Immediate repair bond strengths of microhybrid, nanohybrid and nanofilled composites after different surface treatments

Comparison of the shear bond strengths of two different polyetheretherketone (PEEK) framework materials and CAD-CAM veneer materials

BACKGROUND

This study evaluated the shear bond strength (SBS) of two different polyetheretherketone (PEEK) and CAD-CAM materials after aging.

METHODS

A total of 42 frameworks were designed and milled from 2 different PEEK discs (Copra Peek, P and BioHPP, B). P and B frameworks were divided into 3 subgroups (n = 7). 14 slices were prepared each from feldspathic ceramic (Vitablocs Mark II, VM), hybrid nanoceramic (Cerasmart, CS), and polymer-infiltrated ceramic (Vita Enamic, VE) blocks. After surface preparations, the slices were cemented to P and B surfaces. The samples were subjected to thermal aging (5000 cycles). SBS of all the samples was measured. Fractured surfaces were examined by SEM/EDX analysis. The Shapiro-Wilk, Two-way Robust ANOVA and Bonferroni correction tests were used to analyze the data (a = .05).

RESULTS

Frameworks, ceramics, and frameworks x ceramics had significant differences (p < 0.05). The highest SBS value was seen in B-VM (p < 0.05). VM offered the highest SBS with both P and B. The differences between P-VM, P-CS, P-VE and B-CS and B-VE were insignificant (p > 0.05). According to EDX analysis, ytterbium and fluorine was seen in B content, unlike P. While VM and CS contained fluorine, barium, and aluminum; sodium and aluminum were observed in the VE structure.

CONCLUSION

Bonding of P and B with VM offers higher SBS. VM, CS and VE did not make any difference in SBS for P, however VM showed a significant difference for B.

Scoping review: Effect of surface treatments on bond strength of resin composite repair

OBJECTIVE

to evaluate the existing evidence on surface treatment techniques employed in resin composite repair and their effect on the repair short- and long-term bond strength.

DATA AND SOURCE

This scoping review was performed under the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform.

STUDY SELECTION

A systematic search was conducted in PubMed, Embase, and Scopus and grey literature up to September 2022 without language or date restriction. In vitro studies comparing mechanical surface and/or chemical treatments on repair bond strength of resin composite were included. Studies evaluating experimental adhesive systems or resin composites were excluded. Selection of studies and data extraction were performed. Data from selected studies was qualitatively analyzed.

RESULTS

A total of 76 studies were included in the qualitative analysis. Among the mechanical treatments, alumina blasting was the most frequently used, followed by silica coating and diamond bur. As for chemical treatments, dentin bonding systems were the most frequently evaluated, followed by universal adhesive systems and silane/ceramic primer. The combination of mechanical and chemical pre-treatments increased the repair bond strength of resin composite in both short- and long-term simulated aging scenarios. The evidence obtained from the included studies was classified as moderate quality, mainly due to the medium risk of bias observed across most of the studies.

CONCLUSION

The techniques used to treat the surface of resin composites for repair are diverse. Incorporating a combination of mechanical and chemical pre-treatments resulted in superior repair bond strength of resin composite materials under both short- and long-term simulated aging conditions.

CLINICAL SIGNIFICANCE

The analysis of evidence revealed significant variability among protocols for repairing resin composites. Utilizing both mechanical and chemical pre-treatment methods is important for enhancing the bond strength of resin composites during both short- and long-term simulated aging situations.

Shade matching potential of one-shade resin composites used for restoration repair

To evaluate shade matching ability of one-shade composites used for repair of different resin-based restorative materials. Two one-shade composites or one layering composite of 1 mm thickness were placed over non-aged or aged 3 different base materials of 1 mm thickness to simulate repair. Two millimeters thick base samples were prepared and used for reference (n=12). Shade measurements of reference and repair groups were performed with dental spectrophotometer and color difference (ΔE₀₀) were calculated according to CIEDE2000. Data were analyzed using three-way ANOVA followed by Tukey's test (α=0.05). Regardless of aging and base materials, repairing with layering composite yielded lower ΔE₀₀ than repair of one-shade composites (p<0.05). Repair of non-aged and aged GrandioDisc with any repair composite led to higher ΔE₀₀ values than repair of other base materials (p<0.05). Shade matching performance of one-shade composites for repair of different non-aged or aged resin-based material was not clinically acceptable.

