Panavia F 2.0 bonding to contaminated zirconia ceramic after different cleaning procedures

The Influence of Alumina Airborne-Particle Abrasion with Various Sizes of Alumina Particles on the Phase Transformation and Fracture Resistance of Zirconia-Based Dental Ceramics

The surface of zirconia-based dental ceramic restorations require preparation prior to adhesive cementation. The purpose of this study was to assess the influence of airborne-particle abrasion with different sizes of alumina particles (50 μm, 110 μm, or 250 μm) on the mechanical strength of zirconia-based ceramics' frameworks and on the extent of phase transformations. A fracture resistance test was performed. The central surface of the frameworks was subjected to a load [N]. The identification and quantitative determination of the crystalline phase present in the zirconia specimens was assessed using X-ray diffraction. The Kruskal-Wallis one-way analysis of variance was used to establish significance (α = 0.05). The fracture resistance of zirconia-based frameworks significantly increases with an increase in the size of alumina particles used for air abrasion: 715.5 N for 250 μm alumina particles, 661.1 N for 110 μm, 608.7 N for 50 μm and the lowest for the untreated specimens (364.2 N). The X-ray diffraction analysis showed an increase in the monoclinic phase content after air abrasion: 50 μm alumina particles-26%, 110 μm-40%, 250 μm-56%, and no treatment-none. Air abrasion of the zirconia-based dental ceramics' surface with alumina particles increases the fracture resistance of zirconia copings and the monoclinic phase volume. This increase is strongly related to the alumina particle size.

Comparison of bond strength to three restorative materials after contamination and the use of two cleaning agents

STATEMENT OF PROBLEM

Scientific data on the decontamination effectiveness of a newly introduced cleaning agent are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate and compare the tensile bond strength (TBS) of 3 different restorative bonding surfaces after contamination with saliva following different cleaning protocols.

MATERIAL AND METHODS

A total of 192 disk specimens were made out of 3 materials (n=64); Katana Avencia (A), Katana Zirconia (Z), and e.max CAD (L). The bonding surfaces of all disks were polished, steam cleaned, and then pretreated by following the recommended protocol for each material. The specimens of each group were divided into 4 subgroups (n=16). The first subgroup served as the reference (R), where no contamination was applied. The 3 other subgroups were contaminated with saliva and subsequently rinsed with water for 20 seconds and dried with oil- and water-free air spray. They were then either not treated with any cleaning method (0), cleaned with Katana Cleaner (K), or cleaned with Ivoclean (I). The bonding surfaces of the specimens were perpendicularly luted to plexiglass tubes filled with dual-polymerizing composite resin (Clearfil DC Core) with resin cement (Panavia V5) after the recommended surface conditioning. Each subgroup was further subdivided into 2 groups: stored in 37 °C water for 3 days or subjected to thermal-cyclic loading for 150 days with 37 500 thermal cycles (7500 per month), temperature 5 to 55 °C, and dwell time of 30 seconds. All specimens were subjected to TBS testing in a universal testing machine. Three-way ANOVA was applied. A significant interaction (P<.01) was detected between the 3 different variables (material, treatment, aging). After significant interactions had been revealed by 3-way ANOVA, additional statistical analysis was performed by using separate 2-way ANOVAs, then separate 1-way ANOVAs followed by the Tukey-HSD test for post hoc pairwise comparisons among groups (α=.05 for all tests). All specimens underwent failure mode analysis after TBS testing RESULTS: All specimens survived the storage with thermocycling except for group Z-0, where all specimens debonded during thermocycling. The mean ±standard deviation TBS values ranged from 18.3 ±5.3 MPa to 34.0 ±5.4 MPa after 3 days and from 6.7 ±5.5 MPa to 26.9 ±5.4 MPa after 150 days.

CONCLUSIONS

Contaminated groups that did not receive any cleaning had significantly lower TBS. Thermocycling had a negative effect on the TBS but was not statistically significant for all groups. Using the same cleaning method, the restorative material did had a significant effect on the TBS after 150 days.

Cleaning methods of contaminated zirconia: A systematic review and meta-analysis

OBJECTIVES

The aims of this study were to systematically review the literature and statistically analyze the effectiveness of different cleaning methods on the bond strength of resin cement to zirconia in short- and long-term aging conditions.

DATA/SOURCES

The literature was electronically searched in PubMed (MEDLINE), EMBASE, Wiley, Scopus, and Open Access Theses and Dissertations databases to select relevant articles that evaluated the bond strength between contaminated zirconia and resin cements. A manual search was performed by scanning the reference lists of included studies.

STUDY SELECTION

All articles were published online before April 2022 and in English. Meta-analyses were conducted using random effects models to calculate standardized mean differences (SMD) between uncontaminated zirconia and various cleaning methods in two aging conditions (short- and long-term). Statistical heterogeneity was assessed using I-square statistics. The risk of bias of all included studies was assessed. All statistical analyses were conducted using STATA (StataCorp, College Station, Texas).

RESULTS

Of the 1181 studies, 25 studies met the inclusion criteria for qualitative analyses. In short-term aging condition, cleaning contaminated zirconia with water, alcohol, or acid etching reported significantly lower bond strength than uncontaminated zirconia. For long-term aging condition, cleaning contaminated zirconia with water, cleaning agents, alcohol, or acid etching reported significantly lower bond strength than uncontaminated zirconia. Alumina air-abrasion or cleaning with sodium hypochlorite were comparable to uncontaminated zirconia for both short- and long-term aging conditions.

CONCLUSIONS

This meta-analysis appeared to indicate that the cleaning methods of contaminated zirconia restoration have an effect on zirconia bonding.

The effects of applying a novel cleaner on the bonding strength of zirconia surfaces

This study evaluates how pre-treatment with an MDP-containing cleaning agent (Katana Cleaner, Kuraray) influences the micro-shear bond strength (µSBS) of saliva-contaminated zirconia when used with universal adhesive (UA) systems. Rectangular specimens (2 mm × 12 mm × 15 mm) were obtained (IPS, e.max ZirCAD, MO, B65L17, Ivoclar Vivadent) and divided into three groups; a non-contaminated group (control group)(CON), a contaminated and cleaned with isopropyl alcohol group(ISP), and lastly, a group contaminated and cleaned with an MDP-containing cleaning agent(KAC). Each group was then subdivided into three subgroups according to the UAs used (n = 12). Composite cylinders were prepared and bonded to each surface with Panavia V5 (Kuraray, Noritake Dental). A µSBS test was performed and the data were evaluated with the two-way analysis of variance (two-way ANOVA) and multiple comparisons test (α = 0.05). The highest µSBS values were obtained in the non-contaminated group (p < 0.001), regardless of UAs. All subgroups showed lower µSBS values after saliva contamination, but KAC resulted in significantly higher µSBS values than 99% isopropanol (p < 0.001). Overall, the lowest µSBS value was obtained with 99% isopropanol. The KAC-Clearfil UA subgroup resulted in statistically significantly higher µSBS values than the other UAs (p = 0.035 and 0.007), although all three UAs resulted in sufficient µSBS values. This study revealed that applying KAC followed by a UA containing phosphate monomers produces promising results for improving µSBS values of zirconia, greater than results using 99% isopropanol.Clinical relevance: An MDP-containing cleaning agent followed by a phosphate monomer containing a universal adhesive is a promising method to obtain acceptable bonds with saliva-contaminated zirconia ceramics.

