Dental cements for definitive luting: a review and practical clinical considerations

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.

Effect of Photo-polymerization Delay on the Bond Strength and Microhardness of Dual-polymerizing Resin Cements

STATEMENT OF PROBLEM

To fully maximize the potential of dual-polymerizing resin cements, a thorough understanding of how the light- and chemical-polymerizing components interact in a resin system is required. Disorder in the polymerization process between the two components may hurt one of the components versus the other, affecting the overall properties and performance of the resin cements.

PURPOSE

Evaluate photo-polymerization delay time on dentin shear-bond strength and Vickers microhardness of dual-polymerizing resin cements.

METHODS AND MATERIALS

Shear bond strength (SBS) of self-adhesive (RelyX Unicem 2, 3M ESPE) and adhesive (RelyX Ultimate, 3M ESPE) dual-polymerizing resin cements were evaluated. Dentin specimens (n=80) were prepared for the SBS test according to ISO standard 29022:2013. Teeth were randomly allocated into eight groups based on the type of cement, and photo-polymerization delay times (0, 2, 5, and 10 minutes). Vickers microhardness test (HV) was performed following ASTM E384-17 (n=32) prepared based on cement type and photo-polymerization delay times; specimens were tested after 24 hours of storage. Statistical analysis was performed using two-way ANOVA to determine the individual and combined effects of resin cement type and photo-polymerization delay time on SBS and HV.

RESULTS

Resin cement and photo-polymerization delay times for the adhesive cement at 0- and 2-minute pairings had significantly higher SBS means than all other combinations (p<0.0001). Resin cement type was also statistically significant (p<0.0001). Resin cement type and photo-polymerization delay times were not significant (p=0.3550) for HV.

CONCLUSIONS

Photo-polymerization delay time affected dentin SBS with higher bond strength when photo-polymerization delay time was performed between 2 and 5 minutes with a self-adhesive resin cement, and between 0 and 2 minutes with an adhesive resin cement. Delaying photo-polymerization time to 10 minutes led to inferior dentin SBS and HV for both self-adhesive and adhesive dual-polymerizing resin cements.

Knowledge of Saudi dental students and interns towards luting cements and their applications in fixed prosthodontics

BACKGROUND

Enhancement of students' knowledge is essential in improving their clinical skills and performance. Thus, the curriculum should be prepared to achieve a better outcome. The current study aimed to determine the dental students' and interns' basic knowledge towards dental luting cements and their application in dental practice to improve the theoretical and clinical training sections.

MATERIALS AND METHODS

A cross-sectional study was conducted among dental students and interns at three Colleges of Dentistry in the Kingdom of Saudi Arabia between September 2019-June 2020. An online questionnaire was used which included demographic data, questions about luting cement usage, cementation techniques, and commonly used cements in dental clinics. Descriptive analysis and chi-square test were used to show the association between level of dental education and the use of dental cements using SPSS software. The significance level was set at 5%.

RESULTS

The total respondents were 626 dental students/interns of whom 78.8% were undergraduate dental students. Participants who reported undergraduate studies as the source of information were 79.7%. The type of restoration was the main factor in luting cement selection (62.6%). Concerning the isolation technique in cementing laminate veneers, 49.7% used dri-angles, cotton rolls and saliva ejectors. Dual-cure resin cement was the most common cement used in all the mentioned restorations except in pressed porcelain laminate veneers and cement-retained implant-supported restorations.

CONCLUSIONS

Students' knowledge and practice in managing dental implants and porcelain laminate veneers need to be improved. The selection of a luting agent for a given restoration by students and interns was based on the basic knowledge, available cement, and the type of restoration. Awareness towards the management of short prepared teeth and custom-made cast posts and cores is also limited.

Toxicity of resin-matrix cements in contact with fibroblast or mesenchymal cells

The main aim of this study was to perform an integrative review on the toxic effects of resin-matrix cements and their products in contact with fibroblasts or mesenchymal cells. A bibliographic search was performed on PubMed using the following search terms: "cytotoxicity" AND "fibroblast" OR "epithelial" OR "mesenchymal" AND "polymerization" OR "degree of conversion" OR "methacrylate" OR "monomer" AND "resin cement" OR "resin-based cement". The initial search in the available database yielded a total of 277 articles of which 21 articles were included in this review. A decrease in the viability of mouse fibroblasts ranged between 13 and 15% that was recorded for different resin-matrix cements after light curing exposure for 20 s. The viability of human fibroblasts was recorded at 83.11% after light curing for 20 s that increased up to 90.9% after light curing exposure for 40 s. Most of the studies linked the highest toxicity levels when the cells were in contact with Bis-GMA followed by UDMA, TEGDMA and HEMA. Resin-matrix cements cause a cytotoxic reaction when in contact with fibroblasts or mesenchymal cells due to the release of monomers from the polymeric matrix. The amount of monomers released from the resin matrix and their cytotoxicity depends on the polymerization parameters.

Comparison of the Micro-Shear Bond Strength of Resin Cements to CAD/CAM Glass Ceramics with Various Surface Treatments

This study aimed to compare the effect of acid etching, sandblasting, or silica coating on the micro-shear bond strength of dual-cured resin cements to computer-aided design and computer-aided manufacturing (CAD/CAM) glass ceramic materials. Feldspathic, lithium disilicate, and zirconia-reinforced CAD/CAM ceramics were divided into four groups: control group (C), no surface treatment; hydrofluoric (HF) group, 5% HF acid-etched; sandblasting (SB) group, abraded with 50 µm aluminum oxide (Al₂O₃) particles; silica-coated (CJ) group, abraded with 30 µm silica-modified Al₂O₃ particles. Roughness values were obtained by using a profilometer. The cements were condensed on the surface-treated specimens and a micro-shear bond test was conducted. The ceramic material (p < 0.001) and surface treatment type (p < 0.001) significantly affected the micro-shear bond strength values. HF acid etching can be recommended for the surface pretreatment of feldspathic, lithium disilicate, and zirconia-reinforced CAD/CAM ceramics. Better bond strengths can be obtained with HF acid etching than with sandblasting and silica coating.

Comparison between a glass ionomer cement and a compomer concerning bonded acrylic expander retention and white spot formation : A randomized clinical trial

BACKGROUND

The goal of the present study was to compare a compomer and a glass ionomer cement (GIC) used for full the cementation of acrylic splint-type maxillary expanders with respect to failure rate and white spot lesions (WSLs) in vivo.

METHODS

A total of 120 patients with posterior crossbite and transverse maxillary deficiency were included to the study. The patients were randomly allocated to two groups: GIC group (n = 60) and compomer group (n = 60). The hyrax screw in both groups was activated two times a day for the first week then once a day until the desired amount of expansion was achieved. The rapid maxillary expansion (RME) appliance was left in the mouth for an extra month after the active expansion phase as a retention appliance. Then cementation failures were recorded. In addition, the patients were evaluated for white spot lesions (WSLs) before cementation and after removal of the appliance.

