Effect of curing protocol on the polymerization of dual-cured resin cements

Assessment of Degree of Conversion and Volumetric Shrinkage of Novel Self-Adhesive Cement

The degree of monomer conversion and polymerization shrinkage are two of the main reasons for potential adhesion failure between the tooth structure and the restoration substrate. To evaluate the degree of conversion and polymerization shrinkage of a newly developed self-adhesive resin cement, the degree of conversion (DC) was measured using FTIR under different activation modes, temperatures, and times. Volumetric shrinkage was tested using the AcuVol video imaging method. The experimental cement showed a higher DC than other cements under self-curing. The DC of the experimental cement was higher than that of other cements, except SpeedCem Plus under light curing. The experimental cement had a higher DC than other cements, except SpeedCem Plus in some conditions under dual curing. All self-adhesive cements had a higher DC at 37 °C than at 23 °C under self-curing, and there was no statistical difference between 23 °C and 37 °C under light curing. All self-adhesive cements showed a significantly higher DC at 10 min than at 5 min under self-curing. There was no statistical difference between 5 min and 10 min for most cements under dual curing. All self-adhesive cements statistically had the same volumetric shrinkage under light curing and self-curing. The newly developed self-adhesive resin cement exhibited a higher degree of conversion and similar volumetric shrinkage compared to these commercial self-adhesive resin cements.

Dental Resin-Based Luting Materials-Review

As cementation represents the last stage of the work involved in making various indirect restorations (metal ceramic crowns and bridges, full ceramic crowns and bridges, inlays, onlays, and fiber posts), its quality significantly contributes to the clinical success of the therapy performed. In the last two decades, the demand for ceramic indirect restorations in everyday dental practice has considerably increased primarily due to the growing significance of esthetics among patients, but also as a result of hypersensitivity reactions to dental alloys in some individuals. In this context, it is essential to ensure a permanent and reliable adhesive bond between the indirect restoration and the tooth structure, as this is the key to the success of aesthetic restorations. Resin-based luting materials benefit from excellent optical (aesthetic) and mechanical properties, as well as from providing a strong and durable adhesive bond between the restoration and the tooth. For this reason, resin cements are a reliable choice of material for cementing polycrystalline ceramic restorations. The current dental material market offers a wide range of resin cement with diverse and continually advancing properties. In response, we wish to note that the interest in the properties of resin-based cements among clinicians has existed for many years. Yet, despite extensive research on the subject and the resulting continued improvements in the quality of these materials, there is still no ideal resin-based cement on the market. The manuscript authors were guided by this fact when writing the article content, as the aim was to provide a concise overview of the composition, properties, and current trends, as well as some future guidelines for research in this field that would be beneficial for dental practitioners as well as the scientific community. It is extremely important to provide reliable and succinct information and guidelines for resin luting materials for dental dental practitioners.

Resin composite cements: Current status and a novel classification proposal

OBJECTIVES

Currently, a classification of resin cements that includes relatively recently formulated ("universal") cements is lacking. Furthermore, the terminology used to define different resin cements in the scientific reports is inconsistent. Accordingly, this work aims to: (i) propose a novel classification of resin composite cements; (ii) disambiguate the term "universal cements" and (iii) present an overview of the properties of these cements.

METHODS

An analysis of peer-reviewed literature (PubMed search), as well as market research on definitive resin composite cements were performed.

RESULTS

A tendency toward simplified and versatile luting materials was observed both in the scientific literature and on the dental market with the advent of self-adhesive/one-step resin cements. However, additional priming procedures were necessary to improve their bonding performance in certain clinical situations. Hence, several cements that can be applied both in adhesive and self-adhesive mode were introduced. These cements are associated with a universal adhesive resin, that can be used as a tooth and/or restorative material primer, without the need for other priming systems, regardless of the substrate. These systems should be considered truly universal. Therefore, we hereby suggested a new classification of resin-based cements: (1) adhesive/multi-step; (2) self-adhesive/one-step; (3) universal cements (one- or multi-step). Despite promising in vitro results, clinical trials and long-track laboratory studies are necessary to confirm the reliability of the universal cements.

CONCLUSIONS

This review presented the current advances in the field of resin-based cements, which are reflected in the proposed classification. The term "universal cement" was disambiguated, which will help standardize the terminology used in published research.

CLINICAL SIGNIFICANCE

The classification of resin-based cements and a better understanding of the proper terminology will help standardize the terminology in published research, as well as improve the understanding of the clinical practitioners of the different indications and possible modalities of use of the available cements.

Effect of degree of conversion on the surface properties of polymerized resin cements used for luting glass fiber posts

STATEMENT OF PROBLEM

Lack of conversion of resin cements for luting glass fiber posts in deeper levels of the root canal may compromise clinical performance.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of the degree of conversion on the surface properties of dual-polymerized resin cements used for cemented glass fiber posts according to the root level.

MATERIAL AND METHODS

Fifty maxillary central incisor teeth were endodontically treated, and glass fiber posts were cemented using the following systems: self-adhesive dual-polymerized resin luting cement (RelyX U200) and dual-polymerizing flowable core and a post luting system (Rebilda DC) with a self-etching adhesive (Futurabond DC). The degree of conversion was determined via attenuated total reflectance and Fourier transform infrared spectroscopy, and surface microhardness and cement film thickness were measured. The intraradicular fit was evaluated with microscopy. All tests were performed in the coronal, middle, and apical third of the root canal. Statistical analysis was done with ANOVA and the multiple comparison Tukey test (α=.05).

RESULTS

The degree of conversion was higher in the coronal third using Rebilda DC (65.3 ±4.8%) than RelyX U200 (38.7 ±5.3%) (P<.05); on both resin cements, these values decreased from the coronal to the apical third (30.9 ±3.7%, 61.9 ±8.7%, respectively). The cement film thickness was higher for RelyX U200 in the 3 thirds than for Rebilda DC; significant differences (P<.05) were recorded in both cementing systems in the coronal and apical thirds. In the middle third, no significant differences were observed (P>.05). The mean surface microhardness values increased in the coronal thirds and decreased with increasing root canal depth. The marginal seal in the coronal thirds and the intraradicular fit in the middle thirds showed closer adaptation; however, some tags were observed in the interface resin cement and radicular dentin. Gap and tag formations were observed in the apical third.

CONCLUSIONS

Depending on the root canal third, the surface properties of dual-polymerized resin cements are influenced by the degree of conversion.

Degree of conversion of resin-cements (light-cured/dual-cured) under different thicknesses of vitreous ceramics: systematic review

PURPOSE

This systematic review synthesized and analyzed the scientific evidence on the degree of conversion (DC) obtained by Fourier-transform infrared spectroscopy (FTIR) of light-cured and dual-cured resinous cements, photopolymerized under different thicknesses of vitreous ceramics.

STUDY SELECTION

The study protocol of this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017069319). A comprehensive search (PubMed/MEDLINE, Scopus, EMBASE, and LILACS) was performed for papers including an in vitro design and indexed from January 2007 to December 2020 according to the study purposes. A quality appraisal (specific instrument) and descriptive analysis of the articles that met the inclusion criteria were conducted.

