Compressive and diametral tensile strengths of current adhesive luting agents

A comprehensive in vitro study on the performance of two different strategies to simplify adhesive bonding

Objective

The purpose of this study is to compare the bonding performance and mechanical properties of two different resin composite cements using simplified adhesive bonding strategies.

Materials and methods

Shear bond strength of two resin composite cements (an adhesive cement: Panavia V5 [PV5] and a self‐adhesive cement: RelyX Universal [RUV]) to human enamel, dentin, and a variety of restorative materials (microfilled composite, composite, polymer‐infiltrated ceramic, feldspar ceramic, lithium disilicate and zirconia) was measured. Thermocycle aging was performed with selected material combinations.

Results

For both cements, the highest shear bond strength to dentin was achieved when using a primer (PV5: 18.0 ± 4.2 MPa, RUV: 18.2 ± 3.3 MPa). Additional etching of dentin reduced bond strength for RUV (12.5 ± 4.9 MPa). On enamel, PV5 achieved the highest bond strength when the primer was used (18.0 ± 3.1 MPa), while for RUV etching of enamel and priming provided best results (21.2 ± 6.6 MPa). Shear bond strength of RUV to restorative materials was superior to PV5. Bonding to resin‐based materials was predominantly observed for RUV.

Conclusions

While use of RUV with the selective‐etch technique is slightly more labor intensive than PV5, RUV (with its universal primer) displayed a high‐bonding potential to all tested restorative materials, especially to resin.

Clinical significance

For a strong adhesion to the tooth substrate, PV5 (with its tooth primer) is to be preferred because etching with phosphoric acid is not required. However, when using a wide range of varying restorative materials, RUV with its universal primer seems to be an adequate option.

Evaluation of physical-mechanical properties of self-adhesive versus conventional resin cements

Aim: The purpose of this study was to compare the microhardness, diametral tensile strength, compressive strength and the rheological properties of self-adhesive versus conventional resin cements. Methods: Specimens of a conventional (RelyX ARC) and 3 self-adhesive (RelyX U200, Maxcem Elite, Bifix SE) types of resin cements were prepared. The Knoop test was used to assess the microhardness, using a Microhardness Tester FM 700. For the diametral tensile strength test, a tensile strength was applied at a speed of 0.6 mm/minute. A universal testing machine was used for the analysis of compressive strength and a thermo-controlled oscillating rheometer was used for the Rheology test. One-way ANOVA and Tukey’s test (α=0.05) were used for data analysis. Results: According to microhardness analysis, all the cements were statistically similar (p>0.05), except for Maxcem that presented lower hardness compared with the other cements in relation to the top surface (p<0.05). In the diametral tensile strength test, Relyx U200 and RelyX ARC cements were statistically similar (p>0.05), presented higher value when compared to the Maxcem and Bifix cements (p<0.05). The compressive strength of RelyX ARC and Maxcem Elite cements was statistically higher than RelyX U200 and Bifix cements (p<0.05). Regarding the rheology test, Maxcem Elite and RelyX ARC cements showed a high modulus of elasticity. Conclusions: The self-adhesive cements presented poorer mechanical properties than conventional resin cement. Chemical structure and types of monomers employed interfere directly in the mechanical properties of resin cements.

Influence of Bioactive, Resin and Glass Ionomer luting cements on the fracture loads of dentin bonded ceramic crowns

Objective:

To investigate the failure loads of dentin bonded all-ceramic crowns when luted with Bioactive, resin and glass ionomer cements (GIC) in an in-vitro setting.

Methods:

This study was conducted at King Saud University, Saudi Arabia, from Nov.2018 to March 2019. In this study, 60 premolar teeth were prepared for dentin-bonded ceramic crowns. Lithium disilicate ceramic crowns fabricated using CAD-CAM technique were cemented to teeth using Bioactive (ACITVA), Resin (Nexus 3 Gen) and GIC (Ketac Cem- Maxicap). Half of the bonded specimens in each group were thermocycled (50000 cycles), however the remaining half were not aged (n=10). Fracture loads of bonded crowns were assessed by exposing them to static axial occlusal loads (1mm/min) using a round ended metal probe in a Universal testing machine. Means and standard deviations among the study groups were compared with ANOVA and Tukey-Kramer multiple comparisons test.

Results:

Highest failure loads were observed in resin group without ageing (thermocycling) (689.13±89.41 N), however, the lowest loads were observed in GIC specimens with ageing (243.16±49.03 N). Among non-aged samples, failure loads for Bioactive (480.30±47.26 N) group were less than Resin (689.13±89.41 N) samples but higher than GIC (307.51±45.29 N) specimens respectively. Among the aged specimens, Bioactive (404.42±60.43 N) showed significantly higher failure loads than GIC (243.16±49.03 N), however lower failure loads than Resin (582.33±95.95 N) samples.

Conclusions:

Dentin boned crowns with resin cementation showed higher failure loads than Bioactive and GIC luted crowns. Crowns luted with Bioactive cement showed acceptable failure loads for use as restoration on anterior teeth.

Use of a Resin-lonomer in Crown-Root Fracture Repair of a Canine Tooth of a Dog

A resin-ionomer material was used to repair a longitudinal sub-crestal crown-root fracture of a maxillary canine tooth of a young dog. Infinity™, the resin-ionomer used in this report, has been shown in human studies to be biocompatible with soft and osseous tissues, making it appropriate for use as a subgingival restorative material1,2,3,4,5,6. The tooth was treated endodontically to achieve apexification, followed by conventional endodontic treatment, crown-root fracture repair, and preparation for placement of an Inceram crown.