RESULTS

A total of 12 (20%) and 2 (3.3%) RME devices failed in the GIC and the compomer group, respectively. This difference between groups was statistically significant (p = 0.044). There were also statistically significant differences between the GIC and compomer groups in terms of WSLs on the central (p = 0.06) and lateral (p = 0.011) incisors, and on the first molar (0.028). However, no differences were observed for the canines (p = 0.185), first (p = 0.457) and second premolars (p = 0.116). In total, there was a statistically significant difference between the GIC and compomer groups (p = 0.048), with more WSLs in the GIC group.

CONCLUSIONS

Among the products used in the study, the compomer should be preferred over the GIC for cementation of acrylic splint-type rapid maxillary expanders in terms of failure rate and WSLs.

Materials informatics for developing new restorative dental materials: A narrative review

Materials informatics involves the application of computational methodologies to process and interpret scientific and engineering data concerning materials. Although this concept has been well established in the fields of biology, drug discovery, and classic materials research, its application in the field of dental materials is still in its infancy. This narrative review comprehensively summarizes the advantages, limitations, and future perspectives of materials informatics from 2003 to 2022 for exploring the optimum compositions in developing new materials using artificial intelligence. The findings indicate that materials informatics, which is a recognized and established concept in the materials science field, will accelerate the process of restorative materials development and contribute to produce new insights into dental materials research.

Effect of different surface treatments on resin-matrix CAD/CAM ceramics bonding to dentin: in vitro study

BACKGROUND

Evaluating the effect of different surface treatment methods on the micro-tensile bond strength (µTBS) of two different resin-matrix computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics (RMCs).

METHODS

A standardized inlay preparations were performed on 100 intact maxillary premolars. According to the type of the restorative material, the teeth were randomly divided into two equally sized groups (n = 50): (polymer-infiltrated ceramic (Vita Enamic) and resin-based composites (Lava Ultimate)). The inlays were fabricated using CAD/CAM technology. In each group, the specimens were randomly assigned to five subgroups (n = 10) according to the surface treatment method: group 1 used was the control group (no surface treatment); group 2, was treated with air abrasion with 50 μm Al2O3 (A) and universal adhesive (UA); group 3, was treated with air abrasion with 50 μm Al2O3 (A) and silane coupling agent (S); group 4, was treated with hydrofluoric acid (HF) and universal adhesive (UA) and group 5, was treated with Hydrofluoric acid (HF) + silane coupling agent (S). The inlays were then cemented to their respective preparations using dual-cure self-adhesive resin cement (RelyX U200, 3 M ESPE) according to the manufacturer's instructions. The µTBS test was conducted in all groups, and stereomicroscope and scanning electron microscope were used to inspect the failure mode. The data were statistically analyzed using a two-way analysis of variance (ANOVA) and Tukey's post-hoc multiple comparison tests at a significance level of p < 0.05.

RESULTS

Surface treatments significantly increased the µTBS of the materials compared to the control group (p < 0.05). For CAD/CAM RBCs, the µTBS value highest in group 2 whereas, for PICN, the µTBS value was highest in group 3. Cohesive failure of CAD/CAM restorative material was the most predominant mode of failure in all treated groups, whereas adhesive failure at restoration-cement interface was the most predominant failure mode in the control group.

CONCLUSION

Surface treatments increase the µTBS of resin-matrix CAD/CAM ceramics to tooth structure. Air abrasion followed by universal adhesive and hydrofluoric acid followed by silane application appears to be the best strategies for optimizing the bond strength of CAD/CAM RBCs and PICN respectively.

Update on Dental Luting Materials

A dental luting material aids in the retention and stability of indirect restorations on the prepared tooth structure. In dentistry, clinicians are using a wide range of luting materials for the cementation of indirect restorations. Zinc oxide eugenol and non-eugenol cements, zinc phosphate cement, zinc polycarboxylate cement, glass ionomer cement and resin cements are common dental cements used in dentistry. Each luting material or cement possesses unique properties and clinical implications. An ideal luting cement should be biocompatible, insoluble, resistant to thermal and chemical assaults, antibacterial, aesthetic, simple and easy to use. It should have high strength properties under tension, shear and compression to resist stress at the restoration-tooth interface, as well as adequate working and setting times. So far, no luting material possesses all of these properties of an ideal cement. Scientists have been modifying the conventional luting cements to improve the material's clinical performance and developing novel materials for clinical use. To achieve the best clinical outcome, clinicians should update their knowledge and gain a good understanding of the luting materials so that they can make a wise clinical decision on the material selection and obtain an insight into the development of luting cements. Therefore, the objective of this study is to provide a discussion on the physical, chemical, adhesive and aesthetic properties of common luting materials. The clinical indications of these luting materials are suggested based on their properties. In addition, overviews of the modification of the conventional luting materials and the newly developed luting materials are provided.

Adhesion to a CAD/CAM Composite: Causal Factors for a Reliable Long-Term Bond

Computer aided design/manufacturing (CAD/CAM) technology has become an increasingly popular part of dentistry, which today also includes CAD/CAM resin-based composite (RBC) applications. Because CAD/CAM RBCs are much more difficult to bond, many methods and attachment materials are still being proposed, while the best application method is still a matter of debate. The present study therefore evaluates causal factors for a reliable long-term bond, which includes the surface preparation of the CAD/CAM RBC, aging and the type of luting material. The reliability of the bond was calculated, and supplemented by fractography to identify fracture mechanisms. Five categories of luting materials were used: (1) temporary zinc phosphate cement, (2) glass ionomer cement (GIC), (3) resin-modified GIC, (4) conventional adhesive resin cement (ARC), and (5) self-adhesive RC. Half of the CAD/CAM RBC surfaces (n = 200) were sandblasted (SB) with 50 µm aluminum oxide, while the other half remained untreated. Bond strength measurements of the 400 resulting specimens were carried out after 24 h (n = 200) or after additional aging (10,000 thermo-cycles between 5 and 55 °C) (n = 200). The data were statistically analyzed using one- and three-way ANOVA followed by Games-Howell post-hoc test (α = 0.05) and Weibull analysis. Aging resulted in a significant decrease in bond strength primarily for the conventional cements. The highest bond strengths and reliabilities were recorded for both ARCs. SB caused a significant increase in bond strength for most luting materials, but also caused microcracks in the CAD/CAM RBC. These microcracks might compromise the long-term reliability of the bond in vivo.

Effects of calcium hydroxide intracanal medicament on push-out bond strength of endodontic sealers: A systematic review and meta-analysis

OBJECTIVE

To investigate the effect of calcium hydroxide intracanal medicament on the push-out bond strength of resin-based and calcium silicate-based endodontic sealers.

METHODS

A comprehensive search of was conducted for all relevant in-vitro studies. All randomized controlled in-vitro studies that evaluated the effect of calcium hydroxide on the push-out bond strength of resin-based or calcium silicate-based endodontic sealers were assessed. The variables of interest were extracted, and the risk of the included studies was evaluated. The standardized mean difference was calculated and the significance level was set at p value <0.05.