RESULTS

Nine included studies were analyzed. Two of them used feldspathic ceramics, six used lithium disilicate, and one used both (comparing different types and opacities of ceramics). Three studies found a higher DC in dual cements, while one did not find any significant differences, and five studies found a higher DC in light-cured resin cements. Light-cured cements showed a better DC in relation to dual-cured cements in vitreous ceramic restorations with thicknesses up to 2 mm.

CONCLUSION

According to the findings, the use of good photoactivation is the most relevant variable to achieve an adequate DC in light-cured and dual-cured resin cements. The use of vitreous ceramic restorations with a thickness of less than 2 mm (light-curing cements) shows a better DC. Standardized in vitro studies are required to generate accurate scientific evidence.

NMR Profiling of Reaction and Transport in Thin Layers: A Review

Reaction and transport processes in thin layers of between 10 and 1000 µm are important factors in determining their performance, stability and degradation. In this review, we discuss the potential of high-gradient Nuclear Magnetic Resonance (NMR) as a tool to study both reactions and transport in these layers spatially and temporally resolved. As the NMR resolution depends on gradient strength, the high spatial resolution required in submillimeter layers can only be achieved with specially designed high-gradient setups. Three different high-gradient setups exist: STRAFI (STRay FIeld), GARField (Gradient-At-Right-angles-to-Field) and MOUSE (MObile Universal Surface Explorer). The aim of this review is to provide a detailed overview of the three techniques and their ability to visualize reactions and transport processes using physical observable properties such as hydrogen density, diffusion, T1- and T2-relaxation. Finally, different examples from literature will be presented to illustrate the wide variety of applications that can be studied and the corresponding value of the techniques.

In-vitro cytocompatibility of self-adhesive dual-curing resin cements on human mesenchymal stem cells (hMSC) and periodontal ligament cells (PDL-hTERT)

OBJECTIVES

Self-adhesive dual cured resin cements provide easier clinical application than conventional resin cements but release higher amounts of unreacted monomers, potentially affecting their biocompatibility. This study aimed to compare the cytotoxic effects of self-adhesive dual cured resin cements with two conventional resin cements.

METHODS

Samples of four resin cements, two self-adhesive dual cured cements (group A: RelyX Unicem, group B: SmartCem), and two conventional resin cements (group C: Panavia 2.0, group D: Variolink Esthetic DC) were prepared with a similar dimension under standardized polymerization conditions and stored in water. For each material 18 samples were used and cell cultures of human mesenchymal stem cells (hMSCs) or periodontal ligament cells (PDL-hTERT) were added under appropriate conditions. One experimental group (group E) was left untreated as control. A cell viability WST test, was performed in each experimental group at day 1, 7, 14 and 21. Moreover, microscopic examination of cells was performed using cell viability staining.

RESULTS

Viability of both cell types as determined by WST test was significantly impaired at all time periods by the four different cement materials compared to the untreated control. Comparison between the four materials revealed different inhibition of the viability of both, PDL-hTERT and hMSC cells (group C > group B > group A > group D; p < 0.0001).

SIGNIFICANCE

All resin-based cements caused significant impairment of cell viability, reflecting considerable cytotoxicity. Variolink caused significantly smaller changes of viability than the other tested materials.

Influence of curing modes on conversion and shrinkage of dual-cure resin-cements

OBJECTIVE

To explore the effect of curing modes of dual-cure resin cements on their degree of conversion (DC) and polymerization shrinkage (PS) over specific post-activation periods.

METHODS

Five self-adhesive (PANAVIA SA, RelyX Universal Resin, RelyX Unicem 2, Bifix SE, and SpeedCEM Plus) and three conventional (PANAVIA V5, Nexus Third Generation, and RelyX Ultimate Universal) dual-cure resin cements were studied. Four specimens (n = 4) were made per curing mode (light/self-cure) to measure either DC or PS. FTIR was utilized to measure real-time DC (%) over 24 h. The Bonded Disk method was used to measure shrinkage at 23 °C over 1 h. The data were analyzed using one-way ANOVA, Tukey post-hoc tests and independent/ paired sample t-tests (a = 0.05).

RESULTS

After 1 h post-activation, the DC of light-cured (LC) specimens ranged between 66.6% and 77.4%, whereas for self-cured (SC) specimens DC ranged between 44.4% and 73.2%. After 24 h, the DC of LC specimens ranged between 74.8% and 82.4% and between 62.7% and 81.7% for SC specimens. After 24 h, the DC of three cements (BSE, PV5, and RXU) were comparable between their curing modes (p > 0.05), whereas five cements (CEM, NX3, PSA, RXU2, RXL) had significantly lower DC for SC compared to LC specimens (p < 0.05). After 1 h post-activation, shrinkage ranged between 5.9% and 8.5% for LC and between 4.9% and 8.3% for SC specimens. Most cements were not significantly different between curing modes. However, light-cured PAS, RXL and RXU2 had significantly higher shrinkage (p < 0.05). After 1 h post-activation, a strong positive correlation existed between conversion and shrinkage (LC: r² = 0.95 and SC: r² = 0.93).

SIGNIFICANCE

Whenever light access is possible, light-curing of resin-cements remains beneficial to the overall efficacy of their conversion and thus all factors that depend on that. Conversion and shrinkage behavior are intrinsically important factors in clinical selection of resin-cement products.

Bonding Reactions of Dental Self-Adhesive Cements with Synthetic Hydroxyapatite as a Function of the Polymerization Protocol

Objectives

This study evaluated the influence of the cement composition and different polymerization protocols on the bonding chemical interaction of self-adhesive cements with synthetic hydroxyapatite.

Materials and Methods

Two commercial self-adhesive resin cements (RelyX U200 and Maxcem Elite) were selected, manipulated, mixed with hydroxyapatite dry powder (HAp), dispensed into molds, and distributed into three groups according to polymerization protocols: immediate photoactivation (IP); delayed photoactivation, 10 min self-curing and light-curing (DP); and chemical activation (CA, no light exposure). The detailed chemical information, at atomic scale, on the surface and deeper into the bulk of self-adhesive cement/hydroxyapatite mixtures was evaluated with X-ray photoelectron spectroscopy (XPS).

Results

Chemical elements were detected in both cements, such as Na, O, Ca, C, P, and Si. Other elements were detected in minor concentrations. RelyX U200 exhibited the most intense formation of calcium salts products when the cement/HAp mixtures were photoactivated (immediate or delayed). RelyX U200/HAp mixture under delayed photoactivation (DP) also exhibited higher binding energy between calcium moieties of the HAp and methacrylates in the cement. A higher energy difference in the interaction of HAp with the cement comparing the bulk and surface areas was observed when RelyX U200 underwent the delayed photoactivation protocol. Maxcem Elite exhibited an increased chemical reactivity when either chemically activated or immediately photoactivated and a higher binding energy of the carboxyl groups bonded to the calcium of HAp when chemically activated.

Conclusions

The interaction of cements with hydroxyapatite is chemical in nature and leads to the formation of calcium salts, which may favor better integrity and longevity of adhesive restorations. The polymerization protocol affects the chemical interaction in mixtures of self-adhesive cements and hydroxyapatite, influencing the formation of these salts and the establishment of intermolecular interactions between the HAp and the cements.

