Effect of ceramic shade on the degree of conversion of a dual-cure resin cement analyzed by FTIR

The effect of photoinitiator type and filler load on physicochemical and mechanical properties of experimental light-cured resin cements through lithium disilicate ceramics of different shades and thicknesses

OBJECTIVE

This study investigated the influence of photoinitiator types on degree of conversion (DC), rate of polymerization (RP), flexural strength (FS), flexural modulus (FM), and light transmittance (LT) of filled and unfilled light-curable resin cements through different thicknesses and shades of lithium disilicate ceramics.

METHODS

Lithium disilicate ceramic discs (IPS Emax Press, background [0.0], 0.5, 1.0, 2.0, 3.0, and 4.0 mm, shades A1 and BL3) were prepared. Experimental resin-based cements [TEGDMA/BisGMA (50/50 mass%)] were prepared using either camphorquinone (CQ)/amine (0.44/1.85 mol%) or TPO (0.44 mol%)], and a micro and nanofiller loads of nil (unfilled); 40/10 mass%; and 50/10 mass%). Resin cements (0.2 mm thick) were placed on the lower surface of the ceramic specimens and light-activated for 30 s from the upper surface using a Bluephase Style curing light (exitance at tip: 1236 mW/cm2 ± 1.20). LT and distribution of irradiance through the ceramics were measured using a UV-vis spectrometer and a beam profile camera, respectively (n = 3). The DC and RP were measured in real-time using mid infrared spectroscopy in attenuated total reflectance (ATR) mode (n = 3). FS and FM were measured using a universal testing machine (n = 5). Statistical analyses were performed on LT, DC, RP, FS, and FM data using a general linear model, and supplementary ANOVA and post hoc Tukey multiple comparison test were also performed (α = .05).

RESULTS

Thicknesses, shades, photoinitiator type, and fillers load significantly influenced the optical and mechanical characteristics of the resin-based materials (p < 0.05). The BL3 shade ceramic provided higher values of DC, RP, FS, FM, and LT compared with the A1 shade (p < 0.05). Increasing ceramic thickness decreased the properties of the resin-based materials (p < 0.05). Generally, TPO improved mechanical properties of the resin cement compared with CQ (p < 0.05).

SIGNIFICANCE

The luting process of indirect restorations may be improved by using high molar absorptivity, more reactive, and more efficient photoinitiators such as TPO, as opposed to conventional CQ. The use of such initiator may allow the placement of thicker and more opaque indirect restorations.

Effects of ceramic thickness, ceramic translucency, and light transmission on light-cured bulk-fill resin composites as luting cement of lithium disilicate based-ceramics

PURPOSE

To assess the effects of ceramic thickness, ceramic translucency, and light transmission on restorative composites used as luting cement for lithium disilicate-based ceramics.

METHODS

Four luting types of cement were tested (n=8); a dual-cured resin cement (Multilink N), a light-cured conventional flowable composite (Tetric N-Flow), and two light-cured bulk-fill flowable composites (Tetric N-Flow Bulk Fill and X-tra base). The 20 s- or 40 s-light (1000 mW/cm2) was transmitted through 1- or 2-mm-thick high- or low-translucency (HT- or LT-) ceramic discs (IPS e.Max press) to reach the 1-mm-thick luting cement. Light transmitted to cement without ceramic served as a control. Vickers hardness number (VHN), flexural strength (FS), fractography, and degree of conversion (DC) were evaluated. One-way and multi-way analysis of variance was conducted to determine the effects of factors on VHN and FS.

RESULTS

Ceramic thickness, light transmission time, and cement type significantly affected the VHN of the luting cement (P < .000). Only Multilink N (LT- and HT-1mm) and Tetric N-Flow (HT-1mm) reached 90% VHN of corresponding control by 20 s-light transmissions, but Tetric N-Flow exhibited lowest VHN and approximately 1/3-1/2 VHN of Multilink N (P < 0.05). X-tra base expressed superior physicochemical properties to Tetric N-Flow Bulk Fill (P < 0.05) and reached >90% VHN of control in all conditions with 40 s-light transmissions except for LT-2 mm. DC, FS, and fractography supported these findings.

CONCLUSIONS

The light-cured bulk-fill composite served as a luting cement for lithium-disilicate-based ceramics in a product-dependent manner. Light transmission time is crucial to ensure sufficient luting cement polymerization.

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.

