Film thickness of new adhesive luting agents

The Effect of the Initiator/Activator/Accelerator Ratio on the Degree of Conversion, Film Thickness, Flow, and Cytotoxicity of Dual-Cured Self-Adhesive Resin Cements

Although self-adhesive resin cements are convenient and less technique-sensitive materials for dental clinicians, they exhibit a lower degree of conversion due to acidic components in their composition. Supplementation of the initiator, accelerator, and activator in self-adhesive resin cements has been suggested to compensate for the lower degree of conversion. This study aimed to evaluate the effects of different combinations of self-curing initiators, self-curing activators, and accelerators on the degree of conversion (DC) of self-adhesive resin cements. A dual-cured self-adhesive resin was prepared using six combinations of initiators, activators, and accelerators. The change in the DC over time was evaluated with and without light curing. The film thickness, flow properties, and cytotoxicity of each formulation were assessed. The results showed that all supplemental components had an effect on increasing the DC, but a greater increase in the DC was observed in the following order: activator, accelerator, and initiator. The cytotoxicity of the resin cements was related to the DC values, as resin cements with lower DC values exhibited higher cytotoxicity. The film thickness met the ISO standards for all groups. The results suggest that utilizing an activator is the most effective approach to enhance the DC in self-adhesive resin cement and that cytotoxicity tended to increase with lower DC values, whereas film thickness and flow properties demonstrated no correlation with DC values.

Effect of Luting Materials on the Accuracy of Fit of Zirconia Copings: A Non-Destructive Digital Analysis Method

The marginal accuracy of fit between prosthetic restorations and abutment teeth represents an essential aspect with regard to long-term clinical success. Since the final gap is also influenced by the luting techniques and materials applied, this study analyzed the accuracy of the fit of single-tooth zirconia copings before and after cementation using different luting materials. Forty plaster dies with a corresponding zirconia coping were manufactured based on a single tooth chamfer preparation. The copings were luted on the plaster dies (n = 10 per luting material) with a zinc phosphate (A), glass-ionomer (B), self-adhesive resin (C), or resin-modified glass-ionomer cement (D). The accuracy of fit for each coping was assessed using a non-destructive digital method. Intragroup statistical analysis was conducted using Wilcoxon signed rank tests and intergroup analysis by Kruskal-Wallis and Mann-Whitney U tests (α = 0.05). Accuracy of fit was significantly different before/after cementation within A (0.033/0.110 µm) and B (0.035/0.118 µm; p = 0.002). A had a significantly increased marginal gap compared to C and D, and B compared to C and D (p ≤ 0.001). Significantly increased vertical discrepancies between A and B versus C and D (p < 0.001) were assessed. Of the materials under investigation, the zinc phosphate cement led to increased vertical marginal discrepancies, whereas the self-adhesive resin cement did not influence the restoration fit.

Comparison of Marginal and Internal Adaptation in Endocrowns Milled from Translucent Zirconia and Zirconium Lithium Silicate

Purpose

This study aimed to compare marginal and internal adaptation in endocrowns made from translucent zirconia and zirconium lithium silicate using CAD-CAM technology.

Materials and Methods

Twenty-eight freshly extracted upper molars were mounted in acrylic resin and underwent root canal therapy and endocrown preparation up to 2 mm above the cementoenamel junction. Endocrowns were CAD-CAM milled from zirconium lithium silicate (ZLS) and translucent zirconia (Zr). Internal and marginal adaptation was assessed by the replica technique before cementation. Marginal adaptation was evaluated by a stereomicroscope (×32) before and after cementation and also after thermomechanical aging.

Results

The ZLS group showed significantly higher internal adaptation compared to the Zr group (P = 0.028), while the marginal adaptation differences, at different times with different methods, were not statistically significant (P > 0.05). Axiomarginal angle had the highest and axiopulpal angle showed the lowest adaptation in both groups. The cementation process and thermomechanical aging increased the marginal gap in both groups significantly (P < 0.001). The marginal gap assessed by the replica technique before cementation was 7.11 µm higher than direct view under a stereomicroscope with intraclass correlation coefficient of 0.797.