Influence of curing modes on thermal stability, hardness development and network integrity of dual-cure resin cements

OBJECTIVE

To explore the effect of different curing modes of conventional and self-adhesive dual-cure resin cements on their rates of thermal decomposition, hardness development and network integrity.

METHODS

Five self-adhesive (PANAVIA SA, RelyX Universal Resin, RelyX Unicem 2, Bifix SE and SpeedCEM Plus) and three conventional (PANAVIA V5, Nexus Third Generation and RelyX Ultimate Universal) dual-cure resin cements were investigated. Thermal decomposition stages, initial onset temperatures, the maximum rate of mass-loss and the filler mass-fraction of each resin cement were analysed by thermogravimetric analysis (TGA). Surface hardness was measured at 1h post-cure and after 24h of dry storage at 37°C. The relative network integrities were estimated from reductions in hardness after 168h of water storage. Data were analysed via one-way ANOVA, Tukey post-hoc tests and paired/independent sample t-tests (a=0.05).

RESULTS

No difference was apparent between TGA data for self-cured and light-cured specimens. Numerical differentiation of mass-loss versus temperature showed either single or multiple peaks. For the set of 8 cements, the maximum rate of mass-loss (%/°C) correlated negatively with residual mass at 600°C. All dry-stored cements increased in hardness from 1 to 24h, ranging from 20.4% to 52.6% for light-cure mode and from 41.3% to 112.6% for self-cure. After 168h water storage, the hardness of cements decreased: by 18.5%-36.2% for light-cured and by 9.8%-17.9% for self-cured. Overall, surface hardness was greater for light-cured cements. The initial onset temperature (IOT) of thermal decomposition correlated negatively with the hardness decrease produced by water-storage: r²=0.77 for light-cure and r²=0.88 for self-cure. This provided the basis for a relative scale of composite network integrity, probably reflecting differences in cross-link density.

SIGNIFICANCE

Light-curing, where possible, remains beneficial to the hardness and related properties of dual-cure resin cements. Combination of TG analysis and solvent softening experiments give an indication of relative network integrity - between materials - and their relative cross-link densities.

Evaluation of the Bond Strength of Densely Sintered Ceramics Subjected to Extended Firing

Introduction

Critical failures in ceramic materials can be caused by the processing mode, which includes all steps taken in the manufacture of a ceramic part, from molding to firing.

Purpose

To evaluate the effect of extended firing on bond strength in densely sintered ceramics of the zirconium reinforced lithium silicate, lithium disilicate, and feldspathic ceramic.

Materials and Methods

Three types of ceramics were evaluated: zirconium reinforced lithium silicate, lithium disilicate, feldspathic ceramic. A total of 6 ceramic blocks, two for each material were used in the study. Each block was cut into four square sections. A total of 24 ceramic surfaces were randomly distributed into 6 groups (n = 4 surfaces per group) divided according to the variables: heat treatment: conventional firing or extended firing; test time: immediate (24 hours after cementation) or longevity (after 1000 cycles of thermocycling). The bond strength tests were performed in a semi-universal test machine for microshear bond strength. For data analysis, the Shapiro-Wilk test was performed to evaluate the normality between the groups measured, and regarding homoscedasticity (homogeneity of variances) by the Bartlett test. The comparisons between the groups were made using the nonparametric Kruskal-Wallis test.

Results

There was no statistically significant difference of the resistance values in relation to the thermal treatment methods (conventional firing and extended firing) in any ceramic group (p <0.05). Among the times (immediate and long), there was a statistically significant difference (p <0.05), with higher resistance values for immediate time.

Conclusion

Extended firing did not influence the micro-shear bond strength of zirconium reinforced lithium silicate, lithium disilicate, feldspathic ceramic.

Hardness Development in Resin Composite Core Materials

PURPOSE

To investigate the hardness characteristics of 13 contemporary resin core materials.

MATERIALS AND METHODS

Specimens (n = 12) were fabricated using stainless steel molds with top surfaces of dual-cure products photopolymerized while additional groups were allowed to self-cure. Twelve Knoop hardness indentations 500 microns apart were obtained of photopolymerized top and bottom sample surfaces as well as the self-cured sample surface with the mean recorded as the representative sample hardness. Testing was completed at 10 minutes, 1 hour, and 24 hours. In addition, hardness values were compared to that obtained from polished coronal dentin samples. Mean data between groups were analyzed with Kruskal-Wallis/Dunn's, within groups with repeated measures ANOVA/Tukey's.

RESULTS

Hardness results were material dependent. All but two products demonstrated a 0.8 bottom/top Knoop hardness ratio at 10 minutes. Product's self-cure cure reaction did not attain hardness similarity with any photopolymerized top surfaces and while some materials were found to have similar dentin hardness to resin top surface ratio similarity, only one product had hardness equal to or greater than that of dentin during any time period.

CONCLUSIONS

Under this study's conditions, hardness development was material dependent and all but two products demonstrated adequate hardness-derived degree of cure assessment at 10 minutes after preparation. Self-cured samples demonstrated hardness increase; however, no self-cured material achieved hardness similarity to photopolymerized top surfaces. None of the materials achieved hardness similarity to dentin and only one product demonstrated hardness greater than that of dentin.

Electric current effects on bond strength, nanoleakage, degree of conversion and dentinal infiltration of adhesive systems

To evaluate the effect of three adhesive systems applied under electric current on microtensile bond strength (μTBS) and degree of conversion (DC). Molar teeth were restored with the aid of three adhesive systems (Adper Single Bond 2-SB2; Clearfil SE Bond-CSE; and Single Bond Universal-SBU) under different electric current intensities (0 μA; 25 μA; and 50 μA). Composite resin blocks were built up in increments (2 mm) and sectioned into 1 × 1 mm beams. The μTBS was tested after 24 h and 1 y distilled water storages. Samples (n = 10) from 24 h to 1 y storages were immersed in a 50% ammoniacal silver nitrate solution and submitted to scanning electron microscopy. The silver nitrate in the hybrid layer was quantified (ImageJ software). The adhesive systems' dentinal infiltration was analyzed using confocal laser scanning microscopy. Fourier transform near infrared spectroscopy was used to measure the DC. The μTBS data were submitted to two-way ANOVA (time vs. electric current) and Bonferroni's test (α = 0.05). Quantitative nanoleakage data were submitted to two-way ANOVA (electric current vs. adhesive) and Bonferroni's test (α = 0.05). DC data were submitted to one-way ANOVA and Tukey's test (α = 0.05) for each adhesive system. The electric current statistically increased the μTBS for SB2 and CSE in 24 h storage, as well as for SB2, CSE and SBU in 1 y storage. No significant difference was observed between storage time for CSE and SBU. When compared to the control, electric currents (25 μA and 50 μA) showed significantly higher DC mean values for SB2 and SBU, and had no effect on CSE. The electric currents (25 μA and 50 μA) reduced the adhesive system's nanoleakage after 1-year storage, and improved the infiltration of SB2 and CSE. Both electric current intensities improved dentinal interface stability.

