens. Composite resin was then cured, and then Group 1B and group 2B were thermocycled under a standard temperature. The bond strength of the specimen was tested using universal testing machine.

Result:

The result showed that there was no significant difference in shear bond strength between the groups, although higher shear bond strength was observed in the PEEK group.

Conclusion:

Shear bond strength of PEEK is similar to zirconia. The results suggest that the pretreatment method and primers used were effective in improving the bonding of resin cements to zirconia ceramic and the bonding properties of the veneering resin to the PEEK surface.

Comparison between Shear Bond Strength of Er:YAG and Er,Cr:YSGG Lasers-Assisted Dentinal Adhesion of Self-Adhering Resin Composite: An Ex Vivo Study

(1) Background: Bonding composite to tooth structure is still evolving with a substitute for phosphoric acid being the main challenge. Lately, a self-adhering composite (SAC) was developed, promising to simplify bonding to tooth structure. Unfortunately, retention especially to dentin, was not as good as the gold standard three steps bonding system. During the last 2 decades, lasers were used to enhance shear bond strength of composite to tooth structure. However, the literature provided limited information regarding laser efficiency in the immediate, as well as the long term, adhesion success of SACs to dentin. The purpose of our study was to define the optimal irradiation conditions to improve the adhesion of self-adhering flowable resin composite to dentin exposed to Er:YAG and Er,Cr:YSGG laser irradiation. (2) Methods: Seventy-two freshly extracted human third molars, prepared to have flat dentinal surfaces, were randomly divided into three groups (n = 24) including a control group (Group 1) in which dentin was left without laser irradiation. The other two groups (Group 2 and 3) received standardized irradiation at a speed of 1 mm/second with Er:YAG (60 mJ; SSP mode = 50 μs; 10 Hz; fluency of 9.4 J/cm²; beam diameter: 0.9 mm; air 6 mL/min; and water 4 mL/min), and Er,Cr:YSGG: 1.5 W; fluency of 17.8 J/cm²; turbo handpiece with MX5 short insert; 20 Hz under air/water spray (65% air, 55% water). Self-adhering flowable resin was applied to dentin in all groups. Half of the specimens were stored in water for 24 h while the other half underwent 3000 thermal cycles. Later, all specimens received a shear bond strength test. Fracture observation was done first under a stereomicroscope then by using a scanning electron microscope. (3) Results: The mean values of shear bond strength for both laser-treated dentin groups (Er:YAG laser: 13.10 ± 1.291, and Er,Cr:YSGG: 14.04 ± 5.233) were higher than in the control group 1 (8.355 ± 2.297) before thermocycling. After thermocycling, shear bond strength decreased in all groups as follows: 10.03 ± 1.503, 10.53 ± 2.631, and 02.75 ± 1.583 for Er:YAG, Er,Cr:YSGG, and nonirradiated dentin, respectively. Shear bond strength values showed a significant difference between the control group (Group 1) and both lasers groups (Group 2 and 3). Statistical analysis of stereomicroscope observation revealed no significant difference between laser irradiation and failure mode (p < 0.136). SEM observation of the dentin surface in both laser-irradiated groups showed opened tubules, absence of smear layer as well as an increase of resin infiltration into dentinal tubules. (4) Conclusion: Er:YAG and Er,Cr:YSGG lasers enhance self-adhering flowable resin shear bond strength values and improve its longevity by eliminating the smear layer, opening dentinal tubules and increasing resin infiltration into the microstructure.

Evaluation of the repair capacities and color stabilities of a resin nanoceramic and hybrid CAD/CAM blocks

PURPOSE

This study evaluated the color stabilities of two computer-aided design and computer-aided manufacturing (CAD/CAM) blocks and a nanofill composite resin and the microtensile bond strength (µTBS) between the materials.