Influence of the thickening agent contained in a phosphoric acid etchant on bonding between feldspar porcelain and resin cement with a silane coupling agent

Phosphoric acid (PA) etchants are widely used for the bonding pretreatment of teeth; however, their influences on the bonding between glass-ceramics and resin cement have not been clarified yet. This study investigated the effect of a thickening agent on the bonding strength between feldspar porcelain treated with a PA etchant and resin cement with a silane coupling agent. The experiments were performed using two PA etchants: commercial one and prepared one consisting a PA aqueous solution and poly(ethylene glycol) thickening agent. The samples were evaluated by shear bond strength testing, scanning electron microscopy, and Fourier-transform infrared spectroscopy. The obtained results revealed that the thickening agent adhered to the porcelain surface and inhibited cement bonding. Meanwhile, PA remained on the surface due to the presence of the thickening agent and activated the silane coupling agent. Overall, the PA etchant did not improve the bond durability.

Effect of phosphoric acid and sodium hydroxide on cleaning and bonding of saliva-contaminated feldspar porcelain

Purpose Hydrofluoric acid has been used to remove salivary contamination in dental glass-ceramics before bonding treatment. However, alternative methods are required because hydrofluoric acid is harmful. This study examined the cleaning effects of phosphoric acid and sodium hydroxide on glass-ceramics for bonding pre-treatment.Methods Feldspar porcelain was divided into four groups: (C) cleaned porcelain without any contamination, (S) porcelain contaminated with saliva, (SPA) porcelain cleaned with 37% phosphoric acid after saliva contamination, and (SSH) porcelain cleaned with 10% sodium hydroxide after saliva contamination. Each sample was bonded to the resin cement using a silane-containing primer. They were then subjected to a shear bond strength (SBS) test. Each surface was analyzed by scanning electron microscopy (SEM), contact angle measurements, and Fourier transform infrared spectroscopy (FT-IR).Results The SBS of group SSH was comparable to that of group C but significantly higher than that of groups S and SPA. SEM observations showed that saliva-like structures remained on the samples of groups S and SPA, but not on the SSH group. The contact angles of groups C and SSH were comparable and significantly smaller than those of groups S and SPA, respectively. FT-IR analysis also revealed saliva in groups S and SPA, which was absent in the SSH group.Conclusions The saliva remained on the porcelain even after cleaning with phosphoric acid, and SBS was not restored to the same level as before the contamination. In contrast, sodium hydroxide eliminated saliva and restored SBS to the same level as before contamination.

Effect of different cleansing methods on the artificially aged bond strength of resin to contaminated zirconia: A systematic review

PURPOSE

The aim of this review was to evaluate studies investigating the effect of cleansing methods on the artificially aged bond strength of resin to contaminated zirconia restorations and determine which cleansing method of contaminated zirconia for resin bonding improvement is more efficient.

METHODS

An electronic search of published studies in English language was carried out until July 2021 on Scopus, Web of Science, and Medline databases. Data from in vitro studies involving the evaluation of the artificially aged bond strength of resin to contaminated zirconia following different cleansing methods were included. In vitro studies in which samples were not subjected to at least 5000 thermocycles, were excluded.

RESULTS

Of 162 articles retrieved initially, 19 were eligible to be included in the systematic review, of which 5 articles were excluded. Therefore, the final sample was 14 in vitro studies. All of the included studies for air abrasion suggested this method as an effective cleansing method, but 6 of 8 included studies reported cleaning paste (Ivoclean) as an effective cleansing method. All of the included studies for NaOCl and a cleaning gel (AD Gel) reported their efficacy. Finally, the results of included studies showed the ineffectiveness of phosphoric acid, water, isopropanol, enzymatic detergents, hydrogen peroxide, and acetone.

CONCLUSIONS

Air abrasion has been reported as an effective cleansing method to improve the bond strength of resin to contaminated zirconia. To improve the effectiveness of cleaning paste in resin bonding, another efficient cleansing method should be followed after this method. However, the superior cleaning potential of air abrasion rather than cleaning paste has been reported. Sodium hypochlorite and cleaning gel seem to be as effective as air abrasion, but extensive water-rinsing is necessary after the application of these cleaning agents.

Effect of surface treatment on shear bond strength of relining material and 3D-printed denture base

PURPOSE

This study aimed to analyze the shear bond strength between the 3D-printed denture base and the chairside relining material, according to the surface treatment.

MATERIALS AND METHODS

Cylindrical specimens were prepared using DENTCA Denture Base II. The experimental groups were divided into 6 (n = 10): no surface treatment (C), Tokuyama Rebase II Normal adhesive (A), sandblasting (P), sandblasting and adhesive (PA), sandblasting and silane (PS), and the Rocatec system (PPS). After bonding the chairside relining material to the center of the specimens in a cylindrical shape, they were stored in distilled water for 24 hours. Shear bond strength was measured using a universal testing machine, and failure mode was analyzed with a scanning electron microscope. Shear bond strength values were analyzed using one-way analysis of variance, and Tukey’s honest significant difference test was used for post-hoc analysis (P < .05).

RESULTS

Group PPS exhibited significantly higher shear bond strength than all other groups. Groups P and PA displayed significantly higher bond strengths than the control group. There were no significant differences between groups PS and A compared to the control group. Regarding the failure mode, adhesive failure occurred primarily in groups C and A, and mixed failure mainly in groups P, PA, PS, and PPS.

CONCLUSION

The shear bond strength between the 3D-printed denture base and the chairside relining material exhibited significant differences according to the surface treatment methods. It is believed that excellent adhesive strength will be obtained when the Rocatec system is applied to 3D-printed dentures in clinical practice.

Assessment of Different Techniques for Adhesive Cementation of All-Ceramic Systems

Background and Objectives: Modern esthetic dentistry is based on all-ceramic restorations. Dentists still have reservations about using these restorations due to a lack of understanding of the cementation technique, which depends on the type of ceramic used. The aim of the study is to evaluate the approaches and practices of clinicians regarding the adhesive cementation of all-ceramic restorations. Materials and Methods: An online questionnaire regarding the use of all-ceramic restorations and their bonding methods was designed by distinguishing the cementation of oxide and silica-based ceramics. The survey included dentists practicing in Timiș County, Romania. The questionnaire and the evaluation of the answers were designed based on the techniques and evidence from the literature. Results: Considering the work experience, we obtained two groups: group 1—1 to 6 years and group 2—6 to 9+ years. The results revealed significant values when comparing the two groups in the surface protocol and decontamination (p = 0.005), type of cement used (p = 0.002), and isolation techniques (p = 0.002). Conclusions: The results show that many clinicians need additional training to improve their cementing technique and avoid the confusion caused by insufficient information about the interrelationship between the type of ceramic and the cementation procedure.