Fluorinated Montmorillonite Composite Resin as a Dental Pit and Fissure Sealant

Molar pits and fissures tend to be affected by caries due to cleaning difficulties. As such, the filling of pits and cracks with sealants is common to deter the onset of caries. However, current clinical practices rely on sealants that lack the ability to release and recharge fluoride ions. Thus, we herein report the development of a fluoride-montmorillonite nanocomposite resin that has the potential to provide sustained release of fluoride due to the strong adsorption of fluoride by montmorillonite. X-ray diffractometry, thermogravimetric analysis, and Fourier-transform infrared spectroscopy were employed to confirm the successful insertion of the polymer into the interlayer structure. The mechanical properties (viscosity, hardening depth, hardness, diametral tensile strength, flexural strength, and wear resistance) of the developed composite resin were then examined, and simulation of the oral environment demonstrated a good fluoride ion release and recharge ability for the effective prevention of dental caries. Finally, we demonstrated the non-cytotoxic nature of this material using the water-soluble tetrazolium salt (WST-1) test. We expect that the described fluoride-containing composite resin may become a new clinical option in the near future.

A Review of Dental Cements

This review provides an in-depth comparison of advantages and disadvantages of different types of dental cements as they are used for cementing base metal alloy crowns in dogs.

What is the Best Available Luting Agent for Implant Prosthesis?

Cement-retention is a viable option in restoring dental implants. A wide range of dental cements with different properties are commercially available for use in the cementation of implant prostheses. The selection of a dental cement for proper clinical application can be challenging. This article overviews the commercially available dental cements used in cement-retained implant-supported prostheses. Guidelines for cement selection are presented according to abutment and prosthetic material. Cementation techniques to reduce excess cement in peri-implant tissues are also mentioned.

Effect of aging and curing mode on the compressive and indirect tensile strength of resin composite cements

BACKGROUND

Resin composite cements are used in dentistry to bond ceramic restorations to the tooth structure. In the oral cavity these cements are subjected to aging induced by masticatory and thermal stresses. Thermal cycling between 5 and 55 °C simulates the effect of varying temperatures in vitro. Purpose of this study was to compare indirect tensile to compressive strength of different cements before and after thermal cycling. The effect of the curing mode was additionally assessed.

METHODS

Indirect tensile strength and compressive strength of 7 dual-curing resin composite cements (Multilink Automix, Multilink SpeedCem, RelyX Ultimate, RelyX Unicem 2 Automix, Panavia V5, Panavia SA Plus, Harvard Implant semi-permanent) was measured. The specimens were either autopolymerized or light-cured (n = 10). The mechanical properties were assessed after 24 h water storage at 37 °C and after aging (20,000 thermo cycles) with previous 24 h water storage at 37 °C.

RESULTS

Indirect tensile strength ranged from 5.2 ± 0.8 to 55.3 ± 4.2 MPa, compressive strength from 35.8 ± 1.8 MPa to 343.8 ± 19.6 MPa.

CONCLUSIONS

Thermocyclic aging of 20,000 cycles can be considered a suitable method to simulate the degradation of indirect tensile strength but not compressive strength of resin composite cements. The effect of thermocycling and the curing mode on the resin composite cements is material dependent and cannot be generalized.

Strength comparison of anterior teeth restored with ceramic endocrowns vs custom-made post and cores

PURPOSE

The aim of the study was to compare strength of the anterior teeth restored with ceramic endocrowns versus custom-made post and core.

METHODS

The investigation used the finite element analysis. Three 3-D models of maxillary central incisor were created: model A-tooth restored with metal post and core with ceramic crown; model B-tooth with leucite ceramic endocrown; model C-tooth with lithium disilicate ceramic endocrown. Each model was subjected to a 100N force applied at a distance of 5mm from the incisal edge, at the angle of 130° to the long axis of the tooth. The modified von Mises failure criterion was used to evaluate the strength of the dentin, ceramic and resin cement, and Huber-Mises-Hencky failure criterion for cast alloy. Contact stresses in the cement-tissue adhesive interface were calculated.

RESULTS

The lowest stresses occurred in the anterior tooth restored with custom post and core (model A). The mvM stress of 47.5MPa concentrated in leucite ceramic endocrown (model B) and its value was close to the tensile strength of this material. The maximal mvM stresses in the lithium disilicate ceramic endocrown (model C) were 4 times lower than tensile strength of this material. In all cases contact stresses in the adhesive interface under restorations did not exceed the resin cement bond strength to dentin.

CONCLUSIONS

Leucite ceramic endocrowns in incisors may fracture during physiological loading. Endocrowns made of lithium disilicate ceramic are resistant to failure. Posts and prosthetic crowns are still recommended for anterior teeth restorations.

Effect of activation modes on the compressive strength, diametral tensile strength and microhardness of dual-cured self-adhesive resin cements

The purpose of this study was to compare the compressive strength, diametral tensile strength and microhardnss of several selfadhesive resin cements (Rely-X U200, Clearfill SA Luting, G-CEM LinkAce, Maxcem Elite, PermaCem 2.0, and Zirconite) using different activation modes (self-cured, light-cured) and testing time (immediately, 24 h, thermocycling). Specimens were prepared for the compressive strength (Ø 4×6 mm) and diametral tensile strength and microhardness (Ø 6×3 mm) according to ISO standards. The strength after 24 h was higher than immediately after. In addition, G-CEM showed the highest values. In terms of the activation modes, Rely-X U200, PermaCem 2.0 had higher values in the light-curing than the self-curing. In conclusion, all cements demonstrated clinically available strength values and revealed differences in strength according to their composition, testing time and activation mode. Furthermore, correlation was found between the microhardness (degree of conversion) and mechanical strengths of the cements tested.

Assessment of 68 Prosthodontic Crowns in 41 Pet and Working Dogs (2000-2012)

A search of the medical and dental records at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania was conducted to identify dogs that received full or partial prosthodontic crowns over a 13-year period (2000-2012). Forty-one dogs with a total of 68 prosthodontic crowns were identified. Further criteria for acceptance into the study included presence of complete medical records containing adequate information pertaining to the procedures performed, and current follow-up either by telephone, electronic mail, or via in-person examination. Treatment was considered to be successful when the prosthodontic crown was in place and there was no further structural injury to the tooth upon making contact with the client or at the time of death of the dog confirmed by the client. The mean number of days the prosthodontic crowns remained in place without further injury to the tooth was 1,598 (range, 161-4, 464 days [median, 1,414 days], standard deviation 1,093 days). Bond failure between the cement and the tooth or the cement and the prosthodontic crown occurred in 3 cases (4.4%). Fracture of the prosthodontically treated tooth occurred in an additional 7 cases (10.3%). Treatment was classified as successful in 58 cases (85.3%). The results suggest that prosthodontic crown therapy is a successful, practical, and durable treatment option for protection of previously injured teeth in pet and working dogs.