RESULTS

A total of 26 studies were eligible for analysis. There were 45 independent comparison groups and 1009 recruited teeth. The pooled data showed no significant difference in push-out bond strength between calcium hydroxide and control group in the resin-based group (SMD = 0.03; 95% CI = -0.55, 0.60; p = 0.93), and calcium silicate-based group (SMD = 0.02; 95% CI = -0.31, 0.35; p = 0.90). Most of the studies (21 out of 26) were at medium risk of bias and five studies showed a low risk of bias.

CONCLUSION

The available evidence suggests that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of the resin- and calcium silicate-based endodontic sealers.

CLINICAL SIGNIFICANCE

The results of this meta-analysis suggest that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of resin-based and calcium silicate-based endodontic sealers.

Comparison of Bond Strength in the Different Class of Resin Cements to Cast and CAD/CAM Co-Cr Alloys

Objectives

Despite the widespread use of resin cements in cementing dental restorations, their bond strength to CAD/CAM base metal alloys is not widely studied. This study aimed to evaluate the microshear bond strength (μSBS) between cobalt-chrome (Co-Cr) alloys fabricated using casting or CAD/CAM methods with three types of resin cements.

Materials and Methods

Fifty Co-Cr blocks were prepared with CAD/CAM or casting technique. Specimens were divided using primer or not and bonded to three types of resin cements: Panavia F2, RelyX Unicem, and Duo-Link. The differences between the mean μSBS values were analyzed using the two-way ANOVA test and Tukey analysis (α = 0.05). The mode of failure was evaluated using a stereomicroscope. In addition, the specimens were examined by scanning electron microscopy (SEM) based on two received signals: backscattered electrons (SEB) and secondary electrons (SEs). One intact alloy specimen in each group was analyzed by energy-dispersive X-ray spectroscopy (EDX).

Results

Most of the specimens in the no-primer group were prematurely debonded. Statistical analyses showed that the interaction between the alloy substrate and cement type was significant (p=0.001). The bond strength of Panavia F2 was significantly higher than Duo-Link in the CAD/CAM group (p=0.001). SEM evaluation confirmed the difference in grain structures, while EDX showed no remarkable difference in the chemical composition of the alloy substrates.

Conclusion

Alloy fabrication technique may influence the bond strength of resin cements. In the CAD/CAM group, cement containing MDP molecules exhibited higher strength than the etch-and-rinse one.

Cement selection criteria for full coverage restorations: A comprehensive review of literature

BACKGROUND

Proper cement selection in fixed prosthesis plays a determinative role in providing long-term serviceability, retention, caries prevention, and patient satisfaction. This study, reviews different luting agent characteristics and their application based on different clinical situations and different types of full coverage restorations.

MATERIAL AND METHODS

An electronic search was conducted through PubMed, Medline, and Google scholar using following keywords or combinations: restoration, full coverage, PFM, porcelain fused to metal, all ceramic, zirconia, ceramic, casting, fixed partial denture, cement*, dental cement, cement selection, and retention. The most related articles were selected for review.

RESULTS

Choosing a proper luting agent is highly dependent on scientific knowledge regarding the characteristics of restorative materials and luting agents. Conventional cements could be indicated in various situations; however, some restorative materials or clinical situations call for resin-cements to provide predictable retention, support, and durability.

CONCLUSIONS

Conscious selection of retentive cement for each type of restoration/material is necessary to provide predictable successful treatment and reduce the potential complications. Key words:Adhesive cement, dental bridgework, dental cements, dental crowns, dental porcelain, prostheses and implants.

Application of Texture and Fractal Dimension Analysis to Evaluate Subgingival Cement Surfaces in Terms of Biocompatibility

Biocompatibility is defined as “the ability of a biomaterial, prosthesis, or medical device to perform with an appropriate host response in a specific application”. Biocompatibility is especially important for restorative dentists as they use materials that remain in close contact with living tissues for a long time. The research material involves six types of cement used frequently in the subgingival region: Ketac Fil Plus (3M ESPE, Germany), Riva Self Cure (SDI, Australia) (Glass Ionomer Cements), Breeze (Pentron Clinical, USA) (Resin-based Cement), Adhesor Carbofine (Pentron, Czech Republic), Harvard Polycarboxylat Cement (Harvard Dental, Great Britain) (Zinc polycarboxylate types of cement) and Agatos S (Chema-Elektromet, Poland) (Zinc Phosphate Cement). Texture and fractal dimension analysis was applied. An evaluation of cytotoxicity and cell adhesion was carried out. The fractal dimension of Breeze (Pentron Clinical, USA) differed in each of the tested types of cement. Adhesor Carbofine (Pentron, Czech Republic) cytotoxicity was rated 4 on a 0–4 scale. The Ketac Fil Plus (3M ESPE, Germany) and Riva Self Cure (SDI, Australia) cements showed the most favorable conditions for the adhesion of fibroblasts, despite statistically significant differences in the fractal dimension of their surfaces.

Does Preheating Resin Cements Affect Fracture Resistance of Lithium Disilicate and Zirconia Restorations?

This paper assesses the impact of preheating of adhesive cement on the fracture resistance of lithium disilicate and zirconia restorations. Methods: A total of 80 human maxillary premolar teeth were assigned into 8 groups (n = 10) according to material type (either lithium disilicate or zirconia) and type of resin cement (either LinkForce or Panavia SA) with preheating temperature at 54 °C or at room temperature (25 °C). Teeth were prepared and restored with either lithium disilicate or zirconia restorations. After cementation, specimens were thermal cycled (10,000 cycles, 5 °C/55 °C), then load cycled for 240,000 cycles (50 N). Each specimen was statically loaded until fracture and the load (N) at fracture was recorded, then the failure mode was detected. Statistical analysis of data was performed (p ≤ 0.05). Results: There was no significant difference (p = 0.978) in fracture mean values between LinkForce and Panavia SA. Statistically significant difference (p = 0.001) was revealed between fracture resistance of lithium disilicate restorations cemented with LinkForce at 25 °C and at 54 °C; however there was no significant difference (p = 0.92) between the fracture resistance of lithium disilicate restorations cemented with Panavia SA used at 25 °C and at 54 °C. Regarding the interaction between ceramic material, cement type, and cement preheating, there was no significant effect (p > 0.05) in fracture resistance. The cement type does not influence the fracture resistance of ceramic restorations. Preheating of resin cement has negatively influenced the fracture resistance of all tested groups, except for lithium disilicate cemented using LinkForce cement.

Comparison of the residual cement on custom computer-aided design and computer-aided manufacturing titanium and zirconia abutments: A preliminary cohort study

STATEMENT OF PROBLEM

Clinical studies comparing the occurrence and quality of residual cement between custom zirconia and custom titanium abutments with subgingival margins are scarce.

PURPOSE

The purpose of this clinical study was to assess the difference in the amount of residual cement between custom zirconia and titanium abutments with a 1-mm subgingival margin.