Effect of Different Cleaning Methods on Shear Bond Strength of Resin Cement to Contaminated Zirconia

The aim of this study was to evaluate the effect of different cleaning methods on the shear bond strength (SBS) of resin cement to contaminated zirconia specimens. Eighty rectangular-shaped specimens (2 × 5 × 10 mm) were fabricated from Zirconia blocks (IPS e.max ZirCAD) and randomly divided into 8 groups (n = 10). Group A (control) was not exposed to contaminants. The following tests specimens were contaminated with saliva and silicone indicating paste. Group B was coated with ceramic primer, then subjected to contamination. Groups C, D, E, F, G, and H were contaminated; cleaned with water rinse, Ivoclean, air particle abrasion, hydrofluoric acid, KATANA^TM Cleaner and ZirClean^TM, respectively, and then coated with ceramic primer and bonded to dual cure resin cement cylinders. All the specimens were subjected to artificial aging and surviving specimens were subjected to the SBS test. For statistical analysis, ANOVA and multiple comparison methods at the 0.05 significance level were used. There was no statistically significant difference among Ivoclean (21.48 ± 2.90 MPa), air particle abrasion (21.92 ± 2.85 MPa), and the control group (24.68 ± 5.46). The application of ceramic primer before contamination did not preserve the SBS of resin cement to zirconia. Cleaning the contaminated zirconia surface with hydrofluoric acid (15.03 ± 3.63) or KATANA^TM Cleaner (17.27 ± 7.63) did not restore SBS to the uncontaminated state, but it was significantly higher than simply rinsing with water (12.46 ± 5.17) or the use of ZirClean^TM (11.59 ± 5.53). The bond strength of resin cement to zirconia was influenced by cleaning methods.

Effect of ethyl cellulose coating as an evaluation agent against contamination on the bond strength of zirconia restorations: An in vitro study

STATEMENT OF PROBLEM

During the trial placement of zirconia restorations, contamination of the bonding surface is inevitable. Although cleaning methods for contaminated surfaces have been described, a method of preventing saliva contamination of the bonding surface of zirconia restorations is lacking.

PURPOSE

The purpose of this in vitro study was to investigate an ethyl cellulose coating as an evaluation agent to mitigate the effects of saliva contamination on the bond strength of zirconia restorations.

MATERIAL AND METHODS

Experimental groups representing different cleaning methods of tetragonal yttria-stabilized tetragonal zirconia polycrystal (4Y-TZP) surfaces were investigated for shear bond strength with a resin luting agent, and the failure mode was analyzed. The 9.0×7.0×5.0-mm zirconia blocks (n=72) were assigned as follows: Group N: uncontaminated control; Group CU: contaminated with saliva, followed by ultrasonic cleaning with ethanol; Group CI: contaminated with saliva, followed by application of a zirconia cleaner; Group PCW: preapplication of a zirconia primer, contaminated with saliva, followed by cleaning with water spray; Group ECU: precoating with the ethyl cellulose agent, contaminated with saliva, followed by removal of the agent in an ultrasonic bath with ethanol. Each group was divided into 3 subgroups (immediate, short-term aging, and long-term aging), and the shear bond strength was measured (n=24). To analyze the bonding surface characteristics, the contact angle was measured (n=5). The surfaces of the zirconia specimens in each experimental group were evaluated by using a field emission scanning electron microscope (n=5). Time-of-flight secondary ion mass spectroscopy was used for the chemical analysis of the conditioned surfaces (n=3). A 2-way analysis of variance (ANOVA) with main effect model for shear bond strength results and a 1-way ANOVA for contact angle data were performed as statistical analysis, followed by the Bonferroni post hoc test (α=.05).

RESULTS

The shear bond strength was significantly higher in the ECU group than in the groups with the other cleaning methods (P<.05). After the removal of ethyl cellulose with ethanol, the contact angle and surface topography were found to be similar to those of the control group, and no saliva contaminants were identified in the spectroscopy analysis.

CONCLUSIONS

Coating with ethyl cellulose may protect the bonding surface of zirconia restorations from salivary contamination better than cleaning a contaminated surface.

Revolution of Current Dental Zirconia: A Comprehensive Review

The aim of this article is to comprehensively review the revolution of dental zirconia (Zir), including its types, properties, applications, and cementation procedures. A comprehensive search of PubMed and Embase was conducted. The search was limited to manuscripts published in English. The final search was conducted in October 2021. Newly developed monolithic Zir ceramics have substantially enhanced esthetics and translucency. However, this material must be further studied in vitro and in vivo to determine its long-term ability to maintain its exceptional properties. According to the literature, monolithic translucent Zir has had promising results and a high survival rate. Thus, the utilization of this material is indicated when strength and esthetics are needed. Both the materials and methods used for cementation of monolithic Zir have significantly improved, encouraging dentists to use this material, especially when a conservative approach is required. Zir restorations showed promising outcomes, particularly for monolithic Zir crowns supported with implant and fixed dental prostheses.

The Durability of Zirconia/Resin Composite Shear Bond Strength using Different Functional Monomer of Universal Adhesives

OBJECTIVE

 This study examined the effectiveness of different functional monomers in universal adhesives on zirconia/resin composite bond strength both before and after thermocycling. Four universal adhesives (G-premio bond universal, GPU; Clearfil Tri-S bond universal, CTB; Optibond Universal, OBU; Tetric N-bond universal; TNU), one adhesive (single bond 2; SB2), and one ceramic primer (Clearfil ceramic primer plus, CCP) were used in this study.

MATERIALS AND METHODS

 Zirconia discs were prepared and embedded in acrylic. Specimens were polished and sandblasted with alumina. The specimens were randomly divided into two groups (24 hours and the thermocycled), and each group was divided into six subgroups (n = 10), according to zirconia surfaces treatments: no Tx, CCP + SB2, GPU, CTB, OBU, TNU. An Ultradent mold was located on top of the treated zirconia surface. The resin composite was filled into the mold and then light-cured. A universal testing device was used to determine the shear bond strength.

STATISTICAL ANALYSIS

 The data were statistically analyzed using one-way ANOVA and Tukey's test.

RESULTS

 After water storage for 24 hours, the shear bond strengths were GPU > CCP + SB2 = CTB = OBU = TNU > no Tx (p < 0.05). After thermocycling, the shear bond strengths were CCP + SB2 = GPU = CTB = TNU > OBU > no Tx (p < 0.05).

CONCLUSION

 The universal adhesives containing 10-MDP exhibited the best performance in the shear bond strength of the zirconia/resin composite interface both before and after thermocycling.

Microshear bond strength of dual-cure resin cement in zirconia after different cleaning techniques: an in vitro study

PURPOSE

This study aimed to compare the microshear bond strength (µSBS) of dual-cure resin cement in CAD-CAM zirconia after different cleaning techniques.

MATERIALS AND METHODS

Fifty discs of zirconia-based ceramic from Ivoclar Vivadent were embedded in acrylic resin. The discs were divided into five groups according to the cleaning methods used: Group 1: drying with spraying + sandblasting with Al₂O₃; Group 2: washed with water and dried with spraying + sandblasting with Al₂O₃; Group 3: washed with distilled water and dried with spraying + sandblasting with Al₂O₃ + zirconium oxide (Ivoclean); Group 4: washed with distilled water and dried with spraying + sandblasting with Al₂O₃ + potassium hydroxide (Zirclean); and Group 5: washed with distilled water and dried with spraying + sandblasting with Al₂O₃ + 1% NaClO. All of the groups were contaminated with artificial saliva for 1 minute and then cleaned. Statistical analyses were performed using ANOVA and Tukey's tests.

RESULTS

There were statistically significant differences among all groups for µSBS (P < .05). The group treated with zirconium oxide (Group 3) showed the highest µSBS (18.75 ± 0.23 MPa).