Effect of Two Immediate Dentin Sealing Approaches on Bond Strength of Lava™ CAD/CAM Indirect Restoration

The objective of this work was to compare the micro-tensile bond strength (µTBS) of CAD/CAM (Computer-Aided Design/ Computer-Aided Manufacturing) specimens cemented with different pairing of adhesives and resin-cements using two Immediate Dentin Dealing (IDS) approaches in comparison with Delay Dentin Sealing (DDS). Coronal dentin from 108 molars were divided into nine groups (n = 12) depending on the adhesive/resin-cement (A-C) assigned. Lava™ Ultimate (4 × 10 × 10 mm) was cemented according to different strategies: IDS1(cementation after dentin sealing), DDS (dentin sealing and cementation at 2-weeks), IDS2 (immediate dentin sealing and cementation at 2-weeks). Samples were sectioned and tested until failure to determine the µTBS. Failure mode was categorized as dentin/cement (DC), at Lava™ Ultimate/cement (LC) and hybrid (H). Kruskal–Wallis and Mann–Whitney U tests and influence of the type of failure on the µTBS by survival analysis with competing risk was explored. Mostly, µTBS values were equal or higher in IDS2 than DDS. In general, A-Cs that showed higher µTBS, have high percentages of LC failure. Survival analysis with competing risk between DC + H and LC values showed that some A-Cs would significantly increase the µTBS values for IDS2. A-Cs with the highest adhesion values showed a high percentage of fractures at the LC interface, suggesting that the adhesion at the adhesive/dentin interface would be higher.

Time-dependent Microhardness Gradients of Self-adhesive Resin Cements Under Dual- and Self-curing Modes

CLINICAL RELEVANCE

Acid-functional monomers in self-adhesive resin cements may decrease their self-curing polymerization ability. Light irradiation optimizes polymerization performance.

SUMMARY

Purpose: The aim of this study was to investigate Knoop microhardness of self-adhesive resin cements under dual- and self-curing modes in simulated canals for describing the polymerization behavior.Methods and Materials: Slots in lightproof silicone cylinders with one open end were filled with the following eight materials: a traditional resin cement (Duolink), a core build-up resin material (MultiCore Flow), and six self-adhesive resin cements (RelyX Unicem 2, G-Cem Automix, Maxcem, Biscem, Multilink Speed, and PermaCem 2.0). The resins were exposed to light through the open end and then stored in a lightproof box. The Knoop hardness gradient for each resin was measured after 1 hour and 120 hours. Surface readings were obtained at 1-mm intervals from 1 mm to 10 mm away from the open ends. The data were analyzed by two-way analysis of variance and the Student-Newman-Keuls test (α=0.05).Results: All the resin materials had stable Knoop hardness numbers (KHNs) at a certain depth; their KHNs in the self-curing mode did not change (p>0.05). The region above this certain depth was regarded as having undergone the dual-curing mode, and the KHN decreased gradually with depth (p<0.05). Between 1 and 120 hours postexposure, the ratio of the KHN at a 5-mm depth (self-cured) to that at a 1-mm depth (dual-cured) increased in Duolink and MultiCore Flow. However, the ratios of the six adhesive resin cements varied.Conclusion: Without light, most self-adhesive resin cements differed from traditional dual-cured resin materials in terms of Knoop micro-hardness, and they had a lesser capacity for chemical-induced curing.

Comparison of two curing protocols during adhesive cementation: can the step luting technique supersede the traditional one?

This study aims to compare the degree of conversion of two different curing protocols used during adhesive cementation. The following resin luting agents were tested: Hri Flow (MF) and pre-heated Hri Micerium (MH); light-cure Nexus Third Generation (NX3L) and dual-cure Nexus Third Generation (NX3D); dual cured RelyX Ultimate (RXU) and light-cure RelyX Veneers (RXL). For each tested material, ten samples were prepared and divided into two groups which had different curing protocols (P1 and P2): in P1, samples were cured for 40 s; in P2, samples were cured for 5 s, and then, after 20 s, cured again for additional 40 s. The degree of conversion (DC) was evaluated both during the first 5 min of the curing phase and after 1, 2, 7, 14 and 28 days (p = 0.05). Different trends were observed in DC values after 5 min by comparing P1 and P2. In both P1 and P2, DC decreased as follows, MH > MF > NX3L > RXL > RXU > NX3D. There were significant differences of DC values among all resin luting agents (p < 0.05) in P1, while no significant differences existed between MH and MF, and NX3L and RXL in P2. At 1, 2, 7, 14 and 28 days the light curing luting agents had a higher DC than the dual luting agents (p < 0.05). P1 and P2 were not statistically different at each time point (p > 0.05). Both P1 and P2 protocols let achieve an acceptable DC after 28 days. The tested P2 can be safely used to lute indirect restorations, simplifying the removal of cement excesses.

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

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

Effect of Tack Cure on Polymerization Shrinkage of Resin-based Luting Cements

CLINICAL RELEVANCE

Self-cure after tack cure could result in a lower polymerization shrinkage in some resin-based luting cements, which is closely related to lower degree of cure.

SUMMARY

Influence of curing modes on the degree of conversion and mechanical parameters of dual-cured luting agents

PURPOSE

To investigate the effects of different curing modes, including tack cure, on the degree of conversion (DC) and mechanical parameters of dual-cured luting agents for all-ceramic restorations.

METHODS

Immediate light curing, intermittent light curing (2-s tack cure and a 1-min interval before the main cure), delayed light cuing (2-min delay) and chemical or no light curing were used to cure two dual-cured luting agents, RelyX Unicem and PermaCem 2.0, through a 1.5-mm thick lithium disilicate ceramic slide. DC (n=3), micro-hardness (n=5), shrinkage strain (n=4) and shrinkage stress (n=3) were measured under the aforementioned curing modes. The data were analyzed using two-way ANOVA and post-hoc Tukey HSD test, with the level of significance set at α=0.05.

RESULTS

For both luting agents, all the light-curing modes produced similar final DC, but using chemical cure only could significantly reduce the DC. The mechanical parameters followed a similar pattern. There were positive but nonlinear correlations between DC and the other mechanical parameters, with the increase in these parameters with DC being slower initially.

CONCLUSIONS

Provided adequate light curing is applied to a dual-cured luting agent, delaying the light curing or using a tack cure first to facilitate seating of a restoration may not have a significant impact on the luting agent's final degree of conversion. However, using chemical cure only may result in inadequate cure of the luting agent and is recommended only for highly opaque restorations.

Effects of Polymerization Mode and Interaction with Hydroxyapatite on the Rate of pH Neutralization, Mechanical Properties, and Depth of Cure in Self-Adhesive Cements

Objective The aim of the study was to evaluate the physicochemical properties of self-adhesive resin cements associated with hydroxyapatite (HAp) according to the polymerization activation.

Materials and Methods Specimens of cements (PermaCem 2.0 [DMG]; MaxCem Elite [Kerr], and RelyX U200 [3M ESPE]) were distributed into three groups: activation mode; self-cured and dual-cured modes; and association or not with HAp powder mode. The pH neutralization was evaluated as a function of time. Flexural strength and elastic modulus were also tested (0.5 mm/min.). The depth of cure was also analyzed using the scraping test (ISO 4049). Infrared spectroscopy was also used to collect the spectra of specimens to evaluate the chemical bonds. Statistical comparisons were conducted at 5% of significance.