MATERIAL AND METHODS

Eighty participants were randomized to receive either a custom zirconia abutment with a bonded titanium insert or a custom titanium abutment with a 1-mm subgingival margin on a posterior bone-level implant. Monolithic lithium disilicate crowns with a screw-access hole were cemented to abutments randomly with either a resin-modified glass ionomer cement or a resin cement. After cementation, the crown-abutment assemblies were removed and photographed from the mesial, buccal, distal, and lingual of the specimen to record the residual cement. The length along the abutment margin of each aspect of the assembly was measured. The surface area of the residual cement (SA) and the surface area of the residual cement per unit length of margin (SA_P) were calculated. Results for the groups were compared with the Fisher exact test, the Friedman test, and the Mann-Whitney U test (α=.05).

RESULTS

The median (lower quartile, upper quartile) of SA and SA_P for the custom zirconia abutment with a bonded titanium insert was 1.9 (0.5, 3.9) mm² and 0.086 (0.032, 0.02) mm², respectively, and for the custom titanium abutment, the values were 2.9 (1.3, 5.1) mm² and 0.138 (0.062, 0.239) mm², respectively. No significant difference was found between the custom zirconia abutments with bonded titanium inserts and titanium abutments for SA (P=.075) and SA_P (P=.083) with the Mann-Whitney U test. No significant difference was found in residual cement between the 4 aspects of the abutment (SA: P=.852; SA_P: P=.954) with the Friedman test and between the 2 types of cement (SA: P=.447; SA_P: P=.878) with the Mann-Whitney U test.

CONCLUSIONS

A similar amount of subgingival residual cement was recorded around the abutment-crown assembly, regardless of the abutment material or cement type used.

Bilayered ceramic anterior restorations with reinforcement of the incisal edge by using lithium disilicate: A multicenter retrospective survival analysis with a maximum of 6-year follow-up

STATEMENT OF PROBLEM

The esthetics of anterior lithium disilicate restorations can be enhanced if the buccal aspect is layered with a feldspathic ceramic. However, whether fractures and chipping of this layer are a prevalent complication is unclear.

PURPOSE

The purpose of this retrospective study was to evaluate the incidence of incisal fracture of a specially designed lithium disilicate reinforcement of the incisal edge for indirect anterior bilayered restorations on both teeth and implants.

MATERIAL AND METHODS

A total of 924 anterior bilayered pressed lithium disilicate restorations in 324 patients and made in one dental laboratory were delivered by 4 restorative dentists. The restorations had the palatal side of the incisal edge in monolithic lithium disilicate and the facial side in feldspathic porcelain. The restorations were evaluated for survival and the occurrence of fracture or chipping. Survival analyses were performed by using the Kaplan-Meier and log rank (Mantel-Cox) tests (α=.05).

RESULTS

Of the 924 restorations, 798 (236 complete crowns, 562 partial restorations) were placed on teeth and 126 on implants. The mean observation time was 38 months (3 to 72 months). The survival rate was 96.5%, with 14 failures occurring. The failures were fracture after dental trauma (n=5), ceramic fracture (n=1), debonding (n=6), poor shade match (n=1), and tooth loss (n=2). Restorations in patients with parafunctional habits and endodontically treated teeth showed a significant decrease in survival rate (P=.018). No significant differences were found between the survival of restorations on teeth and implants and between complete crowns and partial restorations (P=.021). No chipping was observed on any restorations in the study.

CONCLUSIONS

Modified anterior bilayered ceramic restorations showed good survival rates, and no chipping was observed up to 6 years of follow-up. Parafunctional habits and endodontic treatment had a negative effect on the survival rate of restorations. The support of tooth or implant and the restoration type had no effect on the survival.

Aspiration of the dental crown in an elderly patient

The aspiration of objects and foreign bodies requires quick and systematic care. During emergent orotracheal intubation, accidental dental crown release can cause a threat to the patient's life. This paper aimed to report a case of foreign body (dental prosthetic crown) aspiration and its management and discuss alternative approaches. An 81-year-old male patient, who was admitted to the hospital's intensive care unit (ICU) for meningitis, presented with altered consciousness, and decreased oxygen saturation. He underwent emergent orotracheal intubation. After intubation, chest radiography was performed to check for proper orotracheal tube positioning and lung expansion. The resultant images revealed the presence of a foreign body within the right lower lobe bronchus in the shape of a dental crown. The foreign body, intubation cannula and basket clamp were successfully removed, followed by reintubation of the patient. The foreign body was a prosthetic upper premolar dental crown (24). While care should be taken to avoid complications, if a foreign body is aspirated during emergent orotracheal intubation, endoscopic removal appears safe and effective. Careful creation, placement, maintenance, and preservation of prosthetic crowns are critically important in elderly patients.

Bond integrity and microleakage of dentin-bonded crowns cemented with bioactive cement in comparison to resin cements: in vitro study

OBJECTIVE

The aim was to compare restorative marginal integrity of ceramic crowns luted with bioactive and resin cements using micro-computed tomography (micro-CT) microleakage evaluations and bond strength assessment.

METHODS

Thirty molar teeth were prepared by sectioning and polishing for dentin exposure for resin cement build-ups. Teeth were randomly divided among three groups of cements: (1) bioactive (ACTIVA); (2) glass ionomer cement (GIC; Ketac Cem); and (3) resin luting agent (Nexus 3). Bonding regime and build-ups (4 mm × 2 mm) were performed using the recommended protocol. For microleakage assessment, 30 premolar teeth were prepared for dentin-bonded crowns using lithium disilicate ceramic and the computer-aided design and computer-aided manufacturing technique. Crowns were cemented with standard load, cement amount, and duration using three cements (Group A: bioactive; Group B: GIC; Group C: resin) and photopolymerized. Cemented crowns were evaluated for volumetric infiltration using micro-CT (Skyscan, Bruker 1173- at 86 kV, 93 µA, 620 ms) after immersion in 50% solution of silver nitrate (AgNO₃) (24 hours). Shear bond strength (SBS) was assessed by fracture of cement build-ups at a cross-head speed of 0.5 mm/min in a universal testing machine.

RESULTS

Mean SBS among bioactive (21.54 ± 3.834 MPa) specimens was significantly higher than that for GIC (14.08 ± 3.25 MPa) specimens (p < 0.01), but they were comparable to resin samples (p > 0.05) (24.73 ± 4.32 MPa). Microleakage was significantly lower in crowns luted with bioactive (0.381 ± 0.134) cement compared to GIC (1.057 ± 0.399 mm³) (p < 0.01) and resin (0.734 ± 0.166 mm³) (p = 0.014) cemented crowns. The type of luting agent had a significant influence on the microleakage of crowns and bond strength to dentin (p < 0.05).

CONCLUSION

Bioactive cement exhibited less microleakage and comparable SBS to resin luting agents in in vitro conditions.