MATERIALS AND METHODS

Twelve specimens of 4 mm height were prepared for both Lava Ultimate (L) and Vita Enamic (E) CAD/CAM blocks. Half of the specimens were thermocycled (10,000 cycle, 5° to 55℃) for each material. Both thermocycled and non-thermocycled specimens were surface treated with one of the three different methods (Er,Cr:YSGG laser, bur, or control). For each surface treatment group, one of the thermocycled and one of non-thermocycled specimens were restored using silane (Ceramic Primer II), universal adhesive (Single Bond Universal), and nanofill composite resin of 4-mm height (Filtek Ultimate). The other specimens were restored with the same procedure without using silane. For each group, 1 × 1 × 8 mm bar specimens were prepared using a microcutting device. Bar specimens were thermocycled (10,000 cycle, 5° to 55℃) and microtensile tests were performed. Staining of the materials in coffee solution was also compared using a spectrophotometer. Data were analyzed using one-way ANOVA, t-test and post-hoc Scheffe tests.

RESULTS

µTBS were found similar between the thermocycled and non-thermocycled groups (P>.05). The highest µTBS (20.818 MPa) was found in the non-thermocycled, bur-ground, silane-applied E group. Silane increased µTBS at some E groups (P<.05). Composite resin specimens showed more staining than CAD/CAM blocks (P<.05).

CONCLUSION

CAD/CAM blocks can be repaired with composite resins after proper surface treatments. Using silane is recommended in repair process. Color differences may be shown between CAD/CAM blocks and the nanofill composite after a certain time period.

Repair bond strength of resin composite to three aged CAD/CAM blocks using different repair systems

PURPOSE

The purpose of this study is to evaluate the repair bond strength of a nanohybrid resin composite to three CAD/CAM blocks using different intraoral ceramic repair systems.

MATERIALS AND METHODS

Three CAD/CAM blocks (Lava Ultimate, Cerasmart, and Vitablocks Mark II) were selected for the study. Thirty-two specimens were fabricated from each block. Specimens were randomly divided into eight groups for the following different intraoral repair systems: Group 1: control group (no treatment); Group 2: 34.5% phosphoric acid etching; Group 3: CoJet System; Group 4: Z-Prime Plus System; Group 5: GC Repair System; Group 6: Cimara System; Group 7: Porcelain Repair System; and Group 8: Clearfil Repair System. Then, nanohybrid resin composite (Tetric Evo Ceram) was packed onto treated blocks surfaces. The specimens were thermocycled before application of repair systems and after application of composite resin. After second thermal cycling, blocks were cut into bars (1 × 1 × 12 mm³) for microtensile bond strength tests. Data were analyzed using two-way ANOVA and Tukey's HSD test (α=.05).

RESULTS

Cimara System, Porcelain Repair, and Clearfil Repair systems significantly increased the bond strength of nanohybrid resin composite to all CAD/CAM blocks when compared with the other tested repair systems (P<.05). In terms of CAD/CAM blocks, the lowest values were observed in Vitablocks Mark II groups (P<.05).

CONCLUSION

All repair systems used in the study exhibited clinically acceptable bond strength and can be recommended for clinical use.

In vitro evaluation of shear bond strength of orthodontic metal brackets to aged composite using a self-adhesive composite: Effect of surface conditioning and different bonding agents

OBJECTIVES

Bracket bonding to composite surfaces is increasing. This study sought to assess the effect of different adhesives (acid etchant+Transbond XT™, acid etchant+Vertise Flow™, Vertise Flow™) with different surface treatments (no preparation, bur, sandblasting, Er:YAG laser) on shear bond strength (SBS) of metal brackets to aged composite.

MATERIALS AND METHODS

In this in vitro, experimental study, Filtek™ Z250 composite discs were fabricated (10×4mm). After thermocycling (10,000 cycles between 5-55°C), the samples were randomly divided into three groups (n=48) based on the type of adhesive namely acid etchant+Transbond XT™, Vertise Flow™, and acid etchant+Vertise Flow™. Samples in each group were randomly divided into four subgroups (n=12) based on the surface treatment including no-treatment, diamond bur, sandblasting and Er:YAG laser. Samples in each group were randomly divided into three subgroups (n=12) based on the type of adhesive namely acid etchant+Transbond XT™, Vertise Flow™, and acid etchant+Vertise Flow™. After bracket bonding to composite discs, the samples underwent thermocycling (5000 cycles between 5-55°C), and their SBS was measured in a universal testing machine. The samples were then inspected under a stereomicroscope at x10 magnification to determine their mode of failure and adhesive remnant index (ARI).