Post-Cure Development of the Degree of Conversion and Mechanical Properties of Dual-Curing Resin Cements

This study investigated the effect of different curing conditions on the degree of conversion and mechanical properties of contemporary dual-curing resin cements. The material specimens were either light-cured directly, light-cured through a 1-mm lithium disilicate glass-ceramic layer, or self-cured. The degree of conversion was measured in 0.1-mm films using Fourier-transform infrared spectroscopy 1 day, 7 days, and 28 days post-cure. Specimens used to study the flexural strength and modulus were prepared according to the ISO 4049 protocol, stored for 28 days post-cure, and subjected to accelerated aging by absolute ethanol immersion. The degree of conversion values ranged between 44.3–77.8%. Flexural strength varied between 11.4–111.1 MPa, while flexural modulus amounted to 0.7–5.5 GPa. The degree of conversion was significantly affected by material type, curing conditions, and post-cure time; however, variations in curing conditions were the least influential factor. A statistically significant effect of curing conditions on the degree of conversion was identified for only one of the five materials tested, whereas the flexural strength and modulus of all tested materials were significantly reduced in the experimental groups that were light-cured through a ceramic layer or self-cured. The effect size analysis showed that mechanical properties were most affected by the material type, while the differences in curing conditions were less influential. A comparison of the degree of conversion and mechanical properties indicated that different curing conditions may lead to significantly different flexural strength and modulus, which are not necessarily accompanied by identifiable variations in the degree of conversion.

Effect of Optical Properties of Lithium Disilicate Glass Ceramics and Light-Curing Protocols on the Curing Performance of Resin Cement

This study aimed to investigate the effects of optical properties of lithium disilicate glass ceramics and the light-curing protocols (LCP) on the curing performance of light-cured resin cement. Lithium disilicate glass-ceramics with different optical properties were sectioned to produce ceramic specimens of 0.8 mm thickness. Irradiance through the ceramic specimens was measured by a radiometer. Light transmittance of ceramics was assessed using a UV/Vis spectrophotometer. The light-cured resin cement was injected into a Teflon mold and ceramics with different optical properties were placed on it, cured under different LCPs, and the degree of conversion (DC) and Vickers microhardness of the resin cement were separately measured by Micro-ATR/FTIR spectrometry and the microhardness tester. The shade (p < 0.001) and transparency (p < 0.001) of ceramics affect the irradiance of the light-curing unit. The transparency (p < 0.001) of the ceramic and light-curing protocols (p < 0.001) affect the DC and microhardness of resin cements. When the thickness of the ceramic is 0.8 mm, the light transmittance of the ceramic and the curing performance of the resin cement increase with the increase of the transparency of the ceramic. An appropriate increase in irradiance and exposure time can optimize the curing performance of resin cement. These factors should be taken into account by the clinician when designing the bonding solution for porcelain veneers.

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.

Impact of adhesive primer and light-curing on polymerization kinetics of self-adhesive resin cement in association with free radical reaction

This study analyzed the impact of adhesive primer and light-curing on the polymerization kinetics of urethane dimethacrylate-based self-adhesive resin cement combined with free radical reaction. Specimens were prepared by mixing the cement paste with or without adhesive primer. Subsequently, specimens were light-cured or set without light-curing. The degree of conversion (DC), Vickers hardness (Hv), and free radical concentrations were repeatedly measured up to 168 h after the curing initiation. Irrespective of the curing procedures, DC, Hv, and free radical concentration rapidly increased during the initial 30 min of curing. The specimens cured with adhesive primer and/or light-curing generally showed higher values of DC, Hv, and radical concentration than those set by chemical curing alone, especially during the initial polymerization phase. Kinetic analysis using a linear mixed model revealed that the adhesive primer had a higher coefficient estimate than light-curing, indicating that the former had a higher impact on the polymerization. Additionally, the adhesive primer alleviated the Hv reduction caused by water and air during the initial polymerization phase, although light-curing hardly prevented the polymerization inhibition. Therefore, we suggest that application of adhesive primer is beneficial to achieve higher degree of conversion and better mechanical properties of self-adhesive resin cements by enhancing free radical reactions.

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.

Effect of lithium disilicate ceramic thickness, shade and translucency on transmitted irradiance and knoop microhardness of a light cured luting resin cement

This in vitro study evaluates the influence of pressed lithium disilicate thickness, shade and translucency on the transmitted irradiance and the Knoop microhardness (KHN) of a light-cured resin cement at two depths. One hundred and thirty-five ceramic discs of IPS e.max Press (Ivoclar Vivadent) were fabricated and divided into twenty-seven groups (n = 5) according to the association between translucency: HT (hight translucency), LT (low translucency), and MO (medium opacity); shade: BL2, A1 and A3.5; and thickness: 0.5 mm, 1.5 mm, and 2.0 mm. One side of each ceramic disc was finished, polished and glazed. The irradiance (mW/cm²) of a multiwave LED light curing unit (Valo, Ultradent) was evaluated with a potentiometer (Ophir 10ª-V2-SH, Ophir Optronics) without (control group) or with interposition of ceramic samples. The microhardness of Variolink Esthetic LC resin cement (Ivoclar Vivadent) was evaluated after 24 h at two depths (100 μm and 700 μm). Data were submitted to ANOVA followed by Tukey's test (α = 0.05). Irradiance and KHN were significantly influenced by ceramic thickness (p < 0.0001), shade (p < 0.001), translucency (p < 0.0001) and depth (p < 0.0001). Conclusions: the interposition of increasing ceramic thicknesses significantly reduced the irradiance and microhardness of resin cement. Increased depth in the resin cement showed significantly reduced microhardness for all studied groups. Increased ceramic opacity reduced the KHN of the resin cement at both depths for all ceramic thicknesses and shades.

