A critical evaluation of bond strength tests for the assessment of bonding to Y-TZP

New adhesive protocol improves shear bond strength of Polyetherketoneketone (PEKK)

OBJECTIVE

Inert surface of Polyetherketoneketone (PEKK) jeopardizes resin bonding. This study aimed to present a new adhesive protocol to improve PEKK bonding.

METHODS

A total of 360 PEKK blocks were milled, polished (maximum roughness of 0.20 µm), and randomly assigned to groups. The new protocol was applied (n = 36) and compared to conventional treatments (no treatment; sandblasting (110-µm Al2O3 and silica); no adhesive; Visiolink (Bredent); and PEKKbond (AnaxDent)) (n = 36). For the new protocol, the surface was blasted (110 µm Al2O3 and 96% isopropyl alcohol at 60 psi), followed by 96% isopropyl alcohol washing, and air drying. PEKKbond was applied (dried for 3 min at 77 °C), followed by Visiolink (dried for 3 min at 60 °C); both light-cured for 3 min (800 mW/cm2). Preopaque (GC Europe) and Opaque (AnaxDent) were applied and light-cured (5 min). Morphological topography was analyzed, and flowable gingiva-colored composite (AnaxGum, AnaxDent) was bonded. All specimens were aged for 24 h and thermocycled (5000 cycles, 5-55 °C). Shear bond strength (SBS) was measured (MPa) and data were analyzed by two-way ANOVA, Tukey, and Weibull moduli estimation (α = 0.05).

RESULTS

The highest SBS values were found in the new protocol (p < 0.05), regardless of aging. Thermocycling reduced SBS (p < 0.05), while Al2O3 and PEKKbond produced higher SBS values than silica and Visiolink, respectively (p < 0.05).

SIGNIFICANCE

The new protocol strongly improves PEKK adhesiveness, and this can reflect in the longevity of prostheses.

Zirconia bond strength durability following artificial aging: A systematic review and meta-analysis of in vitro studies

The present study systematically reviewed the literature regarding the bond strength durability of zirconia ceramics to resin-based luting cements after application of different bonding protocols and aging conditions. Electronic searches in PubMed, Scopus, and Web of Science databases were performed for relevant literature published between January 1st 2015 and November 15th 2022. Ninety-three (93) English language in-vitro studies were included. The percentage of the mean bond strength change was recorded prior to and after artificial aging, and the weighted mean values and 95% confidence intervals were calculated. Bonding protocols were classified based on the combination of MDP/non-MDP containing cement/primer and surface pretreatment, as well as the level of artificial aging performed. Alumina sandblasting (SA) was identified as the most frequently used surface pre-treatment while an insufficient number of studies was identified for each category of alternative surface treatments. The combination of MDP cement with tribochemical silica coating (TSC) or SA yielded more durable results after aging, while the application of SA and TSC improved bond durability when a non-MDP cement and a non-MDP primer were used. TSC may lead to increased bond durability compared to SA, whereas MDP cements may act similarly when combined with SA or TSC.

Effect of Surface Treatment of Zirconia on the Shear Bond Strength of Resin Cement: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to evaluate the effect of different surface treatments on the shear bond strength (SBS) values between zirconia and resin cement compared to untreated specimens. The effects of various surface treatments on the bond strength between zirconia and resin cement were investigated by searching relevant articles on PubMed, ScienceDirect, and Google Scholar databases. A total of 13 studies that met the inclusion and exclusion criteria and addressed the research question were selected for statistical analysis. The studies were evaluated for heterogeneity, and a meta-analysis was performed. In total, 13 in vitro studies were included in accordance with the eligibility criteria. All 13 studies consistently demonstrated that silica coating yielded the highest SBS, followed by sandblasting and laser treatments. The meta-analysis using a random-effect model indicated a significant intergroup comparison, except for a few studies. Among the three treatments examined, the silica coating of zirconia was identified as the most effective in enhancing the bond strength between zirconia and resin cement. Further controlled laboratory and clinical studies are necessary to validate these findings and explore additional factors that may influence the effects of these surface treatments.