Results The aggressiveness of the self-adhesive resin cements evaluated varied among the materials with a tendency for neutralization. Self-cure groups exhibited lower pH throughout the entire evaluation when compared with that of the dual-cure ones, irrespective of the addition of HAp. MaxCem Elite when photoactivated was the only cement influenced by the addition of the HAp in terms of mechanical properties. The self-adhesive cements tested presented equivalent depth of cure based on the ISO 4049 requirements, regardless of the evaluated factors.

Conclusions Based on the parameters evaluated, the results demonstrated that most of the self-adhesive cements remained unaltered or improved when mixed with HAp, regardless of the activation mode.

Influence of different curing modes on flexural properties, fracture toughness, and wear behavior of dual-cure provisional resin-based composites

We investigated the influence of different curing modes on the mechanical properties and wear behavior of dual-cure provisional resin-based composites (DCPRs). Three DCPRs and a self-curing bis-acryl provisional resin-based composite were used. Flexural strength (σ_F), elastic modulus (E), resilience (R), and fracture toughness (K_IC) were measured. The specimens were fabricated with and without light irradiation, stored in distilled water at 37°C for 24 h, and subjected to 5,000 or 10,000 thermal cycles. For sliding impact wear testing, 12 specimens were prepared with and without light irradiation. The maximum facet depth and volume loss were determined using a noncontact profilometer. Some of the mechanical properties and wear behavior of DCPRs are affected by light irradiation. This study indicated that proper light irradiation is important in polymerization process of the DCPRs to enhance the wear resistance and some mechanical properties.

Effect of various polymerization protocols on the cytotoxicity of conventional and self-adhesive resin-based luting cements

OBJECTIVES

This study evaluated the cytotoxicity of resin-based luting cements on fibroblast cells using different polymerization protocols.

MATERIALS AND METHODS

Two conventional dual-polymerized (RelyX ARC, VariolinkN) and two self-adhesive resin cements (RelyX Unicem, Multilink Speed) specimens were polymerized using four different polymerization protocols: (a) photo-polymerization with direct light application, (b) photo-polymerization over ceramic and (c) resin nano-ceramic discs and (d) auto-polymerization. The specimens were then assigned to four groups to test cytotoxicity at 0, 1, 2 and 7 preincubation days (n = 5). MTT test was performed using NIH/3T3 fibroblast cells. Data were analysed using three- and one-way ANOVA. Multiple comparisons were made using Bonferroni post hoc test (p < 0.05).

RESULTS

The highest cytotoxic values were recorded at day 2 for conventional resin cements and at day 0 for self-adhesive resin cements. Self-adhesive resin cements showed the most cytotoxic effect at the second day, while conventional resin cements presented immediate cytotoxicity. Auto-polymerized resin specimens and especially Multilink Speed demonstrated the most cytotoxic effect regardless of the preincubation time. Cytotoxicity of cements tested reached the lowest level at day 7. Interposition of ceramic or nano-ceramic restorative material did not significantly affect the cytotoxicity of tested luting cements (p > 0.05).

CONCLUSIONS

Cytotoxicity of dual-polymerized resin cements was material-dependent and decreased gradually up to 7 days. Photo-polymerization plays an important role in reducing the cytotoxic effects.

CLINICAL RELEVANCE

When luting ceramic or resin nano-ceramic restorations of which thickness does not exceed 2 mm, the level of cytotoxicity with the tested materials is not significant. Luting of restorative materials that do not allow for light transmission such as metal-fused porcelain, clinicians should be cautious in the use of dual-polymerized conventional resin cements as only auto-polymerization of resin cements takes place under such materials.

In Vitro Cytotoxicity of Self-Adhesive Dual-Cured Resin Cement Polymerized Beneath Three Different Cusp Inclinations of Zirconia

The aim of the present study was to evaluate the in vitro cytotoxicity of self-adhesive dual-cured resin cement (SADRC) polymerized beneath three different cusp inclinations of zirconia with different light curing time. A commercial SADRC (Multilink Speed) was polymerized beneath zirconia (ZrO₂) with three different cusp inclinations (0°, 20°, and 30°) for 20 s or 40 s. After being stored in light-proof box for 24 h, the ZrO₂-SADRC specimens were immersed in DMEM for 72 h and then we got the extract solution, cultured the human gingival fibroblasts (HGF, 8 × 10³ per well) with 100% or 50% concentrations of the extract solution for 24 h, 72 h, and 120 h, respectively, and evaluated cytotoxicity of the polymerized SADRC with CCK-8 assay in optical density (OD) values, relative growth rates (RGR), and cytotoxicity grades. Statistical analysis was conducted using a two-way ANOVA followed by post hoc Student–Newman–Keuls test. The OD values varied from 0.8930 to 3.2920, the RGR varied from 33.93% to 98.68%, and the cytotoxicity grades varied from 0 to 2. There was significant difference in the OD values among the different cusp inclinations of zirconia (P < 0.001), and there was significant difference in the OD values between the different light curing times in some situations (P < 0.05). The cusp inclination of zirconia affects the in vitro cytotoxicity of SADRC. Prolonging the light curing time from 20 s to 40 s can reduce the in vitro cytotoxicity of SADRC when the cusp inclination of zirconia is smaller than 20°.

Delayed Photoactivation of Dual-cure Composites: Effect on Cuspal Flexure, Depth-of-cure, and Mechanical Properties

Objectives:

This study tested whether delayed photoactivation could reduce shrinkage stresses in dual-cure composites and how it affected the depth-of-cure and mechanical properties.

Methods and Materials:

Two dual-cure composites (ACTIVA and Bulk EZ) were subjected to two polymerization protocols: photoactivation at 45 seconds (immediate) or 165 seconds (2 minutes delayed) after extrusion. Typodont premolars with standardized preparations were restored with the composites, and cuspal flexure caused by polymerization shrinkage was determined with three-dimensional scanning of the external tooth surfaces before restoration (baseline) and at 10 minutes and one hour after photoactivation. Bond integrity (intact interface) was verified with dye penetration. Depth-of-cure was determined by measuring Vickers hardness through the depth at 1-mm increments. Elastic modulus and maximum stress were determined by four-point bending tests (n=10). Results were analyzed with two- or three-way analysis of variance and pairwise comparisons (Bonferroni; α=0.05).

Results:

Delayed photoactivation significantly reduced cuspal flexure for both composites at 10 minutes and one hour (p≤0.003). Interface was &gt;99% intact in every group. Depth-of-cure, elastic modulus, and flexural strength were not significantly different between the immediate and delayed photoactivation (p&gt;0.05). The hardness of ACTIVA reduced significantly with depth (p&lt;0.001), whereas the hardness of Bulk EZ was constant throughout the depth (p=0.942).

Conclusions:

Delayed photoactivation of dual-cure restorative composites can reduce shrinkage stresses without negatively affecting the degree-of-cure or mechanical properties (elastic modulus and flexural strength).