RESULTS

No significant difference was noted in SBS between adhesives in no-preparation and laser groups (P>0.05). In all adhesive groups, sandblast had highest SBS, but it was not significantly different in Vertise Flow™ groups, with and without etching. The SBS provided by acid etchant+Transbond XT™ was significantly higher than that of the other two adhesives (P<0.05). The SBS of sandblasted samples was significantly higher compared with other surface treatments in all adhesive subgroups (P<0.05).

CONCLUSION

Bracket bonding to aged composite using Vertise Flow™ with or without surface treatment can serve as an alternative to the conventional orthodontic adhesives.

Effects of Endodontic Access Cavity Design and Thermocycling on Fracture Strength of Endodontically Treated Teeth

Introduction

This study aimed to assess the fracture strength of endodontically treated mandibular molars with traditional endodontic access cavity (TEC) and truss endodontic access cavity (TREC) designs that were restored with composite resin and underwent thermocycling.

Methods

Sixty mandibular first and second molars were randomly divided into 6 groups (n=10) of intact controls without thermocycling (group 1), intact controls with thermocycling (group 2), TEC without thermocycling (group 3), TEC with thermocycling (TEC-TC, group 4), TREC without thermocycling (group 5) and TREC with thermocycling (TREC-TC, group 6). The root canals were then instrumented to #25,7% using nickel-titanium files and were filled with gutta-percha and AH26 sealer with lateral compaction technique. Access cavity was restored with Gradia composite. All teeth were then thermocycled for 480 cycles between 5°C and 55°C for 30 seconds and their fracture strength was measured in a universal testing machine with a round-end piston with 6 mm diameter at a speed of 1 mm/min. Data were analyzed using two-way and one-way ANOVA.

Results

Without thermocycling, the fracture strength of endodontically treated teeth with TREC designs had no significant difference with the control group (P>0.05). However, both TEC and TREC designs significantly decreased the fracture strength of endodontically treated teeth after thermocycling (P<0.05), such that minimum fracture strength was noted in TEC-TC group.

Conclusion

Under the conditions of this ex vivo study, TREC enhances the fracture strength of endodontically treated teeth under thermal stresses.

Biofilm composition and composite degradation during intra-oral wear

OBJECTIVES

The oral environment limits the longevity of composite-restorations due to degradation caused by chewing, salivary and biofilm-produced enzymes and acids. This study investigates degradation of two resin-composites in relation with biofilm composition in vitro and in vivo.

METHODS

Surface-chemical-composition of two Bis-GMA/TEGDMA composites was compared using X-ray-Photoelectron-Spectroscopy from which the number ester-linkages was derived. Composite-degradation was assessed through water contact angles, yielding surface-exposure of filler-particles. Degradation in vitro was achieved by composite immersion in a lipase solution. In order to evaluate in vivo degradation, composite samples were worn in palatal devices by 15 volunteers for 30-days periods in absence and presence of manually-brushing with water. PCR-DGGE analysis was applied to determine biofilm composition on the samples, while in addition to water contact angles, degradation of worn composites was assessed through surface-roughness and micro-hardness measurements.

RESULTS

In vitro degradation by lipase exposure was highest for the high ester-linkage composite and virtually absent for the low ester-linkage composite. Filler-particle surface-exposure, surface-roughness and micro-hardness of both resin-composites increased during intra-oral wear, but filler-particle surface-exposure was affected most. However, based on increased filler-particle surface-exposure, the high ester-linkage composite degraded most in volunteers harvesting composite biofilms comprising Streptococcus mutans, a known esterase and lactic acid producer. This occurred especially in absence of brushing.

SIGNIFICANCE

Degradation during intra-oral wear of a low ester-linkage composite was smaller than of a high ester-linkage composite, amongst possible other differences between both composites. S. mutans herewith is not only a cariogenic, but also a composite-degradative member of the oral microbiome.