Examination of the Shear Force Resistance of Laminate Veneers Adhered with Different Resin Cements

OBJECTIVES: This study investigated the mechanical properties of laminate veneers to determine their resistance to the shear force of three different types of cement used in the restorations. MATERIAL and METHODS: Laminate veneers were prepared using the standard tooth preparation methods for 30 extracted maxillary central incisors. To standardize the depth, guide burs were used to prepare a depth of 0.5 mm from the buccal angle. The samples were allocated into three randomized groups (n = 10): Group A (resin using the total etch method and Variolink Esthetic DC resin cement; Group B (resin using the PANAVIA F2.0 self-etch method; and Group C (self-adhesion bonded with Rely X U200 resin cement). The prepared specimens were stored in distilled water for one week before a shear test was used to determine the resistance of the veneers to the bonding. The obtained data were evaluated statistically. RESULTS: The values of the shear bond strength were statistically significant depending on the type of resin cement that was applied (p ˂ 0.05). The specimens that were cemented using the total-etch method (18.79±4.48 MPa) had the lowest shear force value. The obtained data were evaluated statistically by Tukey multiple comparison test (p > 0.05). CONCLUSIONS: The cement is a highly effective factor in the bonding between fixed prosthetic restorations and the abutment tooth, and the cement used must have sufficient resistance to shear forces.

Aspects and Principles of Material Connections in Restorative Dentistry-A Comprehensive Review

The combination of two dissimilar materials has always been a serious problem in dentistry. In order to meet this challenge, it is necessary to combine both chemical methods (treatment with silanes, (meth)acrylic functional monomers) and the development of the surface of the joined material in a physical way, e.g., by sandblasting with alumina, alumina with silica, acid etching, the use of lasers and other means. The purpose of this literature review is to present all methods of joining dental composites with other materials such as ceramics, metal, another composite material. This review covers articles published within the period 2012-2022 in journals indexed in the PubMed database, written in English and describing joining different dental materials to each other. All the critical steps of new joint preparation have been addressed, including proper cleaning of the joint surface, the application of appropriate primers capable of forming a chemical bond between ceramics, zirconium oxide or metals and alloys, and finally, the application of new composite materials.

Shear Bond Strength of a Direct Resin Composite to CAD-CAM Composite Blocks: Relative Contribution of Micromechanical and Chemical Block Surface Treatment

This study aims to compare the shear bond strength (SBS) of a direct resin composite to CAD-CAM resin composite blocks treated with different surface treatments: micromechanical, chemical or a combination of both. Eight CAD-CAM resin composite blocks, namely Brilliant Crios, Cerasmart 270, Vita Enamic, Grandio block, Katana Avencia, Lava Ultimate, Tetric CAD and Shofu Block HC were chosen. The micromechanical surface treatment protocols tested were hydrofluoric acid, polyacrylic acid or sandblasting, and the chemical one was a universal primer. These treated CAD-CAM blocks were tested to determine the SBS of a light-curing composite resin Z100 bonded to their surface. Two-way ANOVA followed by Tukey’s post hoc test was used to investigate the difference in SBS. Failures were analyzed by Fisher’s exact test. Bonding interfaces were examined by scanning electron microscopy. The micromechanical surface treatments give the highest SBS values: sandblasting appears to be the most efficient procedure for dispersed filler composite blocks, while hydrofluoric acid etching is preferable for polymer-infiltrated ceramic network (PICN) blocks. The use of universal primer does not improve SBS values on dispersed filler composite blocks. For PICN blocks, the use of universal primer significantly increases SBS values when combined with hydrofluoric acid etching.

Cytotoxicity and Bonding Property of Bioinspired Nacre-like Ceramic-Polymer Composites

For clinical applications, non-cytotoxicity and good bonding property of dental restorative materials are the most essential and important. The aim of this study was to evaluate the potential for clinical applications of two novel bioinspired nacre-like ceramic (yttria-stabilized zirconia)-polymer (polymethyl methacrylate) composites in terms of the cytotoxicity and bonding property. The relative growth rates (24 h) of the Lamellar and Brick-and-mortar composites measured by CCK8 were 102.93%±0.04 and 98.91%±0.03, respectively. According to the results of cytotoxicity and proliferation experiments, the two composites were not cytotoxic to human periodontal ligament fibroblasts (HPDLFs) in vitro. Both composites exhibited improved bonding strength as compared to the Control group (Vita In-Ceram YZ). As the polymer content in the composite material increases, its bonding strength also increases, which enhances the application potential of the material in the field of dental restoration. Meanwhile, by controlling the direction of loading force in the shear test, the effect of microstructure on the bonding strength of anisotropic composites was studied. After sandblasted, the bonding strengths of the Lamellar group in the longitudinal and transverse shear directions were 17.56±1.56 MPa and 18.67±1.92 MPa, respectively, while of the Brick-and-mortar group were 16.36±1.30 MPa and 16.99±1.67 MPa, respectively. The results showed that the loading direction had no significant effect on the bonding strength of the composites.