CONCLUSION

When applied to zirconia, the cleaning methods affected the bonding with resin cement differently.

Retention Forces of Monolithic CAD/CAM Crowns Adhesively Cemented to Titanium Base Abutments-Effect of Saliva Contamination Followed by Cleaning of the Titanium Bond Surface

The aim of this study was to investigate the effects of saliva contamination and the cleaning of the bond surface of titanium base (ti-base) abutments on the bonding stability and retention force values. The bond surface of the ti-base abutments was treated with airborne-particle abrasion. After contamination, the ti-base abutments underwent different cleaning protocols: water spray (H2O); alcohol (ALC); suspension of zirconium particles (SZP); reapplied airborne-particle abrasion (APA); and a control condition without contamination and cleaning (CTR). All lithium disilicate crowns were bonded to the ti-base abutments using a primer and a self-curing composite. Bonded specimens underwent thermo-mechanical aging. Bond failure analysis and pull-off testing were performed. Bond failure occurred more frequently in groups H2O, ALC, SZP, and APA (p < 0.05). Significant differences in retention force values were only found between CTR and ALC (p < 0.05). Specimens which did not show bond failure after ageing had higher retention force values than the specimens that showed bond failure (p < 0.05). Saliva contamination with cleaning can degrade the bonding properties to titanium. For the retention force values, only the protocol with alcohol after contamination could not restore the values.

Cleaning Zirconia Surface Prior To Bonding: A Comparative Study of Different Methods and Solutions

PURPOSE

To evaluate resin cement bond strength after removal of salivary contamination from a zirconia surface using different cleaning solutions and air-borne particle abrasion.

MATERIALS AND METHODS

One-hundred and twenty zirconia specimens (KATANA STML, Noritake) were prepared and divided into 12 groups (n = 10). Groups were subjected to a notched-edge shear bond strength test (ISO 29022) to analyze the bonding efficiency of a resin cement (Panavia V5, Kuraray Noritake Dental Inc.) before and after contamination with saliva. Group 1 (control) was prepared and cemented without salivary contamination. Group 2 was coated with ceramic primer (Clearfil Ceramic Primer Plus, Kuraray Noritake Dental Inc.) then subjected to salivary contamination then tested. Group 3 was contaminated, cleaned by air-borne particle abrasion, ceramic primer and resin cement applied, and tested. Groups 4 to 12 were contaminated, and then different cleaning solutions (water, 4.5% hydrofluoric acid, 35% phosphoric acid, Ivoclean, KATANA cleaner, Zirclean, sodium hypochlorite 4%, and 7.5%) were used to decontaminate the zirconia surface, followed by ceramic primer, resin cement application, and tested. One-way ANOVA and Tukey post-hoc analysis was used to analyze the data.

RESULTS

One-way ANOVA showed statistical differences among cleaning procedures (p < 0.001, F = 13.48). Air-borne particle abrasion was the only group which provided a bond strength (21 ± 2.8 MPa) that was not statistically different than the control group in which no contamination occurred (25.3 ± 3.3 MPa) (p = 0.247). The use of hydrofluoric acid and zirconia cleaning solutions resulted in bond strengths values which were not statistically different from each other (17.5-19.1 MPa).

CONCLUSION

Air-borne particle, zirconia cleaning solutions and hydrofluoric acid are feasible to decontaminate the zirconia surface from saliva prior to bonding the restoration.

Influence of the application of a pre-sintered surface augmentation on zirconia and lithium disilicate bonding using an adhesive composite resin cement

OBJECTIVE

The purpose of this laboratory study is to evaluate the application of a pre-sintered surface augmentation to zirconia (Zir) and lithium disilicate (LDS) ceramics on the delamination strength of adhesive resin cement. The applied surface augmentation was the ruling of lines to the pre-sintered surface of the ceramics.

METHODS

Ninety milled Zir and sixty pressed LDS specimens (3mm×0.5mm×25mm) were created and divided into five groups (n=30). Group 1: Zir no surface treatment (control Zir-NT); Group 2: Zir airborne particle abraded (Zir-APA) with 30μm CoJet; Group 3: Zir pre-sintered surface augmentation (Zir-SA); Group 4: LDS etched (control LDS-etched) and; Group 5: LDS with pre-sintered surface augmentation and etching (LDS-SA). A resin adhesive cement (3mm×1mm×8mm) was then applied and cured to the ceramic specimens. The delamination strength values of the resin cement from the ceramic were recorded. The delamination strength data were analysed statistically using one-way ANOVA and Turkey post hoc analysis.

RESULTS

The mean delamination strength and standard deviation, when comparing only the Zir-SA to the resin cement were statistically different (p<0.001); Zir-SA 63.42±11.85, Zir-NT 26.82±12.07, and Zir-APA 48.11±17.85MPa. Comparison between LDS groups were not significantly different (p=0.193); LDS-etched 33.49±16.07 and LDS-SA 28.83±10.15MPa. The delaminated Weibull modulus was highest for surface augmentation Zir specimens (m=13.56) but decreasing to less than half for Zir-APA (m=6.27) and Zir-NT (m=5.68). The Weibull values for the LDS-SA and LDS-etched specimens was 5.63 and 3.38 respectively.

SIGNIFICANCE

Incorporating the pre-sintered surface augmentation to zirconia improved the delamination strength and reliability of Zir to the resin cement but not for LDS.

Influence of different cleaning procedures on the shear bond strength of 10-methacryloyloxydecyl dihydrogen phosphate-containing self-adhesive resin cement to saliva contaminated zirconia

PURPOSE

To evaluate the effect of different cleaning methods on the shear bond strength (SBS) of a 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing self-adhesive resin cement to zirconia after saliva contamination.

METHODS

Sixty zirconia specimens were randomly divided into four groups (n=15) according to treatment surface. Except for the control group, all samples were contaminated with saliva and were then rinsed with water-spray and air-dried. Subsequently, the specimens were either treated with a cleaning paste (CP), with argon plasma (AP), or did not undergo an additional cleaning process (WS). An MDP-containing self-adhesive resin cement was applied onto the ceramic surfaces. Specimens were stored in water (24 hours) followed by thermocycling (5°C to 55°C for 10.000 cycles). SBS tests were performed in a universal testing machine, and the results (MPa ± SD) were statistically analyzed using ANOVA and Bonferroni post-hoc test. Fractured surfaces were examined to identify the failure types using a stereomicroscopy and SEM.

RESULTS

The surface cleaning treatment (p < 0.05) significantly affected the results. The highest SBS values were observed in the control group (12.16 ± 1.22 MPa) and were statistically comparable to values for the CP group (11.38 ± 1.65 MPa). The AP group (9.17 ± 1.06 MPa) showed significantly higher bond strength than the WS group (6.95 ± 1.20 MPa), but it showed significantly lower strength than the control and CP groups.

CONCLUSIONS

The CP application was the most effective method in removing saliva contamination. The AP treatment could not restore the SBS to the same level as uncontaminated specimens.

Survey of clinically used adhesive ceramic bonding methods - follow up after 12 years

OBJECTIVES

This survey evaluated dentists' use of adhesive bonding methods of all-ceramic restorations over a period of twelve years. This is a follow-up survey which had been undertaken in 2007, 2011, and in 2015 [1].