Effect of Argon Plasma Surface Treatment on Repair of Resin Composite Aged Two Years

OBJECTIVES

To evaluate the effect of argon plasma treatment (PLA) when combined with sandblasting (SAN), silanization (SIL), and hydrophobic bonding resin (HBR) on the shear bond strength (SBS) of a two-year water-aged resin composite bonded to a newly placed composite after 24 hours and one year of water-storage.

METHODS AND MATERIALS

Thirty-six light-cured composite plates (20mm x 20mm x 4mm thick) were obtained and stored at 37°C in distilled water for 2 years. These aged plates were distributed into 6 groups (n=6) according to the surface treatment: no treatment (Negative Control); SAN+SIL+HBR (Positive Control); SAN+PLA+SIL+HBR; PLA+ SIL+HBR; PLA+SIL; PLA+HBR. Fresh resin composite cylinders were built up using silicone molds (hole: 1.5 mm high x 1.5 mm diameter) positioned over the aged plates. Half of the SBS samples were stored in distilled water for 24 hours and loaded until failure, while the other half were stored for 1 year before being tested. Data were submitted to two-way analysis of variance and post-hoc Tukey Test (preset alpha of 0.05).

RESULTS

Positive Control, SAN+PLA+SIL+HBR and PLA+SIL+HBR groups presented higher SBS means at the 24 hour evaluation. After 1 year of water storage, all groups demonstrated significant SBS reduction, with the SAN+PLA+SIL+HBR group presenting the highest SBS.

CONCLUSIONS

Resin plasma treatment in combination with other surface treatments can improve the SBS of composite repairs after one year of water storage. The SBS of the composite repair was not stable over time regardless of the surface treatment.

Influence of Surface Conditioning on the Repair Strength of Bioactive Restorative Material

OBJECTIVE

To evaluate the effects of surface treatment and repair material on the repair shear bond strength (SBS) of the bioactive restorative material.

METHODS

A total of 240 Activa BioActive Restorative (Activa) discs were prepared, aged, and polished, and divided randomly into eight groups (n = 30). Groups 1-4 discs were repaired with bulk-fill flowable resin-based composite (Bulk-RBC), and Groups 5-8 discs with Activa. Surface treatment used for each repair material type were air abrasion with silica-coated 30-m Al₂O₃ particles (air abrasion) (Groups 2 & 6), Air abrasion with universal primer (Groups 3 & 7), and Air abrasion with universal adhesive (Groups 4 & 8). Groups 1 and 5 were controls without surface treatment. SBS test was performed, and the failure mode and surface topography were assessed.

RESULTS

Surface treatment with air abrasion significantly improved the SBS for repair using both Activa and Bulk-RBC. Repair SBS using Activa was significantly higher compared with Bulk-RBC. Cohesive failure in substrate and mixed failures were most common in the surface-treated groups (2-4, 6-8). Air abrasion produced prominent surface topography changes compared with polishing.

CONCLUSION

Air abrasion enhances the repair SBS of aged bioactive restorative material. The use of the same material (Activa) for repair affords a higher bond strength compared with the use bulk-RBC.