Evaluation of Tensile Bond Strength between Self-Adhesive Resin Cement and Surface-Pretreated Zirconia

The tensile bond strength between zirconia subjected to different surface-pretreatment methods and methacryloyloxydecyl-dihydrogen-phosphate (MDP)-containing self-adhesive resin cement was evaluated herein. Eighty-eight cylindrical zirconia specimens were randomly divided into the following four groups based on the pretreatment method: (1) no treatment, (2) air abrasion, (3) HNO3/HF etching, and (4) zirconia-nanoparticle coating. The tensile bond strength of the zirconia−resin-cement complexes was investigated. One-way ANOVA and post hoc tests were performed at a 95% significance level, and the Weibull modulus was calculated. Fracture patterns were visualized by SEM. The surface roughness of the specimens without resin bonding was evaluated by AFM. The tensile bond strength of the specimens decreased as follows: Groups 3 > 4 > 2 > 1 (28.2 ± 6.6, 26.1 ± 5.7, 16.6 ± 3.3, and 13.9 ± 3.0 MPa, respectively). Groups 3 and 4 had significantly higher tensile bond strengths (p < 0.05) and lower fracture probabilities than those of Groups 1 and 2. They also showed both mixed failure and resin-cement cohesive failure, whereas Groups 1 and 2 showed mixed failure exclusively. The zirconia−resin tensile bond was stronger after HNO3/HF etching or ZrO2-nanoparticle coating than after air abrasion or no treatment. The estimated surface roughness decreased as follows: Groups 3 > 4 > 2 > 1. The combination of zirconia pretreated with HNO3/HF etching or ZrO2-nanoparticle coating and an MDP-containing self-adhesive resin cement can increase the clinical longevity of zirconia restorations by preventing their decementation.

Is the Er:YAG laser affect the surface characteristics and bond strength of Y-TZP?

This study evaluated the surface characteristics and bond strength of Y-TZP treated with Er:YAG laser at different focal distances. 120 Y-TZP blocks were divided into five groups (n=24), according to the surface treatment: no treatment (C-); sandblasting with silica-coated aluminum oxide particles (C+); and Er:YAG laser application at focal distances of 1mm (Er:YAG-1), 4mm (Er:YAG-4), and 7mm (Er:YAG-7). Surface characteristics were analyzed using Vickers microhardness, confocal laser microscope, scanning electron microscopy (SEM), and X-ray diffractometer (XRD). For the bond strength test, 100 Y-TZP blocks were subdivided into two subgroups (n=10), according to the resin cement used: with (MDP+) or without 10-methacryloyloxydecyl dihydrogen phosphate (MDP-). The Vickers microhardness and surface roughness were analyzed by one-way ANOVA and bond strength by two-way ANOVA and Tukey's test for both (α=0.05). Vickers microhardness differences were not observed between the groups (p>0.05); C+ showed higher surface roughness values. SEM images showed micromorphological differences between the groups. The XRD data detected tetragonal crystals for C- and, for the other groups, tetragonal and monoclinic peaks. For bond strength, no statistically difference significance were observed among the cements with or without MDP (p>0.05) but showed significant difference between the surface treatments (C+ > C- = Er:YAG1 > Er:YAG4 = Er:YAG7) (p<0.05). Suggested that the Er:YAG laser cannot replace conventional treatment with aluminum oxide particles and the presence of MDP in the resin cement had no influence on the bond strength.

Current scenario on adhesion to zirconia; surface pretreatments and resin cements: A systematic review

Several methods have been proposed to increase bonding of zirconia with resin. However, we are still to find the Holy Grail. A systematic literature review was performed through PubMed on international literature from January 2000 to May 2021 with relevant Medical Subject Headings terms. 56 articles were found to be relevant. Of all the different methods proposed, mechanochemical pretreatment of zirconia surface with alumina oxide and use of 10-methacryloyloxydecyl dihydrogen phosphate were found to be most effective as per majority of studies. New methods that require further research also surfaced.

Is the bond strength of zirconia-reinforced lithium silicate lower than that of lithium disilicate? A systematic review and metaanalysis

PURPOSE

This study systematically reviewed the literature to compare the bond strength of resin composites with that of zirconia-reinforced lithium silicate (ZLS) and lithium disilicate (LD).

STUDY SELECTION

This review was structured based on the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA 2020) statement. This study was registered at the International Prospective Register of Systematic Reviews (CRD42021256900). Studies were searched via PubMed, Web of Science, and Google Scholar databases without language or publication year limits. In vitro studies that evaluated the bond strength of the resin composites to ZLS and LD were included. The risk of bias in all the included articles was evaluated. Statistical analyses were performed using the Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK).