Retention of bonded titanium copings fixed to implant abutments

STATEMENT OF PROBLEM

Conical abutments can be laser welded to the abutment base to compensate for differing implant axes. As laser welding requires expensive equipment, alternative methods for bonding the conical abutment part with the abutment base should be considered.

PURPOSE

The purpose of this in vitro study was to evaluate the retention of Ti-6Al-7Nb copings bonded adhesively to Ti-6Al-7Nb abutments and to compare it with the stability achieved by laser welding.

MATERIAL AND METHODS

A total of 104 two-part Ti-6Al-7Nb specimens were prepared and divided into 13 groups with 8 specimens each. In this 2-part study, 3 luting resins (Panavia F 2.0 [PF]; Multilink Automix [MA]; Superbond C&B [SB]) were used with or without metal priming (PR). The laser welding group (LW) served as the control. After storage for 1 or 150 days (150 days with thermal cycling [TC]), push-out retention and welded joint stability were tested. The data were analyzed with ANOVA and the Tukey HSD multiple comparison tests.

RESULTS

The choice of resin, thermal cycling, and metal priming had a significant effect on resin push-out retention. LW provided the strongest retention, followed by PF, MA, and SB. For PF and SB, TC decreased retention. PR did not lead to higher retention but provided better bonding stability when TC was applied.

CONCLUSIONS

The retention values suggest that considering the maximum mastication forces, resin bonding is an appropriate substitute for the laser welding method.

Retention of Root Canal Posts: Effect of Cement Film Thickness, Luting Cement, and Post Pretreatment

The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc] and a self-etch adhesive resin cement [Panavia F2.0]) were used. After removal of the crowns of 360 extracted premolars, canines, or incisors, the root canals were prepared with a parallel-sided drill system to three different final diameters. Half the posts did not receive any pretreatment. The other half received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement, pretreatment with tribochemical silicate coating significantly increased retention of the posts. Increased cement film thickness resulted in decreased retention of untreated posts and of pretreated posts luted with zinc phosphate cement. Increased cement film thickness had no influence on retention of pretreated posts luted with resin cement. Thus, retention of the posts was influenced by the type of luting cement, by the cement film thickness, and by the post pretreatment.

Conventional glass-ionomer materials: A review of the developments in glass powder, polyacid liquid and the strategies of reinforcement

OBJECTIVES

The development of glass-ionomers (GIs) from the earliest experimental GI formulations to the modern day commercially available GIs was reviewed. The aim of the review was to identify the developments in the glass powder and polyacid liquid constituents of GIs since their inception in the late 1960s.

DATA

The glass powder has undergone major changes from the earliest GI powder formulation (G200) in an effort to enhance the reactivity with the polyacid liquid. The GI liquids have also been optimised by the manufacturers in terms of polyacid composition, molecular weight and concentration to improve the handling characteristics. Despite these developments in the glass powder and polyacid liquid constituents, GIs cannot 'truly' be advocated for the restoration of posterior dentition due to the poor mechanical properties when compared with dental amalgam and resin-based composites (RBCs).

SOURCES

Various attempts to improve the mechanical properties of GIs through substitution of reinforcing fillers to the GI powder or modification of the GI liquid were identified in the dental literature. Despite the claimed improvements in mechanical properties of the modified GIs, a wide variation in mixing and testing conditions was identified which prevented a valid assessment of the reported reinforcement strategies. When investigating a GI reinforcement strategy it is crucial that the mixing and testing conditions are standardised to allow a valid comparison between studies.

STUDY SELECTION

The dental literature reporting the earliest experimental GIs to modern day commercially available GIs (1969-2015) was reviewed. In addition, full-text publications and abstracts published in English reporting various GI reinforcement strategies were included.

CONCLUSION

Nevertheless, major improvements in GI formulations through a reinforcement strategy have yet to be made to enable clinical usage of GIs for the restoration of posterior dentition.

CLINICAL SIGNIFICANCE

GIs chemically are inherently weak but bond to sound tooth structure without the need for preconditioning or removal of sound tooth structure such that improvements in the mechanical properties of GIs would be desirable. Although advances have been made through different GI glass powder and polyacid liquid formulations over the past 40 years, further improvements in the mechanical properties of the current GIs are required to be indicated for the restoration of posterior dentition. The literature is replete with reports on GI reinforcement, however, improved reporting and control of mixing and testing conditions are required for a valid assessment of the reinforcement strategies.

In vitro tensile strength of luting cements on metallic substrate

The aim of this study was to determine the tensile strength of crowns cemented on metallic substrate with four different types of luting agents. Twenty human maxillary molars with similar diameters were selected and prepared to receive metallic core castings (Cu-Al). After cementation and preparation the cores were measured and the area of crown's portion was calculated. The teeth were divided into four groups based on the luting agent used to cement the crowns: zinc phosphate cement; glass ionomer cement; resin cement Rely X; and resin cement Panavia F. The teeth with the crowns cemented were subjected to thermocycling and later to the tensile strength test using universal testing machine with a load cell of 200 kgf and a crosshead speed of 0.5 mm/min. The load required to dislodge the crowns was recorded and converted to MPa/mm(2). Data were subjected to Kruskal-Wallis analysis with a significance level of 1%. Panavia F showed significantly higher retention in core casts (3.067 MPa/mm(2)), when compared with the other cements. Rely X showed a mean retention value of 1.877 MPa/mm(2) and the zinc phosphate cement with 1.155 MPa/mm(2). Glass ionomer cement (0.884 MPa/mm(2)) exhibited the lowest tensile strength value. Crowns cemented with Panavia F on cast metallic posts and cores presented higher tensile strength. The glass ionomer cement showed the lowest tensile strength among all the cements studied.