Evaluation of the effect of different surface conditioning methods on shear bond strength of metal brackets bonded to aged composite restorations

INTRODUCTION

There are controversies regarding the most reliable conditioning method of the aged composite surface to ensure optimum bond strength. The purpose of this study was to evaluate the shear bond strength of metal brackets to microhybrid composite restorations after different surface preparation techniques.

MATERIALS AND METHODS

A total of sixty microhybrid composite samples were prepared using upper right central incisor celluloid crown as a mold. Samples were treated with 4 different surface conditioning methods: (1) etching, (2) sandblasting, (3) grinding, and (4) CO₂ laser irradiation. Samples were then bonded with metal brackets and underwent shear bond strength testing. A scanning electron microscope was carried out and the data was analysed by one-way ANOVA and post-hoc Tukey test. Bond failure was examined by stereomicroscope and scored based on adhesive remnant index (ARI). Kruskal-Wallis test was used to compare ARI values (α=0.05).

RESULTS

Shear bond strength values in the sandblasting group (17.18±1.53MPa) were significantly higher than the other groups. There was no significant difference between the grinding (12.87±3.38MPa) and laser (11.08±1.37MPa) groups (P=0.09). The lowest values were recorded in the etching group (6.78±1.69MPa). There was a significant difference in ARI scores among the four groups (P<0.001). ARI scores were mostly 2 and 3 in the sandblasting and grinding group, while in the etching and laser groups ARI was mostly 0 and 1.

CONCLUSIONS

Surface preparation by sandblasting and CO₂ laser provides clinically acceptable results with regards to bond strength and ARI score, however grinding and acid etching failed to produce the same results.

Repair bond strength of composite: Effect of surface treatment and type of composite

Background

By an increase in use of composite restorations, some defects are also seen in these restorations, which need to be repaired. Since complete replacement of an old restoration may compromise the tooth structure, repair of defect is a more practical approach if there is no caries recurrence. Risk of pulp injury also decreases as such. One major challenge in restoration repair is to obtain a durable bond between the new and old composite. Laser irradiation has been suggested for surface preparation of old composite. This study aimed to assess the effect of composite surface preparation with Er,Cr:YSGG laser on microtensile bond strength to new composite.

Material and Methods

A total of 18 blocks were fabricated in three groups of nanohybrid, microhybrid and Beautiful II giomer measuring 4x7x7 mm and subjected to 10,000 thermal cycles between 5-55°C with 30 seconds of dwell time. The samples were randomly assigned to no surface treatment (etching and bonding) or laser plus etching and bonding groups. Composite cylinders measuring 4x7x7 mm were fabricated of Beautiful, nanohybrid and microhybrid composites on old composite surfaces and subjected to 500 thermal cycles for 50 seconds between 5-55°C with 30 seconds of dwell time. Each block was sectioned into 10 samples and they were subjected to microtensile bond strength test. Data were analyzed using ANOVA and Tukey’s test.

Results

In all composites, the mean bond strength in laser subgroups was higher than that in control subgroups except for giomer, which showed lower bond strength in laser subgroup. The lowest mean bond strength was noted in repair of Z350XT with Z350XT when the surface of old composite was etched (10.92 MPa). The highest mean bond strength was noted in repair of Z250 with giomer when the old composite surface was irradiated with laser (30.55 MPa).

Conclusions

Er,Cr:YSGG laser plus etching increased the bond strength in all groups except for giomer group, which showed a reduction in bond strength.

Key words:Composite resins, surface treatment, tensile bond strength, laser, er,cr:ysgg, giomer.

Effect of thermocycling and surface treatment on repair bond strength of composite

Background

Repair of composite restorations is a conservative method that can increase the longevity and durability of restorations while preserving the tooth structure. Achieving a suitable bond between the old and new composite is difficult. To overcome this problem, some methods have been recommended to increase the repair bond strength of composite.This study aimed to assess the effect of aging by thermocycling (5,000 and 10,000 cycles) and mechanical surface treatments (Er,Cr:YSGG laser and bur) on repair shear bond strength of composite resin.