Conclusion

Zirconia seems to be an acceptable material for endocrown with comparable internal and marginal adaptation to ZLS. Cementation and thermomechanical aging had significantly negative effects on marginal gap. The marginal gap assessed by the replica technique was higher than direct view under the stereomicroscope technique.

Influence of Material and Surface Roughness of Resin Composite Cements on Fibroblast Behavior

Clinical Relevance

A well-polished cement surface increases the viability and spreading of gingival fibroblasts. The tested resin composite cements did not reveal any cytotoxic effects.

SUMMARY

Objective: This in vitro study aimed to investigate the effect of cement type and roughness on the viability and cell morphology of human gingival fibroblasts (HGF-1).

Methods and Materials: Discs of three adhesive (Panavia V5 [PV5], Multilink Automix [MLA], RelyX Ultimate [RUL] and three self-adhesive (Panavia SA plus [PSA], SpeedCem plus [SCP], RelyX Unicem [RUN]) resin composite cements were prepared with three different roughnesses using silica paper grit P180, P400, or P2500. The cement specimens were characterized by surface roughness and energy-dispersive X-ray spectroscopic mapping. A viability assay was performed after 24 hours of incubation of HGF-1 cells on cement specimens. Cell morphology was examined with scanning electron microscopy.

Results: The roughness of the specimens did not differ significantly among the different resin composite cements. Mean Ra values for the three surface treatments were 1.62 ± 0.34 μm for P180, 0.79 ± 0.20 μm for P400, and 0.17 ± 0.08 μm for P2500. HGF-1 viability was significantly influenced by the cement material and the specimens’ roughness, with the highest viability for PSA ≥ RUN = MLA ≥ SCP = PV5 &gt; RUL (p&lt;0.05) and for P2500 = P400 &gt; P180 (p&lt;0.001). Cell morphology did not vary among the materials but was affected by the surface roughness.

Conclusion: The composition of resin composite cements significantly affects the cell viability of HGF-1. Smooth resin composite cement surfaces with an Ra of 0.2–0.8 μm accelerate flat cell spreading and formation of filopodia.

Evaluation of Film Thickness of Crown Disclosing Agents and Their Comparison with Cement Film Thickness after Final Cementation

OBJECTIVE

 Verification of the accuracy of crown fit before final cementation is imperative. The aim of this in vitro study was to evaluate the film thickness of commonly used dental crown disclosing materials and their comparison with final cement thickness.

MATERIALS

AND METHODS: One hundred fifty provisional crowns (Protemp) were fabricated on standardized resin dies and divided into five groups (N = 150; n = 30) based on five disclosing agents: A = Fit-Checker auto-mix; B = Okklu-top; C = Express; D = Fit-Checker hand-mix; E = Coltene PSI, and Final cement = Relyx U200. Crowns were loaded with test materials, tried over dies under load (50N), and later cemented under same load. Film thickness (µm) was recorded between crown margin and the finish line of die after loading with test material and final cementation using a digital microscope.

STATISTICAL ANALYSIS

 Descriptive statistics, analysis of variance, Tukey's and paired t-test were used for statistical analysis (p < 0.05).

RESULTS

 Significant variations were found between the film thicknesses of the five disclosing agents (p = 0.019). Group-A showed the lowest (131.67 ± 101.10 μm), while group-B (295.00 ± 263.88 μm) showed the highest film thickness (p = 0.011). Film thicknesses after cementation were similar for groups (p = 0.957). Significant difference was observed for group-B disclosing agent versus final cement (p = 0.010). The lowest mean difference between the film thicknesses of the disclosing agent and final cementation of 13.1 μm was revealed for group-A.

CONCLUSIONS

 Variations in the film thicknesses of the tested disclosing agents were found. Fit-Checker auto-mix was found with minimal film thickness and satisfied the requirements as the disclosing agent, while Okklu-top aerosol spray did not.

Effects of abutment diameter, luting agent type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments

PURPOSE

The aim of this study was to evaluate the effects of abutment diameter, cement type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments.