Evaluation of microhardness and water sorption/solubility of dual-cure resin cement through monolithic zirconia in different shades

Aim:

The objective is to evaluate the effect of shades of monolithic zirconia on the microhardness and sorption/solubility of the underlying two dual-cured resin types of cement.

Materials and Methods:

Eighty samples of two dual-cured resin cement discs were polymerized under 60 monolithic zirconia discs in three shades and directly activated resin discs of cement were used as the control group (n = 10). After 24 h storage at 37°C in an incubator, Vickers microhardness and the sorption and solubility were measured.

Statistical Analysis Used:

Two-way ANOVA , one-way ANOVA, Independent t-test, Tukey's honestly significant difference, and Tamhane's T2 tests.

Results:

The mean microhardness of the Variolink N resin cements were significantly higher than Panavia SA ones (P < 0.001). Furthermore, Variolink N cements exhibited lower sorption/solubility than Panavia SA resin cements (both P < 0.05). The ceramic shade had a significant influence on the microhardness of both cements (P < 0.001) but had no significant effect on the sorption/solubility of resin cements (P > 0.05).

Conclusion:

Interposition of monolithic zirconia decreases the microhardness of resin cement especially Panavia SA. In Variolink N, by increasing the chroma saturation of ceramics, the microhardness decreased, however in Panavia SA, it was altered by the shades, but not in a specific pattern. For both cements, there were no statistical differences between the sorption/solubility of samples photo-cured under different shades. There was a reverse correlation between microhardness and water sorption/solubility of both cements.

Core build-up resin composites: an in-vitro comparative study

Aim

Resin composite (RC) are commonly used under full crowns. However, independent information is lacking to guide practitioners regarding core RC material selection. This study aimed at comparing the flexural properties of a large selection of commercially-available core build-up RCs (CBU-RC), either light-, self- or dual-cure, to conventional light-cure RCs.

Methods

RCs were injected into a 25 × 2×2mm Teflon mold, and either light-cured during 20 s (materials with claimed light-cure characteristics) or covered by aluminum during 10 min (dual- and self-cure CBU-RCs). They were subjected after a one-week water storage at 37.5 °C to three-point bending, and Flexural modulus (E _flex) and Flexural Strength (σ _f) were calculated (n = 20). Thermogravimetric analysis (n = 3) was performed to determine inorganic filler content (%).

Results

For dual-cure CBU-RCs, both RC (p < .0001) and light-curing (p = .0007) had a significant influence on E _flex, while only RC was significant for σ _f (p < .0001). Between all conventional RCs and CBU-RCs, significant differences were observed (p < .0001), both regarding E _flex and σ _f, with values ranging from 3.9 to 15.5 GPa and from 76 to 130.3 MPa, respectively. Higher E _flex values were observed for light-cure RCs than for self- and dual-cure ones, while no clear trend was noticed regarding σ _f. Good linear correlation was found between inorganic filler content and E _flex (R ²=0.85, p < .0001), but not with σ _f (R ²=0.08, p = .1609).

Conclusion

This work demonstrated a positive influence of light-curing on dual-cure CBU-RC's E _flex. It also highlighted large differences in flexural properties (especially E _flex) among the investigated materials, questioning the use of some CBU-RCs as dentin replacement in case of large tissue loss.

Effect of the amount of light energy transmitted through CAD/CAM resin block on bonding performance of four types of resin cement adhesive systems

Resin-ceramic hybrid materials for computer-aided design/computer-aided manufacturing (CAD/CAM resins) have been developed. In this study, the effects of the amount of light energy transmitted through the four types of 1.5-mm-thick CAD/CAM resin blocks on the bond performance of corresponding resin cement adhesive systems consisting of an adhesive and a dual-curable resin cement were examined. The bond strengths of the four types of resin cement adhesive systems decreased with decreasing the amount of light energy transmitted through CAD/CAM resin block, due to a decrease in the light-curable ability of dual-curable resin cements. However, the degradation behavior of the bond strengths was strongly affected by the types of adhesives and initiator systems utilized. The adhesive consisting of a dimethacrylate monomer and redox-initiators enhanced the bonding performance of the dual-curable resin cement more effectively than the adhesive, which consists of a dimethacrylate monomer and photo-initiators or a γ-me thacryloxypropyltrimethoxysilane and a 10-methacryloyloxydecyl dihydrogen phosphate.

The effect of thickness and translucency of polymer-infiltrated ceramic-network material on degree of conversion of resin cements

PURPOSE

The aim of the present study was to determine the degree of conversion of light- and dual-cured resin cements used in the cementation of all-ceramic restorations under different thicknesses of translucent (T) and high-translucent (HT) polymer-infiltrated ceramic-network (PICN) material.