Material and Methods

Totally, 120 composite blocks measuring 6x4x4 mm were fabricated of Filtek Z250 composite and were randomly divided into three groups (n=40) based on initial aging protocol: (a) no aging: storage in distilled water at 37°C for 24 hours, (b) 5,000 thermal cycles, (c) 10,000 thermal cycles. Each group was then randomly divided into two subgroups (n=20) based on mechanical surface treatment (laser and bur). The laser and bur-prepared surfaces were silanized and Adper Single Bond 2 was then applied. The repair composite was bonded to surfaces. Half of the samples in each subgroup (n=10) were subjected to 5,000 thermal cycles to assess durability of bond. The remaining half were stored in distilled water at 37°C for 24 hours and all samples were then subjected to shear bond strength testing in a universal testing machine with a crosshead speed of 1mm/min. Data (in megapascals) were subjected to one-way ANOVA and Tukey’s test (P=0.05). Mode of failure was determined under a stereomicroscope.

Results

Bur preparation significantly improved the bond strength compared to laser (P<0.001). Aging by 10,000 thermal cycles significantly decreased the repair bond strength of composite (P<0.001). No significant difference was noted in this regard between distilled water and 5,000 thermal cycles groups (P=0.699). Primary bond strength and bond strength after 5,000 thermal cycles in the same subgroups were not significantly different either (P=0.342).

Conclusions

Aging by 10,000 thermal cycles significantly decreases the repair bond strength of composite and surface preparation by bur provides a higher bond strength compared to laser.

Key words:Thermocycling, Composite, Repair, Laser.

Color stability of lithium disilicate ceramics after aging and immersion in common beverages

STATEMENT OF PROBLEM

The color of an esthetic restoration and its color stability are important for long-term success. However, the impact of common beverages on lithium disilicate ceramic is not well known.

PURPOSE

The purpose of this in vitro study was to investigate color variations of lithium disilicate ceramics after thermocycling (TC) and immersion in commonly consumed beverages.

MATERIAL AND METHODS

A total of 288 specimens (1×10×10 mm) were fabricated from IPS e-max computer-aided design (CAD) (n=72), IPS e-max CERAM ([CER] n=72), IPS e-max Press with glazing ([PG] n=72), and IPS e-max Press without glazing ([PNG] n=72) according to the manufacturer's instructions. Each group was divided into 4 subgroups (n=18): TC, coffee, black tea, and red wine. Thermocycling was performed at 21 900 cycles at 5°C, 37°C, 55°C, and 37°C (3 years' clinical simulation), whereas the specimens were soaked in the staining solutions for up to 54 hours (3 years' clinical simulation). Color parameters L*, a*, and b* were assessed with an ultraviolet-visible spectroscopy recording spectrophotometer. Color difference (ΔE) was calculated using the equation [ΔΕ= [(ΔL*)² + (Δa*)² + (Δb*)²]½]. Intraexaminer reliability was assessed by using the intraclass correlation coefficient. Two-way analysis of variance was used for the analysis of ΔΕ, and the parameters L*, a*, and b* were analyzed with linear mixed models for repeated measurements and the Bonferroni pair-wise comparison test (α=.05).

RESULTS

Parameters ΔΕ, L*, a*, and b* were significantly affected by the interaction between material and treatment (P<.001). A ΔΕ >1 was recorded for PG with tea, wine, and coffee, PG after TC and CER after TC. For L*, greater reduction was observed for PNG with tea and CER after TC, whereas for a* significant changes were positive (to red shades), except for PNG with TC, where PNG with wine showed the greatest positive change. For b*, significant changes were negative (to blue shades) except for PNG with tea and coffee and CAD with tea.

CONCLUSIONS

All groups demonstrated color changes below the clinically perceptible level (ΔΕ<3.7), except PNG in tea which showed statistically significant color differences (ΔΕ>4). CAD presented higher color stability compared with the nonglazed Press specimens.

In vitro evaluation of repair bond strength of composite: Effect of surface treatments with bur and laser and application of universal adhesive

Objectives

This study aimed to assess the effect of surface treatment by bur and laser and application of universal adhesive on repair bond strength of composite resin.