Comparative Analysis of Static and Viscoelastic Mechanical Behavior of Different Luting Material Categories after Aging

The longevity of indirect restorations is primarily determined by the appropriate selection of the luting material. The function of a luting material is to seal the restoration and hold it in place for the time required for service. The mechanical behavior of luting materials and in particular their aging behavior, therefore, play a decisive role. The study provides a comparative analysis of the static and dynamic mechanical behavior of the most commonly used luting material categories-zinc phosphate cement, glass-ionomer cement, resin-modified glass-ionomer cement, resin-based composites, and self-adhesive resin-based composites-and their aging behavior. It also takes into account that luting materials are viscoelastic materials, i.e., materials that respond to external loading in a way that lies between an elastic solid and a viscous liquid. Flexural strength and modulus were determined in a three-point bending test followed by fractography analysis. The quasi-static and viscoelastic behavior was analyzed by a depth-sensing indentation test provided with a dynamic mechanical analysis (DMA) module at 20 different frequencies (1-50 Hz). The fracture toughness was evaluated in a notchless triangular prism (NTP) test. Material type exhibits the strongest influence on all measured properties, while the effect of aging becomes more evident in the material reliability. The variation of the viscoelastic parameters with aging reflects cement maturation or polymer plasticization.

Influence of Hydrofluoric and Nitric Acid Pre-Treatment and Type of Adhesive Cement on Retention of Zirconia Crowns

Background: The aim of this study was to test the impact of hot acids etching and two types of adhesive cement on the retention of zirconia crowns. Methods: Forty maxillary premolars were prepared, and zirconia crowns were designed and fabricated with proximal extensions, then divided into 4 groups (n = 10). Group AP; the crowns were air-abraded and cemented using Panavia SA Cement. Group AL; the crowns were air- abraded and cemented using GC LinkForce. Group AHP; the crowns were air-abraded, etched with the hot acids (48% hydrofluoric acid and 69% nitric acid), and cemented using Panavia SA Cement. Group AHL; the crowns were air-abraded, etched with the hot acids, and cemented using GC LinkForce. Each zirconia crown was pre-treated and bonded to its corresponding tooth. After thermocycling (5–55 °C/10,000), the retention test was performed and the load required to dislodge the crown was reported in Newton (N), and mode of failure was recorded. The retention strength (MPa) was calculated for each tested variable and statistically analyzed. Results: Group AHP showed the highest mean value of the retention strength, followed by group AP then group AHL. Group AL showed the lowest value. A statistically significant effect (p = 0.001) of the hot acids etching on the retention of zirconia crown was found. Also, there was a significant effect (p = 0.000) of the cement type. The interaction between surface treatment and the cement type has no significant impact (p = 0.882). The main mode of failure for Panavia SA Cement is mixed mode of failure, while for G-CEM LinkForce is adhesive failure. Conclusions: Hot acid etching pre-treatment improved the retention of zirconia crown. Usage of Panavia SA Cement with hot acids etching is effective can be used for adhesive cementation of zirconia crown.

Fracture resistance of cement-retained and screw-cement-retained milled posterior crowns with screw-access hole preparations before and after firing: An in vitro study

STATEMENT OF PROBLEM

When a cement-retained lithium disilicate crown needs to be removed, perforation is needed to reach the abutment screw. How this process affects its strength is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the fracture strength of milled lithium disilicate implant crowns with screw-access holes created before and after the firing stages.

MATERIAL AND METHODS

Nine implant replicas with stock abutments were embedded in acrylic resin. Forty-five lithium disilicate (IPS e.max CAD) crowns were designed, milled, and divided into groups. The control group had no screw access, the blue state group had the screw access created in the intermediate phase of the ceramic, and the postfiring group had the screw access created after firing. The crowns were cemented with a self-adhesive resin cement, placed in an incubator for 24 hours and then thermocycled. The screw-access holes were sealed with composite resin. The crowns were loaded to failure with a universal testing machine using a 1- mm-diameter ball at a crosshead speed of 0.5 mm/min and a 5-kN cell load. Data were analyzed by ANOVA and the Tukey post hoc test (α=.05).

RESULTS

Screw-access holes created before and after firing stages had a significant effect on the fracture resistance of lithium disilicate crowns (P=.002). No difference in fracture resistance was observed between the control group and the blue state group (P>.05), while the fracture resistance of the postfiring group was significantly lower than that of the control group and the blue state group (P<.05).

CONCLUSIONS

The fracture strength of lithium disilicate crowns was not affected by a screw-access hole created during the blue state of the ceramic followed by repair with composite resin. Creating a screw-access hole after firing the ceramic reduced fracture strength.

Shear bond strength of glass ionomer and resin-based cements to different types of zirconia

OBJECTIVE

To investigate the shear bond strength (SBS) of a glass ionomer (GI) cement, an 10-methacryloyloxy-decyl dihydrogen phosphate (MDP)-based adhesive resin cement (MDP-based AC), an MDP-based self-adhesive resin cement (MDP-based SAC), an MDP-free self-adhesive resin cement (MDP-free SAC), and a resin-modified GI (RMGI) cement to a 3 mol% yttria-stabilized (3Y-TZP) and a 5 mol% yttria partially stabilized zirconia (5Y-PSZ).

MATERIALS AND METHODS

Fifty blocks were produced using 3Y-TZP and 5Y-PSZ, assigned to subgroups based on the five cements investigated (n = 10) and luted to cylindrical specimens of the same substrate. Each specimen was loaded in a SBS apparatus to failure. Mean SBS (MPa) values and standard deviations were calculated. Data were analyzed using a two-way analysis of variance and Tukey tests (α = .05). Failed specimens were subjected to fractographic analysis.

RESULTS

MDP-based AC and MDP-based SAC cements displayed the highest SBS values with both the substrates; GI cement showed the lowest. RMGI and MDP-free SAC cements performed better with 3Y-TZP than with 5Y-PSZ. Fractographic analysis revealed only adhesive and mixed failures.

CONCLUSIONS

MDP-based AC and MDP-based SAC cements are suitable for both 3Y-TZP and 5Y-PSZ. MDP-free SAC and RMGI cements are adequate choices for 3Y-TZP, but seem less effective with 5Y-PSZ.

CLINICAL SIGNIFICANCE

MDP-based SACs appear to be as reliable as MDP-based ACs for both 3Y-TZP and 5Y-PSZ cementation. Specifically, for 5Y-PSZ cementation, resin-based MDP-free SACs do not seem to guarantee predictable results in terms of SBS.

The antimicrobial and cytotoxic effects of a copper-loaded zinc oxide phosphate cement

Objectives

Evidence about modifications of dental luting materials to minimize biological failure at the “marginal gap” between teeth and fixed prosthodontics is scarce. We compared a copper-modified (Co-ZOP) and a conventional zinc oxide phosphate cement (ZOP) in terms of antimicrobial and cytotoxic potentials in vitro and in vivo.