Hertzian indentation testing of glass-ionomer restoratives: A reliable and clinically relevant testing approach

OBJECTIVES

To investigate the load to failure of encapsulated posterior glass-ionomer (GI) restoratives tested under Hertzian indentation and to explore the validity and reproducibility of the test results achieved for consideration of inclusion as an ISO testing protocol.

METHODS

Groups of 20 disc-shaped specimens (10.0±0.1mm diameter, 3.10±0.03mm thickness) were prepared (in batches of four) from three encapsulated posterior GI restoratives. Discs were tested while resting freely on a dentine analogue material at 24h under Hertzian indentation at a rate of 1mm/min delivered through a 20mm diameter hard steel ball. The failure mode and fracture origin of the GI specimens was assessed by fractography. Statistical analyses of the load to failure data were conducted using SPSS software (p<0.05) with the normality and homogeneity of variance of the load to failure data assessed using the Shapiro-Wilk and Levene's test, respectively. Data was also analysed using regression analyses to identify trends within the load to failure data sets.

RESULTS

The load to failure data for the GI restorative groups investigated were normally distributed (p>0.05), homogenous (p>0.05) and not significantly influenced by batch (p>0.780) or specimen number (p>0.447) although significant differences (p<0.05) between the GI restorative materials were evident. Fractographic analysis identified smooth fracture surfaces parallel to the loading axis where the failure mode was bottom initiated radial cracking. The mean coefficient of variation (CoV) for the GI restorative load to failure data sets achieved using Hertzian indentation testing was 7%.

SIGNIFICANCE

The failure mode and fracture origin of the GI restoratives tested using Hertzian indentation is representative of the clinical situation in vivo. The reliability of the load to failure data sets produced were improved compared with routinely employed mechanical testing approaches suggesting the possibility of inclusion as an ISO testing protocol.

Diametral tensile strength and film thickness of an experimental dental luting agent derived from castor oil

The need to develop new dental luting agents in order to improve the success of treatments has greatly motivated research.

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.

Are encapsulated anterior glass-ionomer restoratives better than their hand-mixed equivalents?

OBJECTIVES

The performance of encapsulated anterior GI restoratives were compared with their hand-mixed equivalents for the range of powder to liquid mixing ratios routinely encountered clinically. The clinically induced variability of powder to liquid mixing variations of an anhydrous GI restorative formulation was also compared with conventional GI restorative formulations that contained a polyalkenoic acidic liquid.

METHODS

Mean compressive fracture strengths, mean elastic moduli and mean total volumetric wear were determined for the encapsulated anterior GI restoratives mechanically mixed in a Capmix or Rotomix machine and the hand-mixed GI restoratives prepared with powder contents reduced from that recommended by the manufacturer (100%) in 10% increments to 50% for a constant weight of liquid. Multiple comparisons of the group means were made using a one-way analysis of variance (ANOVA) and Tukey's multiple range tests employed at P<0.05.

RESULTS

For the encapsulated GI restoratives, the mean compressive fracture strength, mean elastic modulus and in-vitro wear resistance were significantly increased compared with their hand-mixed equivalents prepared with powder contents below that recommended by the manufacturers. The conventional GI restoratives resulted in a linear deterioration (R2>0.95) of the mean compressive fracture strength and mean elastic modulus with powder content compared with the bi-modal deterioration for the anhydrous GI restorative.

CONCLUSIONS

Encapsulated anterior GI restoratives outperform their hand-mixed equivalents for the range of powder to liquid mixing ratios routinely encountered clinically such that they are advocated for use in clinical practice. Anhydrous GI restorative formulations are more susceptible to clinically induced variability on mixing compared with conventional GI restorative formulations that contained a polyalkenoic acidic liquid.

Effect of cement selection and finishing technique on marginal opening of cast gold inlays

STATEMENT OF PROBLEM

The standard cement for partial-veneer cast gold restorations has been zinc phosphate. With increasing interest in using resin and resin-modified glass ionomer cements for this purpose, marginal adaptation with use of these newer cements must be assessed.

PURPOSE

The purpose of this in vitro study was to determine if the marginal adaptation of cast gold inlays is comparable for 3 different luting agents and 3 finishing techniques.

MATERIAL AND METHODS

Cast gold inlays were cemented into triangular preparations on the buccal surface of 45 extracted human molars. Three operators each used a different technique for finishing margins: finishing during cementation (FD), finishing before cementation (FB), and finishing before and during cementation (FBA). The 15 teeth for each operator were divided into 3 subgroups of 5 each to accommodate 3 cements: zinc phosphate (Fleck's zinc phosphate: ZP), resin-modified glass ionomer (RelyX Luting: RXL), and self-adhesive modified resin (RelyX Unicem: RXU). For all specimens, fine sandpaper disks followed by fine cuttle disks were used for finishing the castings. The marginal gap was measured using a Nikon measuring microscope at x50 magnification. Data were analyzed with a 1-way ANOVA for each cement (alpha=.05).

RESULTS

There were significant differences among finishing techniques for each cement (P<.05). For ZP, the smallest mean marginal gaps were for FD (31 microm) and FBA (42 microm). For RXL, FBA produced the smallest gap (19 microm). For RXU, FB (23 microm) and FBA (22 microm) were optimal.

CONCLUSIONS

Within the limitations of this in vitro study, the marginal gap attained with cementation of partial-veneer cast gold restorations with ZP (31 microm) can also be obtained using RXL or RXU. The techniques of FD or FBA are best used for ZP, whereas the FBA technique is best for RXL, and either FB or FBA is optimal for RXU. The FBA technique yielded a small gap; this was common to all 3 cements.

Is encapsulation of posterior glass-ionomer restoratives the solution to clinically induced variability introduced on mixing?

OBJECTIVES

Three GI restorative systems were evaluated to determine if encapsulated GI restoratives performed more favorably than the hand-mixed equivalents prepared with powder contents progressively decreased from that recommended by manufacturers in 10% increments for a constant weight of liquid which are routinely employed in clinical practice.