Materials and Methods

A total of 120 composite blocks measuring 6×4×4 mm were fabricated of Filtek Z250 composite. All samples were subjected to 5,000 thermal cycles and divided into two groups for surface preparation by bur and by Er,Cr:YSGG laser (n = 60). The surfaces were then etched with orthophosphoric acid, rinsed with water and divided into three groups (silane, silane plus Single Bond and silane plus Single Bond Universal). Repair composite was then bonded to aged composite. Half of the samples in each group were stored in distilled water at 37°C for 24 hours and the other half underwent 5000 thermal cycles. All samples were then subjected to shear bond strength testing using a universal testing machine at a crosshead speed of 1 mm/minute. The data were analyzed using one-way ANOVA and Tukey's HSD test. Mode of failure was determined using a stereomicroscope.

Results

Bur preparation plus universal adhesive yielded the highest bond strength (30.16 µ 2.26 MPa). Laser plus silane yielded the lowest bond strength (5.63 µ 2.43 MPa). Bur preparation yielded significantly higher bond strength than laser (P < 0.001). Also, application of universal adhesive significantly improved bond strength compared to conventional adhesive and silane (P < 0.001). Bond strength after aging (5000 thermal cycles) had no significant difference with primary bond strength at 24 hours within each group (P = 0.182).

Conclusion

Surface preparation of aged composite by bur and application of universal adhesive can improve the repair bond strength of composite. Application of silane (without adhesive) in the process of repair cannot provide adequately high repair bond strength.

Effect of surface treatments on shear bond strength of resin composite bonded to CAD/CAM resin-ceramic hybrid materials

PURPOSE

The purpose of this study was to assess the effect of surface treatments on shear bond strength of resin composite bonded to thermocycled and non-thermocycled CAD/CAM resin-ceramic hybrid materials.

MATERIALS AND METHODS

120 specimens (10×10×2 mm) from each material were divided into 12 groups according to different surface treatments in combination with thermal aging procedures. Surface treatment methods were airborne-particle abrasion (abraded with 50 micron alumina particles), dry grinding (grinded with 125 µm grain size bur), and hydrofluoric acid (9%) and silane application. According to the thermocycling procedure, the groups were assigned as non-thermocycled, thermocycled after packing composites, and thermocycled before packing composites. The average surface roughness of the non-thermocycled specimens were measured after surface treatments. After packing composites and thermocycling procedures, shear bond strength (SBS) of the specimens were tested. The results of surface roughness were statistically analyzed by 2-way Analysis of Variance (ANOVA), and SBS results were statistically analyzed by 3-way ANOVA.

RESULTS

Surface roughness of GC were significantly lower than that of LU and VE (P<.05). The highest surface roughness was observed for dry grinding group, followed by airborne particle abraded group (P<.05). Comparing the materials within the same surface treatment method revealed that untreated surfaces generally showed lower SBS values. The values of untreated LU specimens showed significantly different SBS values compared to those of other surface treatment groups (P<.05).

CONCLUSION

SBS was affected by surface treatments. Thermocycling did not have any effect on the SBS of the materials except acid and silane applied GC specimens, which were subjected to thermocycling before packing of the composite resin.

Effects of two erbium-doped yttrium aluminum garnet lasers and conventional treatments as composite surface abrasives on the shear bond strength of metal brackets bonded to composite resins

Background:

Bonding brackets to dental surfaces restored with composites are increasing. No studies to date have assessed the efficacy of laser irradiation in roughening of composite and the resulted shear bond strength (SBS) of the bonded bracket. We assessed, for the 1^st time, the efficacy of two laser beams compared with conventional methods.

Materials and Methods:

Sixty-five discs of light-cured composite resin were stored in deionized distilled water for 7 days. They were divided into five groups of 12 plus a group of five for scanning electron microscopy (SEM): Bur-abrasion followed by phosphoric acid etching (bur-PA), hydrofluoric acid conditioning (HF), sandblasting, 3 W and 2 W erbium-doped yttrium aluminum garnet laser irradiation for 12 s. After bracket bonding, specimens were water-stored (24 h) and thermocycled (500 cycles), respectively. SBS was tested at 0.5 mm/min crosshead speed. The adhesive remnant index (ARI) was scored under ×10 magnification. SEM was carried out as well. Data were analyzed using analysis of variance (ANOVA), Kruskal–Wallis, Tukey, Dunn, one-sample t-test/Wilcoxon tests, and Weibull analysis (α =0.05).