Materials and methods

Specimens of ZOP and Co-ZOP were characterized by the mean arithmetic roughness (Ra) and surface free energy (SFE). Powder components were examined using scanning electron microscopy (SEM). Energy-dispersive X-ray spectroscopy (EDX) showed elemental material compositions. In vitro microbial adhesion was shown using SEM, luminescence, and fluorescence assays. CCK-8 assays of mouse fibroblasts (L929) and human gingival fibroblasts (GF-1) were performed after 6, 24, and 48 h of specimen incubation. In vivo, ZOP and Co-ZOP specimens were applied intraorally for 12 h; biofilm accumulation was shown using SEM.

Results

Ra of ZOP and Co-ZOP showed no significant differences; SFE was significantly higher for Co-ZOP. EDX exhibited minor copper radiation for Co-ZOP, none for ZOP. In vitro fungal adhesion to Co-ZOP was significantly higher than to ZOP; in vitro streptococcal adhesion, cytotoxicity, and in vivo biofilm formation were not significantly different.

Conclusions

Co-ZOP showed low surface allocations of copper with no improved antimicrobial properties compared with conventional ZOP in vitro or in vivo.

Clinical relevance

Antimicrobial effects and low cytotoxicity of biomaterials are important for the clinical outcome. Based on our in vitro and in vivo results, no clinical recommendation can be given for the tested Co-ZOP.

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.

Effects of coloring procedures on shear bond strength between resin cement and colored zirconia

PURPOSE

Debonding is expected as a frequent failure type in zirconia restorations. Therefore the aim of the current study is to evaluate the shear bond strength between colored zirconia and resin cement.

MATERIALS AND METHODS

There were 11 groups evaluated each containing 12 zirconia discs (15 mm x 12 mm x 1.6 mm). Groups were colored with the colors A3, B1, C4, D2, and D4 of the VITA classical shade scale. Coloring procedure was carried out for either 3 second or 60 seconds for the study groups and the control group was left untreated. Specimens were then bonded to translucent resin cement having a thickness of 3 mm and width of 3 mm. The shear bond strength of the samples was measured in a universal testing machine with a crosshead speed of 1 mm per minute. Two-way analysis of variance and Tukey's HSD test were used for pairwise comparisons. Also paired t-test was used for comparing groups with the same color but having different shading times.

RESULTS

Any significant difference was not found between the shear bond strengths of samples depending on whether color or shading times. Among the groups, B1 (60 seconds of coloring) had the highest bond strength (10.05 MPa), while A3 (60 seconds of coloring) showed the lowest bond strength (6.72 MPa). However, these differences were not statistically significant.

CONCLUSION

Coloring zirconia did not affect the shear bond strength between zirconia and resin cement.

Effect of Laser Etching and Spark Erosion on Retention and Resistance of Partial Veneer Crown Copings Luted with Adhesive Resin Cement

Purpose:

There has been less focus on methods to improve the clinical performance of partial veneer crowns. In this study, we wanted to explore the potential of two new surface treatment modalities (laser etching and spark erosion) for improving the longevity of partial veneer crowns.

Material and Methods:

Conventional partial veneer crown preparation was done on 90 extracted premolars by a single operator. All the samples used in the study were divided into three groups. Group A were samples to be treated by sandblasting alone, Group B were samples to be treated by sandblasting followed by laser etching, and Group C were samples to be treated by sandblasting followed by spark erosion. Each group consisted of two Sub Groups: Sub Group I-Retention test group, Sub Group: II-Resistance test group. The prepared teeth were randomly allotted to the three groups and subgroups using lot method. Partial veneer crown copings were fabricated for testing retention and resistance. Castings in each subgroup were luted with resin cement to their respective tooth preparations. Retention and resistance testing of samples were done with the use of an Instron Universal testing machine.

Results:

The two surface treatments, laser etching and spark erosion (Groups B and C) of metal copings significantly improved the retention and resistance compared to sandblasted surfaces alone (P ≤ 0.05). Retention and resistance of copings which were sandblasted and spark eroded (Group C) were found to be highest among the three groups (P ≤ 0.05).

Conclusion:

Within the limitation of this study, it can be concluded that the combination of spark erosion and sandblasting significantly improves the retention and resistance values of partial veneer crown. This study helps to provide better knowledge about the surface treatment required for success of partial veneer crowns.

Cell Viability and Tissue Reaction of NeoMTA Plus: An In Vitro and In Vivo Study

INTRODUCTION

The aim of this study was to evaluate the cell viability and tissue reaction of NeoMTA Plus (NMP; Avalon Biomed Inc, Houston, TX) compared with mineral trioxide aggregate (MTA; Angelus, Londrina, PR, Brazil) and Biodentine (BD; Septodont, Saint-Maur-de-Fossés, France).

METHODS

Fibroblasts (3T3) were plated and exposed to 1% extract from the test material before and after setting. Cytotoxicity assessment was performed using the 3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-tetrazolium bromide and sulforhodamine B assays. In vivo evaluation consisted of polyethylene tube implantation of the materials in rat subcutaneous tissue. Histologic analysis occurred at 7, 30, and 90 days, scoring inflammatory events and collagen fiber formation. Analysis of variance and the Tukey and t tests were used for cytocompatibility assays, and the Kruskal-Wallis test followed by the Dunn test were used for biocompatibility assays (P ≤ .05).

RESULTS

The materials in the cytotoxicity assays presented greater viability after setting (P ≤ .05). NMP and MTA presented higher viability than the control (Dulbecco modified Eagle medium) on the 3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-tetrazolium bromide assay before and after setting (P ≤ .05). The sulforhodamine B assay showed that MTA and BD presented less viability than NMP and the control, and NMP was similar to the control before setting. After setting, MTA and BD presented higher viability when compared with the control group (P ≤ .05), and NMP was similar to control. Inflammatory infiltrate reduction occurred throughout the test periods for all materials. At 7 days, neutrophils were present in BD (P ≤ .05), and granuloma and giant cells were present in BD and MTA. At 30 days, BD showed intense inflammatory infiltrates and a large number of macrophages when compared with NMP, MTA, and the control (P ≤ .05). At 90 days, BD presented a thick fiber layer compared with NMP (P ≤ .05).

CONCLUSIONS

NMP showed similar biocompatible behavior to MTA and BD.

Dislodgement Resistance of Zirconia Copings Cemented onto Zirconia and Titanium Abutments

PURPOSE

To determine the effect of the cement type and abutment material on the tensile strength required to dislodge zirconia copings.

MATERIALS AND METHODS

Two experimental groups of abutments were prepared: (1) titanium abutments (n = 30) and (2) zirconia abutments (n = 30). Sixty zirconia copings (custom designed) were fabricated using 3-dimensional computer-assisted design to have a 6-mm projection above the abutment to accommodate a hole, through which a wire was inserted to attach the zirconia coping to a universal testing machine. Each abutment was placed onto an implant analog embedded in acrylic resin blocks to fit onto the universal testing machine. The zirconia copings were cemented onto the abutments with a provisional luting agent, zinc phosphate (ZP) cement, and adhesive resin cement, and after 5500 thermocycles, a tensile force was applied at a crosshead speed of 0.5 mm/min. The removal force was recorded for each specimen. Two-way analysis of variance (ANOVA) and 1-way ANOVA were used for the statistical analysis (P < 0.05).