An in vitro study to compare the influence of different all-ceramic systems on the polymerization of dual-cure resin cement

Aim:

The aim of the study is to compare the effect of composition of three different all-ceramic systems on the polymerization of dual-cure resin cement, using different curing cycles and evaluated immediately within 15 min and after 24 h.

Materials and Methods:

Resin cement disc samples were fabricated by polymerization through three different all-ceramic disc, namely: lithium disilicate discs – IPS e.max (Group B), leucitereinforced discs – IPS Empress (Group C), zirconia discs – Cercon (Group D), and without an intervening ceramic disc, as control (Group A). A total of 80 resin cement disc samples were fabricated for fur groups (n = 20). Each group further consisted of two subgroups (n = 10), t10 and t20 according to two different exposure times of 10 and 20 s, respectively. Each of the 80 resin disc samples was evaluated for their degree of polymerization achieved, by measuring the microhardness(Vickers hardness number) of the samples immediately within 15 min and after 24 h, giving us a total of 160 readings. Oneway analysis of variance test, ttest, and paired ttest were used for multiple group comparisons followed by Tukey's post hoc for groupwise comparison.

Results:

Direct activation of the resin cement samples of control (Group A) showed statistically significant higher mean microhardness values followed by Groups C then B and D, both immediately and after 24 h. The mean microhardness for immediate post-activation was always inferior to the 24 h post-activation test. For both 10 and 20 s curing cycle, there was a significant increase in the microhardness of the resin cement discs cured for 20 s through the different ceramics.

Conclusion:

Ceramic composition affected the polymerization of dual cured resin cement. Doubling the light irradiation time or curing cycle significantly increased mean microhardness value. Greater degree of conversion leading to an increase in hardness was observed when the resin cement discs were evaluated after 24 h.

Evaluation of Dual-Cure Resin Cement Polymerization under Different Types and Thicknesses of Monolithic Zirconia

Purpose

The aim of the present study was to investigate the effects of the type and thickness of the zirconia material on the microhardness of the underlying dual-cure resin cement.

Materials and Methods

Eight disk-shaped zirconia specimens with a 4-mm diameter and four varying thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were fabricated from two different monolithic zirconia materials: posterior monolithic zirconia (Prettau) and anterior monolithic zirconia (Prettau Anterior). Dual-cure resin cement specimens with a 4-mm diameter and 5-mm height were prepared using Teflon cylinder molds and activated by light beneath the eight zirconia disks and without any zirconia disk for 20 s (n=12). A total of 108 specimens were embedded in acrylic. Vickers hardness of each specimen was measured at three different depths using a microhardness device with a 50-g load. All data were statistically evaluated using three-way ANOVA, one-way ANOVA, independent samples t-tests, and Bonferroni corrected post hoc tests (α=.05).

Results

Dual-cure resin cement's microhardness was significantly higher for the samples polymerized beneath anterior monolithic zirconia compared to posterior monolithic zirconia. The hardness decreased as the thickness increased for both types of zirconia; the latter was attributed to an attenuated curing efficiency.

Conclusion

Microhardness of the dual-cure resin cement is influenced by both the type and the thickness of the monolithic zirconia restoration. Polymerization efficiency for resin cement cured under anterior monolithic zirconia may be superior to cured beneath posterior monolithic zirconia.

Microtensile bond strength of CAD/CAM-fabricated polymer-ceramics to different adhesive resin cements

Objectives

This study evaluated the microtensile bond strength (µTBS) of polymer-ceramic and indirect composite resin with 3 classes of resin cements.

Materials and Methods

Two computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated polymer-ceramics (Enamic [ENA; Vita] and Lava Ultimate [LAV; 3M ESPE]) and a laboratory indirect composite resin (Gradia [GRA; GC Corp.]) were equally divided into 6 groups (n = 18) with 3 classes of resin cements: Variolink N (VAR; Vivadent), RelyX U200 (RXU; 3M ESPE), and Panavia F2 (PAN; Kuraray). The μTBS values were compared between groups by 2-way analysis of variance and the post hoc Tamhane test (α = 0.05).

Results

Restorative materials and resin cements significantly influenced µTBS (p < 0.05). In the GRA group, the highest μTBS was found with RXU (27.40 ± 5.39 N) and the lowest with VAR (13.54 ± 6.04 N) (p < 0.05). Similar trends were observed in the ENA group. In the LAV group, the highest μTBS was observed with VAR (27.45 ± 5.84 N) and the lowest with PAN (10.67 ± 4.37 N) (p < 0.05). PAN had comparable results to those of ENA and GRA, whereas the μTBS values were significantly lower with LAV (p = 0.001). The highest bond strength of RXU was found with GRA (27.40 ± 5.39 N, p = 0.001). PAN showed the lowest µTBS with LAV (10.67 ± 4.37 N; p < 0.001).

Conclusions

When applied according to the manufacturers' recommendations, the µTBS of polymer-ceramic CAD/CAM materials and indirect composites is influenced by the luting cements.

Effect of light absence or attenuation on biaxial flexural strength of dual-polymerized resin cements after short- and long-term storage

OBJECTIVE

To evaluate whether biaxial flexural strength (BFS) of dual resin cements is affected by light absence or attenuation, storage time, or cements' chemical nature.

MATERIALS AND METHODS

One hundred and twenty disk-shaped specimens were made from each cement (non-self-adhesive cement and self-adhesive cement) using Teflon molds on a controlled temperature surface (35°C). Specimens were polymerized as follows (N = 30): self-cured, directly light-cured, light-cured at a distance of 6 mm between the light tip and the specimen, and through a 6-mm thick composite resin barrier (indirectly light-cured). Each group was divided (N = 10) for storage purposes (15 minutes, 24 hours, and 6 months). Specimens were placed into a biaxial-flexure jig and a vertical load was applied until failure. The BFS values were subjected to generalized linear models statistical analysis and Weibull distributions (α = 0.05).

RESULTS

After 15 minutes aging, neither material achieved enough polymerization to perform the BFS test when polymerized using the self-curing mode. The self-adhesive product demonstrated much lower variation in strength with storage time than did the non-self-curing cement.

CONCLUSIONS

Attenuated/light-curing reduced BFS values only for 15-minutes storage period for both materials. Flexural strength of the self-adhesive cement was less affected by light absence/attenuation and storage time.

CLINICAL SIGNIFICANCE

Biaxial flexural strength of a self-adhesive resin cement is less sensitive to variation in light application and storage time than is a non-self-adhesive cement.

Influence of curing protocol and ceramic composition on the degree of conversion of resin cement

OBJECTIVE

Due to increasing of aesthetic demand, ceramic crowns are widely used in different situations. However, to obtain long-term prognosis of restorations, a good conversion of resin cement is necessary. To evaluate the degree of conversion (DC) of one light-cure and two dual-cure resin cements under a simulated clinical cementation of ceramic crowns.