MATERIALS AND METHODS

Sixty abutments with two different diameters, the height of which was reduced to 3 mm, were vertically mounted in acrylic resin blocks with matching implant analogues. The specimens were divided into 2 diameter groups: 4.5 mm and 5.5 mm (n=30). For each abutment a CAD/CAM metal coping was manufactured, with an occlusal loop. Each group was sub-divided into 3 sub-groups (n=10). In each subgroup, a different cement type was used: resin-modified glass-ionomer, resin cement and zinc-oxide-eugenol. After incubation and thermocycling, the removal force was measured using a universal testing machine at a cross-head speed of 0.5 mm/min. In zinc-oxide-eugenol group, after removal of the coping, the cement remnants were completely cleaned and the copings were re-cemented with resin cement and re-tested. Two-way ANOVA, post hoc Tukey tests, and paired t-test were used to analyze data (α=.05).

RESULTS

The highest pulling force was registered in the resin cement group (414.8 N), followed by the re-cementation group (380.5 N). Increasing the diameter improved the retention significantly (P=.006). The difference in retention between the cemented and recemented copings was not statistically significant (P=.40).

CONCLUSION

Resin cement provided retention almost twice as strong as that of the RMGI. Increasing the abutment diameter improved retention significantly. Re-cementation with resin cement did not exhibit any difference from the initial cementation with resin cement.

Effect of Temperature on Film Thickness of Two Types of Commonly used Luting Cements

AIM

The aim of this study is to evaluate the effect of temperature change on film thickness of both types of cements.

MATERIALS AND METHODS

Totally, 60 samples were prepared with 10 in each subgroup, thus comprising 30 in each group. Materials tested were glass ionomer cement (GIC) type I and zinc phosphate type I. Samples were manipulated with manufacturer's instructions and tested according to American Dental Association (ADA) guidelines.

RESULTS

The mean values of film thickness were recorded for both groups I and II. In intragroup comparison of group 1, subgroup III (26.560 ± 0.489 urn) was found to have the highest film thickness followed by subgroup II (24.182 ± 0.576 urn) and the lowest in subgroup I (20.209 ± 0.493 urn). In intragroup comparison of group II, the film thickness recorded in subgroup III (25.215 ± 0.661 urn) was the highest followed by subgroup II (21.471 ± 0.771 urn) and the least in subgroup I (17.951 ± 0.654 urn; p < 0.01). In intergroup comparison of groups I and II, group II (21.545 ± 0.841) was found to have less film thickness than group I (23.650 ± 0.271). The results were found to be statistically significant (p < 0.01).

CONCLUSION

Both zinc phosphate and GICs can be used satisfactorily for luting purpose. The temperature fluctuations have a direct influence on the film thickness. Zinc phosphate has less film thickness than GIC.

CLINICAL SIGNIFICANCE

Zinc phosphate should be preferred over GIC in clinical practice, and more stress should be given in mechanical preparation of crowns for better retentive quality of prosthesis.

Tensile strength of Ni-Cr copings subjected to inner surface sandblasting using different cementing agents: An in vitro study

OBJECTIVES

To evaluate the effect of thermal cycling and inner surface treatment with aluminum oxide at different granulations on the tensile strength of Ni-Cr copings cemented with different cementing agents.

MATERIALS AND METHODS

Ninety-six metal copings were manufactured and divided into two groups: before and after thermal cycling (n = 48). The copings of both groups were internally treated by sandblasting with aluminum oxide particles of 100 (n = 24) and 320 (n = 24) mesh. The copings were cemented on previously manufactured metal cores using zinc phosphate (n = 8), conventional glass ionomer (CGIC) (n = 8) and resin-modified glass ionomer (RMGIC) (n = 8) cements. The tensile strength before and after thermal cycling was then determined (Newtons).

RESULTS

The tensile strength before and after thermal cycling was significantly higher in copings cemented with RMGIC compared to CGIC (p < 0.05) and was similar to that for zinc phosphate (p > 0.05). Thermal cycling and sandblasting of the inner surface of the metal copings with different granulations did not influence retention (p > 0.05).

CONCLUSIONS

Zinc phosphate cements and RMGIC showed similar retention. Additionally, the retention of the cements was not influenced by either thermal cycling or the particle size of the aluminum oxide.

The influence of implant abutment surface roughness and the type of cement on retention of implant supported crowns

OBJECTIVES

To provide relative data on the retentive characters of the commonly used cements on different implant abutment surfaces.