RESULTS

Of the 90 potentially related articles, the full texts of 16 articles were evaluated after screening. Finally, sevenstudies were included in the qualitative synthesis and meta-analysis. All the studies presented a medium risk of bias. The results showed no significant difference in bond strength between the ZLS and LD groups (P = 0.94, mean difference=0.08, and 95% confidence interval=-1.93 to 2.10). However, a significant difference was found in the subgroup analysis considering different types of aging treatments (P = 0.0008) and different types of bond strength tests (P < 0.00001).

CONCLUSION

The bond strength of resin composites was found to be similar to that of ZLS and LD, but different aging treatments and bond strength tests exhibited varying effects on the bond strength.

Adhesion to Zirconia: A Systematic Review of Surface Pretreatments and Resin Cements

This systematic review aims to evaluate the different pretreatments of the zirconia surface and resin cement in order to determine a valid operative protocol for adhesive cementation. Methodologies conducted for this study followed the Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. An electronic search was performed in four databases. The established focus question was: “What type of surface conditioning method is the one that obtains the best adhesion values to zirconia over time by applying a resin cement?” Forty-five relevant papers were found to qualify for final inclusion. In total, 260 different surface pretreatment methods, mainly combinations of air-abrasion protocols and adhesive promoters, were investigated. Altogether, the use of two artificial aging methods, three types of cement and four testing methods was reported. The results showed that mechanicochemical surface pretreatments offered the best adhesive results. Self-adhesive cement and those containing 10-MDP obtained the best results in adhesion to zirconia. Artificial aging reduced adhesion, so storage in water for 30 days or thermocycling for 5000 cycles is recommended. A standardized adhesive protocol has not been established due to a lack of evidence

Effect of Air-Particle Abrasion Protocol and Primer on The Topography and Bond Strength of a High-Translucent Zirconia Ceramic

PURPOSE

To evaluate effect of air-particle abrasion protocol and primer on surface topography and bond strength of resin cement to high-translucent zirconia ceramics.

MATERIALS AND METHODS

Two hundred disk-shaped high-translucent zirconia specimens of 5Y-PSZ were prepared. The specimens were assigned to 5 groups in terms of particle type and air-particle abrasion pressure: (1) control, (2) alumina with 0.2 MPa-air pressure [AB-0.2], (3) alumina with 0.4 MPa-air pressure [AB-0.4], (4) glass beads with 0.2 MPa-air pressure [GB-0.2], and (5) glass beads with 0.4 MPa-air pressure [GB-0.4]. Two different primers 1% MDP (Experimental) and MDP-silane primer (Clearfil Ceramic Primer Plus) was also tested. Stainless steel rods were bonded to the 5Y-PSZ specimens with PANAVIA V5. For each group, the tensile bond strength (TBS) was measured after 24-hour water storage (n = 10) and after 5000 thermal-cycling (n = 10) at crosshead speed of 2 mm/min. The data were statistically analyzed using Weibull analysis. Surface roughness (Sa) was measured using a 3D-Laser Scanning Confocal Microscope (n = 5) and analyzed by t-test with Bonferroni correction. Surface topography using scanning electron microscopy (SEM) and surface elemental analysis using energy dispersion spectroscopy (EDX), and cross-section SEM at the interface with composite cement were also investigated.

RESULTS

In MDP-silane groups, the highest TBS was observed in AB-0.4 after 24 hours and GB-0.4 after thermal-cycling (p < 0.05). In MDP groups, AB groups resulted in the significantly higher TBS than GB groups (p < 0.05). AB-0.4 group showed the highest Sa value compared to all groups (p < 0.005), meanwhile GB groups did not show different Sa compared to control (p > 0.005).

CONCLUSION

Air-abrasion with different particle and blasting pressure can improve bonding to zirconia with proper primer selection. Particularly, glass beads abrasion followed by MDP-silane primer and alumina abrasion followed by MDP primer alone provided stable bond strength of resin cement to high-translucent zirconia after aging. High-translucent zirconia abraded with glass beads achieves a desirable bonding performance without creating surface microcracks which may hinder zirconia's mechanical properties.

Adhesion between zirconia and resin cement: A critical evaluation of testing methodologies