MATERIALS AND METHODS

T and HT PICN blocks were prepared at 0.5, 1.0, 1.5, and 2.0 mm thicknesses (n=80). Resin cement samples were prepared with a diameter of 6 mm and a thickness of 100 µm. Light-cured resin cement was polymerized for 30 seconds, and dual-cure resin cement was polymerized for 20 seconds (n=180). Fourier transform infrared spectroscopy (FTIR) was used for degree of conversion measurements. The obtained data were analyzed with ANOVA and Tukey HSD, and independent t-test.

RESULTS

As a result of FTIR analysis, the degree of conversion of the light-cured resin cement prepared under 1.5- and 2.0-mm-thick T and HT ceramics was found to be lower than that of the control group. Regarding the degree of conversion of the dual-cured resin cement group, there was no significant difference from the control group.

CONCLUSION

Within the limitation of present study, it can be concluded that using of dual cure resin cement can be suggested for cementation of PICN material, especially for thicknesses of 1.5 mm and above.

Dual-curing resin cement with colour indicator for adhesively cemented restorations to dental tissues: Change of colour by curing and some physical properties

The study was aimed to investigate a color indicator containing dual curing resin composite luting cement and to plot the color change to the time of solidification of the cement. In addition some physical properties were studied. Specimens were made of a dual-cure resin cement (Maxcem Elite™ Chroma, Kerr, Orange, CA, USA) and polymerized by autopolymerization only, or with light initiated polymerization. A spectrophotometer was used to quantify the color change of the cement as plotted with the curing time. The efficacy of the curing process was studied by measuring water sorption and the ultimate flexural properties of the cement. The results showed that the flexural strength of cement after autopolymerization was 27.3 MPa and after light initiated polymerization 48.1 MPa. Young’s modulus of bending was 2089.3 MPa and 3781.5 MPa respectively for the same cement samples. Water sorption after two weeks for the autopolymerization cement samples was −1.12 wt% and for the light initiated polymerization samples 0.56 wt%. Non-parametric Spearman’s correlation was measured for autopolymerized cement samples between variables for color and solidification load (N), which showed a strong correlation between curing process and color change (p < 0.05). There was a correlation between the color change and degree of monomer conversion of the dual curing resin composite luting cement which contained a color indicator system for polymerization reaction. The study also suggested that autopolymerization only resulted in suboptimal polymerization of the cement. By additional light curing considerably higher flexural properties were obtained.

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.

Influence of the composition and shades of ceramics on light transmission and degree of conversion of dual-cured resin cements

Objective

Since the transmittance of ceramics can influence the degree of conversion (DC) of resin cements, ceramics composition and shade should be considered in the selection of resin cement. This in vitro study aimed to evaluate the effect of the transmittance of different composition, opacities and shades of ceramics on the degree of conversion of two dual-cured resin cements.

Methodology

Sixty discs were prepared from low translucency (LT) and medium opacity (MO) lithium disilicate ceramic, and zirconia ceramic (Z). Each group was subdivided into 5 subgroups (n=4) in shades A2, A3.5, B2, C2 and D3. The transmittance measurement was performed in a spectrophotometer. The Variolink II and Rely X U200 resin cements were photoactivated by LED (1400 mW/cm2) for 40 s through the ceramic discs and without the discs (control group). The DC was measured with infrared FTIR spectroscopy, immediately after light activation. Data were analyzed with Kruskall-Wallis and one-way ANOVA, following post-hoc comparisons by Tukey test and Pearson’s correlation test (P<0.05).

Results

LT ceramic exhibited higher transmittance values compared to MO and Z ceramics. LTA2 and LTB2 showed statistically higher transmittance values compared to MOA2, MOA3.5 and ZA3.5. For Variolink II, the ceramic interposition did not influence the DC, since there were no statistical differences between groups with ceramic interposition and the control group. For Rely X U200 cement, the interposition of some ceramics types/shades (LTA3.5, MOA2, MOA3.5 and ZA3.5) significantly decreased the DC values compared to control group. A positive correlation was found between the ceramic transmittance and DC values of both tested cements. Conclusions. The transmittance and DC values of the cements were influenced by composition and shades of the ceramics. The higher the transmittance of ceramics, the higher the DC values for both cements.

Evaluation of the light transmission of chairside polymer infiltrated hybrid ceramics in different shades and thicknesses

BACKGROUND:

This in vitro study aimed to evaluate the amount of polymerizing light passing through hybrid ceramic specimens in different shades and thicknesses.

METHODS:

Rectangular-shaped feldspathic ceramic computer aided design and computer aided manufacturing (CAD-CAM) blocks and translucent and high translucent polymer infiltrated hybrid ceramic CAD-CAM blocks in four different shades (1M1, 1M2, 2M2, and 3M2) were sectioned in four different thicknesses (0.8, 1.5, 2, and 3 mm), and a total of 48 groups ( n = 10) were obtained. Feldspathic ceramic specimens served as the control group. The light transmission of each ceramic specimen was measured three times by using a light-emitting diode and a radiometer. Data were statistically analyzed by using univariate analysis of variance (ANOVA) followed by one-way ANOVA, Tukey honest significant difference, and Tamhane T2 tests (α = 0.05).