MATERIALS AND METHODS

A total of 20 implant abutments were divided into 2 groups. Ten implants were unaltered and ten were air borne particle abraded with 50μ aluminium oxide. Three luting agents (Tempbond, IRM and ImProv) were used to secure the crowns to abutments. All the crowns were removed from the abutment with an Instron machine at 0.5mm per minute and tensile bond strengths were recorded. Statistical analysis was performed using Anova, Paired t-test and Post-Hoc tests.

RESULTS

IRM showed the highest mean tensile strength among the three cements when used with treated and untreated implant abutment surfaces. Change in the abutment surface roughness had no effect on the mean tensile bond strength of TempBond and IRM cements, whereas ImProv cement showed reduced tensile strength with sandblasted surface.

CONCLUSION

When increased retention is required IRM cement with either sandblasted or milled surface could be used and when retrievability is required cements of choice could be either TempBond or ImProv.

A comparative evaluation of the effect of dentin desensitizers on the retention of complete cast metal crowns

CONTEXT

Desensitizers are used to reduce dentin hypersensitivity. They affect the surface texture of prepared dentin and may alter the retention of fixed restorations.

AIMS

The aim was to evaluate the effect of dentin desensitizers on the retention of complete cast metal crowns luted with glass ionomer cement.

SUBJECTS AND METHODS

Fifty freshly extracted human premolars were subjected to standardized tooth preparation (20° total convergence, 4 mm axial height) with a computer numerically controlled machine. Individual cast metal crowns were fabricated from a base metal alloy. Dentin desensitizers included none (control), a glutaraldehyde (GLU) based primer (Gluma desensitizer), casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) (GC Mousse), erbium, chromium: YSGG laser (Waterlase MD Turbo, Biolase) and Pro-Argin (Colgate Sensitive Pro-Relief desensitizing polishing paste). After desensitization, crowns were luted with glass ionomer cement and kept for 48 h at 37°C in 100% relative humidity. The samples were tested using a universal testing machine by applying a load at a crosshead speed of 0.5 mm/min.

STATISTICAL ANALYSIS USED

Statistical analysis included One-way ANOVA, followed by the Scheffe post-hoc test with P < 0.05.

RESULTS

All dentin desensitizers showed significantly different values: Pro-Argin (4.10 Megapascals [Mpa]) < CPP-ACP (4.01 mpa) < GLU based primer (3.87 Mpa) < Virgin dentin (3.65 Mpa) < LASER (3.37 Mpa).

CONCLUSIONS

On comparing the effect of prepared virgin dentin, GLU based primer, CPP-ACP, LASER and Pro-Argin on the retention of complete cast metal crowns luted with glass ionomer cement on prepared teeth, it can be concluded that Pro-Argin and CPP-ACP showed the best retention in this in vitro study.

Comparison of 3 luting agents on retention of implant-supported crowns on 2 different abutments

BACKGROUND

For fixed prostheses, retention is one of the most important factors for clinical success. It is unknown whether grooves that increase surface area of implant abutment while retaining the diameter and wall height provide greater uniaxial retention force. The purpose of this study was to determine the retention of 3 different cements on 2 implant abutments with different surface configurations.

MATERIALS AND METHODS

Thirty samples on 2 different abutments (a total of 60 crowns) with different margin and axial walls configuration and surface area were used. Metal crowns were fabricated on the abutment and cemented with 3 different (zinc-phosphate [ZP], glass ionomer [GI], or eugenol-free zinc oxide [ZO]) cements. After cementation, implant-abutment-casting assemblies were thermal cycled 1000 times with 1-minute dwell-time between 5°C and 55°C then subjected to tensile test with universal testing machine until decementation occurred. The mean force required to dislodge castings from abutment was determined.

RESULTS

The luting agents influenced retention of castings on implant abutments, whereas different surface configurations and total surface area of the abutments did not influence the uniaxial retention forces. Among the cements tested, ZP exhibited higher values of retention, followed by GI and eugenol-free ZO.

CONCLUSIONS

The increase in surface area of abutment did not result in improved retention. The present results suggest using ZP rather than GI and eugenol-free ZO in implant-supported crowns to provide higher retention.