This study aimed to analyze different methodologies (tensile, microtensile, shear, microshear, and interfacial toughness) for evaluation of the bond strength between zirconia (Y-TZP) and resin cement. Zirconia ceramic blocks (VITA in-Ceram® YZ, VITA Zahnfabrik, Germany) were obtained, substrate surfaces were air-abraded with aluminum oxide (50 μm) for 10 s (2 bar pressure, distance: 10 mm, angle: 90°). Then, the specimens were washed with distilled water, dried, and coated with Clearfil Ceramic Primer that was actively applied with a microbrush for 20 s. The specimens were then cemented with resin cement under a load of 750 g, followed by photo-polymerization (40 s on each surface). After cementation, the specimens were aged in thermocycling (8000 cycles, 5-55 °C, 30 s for each bath) and subjected to tensile, microtensile, shear, microshear or interfacial toughness tests. All specimens were inspected for failure modes. The microtensile test showed the highest bond value (18.29 N/mm²). The microshear tests showed the highest coefficient of variation (0.59) and highest number of pre-test failures. The interfacial energy to fracture test showed that as the shear stress increased its interaction in the adhesive interface, the coefficient of variation also increased. The bond strength of Y-TZP showed different results according to the methodology, as well as its interfacial energy to fracture varied according to the angulation/type of stress specimen was submitted. The lower the shear stress at the adhesive interface of the mixed tests (interfacial energy to fracture), the lower was the variability of the test.

Adhesion to Zirconia: A Systematic Review of Current Conditioning Methods and Bonding Materials

Background. Reliable bonding between resin composite cements and high strength ceramics is difficult to achieve because of their chemical inertness and lack of silica content that makes etching impossible. The purpose of this review is to classify and analyze the existing methods and materials suggested to improve the adhesion of zirconia to dental substrate by using composite resins, in order to explore current trends in surface conditioning methods with predictable results. Methods. The current literature, examining the bond strength of zirconia ceramics, and including in vitro studies, clinical studies, and a systematic review, was analyzed. The research in the literature was carried out using PubMed and Cochrane Library databases, only papers in English, published online from 2013 to 2018. The following keywords and their combinations were used: Zirconia, 3Y-TZP, Adhesion, Adhesive cementation, Bonding, Resin, Composite resin, Composite material, Dentin, Enamel. Results. Research, in PubMed and Cochrane Library databases, provided 390 titles with abstracts. From these, a total of 93 publications were chosen for analysis. After a full text evaluation, seven articles were discarded. Therefore, the final sample was 86, including in vitro, clinical studies, and one systematic review. Various adhesive techniques with different testing methods were examined. Conclusions. Airborne-particle abrasion and tribo-chemical silica coating are the pre-treatment methods with more evidence in the literature. Increased adhesion could be expected after physico-chemical conditioning of zirconia. Surface contamination has a negative effect on adhesion. There is no evidence to support a universal adhesion protocol.

Effect of Immediate Dentin Sealing on the Bond Strength of Monolithic Zirconia to Human Dentin

Objective:

This study evaluated the shear bond strength (SBS) of pretreated monolithic zirconia surfaces bonded to human dentin following immediate dentin sealing (IDS) using two different self-adhesive resin luting agents.

Methods and Materials:

Sixty intact human third molars were collected, stored, sectioned appropriately, and molded according to ISO 29022:2013, resulting in 120 dentin specimens. Ceramic cylindrical specimens were fabricated using CAD/CAM technology and sintered as recommended (final bonding area A=2.56 mm2). Specimens were randomly assigned to eight groups (15≥n≥14) depending on dentin conditioning method (IDS or delayed dentin sealing [DDS]), zirconia surface pretreatment (airborne particle abrasion [APA] with 50 μm Al2O3 particles at 3 bar for 10 seconds or tribochemical silica coating [TBC] with 30 μm CoJet particles at 2.8 bar for 10 seconds), and adhesive luting agent type (Panavia F2.0 [PAN] or PermaCem Dual Smartmix [PER]). Bonded specimens were water-stored (37°C, 24 hours) and subjected to SBS testing (50-kgF load cell, 1 mm/min). Fracture type was evaluated with stereomicroscopy. Data (MPa) were statistically analyzed using three-way analysis of variance (α=0.05).

Results:

All factors significantly affected SBS values (p&lt;0.001). Dentin conditioning method presented the greatest effect. Mean SBS values ranged from 12.603 MPa (PER-APA-DDS) to 40.704 MPa (PER-TBC-IDS). Based on the fracture type, adhesive failures at the luting agent–zirconia interface were the least common.

Conclusion:

Bonding strategies for monolithic zirconia restorations could potentially benefit from IDS, regardless of the adhesive luting agent system used.

Aged Translucent Aesthetic Zirconia: Bond Strength Analysis

Objective This study evaluates the bond strength of two compositions of aesthetic translucent zirconia (TZ).

Materials and Methods For this evaluation, test specimens were prepared from ICE Zirkon TZ and Prettau Anterior zirconia (PAZ) that were stored in distilled water at 37°C for two time periods: T1 (24 h) and T2 (90 days) to simulate aging. Two factors were evaluated for the samples—ceramic and aging time. The samples were subjected to tests of microshear strength and fracture type and were evaluated using scanning electron microscopy.