METHODS

Mean compressive fracture strengths, associated Weibull moduli and mean elastic moduli were determined for series of 30 nominally identical cylindrical specimens for three hand-mixed GI restoratives prepared with 100-50% of the recommended powder content for a constant weight of liquid and the equivalent encapsulated GI restoratives mechanically mixed in the Capmix or Rotomix machines.

RESULTS

Decreasing the powder content of the three hand-mixed GI restoratives for a constant weight of liquid from that recommended by the manufacturers resulted in a progressive deterioration of the mean compressive fracture strengths and the mean elastic modulus. The elastic modulus was more sensitive than the compressive fracture strength to highlighting the impact of mixing ratio variations in the GI restoratives. There were no significant differences between mean compressive fracture strengths of mechanically mixed encapsulated GI restoratives, however, variations in mean elastic modulus were dependent upon the mixing time employed.

CONCLUSIONS

The employment of an intrinsic material property was more sensitive than a non-intrinsic material property to highlight the impact of mixing ratio variations in hand-mixed restoratives and the effect that the method of mechanical mixing has on encapsulated GI restoratives. Encapsulated GI restoratives are a potential solution to the operator induced variability associated with hand-mixed GI restoratives.

Comparison of the Flexural Strength of Five Adhesive Resin Cements

STATEMENT OF PROBLEM

The increased use of adhesive resin cements in bonded prosthetic restorations has led to restorations debonding under function.

PURPOSE

This investigation evaluated the differences in the flexural strength of new adhesive resin cements as a function of specimen age and storage condition.

MATERIALS AND METHODS

Four new dual-cure cements were compared to C/B Metabond. Twenty specimens of each of the five cements were prepared in a rectangular glass mold (25 x 2 x 2 mm). The new cements were light-activated with a 550 mW/cm(2) lamp for 80 seconds on both the top and bottom surfaces. The auto-cured cement was allowed to set according to manufacturer's directions. Half the specimens were tested immediately after curing while the other half were stored in distilled water at 37 degrees C for 30 days. A three-point bending test was performed using an Instron at a crosshead speed of 1 mm/min. The results were analyzed by analysis of variance and Scheffé tests ( p < 0.05) to examine the effect of specimen age and storage condition.

RESULTS

RelyX ARC exhibited a significantly higher flexural strength compared with Calibra and Panavia F when tested immediately. The standard cement, C/B Metabond, deformed and did not fracture at the immediate test time. After storage, the flexural strength had significantly improved from the immediate test time for Calibra, Cement-It, Panavia F, and C/B Metabond. However, there were no significant differences in the flexural strength among the cements when tested after 30 days in water at 37 degrees C.

CONCLUSION

Immediately after curing, these new adhesive resin cements are not equivalent, as evidenced by the significant variability in the measured flexural strength. The distinctions among the cements diminish after aging in water, which may be due to residual polymerization or a plasticizing effect from water absorption.

CLINICAL SIGNIFICANCE

When light-cured, all the new adhesive resin cements have greater early strengths than the auto-cured cement; however, the wide variation in immediate bending strength suggests that some cements may be more appropriate for use in high-stress clinical situations such as resin-bonded fixed partial dentures.

The influence of montmorillonite clay reinforcement on the performance of a glass ionomer restorative

OBJECTIVES

A pristine calcium montmorillonite (Ca-MMT) and an organically modified 12-amino-dodecanoicacid treated montmorillonite (ADA-MMT) clay were evaluated to determine the reinforcement effect on the performance of a glass ionomer (GI) restorative ChemFil Superior (Dentsply DeTrey, Kanstanz, Germany) to assess the potential as a posterior filling material.

METHODS

Mean compressive fracture strengths and standard deviations were determined for groups of 30 cylindrical specimens with 0.5-2.5 wt.% Ca-MMT and ADA-MMT additions to either the powder or the liquid elements of the GI. Working characteristics were assessed using an oscillating rheometer, the interlayer d-spacings (d(001)) of each MMT clay was determined using X-ray diffraction (XRD) and the set cement structure was determined by scanning electron microscopy (SEM).

RESULTS

The addition of up to 1.0 wt.% ADA-MMT resulted in a significant increase in the mean compressive fracture strength of the GI utilising the one-way ANOVA and Tukey test comparisons at P<0.05. When Ca-MMT clay was added to the GI a significant reduction in mean strength was recorded (P<0.05). MMT clay addition to the powder and liquid element of the GI in excess of 1.0 wt.% resulted in no significant differences in working characteristics although increases in setting times were evident for MMT addition up to 1.0 wt.%. XRD patterns identified the d(001) peaks for Ca- and ADA-MMT at 2 theta angles of 8.44 degrees and 5.07 degrees and d(001) spacings of 1.04 and 1.74 nm, respectively.

CONCLUSIONS

The increased interlayer d-spacings recorded for ADA-MMT clay demonstrates that the clay had expanded layers which may have provided an increased opportunity for the polyacrylic acid chains of the GI restorative to diffuse into the MMT galleries. It is postulated that the increased interlayer d-spacings for the ADA-MMT clay had a positive reinforcing effect on the GI compared with the Ca-MMT clay where no increased performance was identified. The study has highlighted the potential for increasing the performance of GI restoratives when using an organically modified clay as a reinforcement which could increase the potential of GIs as posterior filling materials.

The optimisation of the initial viscosity of an encapsulated glass-ionomer restorative following different mechanical mixing regimes

OBJECTIVES

An optimisation of the mixing ratio of an encapsulated glass-ionomer restorative in terms of compressive strength, working characteristics and pore distribution following mechanical mixing with different mixing machines was undertaken.

METHODS

Mean compressive fracture strengths, standard deviations and associated Weibull Moduli (m) were determined from series of 30 encapsulated specimens with varying powder/liquid mixing ratios. Working characteristics were assessed using an oscillating rheometer and scanning electron microscopy and image analysis was used to investigate the influence of the mixing ratios and mixing regime on the pore distribution.