RESULTS

The mean forces necessary to remove the zirconia copings from titanium abutments were 6.52, 83.09, and 251.18 N for temporary cement, ZP cement, and resin cement, respectively. For zirconia abutments, the required forces were 17.82, 116.41, and 248.72 N.

CONCLUSIONS

The abutment material had no effect on retention, but the cement type affected the retention of the zirconia copings.

Bonding to new CAD/CAM resin composites: influence of air abrasion and conditioning agents as pretreatment strategy

OBJECTIVES

Because of their industrially standardized process of manufacturing, CAD/CAM resin composites show a high degree of conversion, making a reliable bond difficult to achieve.

PURPOSE

The purpose of this experiment was to investigate the tensile bond strength (TBS) of luting composite to CAD/CAM resin composite materials as influenced by air abrasion and pretreatment strategies.

MATERIAL AND METHODS

The treatment factors of the present study were (1) brand of the CAD/CAM resin composite (Brilliant Crios [Coltene/Whaledent], Cerasmart [GC Europe], Shofu Block HC [Shofu], and Lava Ultimate [3M]); (2) air abrasion vs. no air abrasion; and (3) pretreatment using a silane primer (Clearfil Ceramic Primer, Kuraray) vs. a resin primer (One Coat 7 Universal, Coltene/Whaledent). Subsequently, luting composite (DuoCem, Coltene/Whaledent) was polymerized onto the substrate surface using a mold. For each combination of the levels of the three treatment factors (4 (materials) × 2 (air abrasion vs. no air abrasion; resin) × 2 (primer vs. silane primer)), n = 15, specimens were prepared. After 24 h of water storage at 37 °C and 5000 thermo-cycles (5/55 °C), TBS was measured and failure types were examined. The resulting data was analyzed using Kaplan-Meier estimates of the cumulative failure distribution function with Breslow-Gehan tests and non-parametric ANOVA (Kruskal-Wallis test) followed by the multiple pairwise Mann-Whitney U test with α-error adjustment using the Benjamini-Hochberg procedure and chi-square test (p < 0.05).

RESULTS

The additional air abrasion step increased TBS values and lowered failure rates. Specimens pretreated using a resin primer showed significantly higher TBS and lower failure rates than those pretreated using a silane primer. The highest failure rates were observed for groups pretreated with a silane primer. Within the Shofu Block HC group, all specimens without air abrasion and pretreatment with a silane primer debonded during the aging procedure.

CONCLUSIONS

Before fixation of CAD/CAM resin composites, the restorations should be air abraded and pretreated using a resin primer containing methyl-methacrylate to successfully bond to the luting composite. The pretreatment of the CAD/CAM resin composite using merely a silane primer results in deficient adhesion.

CLINICAL RELEVANCE

For a reliable bond of CAD/CAM resin composites to the luting composite, air abrasion and a special pretreatment strategy are necessary in order to achieve promising long-term results.

Effect of Luting Cements On the Bond Strength to Turkom-Cera All-Ceramic Material

BACKGROUND:

The selection of the appropriate luting cement is a key factor for achieving a strong bond between prepared teeth and dental restorations.

AIM:

To evaluate the shear bond strength of Zinc phosphate cement Elite, glass ionomer cement Fuji I, resin-modified glass ionomer cement Fuji Plus and resin luting cement Panavia-F to Turkom-Cera all-ceramic material.

MATERIALS AND METHODS:

Turkom-Cera was used to form discs 10mm in diameter and 3 mm in thickness (n = 40). The ceramic discs were wet ground, air - particle abraded with 50 - μm aluminium oxide particles and randomly divided into four groups (n = 10). The luting cement was bonded to Turkom-Cera discs as per manufacturer instructions. The shear bond strengths were determined using the universal testing machine at a crosshead speed of 0.5 mm/min. The data were analysed using the tests One Way ANOVA, the nonparametric Kruskal - Wallis test and Mann - Whitney Post hoc test.

RESULTS:

The shear bond strength of the Elite, Fuji I, Fuji Plus and Panavia F groups were: 0.92 ± 0.42, 2.04 ± 0.78, 4.37 ± 1.18, and 16.42 ± 3.38 MPa, respectively. There was the statistically significant difference between the four luting cement tested (p < 0.05).

CONCLUSION:

the phosphate-containing resin cement Panavia-F exhibited shear bond strength value significantly higher than all materials tested.

Cementation of Full Coverage Metal Crowns in Dogs

This step-by-step article describes the technique for cementation of a full metal prosthodontic crown on the maxillary fourth premolar tooth of a dog using a common resin-based cement.

Effect of adhesive luting on the fracture resistance of zirconia compared to that of composite resin and lithium disilicate glass ceramic

OBJECTIVES

The purpose of this study was to evaluate the effect of adhesive luting on the fracture resistance of zirconia compared to that of a composite resin and a lithium disilicate glass ceramic.

MATERIALS AND METHODS

The specimens (dimension: 2 mm × 2 mm × 25 mm) of the composite resin, lithium disilicate glass ceramic, and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) were prepared. These were then divided into nine groups: three non-luting groups, three non-adhesive luting groups, and three adhesive luting groups, for each restorative material. In the non-luting groups, specimens were placed on the bovine tooth without any luting agents. In the non-adhesive luting groups, only zinc phosphate cement was used for luting the specimen to the bovine tooth. In the adhesive luting groups, specimens were pretreated, and the adhesive luting procedure was performed using a self-adhesive resin cement. For all the groups, a flexural test was performed using universal testing machine, in which the fracture resistance was measured by recording the force at which the specimen was fractured.

RESULTS

The fracture resistance after adhesive luting increased by approximately 29% in the case of the composite resin, 26% in the case of the lithium disilicate glass ceramic, and only 2% in the case of Y-TZP as compared to non-adhesive luting.

CONCLUSIONS

The fracture resistance of Y-TZP did not increased significantly after adhesive luting as compared to that of the composite resin and the lithium disilicate glass ceramic.

Comparison of the Solubility of Conventional Luting Cements with that of the Polyacid Modified Composite Luting Cement and Resin-modified Glass lonomer Cement

INTRODUCTION

This study was planned to find the solubility of the conventional luting cements in comparison with that of the polyacid-modified composite luting cement and recently introduced resin-modified glass ionomer cement (RMGIC) with exposure to water at early stages of mixing.

MATERIALS AND METHODS

An in vitro study of the solubility of the following five commercially available luting cements, viz., glass ionomer cement (GIC) (Fuji I, GC), zinc phosphate (Elite 100, GC), polyacid-modified resin cement (PMCR) (Principle, Dentsply), polycarboxylate cement (PC) (Poly - F, Dentsply), RMGIC (Vitremer, 3M), was conducted. For each of these groups of cements, three resin holders were prepared containing two circular cavities of 5 mm diameter and 2 mm depth. All the cements to be studied were mixed in 30 seconds and then placed in the prepared cavities in the resin cement holder for 30 seconds.