METHODS

A multiple choice questionnaire regarding adhesive bonding methods for all-ceramic restoration was developed and handed out in 2007 and 2019 to dentist participating in a local annual dental meeting in Northern Germany. The questionnaires were evaluated on the basis of evidence-based techniques from the scientific literature.

RESULTS

Data from 93 questionnaires (2019) were compared with 90 evaluated questionnaires from 2007. Bonding of oxide ceramic had improved over the years of observation (7% to 62%) whereas evidence-based bonding of silicate ceramic restorations decreased from 66% to 38%; common mistakes were using air abrasion on silicate surface. Females showed better values for correct adhesive cementation than males (f: 39-50%, m: 22%-41%). A correlation between correct cementation and years of professional experience could not be revealed.

CONCLUSION

Incorrect bonding of oxide ceramic restorations decreased within the 12 years investigated whereas there was no improvement of evidence-based bonding procedures of silicate ceramics. Still a high number of survey participants need additional training in bonding techniques.

Effects of air-abrasion pressure on mechanical and bonding properties of translucent zirconia

OBJECTIVES

The purpose of this in vitro study was to investigate the effects of different air-abrasion pressures on flexural strength and shear bond strength of a translucent zirconia.

MATERIALS AND METHODS

The translucent zirconia surface was treated with 50 μm abrasive alumina particles at different pressure: 0.1 MPa; 0.2 MPa; 0.3 MPa; 0.4 MPa; 0.5 MPa; untreated specimens were used as control group (n = 33). For each group, three-point bending test was used to evaluate the flexural strength, and surface characterizations were analyzed. Following adhesive bonding and water storage for 24 h, specimens were subdivided into groups baseline and aged (5000 thermocycles). Then, shear bond strength was measured and failure mode was recorded. Statistical analysis was performed with one-way ANOVA and Tukey test (α = 0.05).

RESULTS

Increasing air-abrasion pressure (0.3 MPa, 0.4 MPa, and 0.5 MPa) decreased the flexural strength. Higher air-abrasion pressure resulted in rougher zirconia surfaces and caused more microcracks. The highest shear bond strength was obtained for zirconia surfaces abraded at 0.2 MPa (15.88 ± 2.70 MPa) and 0.3 MPa (14.32 ± 1.12 MPa). Aging did not decrease the strength for all groups except control group (p < 0.001).

CONCLUSIONS

Air-abrasion with 50 μm abrasive alumina particles at 0.2 MPa could achieve good strength for translucent zirconia ceramics while maintaining adequate and durable bonding with resin cement.

CLINICAL RELEVANCE

A total of 0.2 MPa is recommended for air-abrasion procedure applied before a dental restoration fabricated with translucent zirconia is bonded to resin cement.

Effect of zirconia decontamination protocols on bond strength and surface wettability

OBJECTIVE

To evaluate the effects of human saliva decontamination protocols on bond strength of resin cement to zirconia (Y-PSZ), wettability, and microbial decontamination.

MATERIALS AND METHODS

Zirconia plates were sandblasted and divided into (a) not contaminated, (b) contaminated with human saliva and: (c) not cleaned, (d) cleaned with air-water spray, (e) cleaned with 70% ethanol, (f) cleaned with Ivoclean, or (g) cleaned with nonthermal atmospheric plasma (NTAP). The wettability and microbial decontamination of the surfaces were determined after saliva contamination or cleaning. Monobond Plus (Ivoclar Vivadent) was applied after cleaning, followed by Variolink LC (Ivoclar Vivadent). The samples were stored 1 week before shear bond strength (SBS) testing, and data (SBS and wettability) were analyzed by one-way analysis of variance and Tukey test (α = .05).

RESULTS

Saliva contamination reduced SBS to zirconia compared to not contaminated. Both Ivoclean and NTAP produced higher SBS compared to not cleaned and were not significantly different from the not contaminated. Ivoclean produced the highest contact angle, and NTAP the lowest. With the exception of using just water-spray, all cleaning protocols decontaminated the specimens.

CONCLUSIONS

Both Ivoclean and NTAP overcame the effects of saliva contamination, producing an SBS to zirconia comparable to the positive control.

CLINICAL SIGNIFICANCE

Dental ceramics should be cleaned prior to resin cementation to eliminate the effects of human saliva contamination, and Ivoclean and NTAP are considered suitable materials for this purpose.

Bond Strength Stability of Self-adhesive Resin Cement to Etched Vitrified Yttria-stabilized Tetragonal Zirconia Polycrystal Ceramic After Thermomechanical Cycling

The purpose of this study was to evaluate the influence of thermomechanical cycling on the bond strength stability of self-adhesive resin cement to vitrified yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic. Y-TZP ceramic blocks were divided into four groups according to the surface treatments: AS, as sintered; SB, sandblasted with 50-μm Al2O3 particles; LG, vitrification with a low-fusing glaze and etching with 10% hydrofluoric acid; and HC, vitrification with a ceramic liner and etching with 10% hydrofluoric acid. Lithium disilicate ceramic blocks etched with 10% hydrofluoric acid for 20 seconds (EM) were also tested. Blocks of resin composite were cemented on the ceramic block surfaces using a self-adhesive resin cement. Half of the blocks from each group were cut into beams and submitted to microtensile bond strength (μTBS) testing after immersion in water at 37°C for 24 hours and the other half after mechanical (1,200,000 cycles, 98 N, 2.5 Hz) and thermal (10,000 cycles, 5-55°C, 30-second dwell time) cycling (TMC). Data were analyzed using one-way analysis of variance, Tukey's honest significant difference post hoc test, and Student t-test (α=0.05). After 24 hours, EM and LG presented similar and the highest μTBS, whereas AS showed the lowest μTBS (p&lt;0.05). After TMC, EM presented the highest μTBS, followed by LG (p&lt;0.05). Only EM and LG maintained the stability of μTBS after TMC (p&gt;0.05). The bonding to Y-TZP ceramic vitrified with a low-fusing glaze withstood thermomechanical cycling.

Durability of resin bonding to zirconia ceramic after contamination and the use of various cleaning methods

OBJECTIVES

The aim of the study was to evaluate the influence of contamination and different cleaning methods on the tensile bond strength with a phosphate monomer containing luting resin to zirconia ceramic.

METHODS

After the contamination with saliva or silicone disclosing agent, 228 polished and airborne-particle abraded zirconia discs were ultrasonically cleaned with 99% isopropanol. In a second step, the specimens were either treated with argon-oxygen plasma, air plasma, enzymatic cleaning agent or did not undergo an additional cleaning process. Uncontaminated zirconia specimens were used as the control group. X-ray photoelectron spectroscopy (XPS) was used for chemical analysis of the bonding surfaces of specimens. Plexiglas tubes filled with composite resin were bonded to zirconia specimens with a phosphate monomer containing luting resin. Tensile bond strength (TBS) was tested after 3 days or 150 days water storage with 37,500 thermal cycles.

RESULTS

XPS revealed a decrease of the carbon/oxygen ratio after plasma treatment and an increase after treatment with an enzymatic cleaning agent in all groups. All contaminated specimens showed high and durable TBS after cleaning with a combination of isopropanol and a non-thermal atmospheric plasma. After the cleaning with enzymatic cleaning agent the TBS was significantly reduced in all groups after 150 days thermal cycling.