RESULTS

Cement mixing regime or reducing the powder/liquid mixing ratio did not have any significant influence on the compressive strength. Utilising the one-way ANOVA and Tukey test comparisons at P<0.05 the cement manipulation regime significantly increased the compressive strength on increasing the powder content of the capsule by 10% (G110) when a combination of rotational and centrifugal action rather than vibration were employed. Utilising a Rotomix at a powder content of G110 was beneficial in reducing porosity levels within the restorative investigated compared with a conventional mixing machine. Increasing the powder content reduced the working characteristics regardless of the mixing regime.

SIGNIFICANCE

The increased reliability of encapsulated restoratives reported in the literature following mixing with a combination of rotational and centrifugal compared with vibrational action was only evident when the powder content of the restorative under investigation was increased by 10%. The finding suggests that the initial viscosity of the cement mass of the Ketac Fil Plus Aplicap as supplied by the manufacturer may not have been optimised.

Influence of activation modes on diametral tensile strength of dual-curing resin cements

In metallic restorations, the polymerization of dual-curing resin cements depends exclusively on chemical activation. The effect of the lack of photoactivation on the strength of these cements has been rarely studied. This study evaluated the influence of activation modes on the diametral tensile strength (DTS) of dual-curing resin cements. Base and catalyst pastes of Panavia F, Variolink II, Scotchbond Resin Cement, Rely X and Enforce were mixed and inserted into cylindrical metal moulds (4 x 2 mm). Cements were either: 1) not exposed to light (chemical activation = self-cured groups) or 2) photoactivated through mylar strips (chemical and photo-activation = dual-cured groups) (n = 10). After a 24 h storage in 37ºC distilled water, specimens were subjected to compressive load in a testing machine. A self-curing resin cement (Cement-It) and a zinc phosphate cement served as controls. Comparative analyses were performed: 1) between the activation modes for each dual-curing resin cement, using Student’s t test; 2) among the self-cured groups of the dual-curing resin cements and the control groups, using one-way ANOVA and Tukey’s test (alpha = 0.05). The dual-cured groups of Scotchbond Resin Cement (53.3 MPa), Variolink II (48.4 MPa) and Rely X (51.6 MPa) showed higher DTS than that of self-cured groups (44.6, 40.4 and 44.5 MPa respectively) (p < 0.05). For Enforce (48.5 and 47.8 MPa) and Panavia F (44.0 and 43.3 MPa), no significant difference was found between the activation modes (p > 0.05). The self-cured groups of all the dual-curing resin cements presented statistically the same DTS as that of Cement-It (44.1 MPa) (p > 0.05), and higher DTS than that of zinc phosphate (4.2 MPa). Scotchbond Resin Cement, Variolink II and Rely X depended on photoactivation to achieve maximum DTS. In the absence of light, all the dual-curing resin cements presented higher DTS than that of zinc phosphate and statistically the same as that of Cement-It (p > 0.05).

Influence of polymerization mode on flexural properties of esthetic resin luting agents

STATEMENT OF PROBLEM

Dual-polymerized esthetic resin luting agents have become popular. However, it is not clear whether the autopolymerized versions of such products have adequate strength to meet clinical requirements.

PURPOSE

The aim of this study was to investigate the effect of different polymerization modes on the flexural properties of esthetic resin luting agents.

MATERIAL AND METHODS

Ten esthetic resin luting agents were studied. Materials with 3 polymerization modes (dual, auto, and light) were Appeal, Calibra, Illusion, Lute-It, and Variolink-II; those with 2 polymerization modes (dual and auto) were Bistite-II-DC, Cement-It-C&B, Clearfil-DC-Cement, Linkmax, and Nexus2-Dual-Syringe. Five flexural strength specimens (2 x 2 x 25 mm) were made for every available polymerization mode for each material. The specimens were stored in distilled water for 24 hours at 37 degrees C. The specimens were then tested for flexural strength (MPa) and flexural modulus (GPa) using the 3-point bending method on a universal material testing machine at a cross-head speed of 0.5 mm/min. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests (alpha=.05).

RESULTS

Flexural strength values were the highest for dual-polymerized Nexus2-Dual-Syringe (155 MPa), whereas the values were lowest for autopolymerized Bistite-II-DC (56 MPa) and light-polymerized Appeal (63 MPa). Flexural moduli values ranged from 4.3 to 10.0 GPa. The polymerization mode and luting agent influenced flexural strength and modulus significantly (P<.05).

CONCLUSION

Dual-polymerized resin luting agents had higher or equal flexural strength compared to the autopolymerized mode. All the groups tested passed the flexural strength requirement of the ISO 4049 specification.

In vitro evaluation of the retention of zirconia-based ceramic posts luted with glass ionomer and resin cements

The retention of zirconia-based ceramic posts (CosmoPost system) luted with glass ionomer and resin cements was evaluated. Thirty-two extracted, caries-free, unrestored teeth were selected and stored in chlorhexidine and water solution. The teeth were endodontically treated and randomly assigned to two groups (n=16). Each tooth was decoronated and prepared to a depth of 10.0 mm from root surface to receive a 1.4 mm diameter zirconium dioxide post. Each group had posts cemented with either glass ionomer cement (Fuji I) or resin cement (Variolink II). The post/teeth specimens were embedded in resin blocks and subjected to tensile testing. The tensile force required to dislodge the cemented posts in a tensile testing machine was recorded. The mean stress values of both groups were analyzed for statistical differences using ANOVA and Student's t-test. Significance level was set at 5%. Mean peak forces at failure (N) and standard deviation for the tested cements were the following: Fuji I = 121.8 (±17.4) and Variolink II = 228.1 (±36.8). Posts luted with the resin cement presented statistically significant higher tensile bond strength than those retained with glass ionomer (p<0.05). It may be concluded that zirconia posts cemented with resin-based cement (Variolink II) failed at statistically significant higher values compared to those cemented with glass ionomer cement (Fuji I). Regardless of the cement type, the posts failed adhesively at the cement/post interface when subjected to a tensile force.