RESULTS

From all of the observed luting cements, PMCR cement had shown the lowest mean loss of substance at all immersion times and RMGIC showed the highest mean loss of substanceat all immersion times in water from 2 to 8 minutes. The solubility of cements decreased by 38% for GIC, 33% for ZnPO₄, 50% for PMCR, 29% for PC, and 17% for RMGIC.

CONCLUSION

The PMCR cement (Principle-Dentsply) had shown lowest solubility to water at the given time intervals of immersion. This was followed by PC, zinc phosphate, and GIC to various time intervals of immersion.

Retentive strength of implant-supported CAD-CAM lithium disilicate crowns on zirconia custom abutments using 6 different cements

STATEMENT OF PROBLEM

The optimal retention of implant-supported ceramic crowns on zirconia abutments is a goal of prosthodontic treatment.

PURPOSE

The purpose of this in vitro study was to evaluate the retentive strength of implant-supported IPS e.max CAD-CAM (e.max) crowns bonded to custom zirconia implant abutments with different cements.

MATERIAL AND METHODS

An optical scan of a zirconia custom abutment and a complete-coverage modified crown was designed using an intraoral E4D scanner. One hundred twenty lithium disilicate crowns (IPS e.max CAD) were cemented to 120 zirconia abutment replicas with 1 of 6 cements: Panavia 21 (P21), Multilink Hybrid Abutment (MHA), RelyX Unicem 2 (RXU), RelyX Luting Plus (RLP), Ketac Cem (KC), and Premier Implant (PI). The specimens were stored at 37°C in 100% humidity for 24 hours. Half of the specimens were thermocycled for 500 cycles. The retentive force was measured using a pull-out test with a universal testing machine. Mean retentive strengths (MRS) were calculated using 2-way ANOVA and the Tukey-Kramer test (α=.05).

RESULTS

The MRS (MPa) after 24-hour storage were P21 (3.1), MHA (2.5), RXU (2.5), RLP (1.3), KC (0.9), and PI (0.5). The MRS after thermocycling were MHA (2.5), P21 (2.2), RLP (1.8), KC (1.4), RXU (1.1), and PI (0.3). P21 had the highest MRS after 24-hour storage (P<.001), but after thermocycling MHA had the highest MRS (P<.001). RXU showed a significant decrease in MRS after thermocycling (P<.05). Cement residue was mostly retained on the zirconia abutments for P21, while for the other cements' residue was retained on the lithium disilicate crowns.

CONCLUSIONS

The cements tested presented a range of retentive strengths, providing the clinician with a choice of more or less retentive cements. MHA was the most retentive cement after thermocycling. Thermocycling significantly affected the retentive strengths of the P21 and RXU cements.

Comparative study of the radiopacity of resin cements used in aesthetic dentistry

PURPOSE

The aim of this study was to compare the radiopacity of 6 modern resin cements with that of human enamel and dentine using the Digora digital radiography system, to verify whether they meet the requirements of ANSI/ADA specification no. 27/1993 and the ISO 4049/2000 standard and assess whether their radiopacity is influenced by the thickness of the cement employed.

MATERIALS AND METHODS

Three 3-thickness samples (0.5, 1 and 1.5 mm) were fabricated for each material. The individual cement samples were radiographed on the CCD sensor next to the aluminium wedge and the tooth samples. Five radiographs were made of each sample and therefore five readings of radiographic density were taken for each thickness of the materials. The radiopacity was measured in pixels using Digora 2.6 software. The calibration curve obtained from the mean values of each step of the wedge made it possible to obtain the equivalent in mm of aluminium for each mm of the luting material.

RESULTS

With the exception of Variolink Veneer Medium Value 0, all the cements studied were more radiopaque than enamel and dentin (P<.05) and complied with the ISO and ANSI/ADA requirements (P<.001). The radiopacity of all the cements examined depended on their thickness: the thicker the material, the greater its radiopacity.

CONCLUSION

All materials except Variolink Veneer Medium Value 0 yielded radiopacity values that complied with the recommendations of the ISO and ANSI/ADA. Variolink Veneer Medium Value 0 showed less radiopacity than enamel and dentin.

3D FEA of cemented glass fiber and cast posts with various dental cements in a maxillary central incisor

This study aimed to analyse and compare the stability of two dental posts cemented with four different luting agents by examining their shear stress transfer through the FEM. Eight three-dimensional finite element models of a maxillary central incisor restored with glass fiber and Ni–Cr alloy cast dental posts. Each dental post was luted with zinc phosphate, Panavia resin, super bond C&B resin and glass ionomer materials. Finite element models were constructed and oblique loading of 100 N was applied. The distribution of shear stress was investigated at posts and cement/dentine interfaces using ABAQUS/CAE software. The peak shear stress for glass fiber post models minimized approximately three to four times of those for Ni–Cr alloy cast post models. There was negligible difference in peak of shear stress when various cements were compared, irrespective of post materials. The shear stress had same trend for all cement materials. This study found that the glass fiber dental post reduced the shear stress concentration at interfacial of post and cement/dentine compared to Ni–Cr alloy cast dental post.

Comparative Shear-Bond Strength of Six Dental Self-Adhesive Resin Cements to Zirconia

This study compared shear bond strength (SBS) of six self-adhesive resin cements (SARC) and one resin-modified glass ionomer cement (RMGIC) to zirconia before and after thermocycling. The cylinder shape (Φ 2.35 mm × 3 mm) of six SARCs (G-CEM LinkAce (GLA), Maxcem Elite (MAX), Clearfil SA Luting (CSL), PermaCem 2.0 (PM2), Rely-X U200 (RXU), Smartcem 2 (SC2)) were bonded to the top surface of the zirconia specimens with light-curing. RMGIC (Fujicem (FJC)) was bonded to the specimens with self-curing. The shear bond strength of all cemented specimens was measured with universal testing machine. Half of the specimens were thermocycled 5000 times before shear bonding strength testing. Fractured surfaces were examined with a field-emission SEM (10,000×) and analyzed by energy dispersive x-ray analysis. MAX, PM2, SC2 group without thermocycling and GLA, MAX, PM2 group with thermocycling showed adhesive failure, but GLA, CSL, RXU, FJC group without thermocycling and SLC, RXU, SC2, FJC group with thermocycling indicated cohesive failure. Within the limitation of this study, All of SARCs except MAX demonstrated higher bond strength than that of RMGIC regardless of thermocycling. Also, SARC containing MDP monomers (CSL) retained better bonds than other cements.

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.

A castor oil-containing dental luting agent: effects of cyclic loading and storage time on flexural strength

Favorable results in the use of castor oil polyurethane (COP) as pulp capping, membrane material, sealer, mouthwash and in bone repair, associated with the fact that Ricinus communis is not derived from petroleum and it is abundant in Brazil, encourage researches in the development of luting agents.

WITHDRAWN: Effect of different dentin cleaning techniques on bond strength and the micromorphology of dentin/self-adhesive resin cement interface

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