SIGNIFICANCE

The combination of isopropanol and plasma cleaning was effective in removing salvia and disclosing agent contamination. Enzymatic clearing agent was not able to remove contamination effectively and had a negative impact on the TBS of non-contaminated specimens.

Evaluation of the effect of silicone residue after different surface treatments on shear bond strength of glass ionomer cement to the dentin surface

Aim:

Use of silicone fit-checking material during cementation of fixed restoration has shown to leave residual silicone film after peeling off of fit checker (FC). This residual film reduced bond strength of cement to the inner surface of restoration. Silicone residue effect on tooth surface needs to be studied. The aim of this study was to evaluate the effect of residual silicone film on shear bond strength (SBS) of glass ionomer cement (GIC) to dentin surface and the efficacy of different surface treatments (STs) on dentin in the removal of silicone residue.

Materials and Methods:

Fifty freshly extracted human molars were individually mounted on acrylic blocks and occlusal surfaces were ground flat until dentine surface was exposed. Specimens were divided into five groups as follows: Group I: without application of FC (n = 10) as control group; Group II: without any ST after peeling off FC (n = 10); Group III: ST using wet pumice after peeling off FC (n = 10); Group IV: ST with 37% phosphoric acid after peeling off FC (n = 10); and Group V: ST with 10% polyacrylic acid after peeling off FC (n = 10). GIC was placed on the dentinal surface using polyvinyl mold and subjected to SBS test using universal testing machine. The debonded specimens were observed under stereomicroscope for the mode of failure. Selected debonded dentinal surfaces from each group were examined under scanning electron microscope. One-way analysis of variance and Tukey's test.

Results:

Group II (1.083 MPa) showed significantly lower SBS. Among the STs, Group III (2.047 MPa) was comparable to the control group whereas Group IV (1.376 MPa) and Group V (1.63 MPa) were significantly lower. There was no significant association between failures and groups at P = 0.257.

Conclusion:

The residue of silicone was demonstrable on dentin surface after peeling off FC and caused a significant reduction in SBS between GIC and dentin. ST with wet pumice is found to be beneficial in removing silicone residue and improving SBS, followed by phosphoric acid and polyacrylic acid.

Silica-Based Infiltrations for Enhanced Zirconia-Resin Interface Toughness

Novel silica-based infiltrations on the surface of zirconia have the potential to improve their bondability, allowing for the etching/silane adhesive bonding technique. Nonetheless, adhesively bonded joints are subject to mixed tensile and shear stresses when the restoration is in occlusal service. Thus, we aimed to investigate the effect of 2 novel silica-based infiltrations on the interfacial toughness of adhesively bonded zirconia using the Brazil nut method, which allows for controlled types of stresses to be applied at the interfaces. In total, 150 3Y-TZP (In-Ceram YZ; Vita) Brazil nuts were machined and randomly assigned to 3 groups: C, control (air abraded); SG, sol-gel silica infiltration; and GI, glass infiltration. SG specimens were immersed twice in silicic acid for 20 min and dried (100°C, 1 h). GI specimens were presintered (1,400°C, 1 h) before a glass powder slurry was applied to the intaglio surface. All specimens were then sintered (1,530°C, 2 h). Following adhesive bonding (Panavia F 2.0, Kuraray) and water storage (37°C) for 10 d, the Brazil nuts were subdivided into groups baseline and aged (40,000 thermal cycles between 5°C and 55°C, with a dwell time of 30 s). The Brazil nuts were subjected to axial-loading tests using various inclinations (precrack angle with load direction): Θ = 0°, 5°, 10°, 15°, or 25°, which define the stress type at the interface, from pure tension (0°) to increasing levels of shear. Under pure tension (0°), GI yielded superior interfacial fracture energy, SG and C were similar, and aging had no effect. Under predominantly shear stresses (25°), aging significantly decreased interfacial fracture energy of C and SG, while GI remained stable and was superior. The glass infiltration of the zirconia intaglio surface increases its adhesive bonding interfacial toughness. The sol-gel silica infiltration method requires improvement to obtain a homogeneous surface infiltration and an enhanced bond strength.

Effect of cleaning methods on retentive values of saliva-contaminated implant-supported zirconia copings

OBJECTIVE

The aim of this study was to evaluate the effect of different cleaning regimens on retentive strength of saliva-contaminated implant-supported zirconia copings.

MATERIAL AND METHODS

Seventy solid titanium abutments with 5.5 mm height (Straumann) were attached to the regular neck implant analogs (Straumann). The abutment-analog complex was mounted vertically in an autopolymerized T-shaped acrylic resin block. Seventy zirconia copings with an occlusal loop were made. The copings were contaminated with fresh human saliva for 1 min (except the control group). Afterward, the specimens were washed with water spray for 15 s and dried for 15 s. The copings were divided into seven groups according to cleaning methods (n = 10). Group 1: no contamination (control group); Group 2: water spray rinsing; Group 3: airborne particle abrasion; Group 4: immersion in 96% isopropanol; Group 5: applying Ivoclean (Ivoclar Vivadent); Group 6: applying 1% sodium hypochlorite; and Group 7: applying Monobond Plus (Ivoclar Vivadent). The copings were luted with a resin luting agent (RelyX Unicem; 3M ESPE). After 5,000 thermal cycles, the retentive values of the restorations were tested using universal testing machine. The dislodging forces were analyzed using one-way analysis of variance and the Tukey's HSD tests (α = 0.05).

RESULTS

The copings, which were cleaned with Ivoclean and 96% isopropanol, showed the highest retentive values (204.79 ± 44.49 and 232.65 ± 71.36, respectively). There was a significant difference between the studied groups (F = 2.735; p = .02). Tukey's HSD showed that there was no significant difference between the different cleaning procedures and control group except water rinsing group (p = .14). The lowest retentive value was related to the saliva-contaminated group, which were only cleaned with water rinsing method.

CONCLUSION

The retentive values of zirconia-based restorations were adversely affected by saliva contaminations. These restorations can be cleaned by Ivoclean, 96% isopropanol, airborne particle abrasion, 1% sodium hypochlorite, or applying Monobond Plus before luting procedures.

Influence of Contamination on Zirconia Ceramic Bonding

The removal of contaminants prior to the bonding of ceramics is critical for the clinical success of a long-term durable resin bond. This study tested the null hypotheses that there are no contaminants on the zirconia ceramic surface left after try-in simulation, and there are no influences of contamination and cleaning methods on zirconia ceramic bonding durability with 10-methacryloyloxy-decyl dihydrogenphosphate-containing composite resins. After saliva immersion and the use of a silicone disclosing agent, airborne-particle-abraded ceramic specimens were cleaned with acetone, 36% phosphoric acid, additional airborne-particle abrasion, or only water spray. Chemical analyses of specimen surfaces were performed by x-ray photoelectron spectroscopy. The influences of contamination and cleaning methods on ceramic bond durability were examined by tensile testing after 3 or 150 days’ water storage with 37,500 thermal cycles. Contamination, existing after try-in simulation as confirmed by chemical analysis, significantly reduced zirconia ceramic-resin bonds. Airborne-particle abrasion may be the most effective cleaning method.

Cleaning Methods for Zirconia Following Salivary Contamination

PURPOSE

To determine the best method of cleaning saliva-contaminated zirconia in preparation for resin bonding.