Results:

The SBS values (megapascal) were bur-PA (11.07 ± 1.95), HF (19.70 ± 1.91), sandblasting (7.75 ± 1.10), laser 2 W (15.38 ± 1.38), and laser 3 W (20.74 ± 1.73) (compared to SBS = 6, all P = 0.000). These differed significantly (ANOVA P = 0.000) except HF versus 3 W laser (Tukey P > 0.05). ARI scores differed significantly (Kruskal–Wallis P = 0.000), with sandblasting and 2 W lasers having scores inclined to the higher end (safest debonding). Weibull analysis implied successful clinical outcome for all groups, except for sandblasting with borderline results.

Conclusion:

Considering its high efficacy and the lack of adverse effects bound with other methods, the 3 W laser irradiation is recommended for clinical usage.

Effect of different surface treatments on the shear bond strength of nanofilled composite repairs

Background. Repairing aged composite resin is a challenging process. Many surface treatment options have been proposed to this end. This study evaluated the effect of different surface treatments on the shear bond strength (SBS) of nano-filled composite resin repairs.

Methods. Seventy-five cylindrical specimens of a Filtek Z350XT composite resin were fabricated and stored in 37°C distilled water for 24 hours. After thermocycling, the specimens were divided into 5 groups according to the following surface treatments: no treatment (group 1); air abrasion with 50-μm aluminum oxide particles (group 2); irradiation with Er:YAG laser beams (group 3); roughening with coarse-grit diamond bur + 35% phosphoric acid (group 4); and etching with 9% hydrofluoric acid for 120 s (group 5). Another group of Filtek Z350XT composite resin samples (4×6 mm) was fabricated for the measurement of cohesive strength (group 6). A silane coupling agent and an adhesive system were applied after each surface treatment. The specimens were restored with the same composite resin and thermocycled again. A shearing force was applied to the interface in a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests (P < 0.05).

Results. One-way ANOVA indicated significant differences between the groups (P < 0.05). SBS of controls was significantly lower than the other groups; differences between groups 2, 3, 4, 5 and 6 were not significant. Surface treatment with diamond bur + 35% phosphoric acid resulted in the highest bond strength.

Conclusion. All the surface treatments used in this study improved the shear bond strength of nanofilled composite resin used.

Evaluation of the bond strength between aged composite cores and luting agent

PURPOSE

The aim of this study was to evaluate effect of different surface treatment methods on the bond strength between aged composite-resin core and luting agent.

MATERIALS AND METHODS

Seventy-five resin composites and also seventy-five zirconia ceramic discs were prepared. 60 composite samples were exposed to thermal aging (10,000 cycles, 5 to 55℃) and different surface treatment. All specimens were separated into 5 groups (n=15): 1) Intact specimens 2) Thermal aging-air polishing 3) Thermal aging- Er:YAG laser irradiation 4) Thermal aging- acid etching 5) Thermal-aging. All specimens were bonded to the zirconia discs with resin cement and fixed to universal testing machine and bond strength testing loaded to failure with a crosshead speed of 0.5 mm/min. The fractured surface was classified as adhesive failure, cohesive failure and adhesive-cohesive failure. The bond strength data was statistically compared by the Kruskal-Wallis method complemented by the Bonferroni correction Mann-Whitney U test. The probability level for statistical significance was set at α=.05.

RESULTS

Thermal aging and different surface treatment methods have significant effect on the bond strength between composite-resin cores and luting-agent (P<.05). The mean baseline bond strength values ranged between 7.07 ± 2.11 and 26.05 ± 6.53 N. The highest bond strength of 26.05 ± 6.53 N was obtained with Group 3. Group 5 showed the lowest value of bond strength.