RESULTS:

Translucent polymer infiltrated hybrid ceramic specimens exhibited significantly ( p < 0.001) lower light transmission values than high translucent polymer infiltrated hybrid ceramic and feldspathic ceramic specimens, whereas feldspathic ceramic specimens exhibited significantly ( p < 0.001) higher light transmission than translucent and high translucent polymer infiltrated hybrid ceramic specimens. The amount of light transmission significantly ( p < 0.05) decreased when the shade value decreased and the thickness increased.

CONCLUSIONS:

Polymer infiltrated hybrid ceramic specimens showed lower light transmission values than feldspathic ceramic specimens, and the amount of light transmission was affected by the ceramic shade and thickness.

Use of Artificial Neural Network in Determination of Shade, Light Curing Unit, and Composite Parameters' Effect on Bottom/Top Vickers Hardness Ratio of Composites

Objective

To assess the influence of light emitting diode (LED) and quartz tungsten halogen (QTH) light curing unit (LCU) on the bottom/top (B/T) Vickers Hardness Number (VHN) ratio of different composites with different shades and determination of the most significant effect on B/T VHN ratio of composites by shade, light curing unit, and composite parameters using artificial neural network.

Method

Three composite resin materials [Clearfil Majesty Esthetic (CME), Tetric N Ceram (TNC), and Tetric Evo Ceram (TEC)] in different shades (HO, A2, B2, Bleach L, Bleach M) were used. The composites were polymerized with three different LED LCUs (Elipar S10, Bluephase 20i, Valo) and halogen LCU (Hilux). Vickers hardness measurements were made at a load of 100 g for 10 sec on the top and bottom surfaces and B/T VHN ratio calculated. The data were statistically analyzed with three-way ANOVA and Tukey test at a significance level of 0.05. The obtained measurements and data were then fed to a neural network to establish the correlation between the inputs and outputs.

Results

There were no significant differences between the B/T VHN ratio of LCUs for the HO and B shades of CME (p>0.05), but there were significant differences between the B/T VHN ratio of LCUs for shade A2 (p<0.05). No significant difference was determined between the B/T VHN ratio of LCUs for all shades of TNC (p>0.05). For TEC, there was no significant difference between the B/T VHN ratio of halogen and LED LCUs (p>0.05), but a significant difference was determined among the LED LCUs (p<0.05). The artificial neural network results showed that a combination of the curing light and composite parameter had the most significant effect on the B/T VHN ratio of composites. Shade has the lowest effect on the B/T VHN ratio of composites.

Conclusion

The B/T VHN ratio values of different resin-based composite materials may vary depending on the light curing device. In addition, the artificial neural network results showed that the LCU and composite parameter had the most significant effect on the B/T VHN ratio of the composites. Shade has the lowest effect on the B/T VHN ratio of composites.

Investigating the limits of resin-based luting composite photopolymerization through various thicknesses of indirect restorative materials

OBJECTIVE

To determine the limitations of using light-curable resin-based luting composites (RBLCs) to bond indirect ceramic/resin-composite restorations by measuring light transmittance through indirect restorative materials and the resulting degree of conversion (DC) of the luting-composites placed underneath.

METHODS

Various thicknesses (0-4mm) and shades of LAVA Zirconia and LAVA Ultimate were prepared and used as light curing filters. A commercial, light curable RBLC, RelyX Veneer (control) was compared with four experimental RBLCs of the following composition: TEGDMA/BisGMA (50/50 or 30/70wt%, respectively); camphorquinone/amine (0.2/0.8wt%) or Lucirin-TPO (0.42wt%); microfillers (55wt%) and nanofillers (10wt%). RBLCs covered with the LAVA filter were light-cured for 40s, either with the dual-peak BluephaseG2 or an experimental device emitting either in the blue or violet visible band. The samples were analyzed by Raman spectroscopy to determine DC. Light transmittance through the filters was measured using a common spectroscopy technique.

RESULTS

All the factors studied significantly influenced DC (p<0.05). RBLCs with increased TEGDMA content exhibited higher DC. Only small differences were observed comparing DC without filters and filters ≤1mm (p>0.05). For thicknesses ≥2mm, significant reductions in DC were observed (p<0.05). Transmittance values revealed higher filter absorption at 400nm than 470nm. A minimal threshold of irradiance measured through the filters that maintained optimal DC following 40s irradiation was identified for each RBLC formulation, and ranged between 250-500mW/cm².

SIGNIFICANCE

This work confirmed that optimal photopolymerization of RBLCs through indirect restorative materials (≤4mm) and irradiation time of 40s is possible, but only in some specific conditions. The determination of such conditions is likely to be key to clinical success, and all the factors need to be optimized accordingly.

Effect of shade, opacity and layer thickness on light transmission through a nano-hybrid dental composite during curing

OBJECTIVE

The aim of this study was to investigate the effect of shade and opacity on the change in light transmission through different thicknesses of a nano-hybrid composite during curing.