Mechanical property characterization of resin cement after aqueous aging with and without cyclic loading

OBJECTIVE

The purpose of this study was to determine changes in flexural properties of resin cement under cyclic loading and aqueous aging.

METHODS

Panavia F flexural modulus and strength were measured by static loading to failure after 48-h, 31-d, and 60-d aqueous aging at 37 degrees C with and without cyclic loading at clinical stress levels. Six specimens were used for each experimental condition. Scanning electron microscopy (SEM) was also used to characterize the morphology of the fractured surfaces to potentially identify resin cement components particularly susceptible to degradation under simulated clinical function.

RESULTS

A two-factor ANOVA (p< or =0.05) and Least Significant Difference post hoc test indicated that cyclic loading produced a significant increase in the flexural modulus with no significant effect on the flexural strength. In contrast, aqueous aging time produced a significant decrease in flexural strength with no effect on the flexural modulus. The SEM fracture analysis indicated that resin matrix fracture occurred in static-aqueous specimens; while in the aqueous-cycled specimens, resin matrix fracture occurred in addition to an increasing proportion of filler/resin interface fracture as a result of both increased aqueous aging and increased flexural cycles.

SIGNIFICANCE

Evidence suggests that after aqueous aging with cyclic loading to simulate resin cement clinical function, initial degradation may be related to breakdown of the filler/resin interface bond. Such breakdown is potentially reflective of slow crack propagation that may contribute to in vivo resin cement cohesive failure.

Comparison of microleakage of three acid-base luting cements versus one resin-bonded cement for Class V direct composite inlays

STATEMENT OF PROBLEM

Demineralized dentin beneath set cement may adversely affect microleakage under fixed restorations.

PURPOSE

Microleakage of direct composite inlays cemented with acid-base cements and a methyl methacrylate resin cement were evaluated to determine their effect on the integrity of the underlying hybridized dentin.

MATERIALS AND METHODS

Sixty Class V box preparations (3 mm x 3 mm x 1.5 mm) were precisely prepared in previously frozen bovine teeth with one margin in enamel and another margin in dentin. Direct composite inlays (EPIC-TMPT) for each preparation were divided into 4 groups of 15 specimens each and cemented with 3 acid-base cements (control group): Elite, Ketac-Cem, Hy-Bond Carbo-Cem, and 1 adhesive resin cement: C&B Metabond. All specimens were stored in distilled water for 24 hours at 37 degrees C before immersion in 0.5% basic fuchsin for 24 hours. The dye penetration was measured on the sectioned specimens at the tooth-cement interface of enamel and cementum margins and recorded with graded criteria under light microscopy (Olympus Vanox-T) at original magnification x 50, 100, and 200. A Kruskal-Wallis and the Mann-Whitney test at P<.05 were used to analyze leakage score.

RESULTS

All cementum margins of the 3 acid-base cements tested demonstrated significantly higher leakage scores than cementum margins for inlays cemented with the resin cement tested(P<.01). No leakage along the tooth-cement interface was found for inlays retained with the adhesive resin cement.

CONCLUSIONS

Within the limitations of this study, the 3 acid-base cements tested exhibited greater microleakage at the cementum margins than did the adhesive resin cement that was tested.

Effect of a new metal primer on the bond strength between a resin cement and two high-noble alloys

STATEMENT OF PROBLEM

With the development of new adhesive resin cements, the question of surface treatment of noble metal castings with primers has become an important issue.

PURPOSE

This study compared the tensile bond strength and its durability of a new metal primer (Alloy Primer, Kuraray) to 2 noble metal alloys (Au-Ag-Cu-Pt and Au-Pt-Pd-Ag-In).

MATERIAL AND METHODS

Sixty cast disk specimens of each alloy were polished, grit blasted with 50 microm Al(2)O(3), and ultrasonically cleaned in 96% isopropanol. Then, they were either nonprimed or primed only with the Alloy Primer or Alloy Primer combined with ED Primer (Kuraray). Plexiglas tubes filled with self-curing composite resin (Clearfil FII, Kuraray) were bonded to the metal samples with the use of an alignment apparatus and a self-curing luting cement (Panavia 21 Ex). The samples were stored in water, either for 3 days with no thermal cycling or for 150 days with 37,500 thermal cycles. After the different storage conditions, the tensile bond strengths of the specimens were determined.

RESULTS

The mean bond strengths increased over storage time for all groups, except for the grit-blasted Au-Pt-Pd-Ag-In group. However, only in the grit-blasted and the primed groups for the Au-Ag-Cu-Pt alloy was this increase significantly different (P<.01). After 150 days of storage, the mean bond strength to Au-Ag-Cu-Pt alloy was 38.8 MPa without priming, whereas it was 40.6 to 40.8 MPa with the use of the primers. After the same time, the mean bond strength to the Au-Pt-Pd-Ag-In alloy was 20.6 MPa without priming, whereas it was 31. 9 to 37.8 MPa with the use of the primers. When comparing the different bonding methods and different storage times for the alloys, the superiority of the usage of both primers in combination was determined. Conclusion. The tested Alloy Primer significantly improved the bond strength of the dental adhesive resin cement (Panavia 21 Ex) to noble alloys. However, this effect depended on the alloy composition and was much greater for the Au-Pt-Pd-Ag-In alloy than for the Au-Ag-Cu-Pt alloy.

Mechanical properties of dental luting cements

STATEMENT OF PROBLEM

Dental luting cements fail by microcrack formation and bacterial ingress or by gross failure and crown dislodgment. Both of these failure modes are related to mechanical properties and deformation.

PURPOSE

This study evaluated those mechanical properties of cements. METHODS AND MATERIAL. Elastic modulus for 8 representative cements (zinc phosphate, polycarboxylate, glass ionomer, encapsulated glass ionomer, resin-modified glass ionomer, resin composite, and adhesive resin composite) was measured by using a nondestructive technique and evaluated for cement type and storage time (1 hour, 1 day, 1 week, 1 month, 1 year) by 2-way ANOVA (P <.05). Compressive properties (proportional limit, resilience, and toughness), ultimate strengths (compressive, diametral tensile, and flexural), and flexural toughness were determined and evaluated by 2-way ANOVA for 2 crosshead testing rates (5 and 0.5 mm/min) and cement type (P <.05).