CONCLUSION

Appropriate surface treatment method should be applied to aged composite resin cores or aged-composites restorations should be replaced for the optimal bond strength and the clinical success.

Scanning Electron Microscope (SEM) Evaluation of Composite Surface Irradiated by Different Powers of Er:YAG Laser

INTRODUCTION

The aim of this study was to evaluate the composite surface treated by different powers of Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) laser in comparison with bur preparation via scanning electron microscope.

METHODS

Fourteen composite resin blocks with 15× 10 × 10 mm dimensions were used in this study. The samples were divided to seven groups as follow: Group 1 (power: 1 W, Energy: 50 mJ); Group 2 (power: 2 W, Energy: 100 mJ); Group 3 (power: 3W, Energy: 150 mJ); Group 4 (power: 4 W, Energy: 200 mJ); Group 5 (power: 5W, Energy: 250 mJ); Group 6 (power: 6 W, Energy: 300 mJ); Group 7: Diamond bur. Then, the samples were prepared for SEM examination.

RESULTS

The surface treated by Er:YAG laser showed irregular and micro porous surface.

CONCLUSION

It seems that composite surface treatment by Er:YAG laser can be an alternative method for composite repair if suitable parameters are used.

The effect of surface treatment with Er: YAG laser on shear bond strength of orthodontic brackets to fiber-reinforced composite

OBJECTIVES

This study aimed to investigate the effect of surface treatment with Er:YAG laser on shear bond strength (SBS) of orthodontic brackets to fiber-reinforced composite (FRC).

STUDY DESIGN

Ninety human premolars were randomly divided into six groups of 15. FRC bars were bonded to the teeth with a flowable composite (FC) and then underwent following treatments. In group 1 no further treatment was performed. In group 2 the FRC surfaces were covered by FC. An Er:YAG laser was employed to treat FRCs in groups 3 ( 200 mJ/10 Hz) and 4 (300 mJ/15 Hz). The FRC strips in groups 5 and 6 were first covered by FC and then irradiated with Er:YAG laser at 200 mJ/10 Hz (group 5) or 300 mJ/15 Hz (group 6). Stainless steel brackets were bonded to FRCs using a light-cure adhesive system. After 24 hours, the samples were tested for SBS and the adhesive remnant index (ARI) scores were determined.

RESULTS

There was a significant difference in SBS among the study groups (P <0.001). Pairwise comparisons indicated that SBS was significantly lower in group 1 compared to all other groups (p<0.05) except group 2. Bond strength in group 6 was significantly greater than all the study groups (p<0.05) except group 5. No significant difference was found in ARI scores among the groups.

CONCLUSIONS

Covering the FRC surface by a layer of flowable composite and then application of Er:YAG laser at 300 mJ/15 Hz could be recommended to increase bond strength of orthodontic attachments to FRC. Key words:Fiber-reinforced composite, orthodontics, Sshear bond strength, laser, Er:YAG, surface treatment, bracket, FRC.

Effect of Surface Treatment with Er;Cr:YSSG, Nd:YAG, and CO2 Lasers on Repair Shear Bond Strength of a Silorane-based Composite Resin

Background and aims. The aim of the present study was to compare the effect ofsurface treatment with Er; Cr:YSSG, Nd:YAG, and CO₂ lasers on repair shear bond strength of a silorane-based composite resin.

Materials and methods. Sixty eight cylindrical samples of a silorane-based composite resin (Filtek Silorane) were pre-pared and randomly divided into 4 groups as follows: group 1: without surface treatment; groups 2, 3 and 4 with surface treatments using Er; Cr:YSSG, Nd:YAG, and CO₂ lasers, respectively. A positive control group (group 5) was assigned in order to measure cohesive strength. Repair shear bond strength values were measured and data was analyzed using one-way ANOVA and a post hoc Tukey test at a significance level of α=0.05.

Results. There were statistically significant differences in repair shear bond strength values between group 2 and other groups (P < 0.05); and between group 1and groups 3and 4 (P < 0.001); however, there were no significant differences be-tween groups 3 and 4 (P = 0.91).

Conclusion. The repair shear bond strength of silorane-based composite resin was acceptable by surface treatment with lasers