MATERIALS AND METHODS

Twelve different shades of Venus Diamond (Heraeus Kulzer) were placed in disk shaped molds with thickness of 1, 2, and 3 mm (n = 3 per group) and cured with an LED light-curing unit. Initial, final and average irradiance, and the total amount of energy passing through the specimen were measured using the MARC Resin Calibrator at every 10s for a total of 40s. The translucency parameter and the contrast ratio were obtained using a chromameter. Results were analyzed with ANOVA/Tukey's test (α = 0.05).

RESULTS

All shades and all thicknesses (up to 3 mm) experienced an increase in light transmittance during curing. The majority of the increase occurred during the initial 10s exposure, with significant increase occurring from subsequent exposures only in thicker specimens (i.e., 3 mm). The increase in irradiance at the bottom during curing was dependent on shade, with darker shades and greater depths of material showing less increase.

CONCLUSIONS

For one specific resin composite formulation, an increase in translucency occurs as cure progresses, and the increase is enhanced for composites with greater lightness and lower contrast ratio.

CLINICAL SIGNIFICANCE

Composites demonstrate increased light transmittance as curing progress, which may improve depth of cure. The thicker composite showed the least increase in light transmission within the same shade. The increase in translucency is enhanced for composites with great lightness and lower contrast ratio.

Effect of Insufficient Light Exposure on Polymerization Kinetics of Conventional and Self-adhesive Dual-cure Resin Cements

Objectives: The purpose of this study was to investigate the influence of insufficient light exposure on the polymerization of conventional and self-adhesive dual-cure resin cements under ceramic restorations.

Methods: Two conventional dual-cure resin cements (Rely-X ARC, Duolink) and two self-adhesive resin cements (Rely-X U200, Maxcem Elite) were polymerized under different curing modes (dual-cure or self-cure), curing times (20 and 120 seconds), and thickness of a ceramic overlay (2 and 4 mm). Polymerization kinetics was measured by Fourier transform infrared spectroscopy for the initial 10 minutes and after 24 hours. Data were analyzed using mixed model analysis of variance (ANOVA), one-way ANOVA/Student-Newman-Keuls post hoc test, and paired t-test (α=0.05).

Results: When light-curing time was set to 20 seconds, the presence of the ceramic block significantly affected the degree of conversion (DC) of all resin cements. Especially, the DC of the groups with 20 seconds of light-curing time under 4 mm of ceramic thickness was even lower than that of the self-cured groups at 24 hours after polymerization (p&lt;0.05). However, when light-curing time was set to 120 seconds, a similar DC compared with the group with direct light exposure (p&gt;0.05) was achieved in all dual-cure groups except Maxcem Elite, at 24 hours after polymerization.

Conclusions: For both conventional and self-adhesive dual-cure resin cements, insufficient light exposure (20 seconds of light-curing time) through thick ceramic restoration (4 mm thick) resulted in a DC even lower than that of self-curing alone.

Water Sorption and Solubility of Luting Agents Used Under Ceramic Laminates With Different Degrees of Translucency

PURPOSE

The aim of this study was to evaluate the effect of low-thickness ceramic laminate translucency on water sorption and solubility in resin luting agents.

METHODS AND MATERIALS

Ceramic slides (15×0.7 mm) were generated using lithium disilicate (IPS e.max Press, Ivoclar-Vivadent, Schaan, Liechtenstein) that were A1 in color and had decreasing degrees of translucency (high, medium, and low). A slide of transparent glass of similar size was used as the control. Under each slide, 15 specimens (8×0.5 mm) of differing composite materials from the same manufacturer (3M ESPE Dental Products, St Paul, MN, USA) were prepared (n=5): light-cured resin cement (RelyX Veneer); dual-cured resin cement (RelyX ARC); and flowable composite (Z350XT Flow). To evaluate the loss or gain of mass, the specimens were dried until a constant mass was reached. Then, they were immersed in water for seven days and weighed immediately following removal from water. Subsequently, the specimens were dried again until a constant mass was obtained. The mass measurements were used to calculate the water sorption and solubility. Statistical analyses were carried out using a two-way analysis of variance and the Tukey test.

RESULTS

Under the high-translucency ceramic slides, all of the luting agents showed similar performance regarding water sorption; the flowable composite resin and the light-cured resin cement had the lowest solubility values. Under the medium- and low-translucency surfaces, the dual-cured resin cement and the flowable composite resin showed better performance with respect to water sorption and solubility.

CONCLUSIONS

In the case of high-translucency laminates, luting agents with different activation methods might be used. However, even in thin sections, decreasing the translucency of the laminate led to significant loss of light penetration, indicating a decreased likelihood of the physical activation of the resin cement.