MATERIAL AND METHODS

Flat blocks of zirconia were particle abraded with aluminum oxide and divided into eight groups (n = 10). Groups 1 to 4 were first treated with one coat of an MDP primer (Z-prime Plus) and groups 5 to 8 were left untreated. A thin coat of fresh whole saliva was painted on all specimens (except the control, group 1) and left in contact for 3 minutes. The specimens were then cleaned by rinsing with water for 20 seconds (groups 2 and 5), or cleaned with 35% phosphoric acid for 20 seconds and rinsed (groups 3 and 6), or cleaned with a zirconia cleaning solution (Ivoclean) for 20 seconds and rinsed (groups 4 and 7), or abraded with aluminum oxide particles and rinsed (group 5). Following the cleaning procedure, groups 5 to 8 were treated with one coat of Z-prime Plus. A 2.5 mm diameter tube was filled with composite (Z100), affixed to the zirconia surface, and light-cured. Specimens were stored in water (37°C for 24 hours) followed by thermocycling (5°C to 55°C for 10,000 cycles). Shear bond strength testing was performed at a crosshead speed of 1 mm/min. Bond strength values were compared to the control using a Dunnett's test (alpha = 0.05). Contact angles of the zirconia specimens with and without Z-prime Plus were measured with water using a goniometer.

RESULTS

Groups 2, 5, and 8 were not significantly different from the control. Application of Z-prime made the zirconia surface more hydrophobic.

CONCLUSIONS

If salivary contamination occurs after MDP application, rinsing off the saliva with water will preserve bond strength. If salivary contamination occurs prior to MDP application, particle abrasion or cleaning with Ivoclean will preserve bond strength.

Effect of surface treatments on the properties and morphological change of dental zirconia

STATEMENT OF PROBLEM

Creating a rough surface for bonding with airborne-particle abrasion with alumina may damage the surface of zirconia. Other treatment methods for creating a bonding surface without causing damage require investigation.

PURPOSE

The purpose of this in vitro study was to find ways of treating the zirconia surface without causing flaws, debris, pits, microcracks, or tetragonal to monoclinic phase transformation.

MATERIAL AND METHODS

Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic surfaces were treated with gas plasma, argon-ion bombardment, 150-μm abrasive zirconia particles, and abrasive 150-μm alumina particles; untreated surfaces were used as the control group. X-ray diffraction (XRD) and confocal Raman spectroscopy were used to study the phase transformation. The roughness of specimens was measured with a confocal 3D laser scanning microscope. Modification of surface topography was analyzed with field emission scanning electron microscopy (FESEM), and the flexural strength was measured with a universal testing machine. Statistical analyses were performed with 1-way ANOVA, followed by comparison of means with the Tukey honest significant difference test. The standard deviation was calculated with descriptive statistics.

RESULTS

The sintered Y-TZP ceramic used in this study showed 2 phases, tetragonal and cubic. Specimens abraded with 150-μm alumina particles showed a higher monoclinic volume fraction (VmXRD=8.68%) and roughness (Ra=0.91μm) than specimens abraded with 150-μm zirconia particles (VmXRD=1.22%, Ra=0.08μm). One-way ANOVA indicated a significance difference in roughness among groups (P<.01). No phase transformation was observed in specimens treated with argon-ion bombardment or plasma. According to the Raman results, the volume fraction of the monoclinic phase for the specimens treated with airborne-particle abrasion depended on the distance from the ceramic surfaces and decreased with the increase in this distance. A slightly higher flexural strength was observed for untreated specimens (1009 MPa), followed by specimens treated with gas plasma (1000 MPa) and those airborne-particle abraded with 150-μm zirconia particles (967 MPa). The flexural strength of other specimens was lower (940 MPa for specimens abraded with 150-μm alumina particles and 916 MPa for specimens subjected to argon-ion bombardment). One-way ANOVA analysis indicated no significant difference in flexural strengths among all groups (P>.2). FESEM measurements showed that airborne-particle abrading Y-TZP surfaces with 150-μm alumina particles caused more damage to this area than the other methods.

CONCLUSIONS

Y-TZP ceramic surfaces treated with zirconia particles, argon-ion bombardment, and gas plasma were damaged less in comparison with surfaces abraded with alumina particles.

The effect of various sandblasting conditions on surface changes of dental zirconia and shear bond strength between zirconia core and indirect composite resin

PURPOSE

To measure the surface loss of dental restorative zirconia and the short-term bond strength between an indirect composite resin (ICR) and zirconia ceramic after various sandblasting processes.

MATERIALS AND METHODS

Three hundred zirconia bars were randomly divided into 25 groups according to the type of sandblasting performed with pressures of 0.1, 0.2, 0.4 and 0.6 MPa, sandblasting times of 7, 14 and 21 seconds, and alumina powder sizes of 50 and 110 µm. The control group did not receive sandblasting. The volume loss and height loss on zirconia surface after sandblasting and the shear bond strength (SBS) between the sandblasted zirconia and ICR after 24-h immersion were measured for each group using multivariate analysis of variance (ANOVA) and Least Significance Difference (LSD) test (α=.05). After sandblasting, the failure modes of the ICR/zirconia surfaces were observed using scanning electron microscopy.

RESULTS

The volume loss and height loss were increased with higher sandblasting pressure and longer sandblasting treatment, but they decreased with larger powder size. SBS was significantly increased by increasing the sandblasting time from 7 seconds to 14 seconds and from 14 seconds to 21 seconds, as well as increasing the size of alumina powder from 50 µm to 110 µm. SBS was significantly increased from 0.1 MPa to 0.2 MPa according to the size of alumina powder. However, the SBSs were not significantly different with the sandblasting pressure of 0.2, 0.4 and 0.6 MPa. The possibilities of the combination of both adhesive failure and cohesive failure within the ICR were higher with the increases in bonding strength.

CONCLUSION

Based on the findings of this study, sandblasting with alumina particles at 0.2 MPa, 21 seconds and the powder size of 110 µm is recommended for dental applications to improve the bonding between zirconia core and ICR.

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.

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

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

Efficacy of various cleaning solutions on saliva-contaminated zirconia for improved resin bonding

PURPOSE

This study aimed to investigate the efficacy of cleaning solutions on saliva-contaminated zirconia in comparison to air-abrasion in terms of resin bonding.

MATERIALS AND METHODS

For saliva-contaminated airabraded zirconia, seven cleaning methods)-no contamination (NC), water-spray rinsing (WS), additional airabrasion (AA), and cleaning with four solutions (Ivoclean [IC]; 1.0 wt% sodium dodecyl sulfate [SDS], 1.0 wt% hydrogen peroxide [HP], and 1.0 wt% sodium hypochlorite [SHC])-were tested. The zirconia surfaces for each group were characterized using various analytical techniques. Three bonded resin (Panavia F 2.0) cylinders (bonding area: 4.5 mm²) were made on one zirconia disk specimen using the Ultradent jig method [four disks (12 cylinders)/group; a total of 28 disks]. After 5,000 thermocycling, all specimens were subjected to a shear bond strength test with a crosshead speed of 1.0 mm/minute. The fractured surfaces were observed using an optical and scanning electron microscope (SEM).