MATERIAL AND METHODS

Prepared teeth were randomly split according to the ceramic's material, resin cement and curing protocol. The crowns were cemented as per manufacturer's directions and photoactivated either from occlusal suface only for 60 s; or from the buccal, occlusal and lingual surfaces, with an exposure time of 20 s on each aspect. After cementation, the specimens were stored in deionized water at 37°C for 7 days. Specimens were transversally sectioned from occlusal to cervical surfaces and the DC was determined along the cement line with three measurements taken and averaged from the buccal, lingual and approximal aspects using micro-Raman spectroscopy (Alpha 300R/WITec®). Data were analyzed by 3-way ANOVA and Tukey test at =5%.

RESULTS

Statistical analysis showed significant differences among cements, curing protocols and ceramic type (p<0.001). The curing protocol 3x20 resulted in higher DC for all tested conditions; lower DC was observed for Zr ceramic crowns; Duolink resin cement culminated in higher DC regardless ceramic composition and curing protocol.

CONCLUSION

The DC of resin cement layers was dependent on the curing protocol and type of ceramic.

Full in-vitro analyses of new-generation bulk fill dental composites cured by halogen light

The objective of this study was to investigate the full in-vitro analyses of new-generation bulk-fill dental composites cured by halogen light (HLG). Two types' four composites were studied: Surefill SDR (SDR) and Xtra Base (XB) as bulk-fill flowable materials; QuixFill (QF) and XtraFill (XF) as packable bulk-fill materials. Samples were prepared for each analysis and test by applying the same procedure, but with different diameters and thicknesses appropriate to the analysis and test requirements. Thermal properties were determined by thermogravimetric analysis (TG/DTG) and differential scanning calorimetry (DSC) analysis; the Vickers microhardness (VHN) was measured after 1, 7, 15 and 30days of storage in water. The degree of conversion values for the materials (DC, %) were immediately measured using near-infrared spectroscopy (FT-IR). The surface morphology of the composites was investigated by scanning electron microscopes (SEM) and atomic-force microscopy (AFM) analyses. The sorption and solubility measurements were also performed after 1, 7, 15 and 30days of storage in water. In addition to his, the data were statistically analyzed using one-way analysis of variance, and both the Newman Keuls and Tukey multiple comparison tests. The statistical significance level was established at p<0.05. According to the ISO 4049 standards, all the tested materials showed acceptable water sorption and solubility, and a halogen light source was an option to polymerize bulk-fill, resin-based dental composites.

Influence of Different Curing Modes on Polymerization Behavior and Mechanical Properties of Dual-Cured Provisional Resins

This study determined the influence of curing mode on polymerization behavior and mechanical properties of dual-cured provisional resins. Three dual-cured bisacryl-based provisional resins were used: Tempsmart (TS; GC Corp), Luxatemp Automix Solar (LX; DMG Chemisch Pharmazeutishe Fabrik GmbH), and Integrity Multi·Cure (IG; Dentsply Caulk). A self-cured bisacryl-based provisional resin, Protemp Plus (PP; 3M ESPE) and a conventional poly(methyl methacrylate) (PMMA) provisional resin, Unifast III (UF; GC Corp) were used as controls. The inorganic filler content and coefficients of linear thermal expansion of the test materials were measured. Six specimens of each material were used to determine the flexural strength, elastic modulus, and resilience. The changes in ultrasound velocity during polymerization were measured. The average inorganic filler contents of the provisional resins, apart from UF, ranged from 24.4 to 39.3 wt%. The highest inorganic filler content was determined for LX, whereas TS showed the lowest value among the tested materials. The average coefficients of thermal expansion of the tested provisional resins ranged from 77.3 to 107.7 (×10^-6/°C). TS and IG showed significantly lower thermal expansions than the other tested provisional resins. The mean flexural strengths of the provisional resins ranged from 70.4 to 122.6 MPa, the mean elastic moduli ranged from 1.8 to 3.7 GPa, and the mean resilience of the provisional resins ranged from 1.1 to 2.3 MJ/mm³, respectively. Dual-cured provisional resins showed significantly higher flexural strengths than the PMMA resin. However, in all cases, the light-curing mode showed significantly higher flexural strengths than the self-curing mode. In the initial polymerization phase, dual-cured resins in the light-curing mode showed a rapid increase in the speed of sound (V) during light irradiation, followed by a slower increase. Conversely, the dual-cured resins in the self-curing mode showed a slower initial increase, followed by a rapid increase. Although no significant difference in V was observed between 10 and 15 minutes in the light-curing mode of all tested dual-cured resins, a significantly higher V value was obtained at 15 minutes than at 10 minutes in the self-curing modes for LX and IG. Regardless of the curing mode, tested dual-cured provisional resins showed superior mechanical properties than the conventional PMMA provisional resin. However, dual-cured provisional resin flexural properties and polymerization behavior were affected by the curing mode. This study indicated that the light-curing mode might be recommended for all dual-cured provisional resins because of the enhancement of their mechanical properties and reduction of chair time.

Effect of High-Irradiance Light-Curing on Micromechanical Properties of Resin Cements

This study investigated the influence of light-curing at high irradiances on micromechanical properties of resin cements. Three dual-curing resin cements and a light-curing flowable resin composite were light-cured with an LED curing unit in Standard mode (SM), High Power mode (HPM), or Xtra Power mode (XPM). Maximum irradiances were determined using a MARC PS radiometer, and exposure duration was varied to obtain two or three levels of radiant exposure (SM: 13.2 and 27.2 J/cm²; HPM: 15.0 and 30.4 J/cm²; XPM: 9.5, 19.3, and 29.7 J/cm²) (n = 17). Vickers hardness (H_V) and indentation modulus (E_IT) were measured at 15 min and 1 week. Data were analyzed with nonparametric ANOVA, Wilcoxon-Mann-Whitney tests, and Spearman correlation analyses (α = 0.05). Irradiation protocol, resin-based material, and storage time and all interactions influenced H_V and E_IT significantly (p ≤ 0.0001). Statistically significant correlations between radiant exposure and H_V or E_IT were found, indicating that high-irradiance light-curing has no detrimental effect on the polymerization of resin-based materials (p ≤ 0.0021). However, one resin cement was sensitive to the combination of irradiance and exposure duration, with high-irradiance light-curing resulting in a 20% drop in micromechanical properties. The results highlight the importance of manufacturers issuing specific recommendations for the light-curing procedure of each resin cement.

Effect of Photoactivation Timing on the Mechanical Properties of Resin Cements and Bond Strength of Fiberglass Post to Root Dentin

OBJECTIVES

This study tested the hypothesis that photoactivation timing and resin cement affect mechanical properties and bond strength of fiberglass posts to root dentin at different depths.

METHODS

Fiberglass posts (Exacto, Angelus) were luted with RelyX Unicem (3M ESPE), Panavia F 2.0 (Kuraray), or RelyX ARC (3M ESPE) using three photoactivation timings: light curing immediately, after three minutes, or after five minutes. Push-out bonding strength, PBS (n=10) was measured on each root region (coronal, middle, apical). The elastic modulus (E) and Vickers hardness (VHN) of the cement layer along the root canal were determined using dynamic indentation (n=5). A strain-gauge test was used to measure post-gel shrinkage of each cement (n=10). Residual shrinkage stress was assessed with finite element analysis. Data were analyzed with two-way analysis of variance in a split-plot arrangement and a Tukey test (α=0.05). Multiple linear regression analysis was used to determine the influence of study factors.