Luting of CAD/CAM ceramic inlays: direct composite versus dual-cure luting cement

The aim of this study was to investigate bonding effectiveness in direct restorations. A two-step self-etch adhesive and a light-cure resin composite was compared with luting with a conventional dual-cure resin cement and a two-step etch and rinse adhesive. Class-I box-type cavities were prepared. Identical ceramic inlays were designed and fabricated with a computer-aided design/computer-aided manufacturing (CAD/CAM) device. The inlays were seated with Clearfil SE Bond/Clearfil AP-X (Kuraray Medical) or ExciTE F DSC/Variolink II (Ivoclar Vivadent), each by two operators (five teeth per group). The inlays were stored in water for one week at 37°C, whereafter micro-tensile bond strength testing was conducted. The micro-tensile bond strength of the direct composite was significantly higher than that from conventional luting, and was independent of the operator (P<0.0001). Pre-testing failures were only observed with the conventional method. High-power light-curing of a direct composite may be a viable alternative to luting lithium disilicate glass-ceramic CAD/CAM restorations.

Correlation between clinical performance and degree of conversion of resin cements: a literature review

Resin-based cements have been frequently employed in clinical practice to lute indirect restorations. However, there are numerous factors that may compromise the clinical performance of those cements. The aim of this literature review is to present and discuss some of the clinical factors that may affect the performance of current resin-based luting systems. Resin cements may have three different curing mechanisms: chemical curing, photo curing or a combination of both. Chemically cured systems are recommended to be used under opaque or thick restorations, due to the reduced access of the light. Photo-cured cements are mainly indicated for translucent veneers, due to the possibility of light transmission through the restoration. Dual-cured are more versatile systems and, theoretically, can be used in either situation, since the presence of both curing mechanisms might guarantee a high degree of conversion (DC) under every condition. However, it has been demonstrated that clinical procedures and characteristics of the materials may have many different implications in the DC of currently available resin cements, affecting their mechanical properties, bond strength to the substrate and the esthetic results of the restoration. Factors such as curing mechanism, choice of adhesive system, indirect restorative material and light-curing device may affect the degree of conversion of the cement and, therefore, have an effect on the clinical performance of resin-based cements. Specific measures are to be taken to ensure a higher DC of the luting system to be used.

Translucency of Dental Ceramic, Post and Bracket

Translucency of dental ceramics, esthetic posts and orthodontic brackets was reviewed. Translucency parameter (TP) and contrast ratio (CR) are generally used for translucency evaluation. For the evaluation of translucency, two criteria such as the translucency of human teeth (TP = 15-19, 1 mm thick) and the visual perceptibility threshold for the translucency difference (∆CR > 0.07 or ∆TP > 2) were used. In ceramics, translucency differences were in the perceptible range depending on the type of material and the thickness. However, variations caused by the difference in the required thickness for each layer by the material and also by the measurement protocols should be considered. As to the translucency of esthetic posts, a significant difference was found among the post systems. Translucency was influenced by the bracket composition and brand, and the differences by the brand were visually perceptible.

Efeito da intensidade de fontes de luz e barreiras de cerâmica na microdureza de cimento resinoso dual

<title>Resumo</title><sec><title>Introdução</title><p>O cimento resinoso dual é o principal material para cimentação de cerâmicas. Contudo, fatores, como fonte de luz, podem influenciar no desempenho do cimento.</p></sec><sec><title>Objetivo</title><p>Avaliar a influência de duas fontes de luz de diferentes intensidades sobre a microdureza de um cimento resinoso quando fotoativado sob diferentes cerâmicas.</p></sec><sec><title>Material e método</title><p>Foram fotoativados 40 espécimes de cimento resinoso dual (10 mm × 1,0 mm) por meio de duas fontes de luz LED, com intensidades de 1.000 mW/cm² e 800 mW/cm² durante 40 segundos, sob cerâmicas (15 mm × 2 mm) à base de zircônia, espinélio MgAl₂O₄ e dissilicato de lítio. No grupo controle, foi utilizada uma placa de vidro de mesma dimensão. As amostras tiveram a superfície regularizada com lixa d`água (600 e 1200). Após armazenagem a seco no escuro (24 h), foram realizadas as medidas de microdureza Vickers (HMV Shimadzu - 50g/10 segundos). Os dados foram submetidos à Anova fatorial e ao teste de Tukey com nível de significância de 5%.</p></sec><sec><title>Resultado</title><p>O cimento polimerizado apresentou valor médio de microdureza e desvio padrão para o grupo controle de 43,9±1,5 e 43,4±1,3, para as intensidades de 1.000 mW/cm² e 800 mW/cm², respectivamente. O menor valor de microdureza do cimento foi observado para a cerâmica à base de espinélio MgAl₂O₄, polimerizado a 800 mW/cm², com valor de 34,3±3,3.</p></sec><sec><title>Conclusão</title><p>O tipo de cerâmica e a intensidade da fonte de luz influenciam na microdureza do cimento. A intensidade de 1.000 mW/cm² sobre as cerâmicas à base de zircônia e espinélio MgAl₂O₄ resultaram na melhor combinação de valores de dureza do cimento.</p></sec>

Degree of conversion of dual-polymerizing cements light polymerized through monolithic zirconia of different thicknesses and types

STATEMENT OF PROBLEM

Monolithic zirconia restorations are increasingly common. Dual-polymerizing cements have been advocated for cementation. The opacious nature of zirconia restoration can attenuate light, compromising optimal resin polymerization and eventually restoration debonding.