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

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

Conventional and contemporary luting cements: an overview

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

Film thicknesses of recently introduced luting cements

STATEMENT OF PROBLEM

A luting cement must maintain a minimum film thickness over a sufficient period of time to allow seating of indirect restorations. The performance of newer luting cements in this regard has not been evaluated.

PURPOSE

The purpose of this study was to compare the film thicknesses of 6 luting cements, 2 resin-modified glass ionomer (FujiCEM and RelyX Luting Plus), 2 composite resin (Panavia 21 and RelyX ARC), and 2 self-adhesive resin (Maxcem and RelyX Unicem) cements, over 3 minutes.

MATERIAL AND METHODS

The film thickness (microm) of each cement (n=7) was determined at room temperature at 1, 2, and 3 minutes after the start of mixing, according to the testing method set forth in ISO Standard 9917. Means of all cements were compared at the 2-minute interval, and means at the 1- and 3-minute intervals for each were compared to the mean for the same cement at 2 minutes, using 1-way analyses of variance (ANOVA) and Tukey-Kramer multiple comparison tests (alpha=.05).

RESULTS

Except for 1 resin-modified material at 3 minutes, a point beyond its specified working time, all materials produced film thicknesses under 30 microm at 3 minutes and under 26 microm at 2 minutes.

CONCLUSIONS

All of the materials tested meet the ISO standard of 25-microm maximum film thickness for up to 2 minutes after mixing.

Effect of tooth surface roughness on marginal seating and retention of complete metal crowns

STATEMENT OF PROBLEM

Retention and marginal adaptation factors have major influence on the failure of cemented complete veneer crowns.

PURPOSE

This study investigated the effect of axial surface roughness on the marginal seating and retention of silver-palladium crowns luted with zinc phosphate, glass ionomer, and resin cements.

MATERIAL AND METHODS

Coarse and fine diamond stones were used to create various surface roughnesses of premolars. A milling machine was used to control the height and angle of the axial walls of tooth preparations. Ten cast metal crowns in 6 subgroups were luted with 3 cements (Phosphacap, Fuji Cap I, and Panavia 21). Marginal seating was recorded with a Digimatic indicator. Retention was determined by measuring the tensile force required to remove a metal crown with a Lloyd testing machine.

RESULTS

Two-way analysis of variance revealed statistically significant differences (P <.001) in retention for both luting cements and surface roughness. No significant difference was recorded for marginal seating relative to roughness (P =.860) and interaction effects (P =.204). Tukey-HSD tests revealed substantial differences in retention among Phosphacap, Fuji Cap I, and Panavia 21 cements. Significant differences were not confirmed in marginal seating between Fuji Cap I and Phosphacap cements with coarse diamonds, and Phosphacap and Panavia 21 cements with fine diamonds.

CONCLUSIONS

The best retention for complete metal crown was demonstrated for tooth preparations ground with coarse diamonds and cemented with Panavia 21 cement. Differences in axial surface roughness had no effect on the marginal seating of the complete metal crowns.

Current status of luting agents for fixed prosthodontics

STATEMENT OF THE PROBLEM

The long-term clinical outcome of fixed prosthodontic treatment depends, in part, on the use of adhesives that can provide an impervious seal between the restoration and the tooth. There are several types of available luting agents, each possessing unique properties and handling characteristics. No one product is ideal for every type of restoration.

PURPOSE

The purpose of this article is to review available dental luting agents, discuss improvements and drawbacks in newly formulated adhesives, and present the indications for their use.

RESULTS

Each cement type is physically and chemically unique. A single adhesive will not suffice in modern day clinical practice.

Effects of adhesive fixed prosthesis retainer design on resultant resin luting agent thickness

STATEMENT OF PROBLEM

Resin cement thickness may influence the success or otherwise of adhesive fixed prostheses and needs to be quantified for future stress analyses.

PURPOSE

This study evaluated the effect of different complexities of retainer preparation design on resultant resin lute thickness.

MATERIAL AND METHODS

Five retainer designs were evaluated for resin luting thickness (Panavia Ex) after cementation to appropriately selected natural teeth as follows: (1) flat plate retainer; mandibular canine; (2) occlusal rests, mandibular premolar; (3) occlusal rests, proximal grooves, mandibular premolar; (4) modified three-quarter crown, mandibular premolar; and (5) occlusal strut, maxillary premolar. Five samples of each design were prepared in vitro. A mesiodistal and a buccolingual section were obtained from each sample with a diamond saw. Measurements were carried out on the fluorescent cement lute with a confocal microscope. Mean resin thickness and cervical resin thickness were analyzed with analysis of variance and Tukey tests.