Results The results were analyzed using the D'Agostino test, analysis of variance, and Tukey's test ( p < 0.01). Statistically significant differences were observed for ceramic type and aging time.

Conclusion The results showed that PAZ provides significantly superior performance to TZ at the two aging times evaluated.

Effect of different times of nonthermal argon plasma treatment on the microtensile bond strength of self-adhesive resin cement to yttria-stabilized tetragonal zirconia polycrystal ceramic

STATEMENT OF PROBLEM

Nonthermal argon plasma may increase the surface energy of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) dental ceramics. However, studies that evaluated the effect of increased plasma treatment times on the bond strength of resin cements to Y-TZP ceramics are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of different nonthermal argon plasma (NTAP) treatment times on the surface energy and bond strength of a self-adhesive resin cement to Y-TZP ceramic.

MATERIAL AND METHODS

Forty-eighty Y-TZP plates were divided into 2 groups (n=24): as-sintered (AS) and airborne-particle abrasion (APA) with 50-μm Al₂O₃, which were subdivided into 4 groups (n=6) according to the time of NTAP treatment: 0, 20, 60, and 120 seconds. The surface energy was evaluated with a goniometer. Forty Y-TZP blocks submitted to the same surface treatments (8 groups; n=5) were cemented to composite resin blocks, using a self-adhesive resin cement. After storage in distilled water at 37°C for 24 hours, the Y-TZP-composite resin blocks were cut into beams and submitted to a microtensile bond strength (μTBS) test. Data were analyzed using 2-way ANOVA and the Tukey honestly significant differences test (α=.05).

RESULTS

Treatment with NTAP increased the surface energy for AS and APA groups (P<.05). For both groups, the μTBS was as follows: 0 seconds < 20 seconds < 60 seconds = 120 seconds (P<.05). Only after 120 seconds of NTAP treatment was the μTBS of APA higher than that of AS (P<.05).

CONCLUSIONS

Treatment with NTAP improved the surface energy and increased the μTBS of self-adhesive resin cement to Y-TZP ceramic, with higher times of plasma treatment resulting in higher bond strength.

A Comparative Study on the Mechanical Properties of a Polymer-Infiltrated Ceramic-Network Material Used for the Fabrication of Hybrid Abutment

Polymer-infiltrated ceramic-network (PICN) material is a new type of material used for the hybrid abutments of dental implants. This study aimed to compare flexural strength, bond strengths, and fracture-resistance values of PICN with lithium disilicate ceramic (LDS) and to evaluate the effect of thermocycling on the tested parameters. Twenty specimens were fabricated using computer-aided design and manufacturing (CAD-CAM) technology for each material according to three-point bending (n = 10), microshear bond strength (µSBS), and a fracture-resistance test (hybrid abutment, n = 10). All specimens of each test group were divided into two subgroups, thermocycled or nonthermocycled. Hybrid abutments were cemented on titanium insert bases and then fixed on implants to compare fracture resistance. Failure loads were recorded for each test and data were statistically analyzed. Thermocycling decreased bond strength to the resin luting agent and the fracture-resistance values of both materials (p < 0.001), whereas flexural-strength values were not affected. LDS ceramic showed significantly higher flexural strength, bond strength, and fracture-resistance values than PICN material (p < 0.001). Within the limitations of this study, LDS may be a preferable hybrid-abutment material to PICN in terms of mechanical and bonding properties.

In vitro shear bond strength between fluorinated zirconia ceramic and resin cements

PURPOSE

The purpose of this study was to evaluate the efficiency of a gas-phase fluorination method under different fluorination periods through using two resin cements.

MATERIALS AND METHODS

84 zirconia specimens in dimensions of 5 mm × 5 mm × 2 mm were prepared and surface treated with 50 µm aluminum oxide particles or gas phase fluorination for 2 min, 5 min, or 10 min. One specimen in each group was surface analyzed under scanning electron microscope. The remaining specimens were bonded to composite cylinders in dimensions of 2 mm diameter and 3 mm high with Panavia SA Plus or Variolink N. Then, the specimens were stored in 37℃ distilled water for 24 hours and shear bond strength test was applied at a speed of 1 mm/min.

RESULTS

The highest shear bond strength values were observed in the samples fluorinated for 5 minutes and cemented with Panavia SA Plus. Variolink N did not elicit any statistical differences between surface treatments. Panavia SA Plus resin cement and Variolink N resin cements featured statistically significant difference in shear bond strength values only in the case of 5 minutes of fluorination treatment.

CONCLUSION

According to the results of this study, application of 5 minutes of fluorination with 10-methacryloyloxydecyl dihydrogen phosphate monomer (MDP) containing Panavia SA Plus resin cement increased the resin bond strength of zirconia. Fluorination of the zirconia surface using conventional resin cement, Variolink N, did not lead to an increase in bond strength.