RESULTS

Contact angle measurements showed that groups NC, AA, IC, and SHC had hydrophilic surfaces. The X-ray photoelectron spectroscopy (XPS) analysis showed similar elemental distributions between group AA and groups IC and SHC. Groups IC and SHC showed statistically similar bond strengths to groups NC and AA (P>.05), but not groups SDS and HP (P<.05). For groups WS, SDS, and HP, blister-like bubble formations were observed on the surfaces under SEM.

CONCLUSION

Within the limitations of this in vitro study, some of the cleaning solutions (IC or SHC) were effective in removing saliva contamination and enhancing the resin bond strength.

Effect of Cleansing Methods on Saliva-Contaminated Zirconia—An Evaluation of Resin Bond Durability

The aims of this study were to investigate 1) the influence of cleansing methods after saliva contamination and 2) aging conditions (thermocycling and water storage) on zirconia shear bond strength (SBS) with a resin cement. One hundred and eighty zirconia specimens were sandblasted with 50 μm aluminum oxide particles, immersed in saliva for one minute (with the exception of the control group, [C]), and divided into groups according to the cleansing method, as follows: water rinse (W); 37% phosphoric acid gel (PA); cleaning paste (ie, Ivoclean®) containing mainly zirconium oxide (IC); and 70% isopropanol (AL). Scanning electron microscopy was done to qualitatively evaluate the zirconia surface after each cleansing method. For the SBS test, resin cement buttons were bonded to the specimens using a dedicated jig. SBS was evaluated according to standard protocols after 24 hours, 5000 thermal cycles (TC), or 150 days of water storage. Statistical analysis was performed using two-way analysis of variance and Tukey test (p&lt;0.05). Data showed a significant effect for the 150 days of water storage, TC, and 24 hours of water storage (150 days &lt; TC &lt; 24 hours). Group comparisons showed that PA &lt; AL and W &lt; IC and C. SBS ranged from 10.4 to 21.9 MPa (24 hours), from 6.4 to 14.8 MPa (TC), and from 2.9 to 7.0 MPa (150 days). Failure analysis revealed a greater percentage of mixed failures for the majority of the specimens and a smaller percentage of adhesive failures at the ceramic-resin cement interface. Our findings suggest that Ivoclean® was able to maintain adequate SBS values after TC and 150 days of storage, comparable to the uncontaminated zirconia.

Influence of surface treatment of contaminated zirconia on surface free energy and resin cement bonding

Influences of contamination and cleaning methods on the bonding of resin cement to zirconia ceramics were examined. Airborne particle-abraded zirconia (IPS e.max ZirCAD) specimens were contaminated with saliva and cleaned with tap water (SC) or by application of 37% phosphoric acid (PA), Ivoclean (IC), or additional airborne particle abrasion (AB). Specimens without contamination served as controls. After application of Monobond Plus to the surface of the specimens, resin cement was mixed and inserted into a mold. Surface free energies of the specimens were determined by measuring contact angles. Surface treatment and storage conditions significantly influenced bond strength, while there was no significant interaction between the two factors. Surface free energies of the SC and IC groups were significantly lower than those of the other groups. Additional AB of saliva-contaminated zirconia increased the strength of bonding with the resin cement as well as increased surface free energy.

Evaluation of roughness, wettability, and morphology of an yttria-stabilized tetragonal zirconia polycrystal ceramic after different airborne-particle abrasion protocols

STATEMENT OF PROBLEM

Airborne-particle abrasion is an effective method of roughening a zirconia surface and promoting micromechanical interlocks with luting cements. However, the effect of different airborne-particle abrasion protocols on the micromechanical retention mechanism has been poorly investigated.

PURPOSE

The purpose of the study was to evaluate the effect of airborne-particle abrasion protocols on the surface roughness, wettability, and morphology of an yttria-stabilized tetragonal zirconia polycrystal ceramic.

MATERIAL AND METHODS

A total of 140 zirconia specimens (14 × 14 × 1.4 mm) were made from Lava and divided into 7 groups. Their surfaces were treated as follows (n = 20): as-sintered (control); airborne-particle abraded with 50-μm Al2O3 particles; 120-μm Al2O3 particles; 250-μm Al2O3 particles; 30-μm silica-coated Al2O3 particles (Rocatec Soft); 110-μm silica-coated Al2O3 particles (Rocatec Plus); and 120-μm Al2O3 particles followed by Rocatec Plus. The surface roughness (Ra) and wettability analyses were performed on the same specimens of each group. The test liquid used for the wettability analysis was the silane RelyX Ceramic Primer. Two additional specimens (6.0 × 6.0 × 1.0 mm) per group were prepared to evaluate the surface morphology with scanning electron microscopy. The roughness (Ra) data were analyzed by 1-way ANOVA and the Dunnett C test (α = .05), and the wettability data with 1-way ANOVA (α = .05). The Spearman correlation analysis was applied to test for a possible correlation between roughness and wettability.

RESULTS

The control group (0.35 μm) exhibited the lowest mean roughness value (Ra), which was followed by Rocatec Soft (0.40 μm), 50-μm Al2O3 particles (0.52 μm), Rocatec Plus (0.69 μm), 120-μm Al2O3 particles (0.80 μm)/120-μm Al2O3 particles + Rocatec Plus (0.79 μm), and 250-μm Al2O3 particles (1.13 μm). No significant difference was found among the groups concerning wettability. No correlation (rs = -0.09; P = .27) was found between the 2 dependent variables. The scanning electron microscopy analysis indicated that the different airborne-particle abrasion protocols produced differences in the morphologic patterns.

CONCLUSIONS

Although roughness and morphology of the zirconia surface varied according to the airborne-particle abrasion protocol, no close relationship was found between them. The roughness increase seemed to have followed the size of the particles.

Evaluation of the shear bond strength of resin cement to Y-TZP ceramic after different surface treatments

The purpose of this study was to evaluate the effect of various surface treatments on the shear bond strength of Y-TZP (Yttria-Tetragonal Zirconia Polycrystal) ceramics with zirconia primer and two different resin cements both containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP). Zirconia blocks (LAVA, 3M ESPE, St. Paul, MN) were polished and assigned to five groups according to the surface treatment: (1) no further treatment (control); (2) airborne abrasion with Al2 O3 particles; (3) Z-PRIME Plus (Bisco, Schaumburg, IL) applied on polished zirconia; (4) Z-PRIME Plus applied on zirconia after airborne abrasion; and (5) tribochemical silica-coating performed with the CoJet system (3M ESPE) followed by application of ESPE®-Sil (3M ESPE). Each group was further divided into one of two resin cements: Panavia F2.0 (Kuraray, Kurashiki, Okayama, Japan) and Clearfil SA Luting (Kuraray). Resin cement placed inside a gel-cap was polymerized on the zirconia surface. Shear bond strength was tested with a universal testing machine at 0.5 mm/min. One-way analysis of variance and paired t-test were done. (p < 0.05), and scanning electron microscope (SEM) images were taken. Zirconia primer applied after airborne abrasion significantly increased the shear bond strength resulting in the highest value for both resin cements. Control groups for both cements showed the weakest value for shear bond strength. No significant differences were found between the shear bond strengths of the individual resin cements applied to zirconia surfaces treated the same way. In conclusion, the combined surface treatment of airborne abrasion followed by a zirconia primer is recommended for zirconia bonding with Panavia F2.0 and Clearfil SA Luting cements.