RESULTS

Resin thickness (micron) for each of the retainer designs were as follows (mean +/- SD): design 1, 58 +/- 40; design 2, 67 +/- 42; design 3, 80 +/- 28; design 4, 87 +/- 15; and design 5, 85 +/- 29. There were no significant differences among the designs (mean global value 75.4). The three-quarter crown (design 4) had a significantly wider cervical resin thickness (P < or = .01) than designs 1, 2, and 3.

Dental luting agents: A review of the current literature

STATEMENT OF PROBLEM

The practice of fixed prosthodontic has changed dramatically with the introduction of innovative techniques and materials. Adhesive resin systems are examples of these changes that have led to the popularity of bonded ceramics and resin-retained fixed partial dentures. Today's dentist has the choice of a water-based luting agent (zinc phosphate, zinc polycarboxylate, glass ionomer, or reinforced zinc oxide-eugenol) or a resin system with or without an adhesive. Recent formulations of glass ionomer luting agents include resin components (resin-modified glass ionomers), which are increasingly popular in clinical practice.

PURPOSE

This review summarizes the research on these systems with the goal of providing information that will help the reader choose the most suitable material.

MATERIAL

The scientific studies have been evaluated in relation to the following categories: (1) biocompatibility, (2) caries or plaque inhibition, (3) microleakage, (4) strength and other mechanical properties, (5) solubility, (6) water sorption, (7) adhesion, (8) setting stresses, (9) wear resistance, (10) color stability, (11) radiopacity, (12) film thickness or viscosity, and (13) working and setting times. In addition, guidelines on luting-agent manipulation are related to available literature and include: (1) temporary cement removal, (2) smear layer removal, (3) powder/liquid ratio, (4) mixing temperature and speed, (5) seating force and vibration, and (6) moisture control. Tables of available products and their properties are also presented together with current recommendations by the authors with a rationale.

Effect of dynamic loading methods on cement film thickness in vitro

PURPOSE

Reduced cement flm thicknesses can improve crown seating and decrease marginal discrepancies. Improved marginal adaptation has the potential to reduce plaque accumulation, periodontal disease, and cement dissolution. Studies have indicated that dynamic seating methods can reduce seating discrepancies associated with zinc phosphate and resin cements. However, other types of cements and other dynamic techniques have not yet been studied or compared, nor has the mechanism for improved seating been fully explained. Therefore, the purpose of this study was to investigate the effect of a variety of loading methods on the film thicknesses of current types of crown and fixed partial denture cements compressed between glass plates.

MATERIALS AND METHODS

This study investigated the effect of three dynamic loading methods on film thickness of six representative fixed prosthodontic cements. These included zinc phosphate, resin-modified glass ionomer, encapsulated glass ionomer, adhesive composite resin, composite resin, and polycarboxylate. The method was derived from American Dental Association specifications for cement film thickness. In control groups, the cements were placed between two glass glass plates and statically loaded with a 15-kg weight. The test groups were initially similarly loaded, and then for 30 seconds further subjected to simulated repeated patient opening and closing, vibrations from an electromallet, or an ultrasonic device.

RESULTS

Mean film thicknesses ranged from 7.4 micrometers for polycarboxylate / ultrasound up to 40.3 micrometers for composite resin / static. Two-way analysis of variance revealed that the effects of material type and cementation method and their interaction all significantly affected film thickness (P < .0001). Multiple range analysis showed that dynamic methods were generally superior to static loading and that the ultrasonic method was the best overall.

CONCLUSIONS

The different dynamic loading methods all significantly decreased cement film thicknesses between glass plates. The ultrasonic method was the most effective. The type of cement used also influenced film thickness. Composite resins were more affected than other materials.