Can the Application of Multi-Mode Adhesive be a Substitute to Silicatized/Silanized Y-TZP Ceramics?

Abstract This study evaluated the effectiveness of a multi-mode adhesive (SBU-Scotch Bond Universal/3M) as a substitute for silica coating and silane application on the bonding of zirconia ceramics to resin cement. One-hundred and twenty sintered zirconia ceramic blocks (5 x 5 x 5 mm) were obtained, finished by grounding with silicon carbide paper (#600, #800, #1000 and #1200) and randomly divided into 12 groups (n=10) in accordance with the factors “surface treatment” (ScSi - silicatization + silanization; ScSBU - silicatization + SBU; SBU - SBU without photoactivation and SBUp - SBU photoactivated) and “ceramic” (Lava / 3M ESPE, Ceramill Zirconia / Amann Girrbach and Zirkonzahn / Zirkonzahn). Dual resin cement cylinders (RelyX Ultimate/3M ESPE) were subsequently produced in the center of each block using a silicon matrix (Ø=2 mm, h=5 mm) and photoactivated for 40 s (1200 mW/cm2). The samples were stored for 30 days in distilled water (37ºC) and submitted to shear bond strength test (1 mm/min, 100 KgF). Data (MPa) were analyzed under ANOVA (2 levels) and Tukey test (5%). Complementary analyzes were also performed. ANOVA revealed that only the factor “surface treatment” was significant (p=0.0001). The ScSi treatment (14.28A) promoted statistically higher bond strength values than the other ScSBU (9.03B), SBU (8.47B) and SBUp (7.82B), which were similar to each other (Tukey). Failure analysis revealed that 100% of the failures were mixed. The silica coating followed by the silanization promoted higher bond strength values of resin cement and ceramic, regardless of the zirconia ceramic or SBU.

An insight into current concepts and techniques in resin bonding to high strength ceramics

BACKGROUND

Reliable bonding between high strength ceramics and resin composite cement is difficult to achieve because of their chemical inertness and lack of silica content. The aim of this review was to assess the current literature describing methods for resin bonding to ceramics with high flexural strength such as glass-infiltrated alumina and zirconia, densely sintered alumina and yttria-partially stabilized tetragonal zirconia polycrystalline ceramic (Y-TZP) with respect to bond strength and bond durability.

METHODS

Suitable peer reviewed publications in the English language were identified through searches performed in PubMed, Google Search and handsearches. The keywords or phrases used were 'resin-ceramic bond', 'silane coupling agents', 'air particle abrasion', 'zirconia ceramic' and 'resin composite cements'. Studies from January 1989 to June 2015 were included.

RESULTS

The literature demonstrated that there are multiple techniques available for surface treatments but bond strength testing under different investigations have produced conflicting results.

CONCLUSIONS

Within the scope of this review, there is no evidence to support a universal technique of ceramic surface treatment for adhesive cementation. A combination of chemical and mechanical treatments might be the recommended solution. The hydrolytic stability of the resin ceramic bond should be enhanced.

Influence of cement type and ceramic primer on retention of polymer-infiltrated ceramic crowns to a one-piece zirconia implant

STATEMENT OF PROBLEM

The best procedure for cementing a restoration to zirconia implants has not yet been established.

PURPOSE

The purpose of this in vitro study was to measure the retention of polymer-infiltrated ceramic crowns to zirconia 1-piece implants using a wide range of cements. The effect of ceramic primer treatment on the retention force was also recorded. The retention results were correlated with the shear bond strength of the cement to zirconia and the indirect tensile strength of the cements to better understand the retention mechanism.

MATERIAL AND METHODS

The retention test was performed using 100 polymer-infiltrated ceramic crowns (Vita Enamic) and zirconia implants (ceramic.implant CI) The crowns were cemented with either interim cement (Harvard Implant semipermanent, Temp Bond), glass-ionomer cement (Ketac Cem), self-adhesive cement (Perma Cem 2.0, RelyX Unicem Automix 2, Panavia SA), or adhesive cement (Multilink Implant, Multilink Automix, Vita Adiva F-Cem, RelyX Ultimate, Panavia F 2.0, Panavia V5 or Panavia 21) (n=5). Additionally ceramic primer was applied on the intaglio crown surface and implant abutment before cementation for all adhesive cements (Multilink Implant, Multilink Automix: Monobond plus; RelyX Ultimate Scotchbond Universal; Vita Adiva F-Cem: Vita Adiva Zr-Prime; Panavia F2.0, Panavia V5: Clearfil Ceramic Primer) and 1 self-adhesive cement containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP) (Panavia SA: Clearfil Ceramic Primer). Crown debond fracture patterns were recorded. Shear bond strength was determined for the respective cement groups to polished zirconia (n=6). The diametral tensile strength of the cements was measured (n=10). Statistical analysis was performed using 1-way or 2-way analysis of variance followed by the Fisher LSD test (α=.05) within each test parameter.