RESULTS

Cements varied with respect to elastic moduli, compressive proportional limit, compressive resilience, compressive strength, compressive toughness, diametral tensile strength, flexural strength, and flexural toughness. Storage time affected the elastic moduli of different materials in different ways. Elastic moduli of polycarboxylate and glass ionomer cements increased over time, whereas the other materials changed little after the first day. Crosshead rate only significantly affected compressive proportional limit and resilience.

CONCLUSIONS

Luting cements differed considerably with respect to mechanical properties.

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.

Fracture toughness of conventional, resin-modified glass-ionomer and composite luting cements

OBJECTIVES

This study was conducted to determine if significant differences existed between the fracture toughness of three types of luting cement, and, if the method of mixing conventional glass-ionomer luting cements, hand-mixed or mechanically mixed, influenced the value obtained.

METHODS

Three types of luting cement were investigated: conventional glass-ionomer cement (two handmixed and two capsulated cements, KetacCem, Fuji I and KetacCem Maxicap, Fuji Cap I), a resin-modified glass-ionomer cement (Vitremer Luting Cement) and a resin composite cement (Scotchbond Resin Cement). Eleven specimens of each of the six cements were fabricated to determine the plane strain fracture toughness using the chevron notch short rod technique. After seven days the specimens were loaded in a water bath, at a crosshead speed of 4 microns/s and the fracture toughness values calculated.

RESULTS

ANOVA indicated significant differences between the cements (p < 0.0001) and each cement was compared with all others using Fishers PSLD test (p < 0.05). The rank order of results from highest fracture toughness value to lowest (mean +/- s.d.) was Scotchbond Resin Cement (1.31 +/- 0.17), Vitremer Luting Cement (1.08 +/- 0.1), Fuji Cap I (0.37 +/- 0.04), KetacCem Maxicap (0.37 +/- 0.05), Fuji I (0.34 +/- 0.04), KetacCem (0.27 +/- 0.03).

SIGNIFICANCE

Of the cements tested, the resin composite cement is most likely to resist clinical failure by cement cohesive failure.

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.

Microscopic and energy dipersive x-ray analysis of surface adaptation of dental cements to dental ceramic surfaces

STATEMENT OF PROBLEM

Clinical failure rates reported for acid etched/resin-bonded ceramic restorations are significantly lower than those reported for restorations luted with traditional cements. This improved clinical performance may be associated with greater adaptation of the resin cements to the ceramic surfaces.

PURPOSE

The objective of this study was to determine whether the use of resin cements accompanied by acid etching results in improved adaptation when compared with the use of zinc phosphate or glass ionomer cements.

RESULTS

The results of this experiment indicate that superior adaptation of cement to ceramic is produced by acid etching and luting with resin cement. In addition, the results lead to the hypothesis that the high clinical failure rates reported for zinc phosphate or glass ionomer luted restorations are due either to incomplete adaptation or to failure within the cement.

CONCLUSION

The findings indicate that the use of resin cements accompanied by acid etching of the ceramic surface is the preferred technique for clinical placement of all-ceramic restorations.

Evaluation of the clinical performance and effectiveness of adhesively-bonded metal crowns on damaged canine teeth of working dogs over a two- to 52-month period

In this clinical study, 41 metal full crown restorations of canine teeth were placed in 18 working dogs. Twenty-six canine teeth had severe attrition with no involvement of the pulp cavities; 15 fractured canine teeth were endodontically treated. With the exception of one tooth, at least one-third of the coronal part of each canine tooth was available for a supragingivally performed, minimal tooth crown preparation. A dental resin luting cement technique was used to bond the electrolytically etched crown (made from an alloy of cobalt-chrome-molybdenum) to the tooth. The metal crowns were slightly shorter and with a more rounded tip than the original tooth. Posts or post-and-core techniques were not used. Median follow-up period was 30 months (range 2 to 61 months), at which time 36 crowns were found to be intact and functional. Five crowns were lost; three as a result of subsequent injury and fracture of the tooth below the crown; one as a result of use of less than one-third of the coronal portion of the tooth for retention of the crown; and one as a result of an oblique fracture of the root.

Capsulated versus hand-mixed glass-ionomer luting cements for post retention

OBJECTIVES

Glass-ionomer luting cements are supplied in two forms, as loose powder and liquid to be hand-mixed (HM) or pre-proportioned in a capsule to be mechanically mixed (MM). This study was to determine if post retention in pull-out tests was affected by the method of mixing the cement.

METHODS

Two hundred stainless steel posts of diameter 1.75 mm were cemented within post-channels prepared in stainless steel cylinders using two hand-mixed cements FJL and KCL (Fuji I Luting Cement and Ketac-Cem Luting Cement) and two capsulated cements FJC and KCM (Fuji Cap I and Ketac-Cem Maxicap). Three groups of test specimens were prepared. In Group I each cement was mixed as recommended by the manufacturer, Group II cements were placed within a capsule and mechanically mixed and in Group III cements were removed from the capsule and mixed by hand. Specimens were stored for 1 h at 37 degrees C and 100% humidity prior to post pull-out tests at a crosshead speed of 10 mm min-1. The maximum loads at failure were subjected to Weibull analysis and Mann-Whitney tests to determine probabilities of survival and significant differences between the groups.

RESULTS

Significant differences (P < 0.05) were found between all pairs of cements tested except KCM(MM) vs FJL(HM), FJL(MM) vs KCL(HM), KCL(MM), vs KCL(HM), FJC(HM) vs FJC(MM), KCL(MM) vs FJL(MM).

CONCLUSIONS

The capsulated cements as supplied by the manufacturers are preferable to the equivalent hand-mixed formulations, as they give higher probabilities of survival when subjected to a given load. Both capsulated and hand-mixed formulations of Fuji had higher probabilities of survival compared to the corresponding Ketac cements. The probability of post survival can be altered by the method of mixing the cement.