In vivo marginal adaptation of cast crowns luted with different cements

Large marginal crown discrepancies are deleterious. Although previous studies have examined casting seating in vitro, few have evaluated the effects of different luting cements on in vivo seating. Hence this in vivo study compared marginal discrepancies created by different cements on cast crowns. Tooth preparations were completed according to acceptable procedures on previously intact human molars that were severely periodontally compromised and scheduled for extraction. Castings were made by conventional techniques. The castings were randomly assigned to the following luting agents: zinc phosphate cement, resin-modified glass-ionomer cement, and the same resin-modified glass-ionomer cement with a dentinal bonding agent. After 6 months the teeth were carefully extracted, embedded, and sectioned, and vertical and horizontal discrepancies were measured. Analysis of variance revealed that all cements resulted in similar discrepancies. Vertical discrepancies were considerably greater than horizontal discrepancies, and the distributions of marginal discrepancies were skewed towards upper ranges.

Marginal and internal fit of four different types of ceramic inlays after luting. An in vitro study

The marginal and internal fit of four different types of ceramic inlays--Cerec, Celay, Empress, and Vita In-Ceram Spinell--was determined after they had been luted on extracted premolars. For the Cerec inlays sharp and U-shaped proximal box shapings were also compared. There was no statistically significant difference either in the proximal fit or in the gingivoproximal fit between the four inlay systems studied, with the exception of the Cerec inlays made for preparations with sharp proximal boxes, which had wider marginal gaps. At the occlusal margins a significant-principle order of the gap width was established. The best internal fit was recorded for the Celay inlays, whereas there was no significant difference in the internal fit between the other systems. For the Cerec inlays the U-shaped proximal box shaping improved the marginal accuracy all around the restoration.

Luting cement-metal surface physicochemical interactions on film thickness

Low film thickness is critical to the clinical success of cemented castings. This study investigated the effect of luting agent-metal physico-chemical surface interactions on film thicknesses of representative luting agents. Control group luting agents were placed between two glass plates, as described by American Dental Association specifications 8, 61, and 66, and test group luting agents were positioned between glass and metal plates. The materials selected were zinc phosphate cement, polycarboxylate cement, glass ionomer cement, glass ionomer-composite resin hybrid cement and a resinous cement, with a type III gold alloy, a noble metal ceramic alloy, and a base metal ceramic alloy. A two-way analysis of variance and follow-up tests were done. The effects of the type of metal surface, type of cement, and their statistical interaction significantly affected film thickness (p < 0.0001). The type of cement had a greater affect on film thickness than the type of metal. A glass ionomer cement produced lower overall film thicknesses than other cement types, and a noble metal ceramic alloy created lower overall film thicknesses than other types of metal. American Dental Association specifications for cement film thickness did not accurately reflect normal cement use.

In vivo microleakage of luting cements for cast crowns

Standardized tooth preparations were completed on previously intact human molars in vivo, and castings were made with a precious metal ceramic alloy by conventional techniques. The castings were randomly assigned to the following luting agents: zinc phosphate, composite resin-glass ionomer hybrid, and a composite resin-glass ionomer hybrid with a dentinal bonding agent and were cemented in a standardized manner to periodontally compromised molars. After 6 months the teeth were carefully extracted, stained, embedded, and sectioned, and the in vivo microleakage was measured. ANOVA disclosed significant differences between groups, and a multiple comparisons test revealed that the zinc phosphate group leaked significantly more than other cement groups.

Effect of adhesive luting agents on the marginal seating of cast restorations

This study determined the effect of new adhesive luting agents on the marginal seating of cast restorations. Standardized preparations were completed on freshly extracted premolars, impressions were made, and complete metal veneer crowns were cast with a base metal alloy. The castings were placed on their respective teeth and the extent of marginal opening was recorded. They were then assigned to a luting agent group: glass ionomer cement (GI), polycarboxylate cement (PC), microfilled BIS-GMA composite resin with NPG-GMA/PMDM dentinal bonding agent (GMA + NPG), microfilled BIS-GMA/phosphate ester composite resin (GMA/PE), or zinc phosphate cement (ZP). The castings were cemented and marginal openings remeasured. ANOVA revealed that the cement groups were similar before cementation (p 0.35) but were different after cementation (p < 0.0001). Tukey's multiple comparisons test identified statistically similar groups that were different from other groups and ranked them from lesser to greater marginal opening: (GI, ZP, PC) (GMA/PE, GMA + NPG).