RESULTS

Adhesive and self-adhesive resin cements had shear bond strength values of 0.0 to 5.3 MPa and revealed similar retention forces. Cements containing MDP demonstrated shear bond strength values above 5.3 MPa and displayed increased retention. The highest retention values were recorded for Panavia F 2.0 (318 ±28 N) and Panavia 21 (605 ±82 N). All other adhesive and self-adhesive resin cements attained retention values between 222 ±16 N (Multilink Automix) and 270 ±26 N (Panavia SA), which were significantly higher (P<.05) than glass-ionomer (Ketac Cem: 196 ±34 N) or interim cement (Harvard Implant semipermanent: 43 ±6 N, Temp Bond: 127 ±13 N). Application of manufacturer-specific ceramic primer increased crown retention significantly only for Panavia SA.

CONCLUSIONS

Products containing MDP provided a high chemical bond to zirconia. Self-adhesive and adhesive resin cements with low chemical bonding capabilities to zirconia provided retention force values within a small range (220 to 290 N).

Effect of surface treatments on shear bond strength of resin composite bonded to CAD/CAM resin-ceramic hybrid materials

PURPOSE

The purpose of this study was to assess the effect of surface treatments on shear bond strength of resin composite bonded to thermocycled and non-thermocycled CAD/CAM resin-ceramic hybrid materials.

MATERIALS AND METHODS

120 specimens (10×10×2 mm) from each material were divided into 12 groups according to different surface treatments in combination with thermal aging procedures. Surface treatment methods were airborne-particle abrasion (abraded with 50 micron alumina particles), dry grinding (grinded with 125 µm grain size bur), and hydrofluoric acid (9%) and silane application. According to the thermocycling procedure, the groups were assigned as non-thermocycled, thermocycled after packing composites, and thermocycled before packing composites. The average surface roughness of the non-thermocycled specimens were measured after surface treatments. After packing composites and thermocycling procedures, shear bond strength (SBS) of the specimens were tested. The results of surface roughness were statistically analyzed by 2-way Analysis of Variance (ANOVA), and SBS results were statistically analyzed by 3-way ANOVA.

RESULTS

Surface roughness of GC were significantly lower than that of LU and VE (P<.05). The highest surface roughness was observed for dry grinding group, followed by airborne particle abraded group (P<.05). Comparing the materials within the same surface treatment method revealed that untreated surfaces generally showed lower SBS values. The values of untreated LU specimens showed significantly different SBS values compared to those of other surface treatment groups (P<.05).

CONCLUSION

SBS was affected by surface treatments. Thermocycling did not have any effect on the SBS of the materials except acid and silane applied GC specimens, which were subjected to thermocycling before packing of the composite resin.

Comparison of two test designs for evaluating the shear bond strength of resin composite cements

OBJECTIVE

To compare a shear bond strength test for resin composite cements developed in order to better consider the shrinkage stress (here termed "Swiss shear test") with the shear test design according to ISO 29022.

METHOD

Four restorative materials (VITA Enamic (VE), VITA Suprinity (VS), Vitablocs Mark II (VM) and VITA YZ T (YZ)) served as substrate. VE, VS and VM were polished or etched. YZ was polished, sandblasted or etched. Specimens were either bonded according to the Swiss or the ISO shear test. RelyX Unicem 2 Automix, Maxcem Elite and PermaFlo DC were used as cements. Shear bond strength (SBS) was measured. Failure modes (adhesive, cohesive or mixed) were evaluated by means of SEM.

RESULTS

Mean SBS values obtained with the Swiss shear test were significantly lower than those obtained with the ISO shear test. VE and VM exhibited similar SBS, values of VS were significantly higher. On etched surfaces VM and VE exhibited primarily cohesive failures, VS primarily adhesive failures. On polished substrates significantly lower bond strength values and exclusively adhesive failures were observed. YZ exhibited solely adhesive failures. Compared to polished YZ, SBS significantly increased after sandblasting and even more after etching. Only for adhesively failed specimens mean SBS values of Swiss and ISO shear test were strongly correlated.

SIGNIFICANCE

Both test designs showed the same ranking of test results. When adhesive failure occurred test results were strongly correlated. When cohesive failure was involved, both test designs did not provide reliable results.