PURPOSE

The purpose of this in vitro study was to evaluate the influence of material thickness on light irradiance, radiant exposure, and the degree of monomer conversion (DC) of 2 dual-polymerizing resin cements light-polymerized through different brands of monolithic zirconia.

MATERIAL AND METHODS

Dual-polymerizing resin cements (RelyX Ultimate; 3M-ESPE, and Variolink II; Ivoclar, Vivadent) were mixed according to the manufacturers' instructions with a film thickness of 40 μm, placed under a 10 × 10 mm specimen of monolithic zirconia (Prettau Anterior by Zirkonzahn, Katana by Noritake, BruxZir by Glidewell, and Zenostar by Wieland) and a zirconia core control (ICE zirkon by Zirkonzahn) at various thicknesses (0.50, 1.00, 1.50, and 2.00 mm, n = 5 of each thickness). Each specimen was irradiated for 20 seconds (RelyX Ultimate) and 40 seconds (Variolink II) with Elipar S10 (3M-ESPE, 1200 mW/cm(2)). The amount of irradiance and radiant exposure was quantified for each specimen. Fourier transform infrared spectroscopy was used to measure the DC from the bottom surface of the resin. Statistical analysis was performed with 2-way ANOVA and post hoc Tukey honest significant difference (HSD) tests (α = .05).

RESULTS

Light irradiance and radiant exposure decreased as the thickness of the specimen increased (P < .05) regardless of the brand. The ranking from least to highest was BruxZir < ICE zircon = Wieland < Katana = Prettau Anterior. The zirconia brand, thickness, and cement type had a significant effect on the DC (P < .001). The DC decreased significantly as the thickness of the zirconia increased (P < .001). Katana and Prettau Anterior showed the highest DC and BruxZir showed the lowest.

CONCLUSION

The thickness of zirconia affects the DC of resin-based cements. The DC of the resin cements differed significantly between cements and among zirconia brands. More polymerizing time may be needed to deliver sufficient energy through some brands of zirconia.

Polymerization efficiency of two dual-cure cements through dental ceramics

Purpose:

The aim of this study was to evaluate the effect of thickness of zirconia on curing efficiency of resin cements.

Materials and Methods:

Four discs with 4.0 mm in diameter were prepared from non-HIP translucent zirconia blocks using a CAD/CAM system and feldspathic ceramic was layered onto discs. Thus, 4 ceramic disc samples were fabricated: (G) 0.5 mm zirconia- as a control group, (G1) 0.5 mm zirconia and 0.5 mm feldspathic, (G2) 1.0 mm zirconia and 0.5 mm feldspathic and (G3) 2.0 mm zirconia and 0.5 mm feldspathic ceramic layer. 2 different dual cure cements were polymerized using a LED curing unit. Degree of conversion was evaluated using Vickers Hardness Test and depths of cure of samples were measured. Data were analyzed statistically using One-way ANOVA and Tukey’s HSD test (p<0.05).

Results:

Microhardness and depth of cure values were different under same thickness of ceramic discs for two resin cements. As the thickness of the zirconia discs increased, the microhardness values and depth of cure decreased.

Conclusion:

Photocuring time cannot be the same for all clinical conditions, under thicker zirconia restorations (>2.0 mm), an extended period of light curing or a light unit with a high irradiance should be used.

Effect of ceramic thickness and shade on mechanical properties of a resin luting agent

PURPOSE

This study aimed to investigate the influence of ceramic thickness and shade on the Knoop hardness and dynamic elastic modulus of a dual-cured resin cement.

MATERIALS AND METHODS

Six ceramic shades (Bleaching, A1, A2, A3, A3.5, B3) and two ceramic thicknesses (1 mm, 3 mm) were evaluated. Disk specimens (diameter: 7 mm; thickness: 2 mm) of the resin cement were light cured under a ceramic block. Light-cured specimens without the ceramic block at distances of 1 and 3 mm were also produced. The Knoop hardness number (KHN), density, and dynamic Young's moduli were determined. Statistical analysis was conducted using ANOVA and a Tukey B rank order test (p = 0.05).

RESULTS

The bleaching 1-mm-thick group exhibited significantly higher dynamic Young's modulus. Lower dynamic Young's moduli were observed for the 3-mm-thick ceramic groups compared to bleaching 3-mm-thick group, and no difference was found among the other 3-mm groups. For the KHN, when A3.5 3-mm-thick was used, the KHN was significantly lower than bleaching and A1 1-mm-thick ceramic; however, no difference was exhibited between the thicknesses of the same shade.

CONCLUSIONS

The dual-cured resin cement studied irradiated through the 1-mm-thick ceramic with the lightest shade (bleaching ceramic) exhibited a better elastic modulus, and there was no effect in KHN of the resin cement when light cured under different ceramic shades and thicknesses (1 and 3 mm), except when the A3.5 3-mm-thick ceramic was used.

CLINICAL SIGNIFICANCE

Variolink II irradiated through ceramic with the lowest chroma exhibited the highest elastic modulus; therefore, the light activation method might not be the same for all clinical situations.