RESULTS

The five-minute delay photoactivation timing significantly increased the PBS for all resin cements evaluated. The PBS decreased significantly from coronal to apical root canal regions. The mean values for E and VHN increased significantly with the delayed photoactivation for RelyX Unicem and decreased from coronal to apical root regions for all resin cements with the immediate-curing timing.

CONCLUSIONS

The PBS of fiber posts to root dentin, E, and VHN values were affected by the root canal region, photoactivation timing, and resin cement type. Shrinkage stress values decreased gradually with delayed photoactivation for all the cements.

Indirect Restoration Thickness and Time after Light-Activation Effects on Degree of Conversion of Resin Cement

<p>This study evaluated the effects of indirect restorative materials, curing conditions and time on the degree of conversion (DC) of a dual-cured resin cement using infrared spectroscopy. The resin cement (RelyX Unicem 2, 3M ESPE) was applied to the diamond surface of a horizontal attenuated-total-reflectance unit and activated using one of following conditions: self-cure, direct light exposure, light exposure through indirect restorative materials (resin nano-ceramic: Lava Ultimate, 3M ESPE or feldspathic ceramic: Vita Blocks Mark II, Vita Zahnfabrik). Four thicknesses (0.5, 1.0, 1.5 or 2.0 mm) of each indirect material were analyzed, and the light-activation was performed using a blue LED light. Data (n=5) were analyzed by three-way ANOVA, Tukey's post hoc and Dunnett's tests (α=5%). No significant differences in DC were observed between indirect materials of similar thickness. All groups exhibited higher DC after 10 min than after 5 min. At both times points, the self-cure group exhibited significantly lower DC than all the light exposure groups. Only when the overlying indirect restoration had a thickness of 2 mm did DC decrease significantly. The presence of a thick, indirect restoration can decrease the DC of resin cement. DC after 10 min was higher than after 5 min. The self-cure mode yielded lower DC than the light-activating one.</p>

Polymerization kinetics and polymerization stress in resin composites after accelerated aging as a function of the expiration date

OBJECTIVES

To determine the effect of material condition (new, aged, and expired) on the polymerization kinetics and polymerization stress of different classifications of dental composites.

MATERIALS AND METHODS

Specimens were obtained according to the following factors: Composites: (3M ESPE) Filtek P60, Filtek Z250, Filtek Z350XT, and Filtek Silorane; and Material conditions: new, aged, and expired. The syringe composites underwent an accelerated aging protocol (Arrhenius model) representing approximately 9 months of aging. Infrared (IR) spectra were obtained kinetically and were analyzed for: maximum conversion rate (%/s), time into exposure when maximum rate occurred (s), conversion at maximum rate (%), and total conversion (%) at 90 s by comparison of absorption IR peak ratios before and after polymerization. Polymerization was evaluated at the bottom surface of 2.0 mm-thick specimens. Polymerization stress was determined in a tensilometer, inserting the composite between acrylic rods fixed to clamps in a universal test machine and dividing the maximum load recorded by the rods cross-sectional area. Polymerization stress (MPa) was calculated at 300 s. Data were statistically analyzed by two-way ANOVA and Tukey's post hoc test (α=0.05).

RESULTS

The majority of the polymerization kinetic parameters were not influenced by the material condition. Silorane composite presented significantly lower conversion rate and lower conversion at the maximum rate when expired (p<0.05). The nanofilled composite (Filtek Z350XT) presented a significantly higher total conversion when aged and expired compared to the new one (p>0.05). In all conditions, Filtek Z350XT and Filtek Silorane presented significantly lower conversion rates (p < 0.05). Filtek Silorane also exhibited the lowest stress, irrespective of the material condition (p<0.05). The polymerization stress was not influenced by the material condition (p>0.05).

CONCLUSIONS

Most of the kinetic parameters are not influenced by the material condition. Filtek P60 and Filtek Z250 are more stable as both composites present similar polymerization kinetic results, irrespective of the material condition. Silorane composite presents lower stress values among the tested materials in all conditions. Aging does not affect stress development in restorative composites.

Comparison of apical microleakage of dual-curing resin cements with fluid-filtration and dye extraction techniques

BACKGROUND

Endodontically treated teeth with excessive loss of tooth structure are frequently restored using fiber posts. In this in vitro study, the apical leakage of self- and dual-activated curing modes for dual-curing resins cementing a translucent fiber post was evaluated using computerized fluid filtration meter and dye extraction method.

MATERIAL AND METHODS

One hundred and four extracted human maxillary incisors with single root and canal were used. Experimental samples embedded in a closed system were divided into 4 groups (n=20) according to 2 dual-curing luting systems, with 2 different curing modes (either with self- or light-activation): (1) Panavia F 2.0 with self-cure, (2) Panavia F 2.0 with light-activation, (3) Clearfill SA with self-cure, and (4) Clearfill SA with light activation. Twenty-four teeth served as negative and positive controls. Translucent fiber posts were luted in the roots except in the control groups.

RESULTS

Statistical analysis indicated no significant difference in leakage among groups (p>0.05) with 4.12 × 10(-4) (Panavia self-cure), 4.55 × 10(-4) (Clearfill SA self-cure), 5.17 × 10(-4) (Panavia dual-cure), and 5.59 × 10(-4) (Clearfill SA dual-cure) in fluid-filtration method. Absorbance values for dye-extraction method were 266 nanometer (nm) (Panavia self-cure), 268 nm (Clearfill SA self-cure), 270 nm (Panavia dual-cure), and 271 nm (Clearfill SA dual-cure), in which difference among the groups were not statistically significant (p>0.05). When comparing the leakage, assessment methods results showed no statistically significant difference between the tested evaluation techniques (p>0.05).

CONCLUSIONS

Light- and self-activation curing modes of Panavia F 2.0 and Clearfill SA perform similar to each other in a closed system.

Effect of energy density and delay time on the degree of conversion and Knoop microhardness of a dual resin cement

AIM

In the present study, we evaluated the influence of the photo-curing delay time and energy density on the degree of conversion and the Knoop microhardness of a resin cement.

METHODS

Seventy-eight samples were assigned to 13 groups (n = 6), one of which received no light curing (control). The samples were made of a dual-cured resin cement (RelyX ARC) with the aid of a Teflon matrix, submitted to one of the following energy densities (J/cm²): 7, 14, 20, and 28. Delay times were immediate (0), 1 min, or 2 min. After 24 h, the degree of conversion and microhardness were measured at three segments: cervical, medium, and apical. Data were submitted to three-way anova and Tukey's and Dunnett's tests, the latest of which was used to compare the control to the experimental groups.

RESULTS

No interaction was observed between delay time and energy density regarding the degree of conversion. The cervical segment showed the highest values, while the apical showed the lowest. Microhardness values concerning the cervical segment in all groups were statistically different from that obtained for the control.

CONCLUSION

A high-irradiance light-curing unit allows for a reduced irradiation exposure time with a short delay time, aimed at tooth restorations using a dual-cured resin cement.