Adhesion of Resin-Resin and Resin-Lithium Disilicate Ceramic: A Methodological Assessment

The aim of this study was to evaluate four test methods on the adhesion of resin composite to resin composite, and resin composite to glass ceramic. Resin composite specimens (N = 180, Quadrant Universal LC) were obtained and distributed randomly to test the adhesion of resin composite material and to ceramic materials (IPS e.max CAD) using one of the four following tests: (a) Macroshear SBT: (n = 30), (b) macrotensile TBT: (n = 30), (c) microshear µSBT: (n = 30) and (d) microtensile µTBT test (n = 6, composite-composite:216 sticks, ceramic-composite:216 sticks). Bonded specimens were stored for 24 h at 23 °C. Bond strength values were measured using a universal testing machine (1 mm/min), and failure types were analysed after debonding. Data were analysed using Univariate and Tukey’s, Bonneferroni post hoc test (α = 0.05). Two-parameter Weibull modulus, scale (m), and shape (₀) were calculated. Test method and substrate type significantly affected the bond strength results, as well as their interaction term (p < 0.05). Resin composite to resin composite adhesion using SBT (24.4 ± 5)^a, TBT (16.1 ± 4.4)^b and µSBT (20.6 ± 7.4)^a,b test methods presented significantly lower mean bond values (MPa), compared to µTBT (36.7 ± 8.9)^b (p < 0.05). When testing adhesion of glass ceramics to resin composite, µSBT (6.6 ± 1)^B showed the lowest and µTBT (24.8 ± 7)^C,D the highest test values (MPa) (SBT (14.6 ± 5)^A,D and TBT (19.9 ± 5)^A,B) (p < 0.05). Resin composite adhesion to ceramic vs. resin composite did show significant difference for the test methods SBT and µTBT (resin composite (24.4 ± 5; 36.7 ± 9 MPa) vs. glass ceramic (14.6 ± 5; 25 ± 7 MPa)) (p > 0.05). Among substrate–test combinations, Weibull distribution presented the highest shape values for ceramic–resin in µSBT (7.6) and resin–resin in µSBT (5.7). Cohesive failures in resin–resin bond were most frequently observed in SBT (87%), followed by TBT (50%) and µSBT (50%), while mixed failures occurred mostly in ceramic–resin bonds in the SBT (100%), TBT (90%), and µSBT (90%) test types. According to Weibull modulus, failure types, and bond strength, µTBT tests might be more reliable for testing resin-based composites adhesion to resin, while µSBT might be more suitable for adhesion testing of resin-based composites to ceramic materials.

Effects of different surface treatments and adhesive self-etch functional monomers on the repair of bulk fill composites: A randomised controlled study

OBJECTIVE

To evaluate the effect of different adhesive protocols on the microtensile bond strength (μTBS) and integrity of the repaired bulk fill composite interface.

METHODS

Two hundred and seventy composite blocks made of bulk fill composites of different viscosity were randomly assigned to 18 surface conditioning groups (n = 15/group). The universal adhesive systems used were Heliobond™, Tokuyama bond force II™ and Scotchbond Universal™. A nanohybrid resin composite was applied as the repair material. Negative and positive control groups were included. Stick shape specimens of each group were subjected to μTBS testing. Representative samples from all test groups were subjected to microscopic, profilometric and SEM examination to determine their mode of failure. The data were analysed statistically using two-way ANOVA test, Tukey's test and the independent t-test (α = 0.05).

RESULTS

The mean μTBS of all test groups ranged between 28.5 and 46.8 MPa and varied with the type of adhesive system employed. Significantly highest μTBS values were obtained when Tokuyama bond force II™ and Scotchbond Universal™ adhesives were used (p < 0.01) which were comparable to the coherent strength of the bulk fill resin composite in the positive control groups (p > 0.05). The viscosity of the bulk fill composite did not significantly influence repair bond strength. The microscopy and SEM examination of the failed interfaces revealed a mixture of adhesive and cohesive failures.

CONCLUSIONS

Under the tested conditions, significantly greater μTBS of repaired bulk fill composite was achieved when the substrate surface was treated with adhesive systems containing a functional monomer.

CLINICAL SIGNIFICANCE

Eff ;ecting a repair of a bulk fill resin composite restoration with the application of a functional monomer containing adhesive system, such as Tokuyama Bond Force II™ or Scotchbond Universal™, would seem to enhance the interfacial bond strength and integrity of the repaired resin composite interface.

Effect of argon plasma on repair bond strength using nanofilled and microhybrid composites

OBJECTIVES

To evaluate the effect of atmospheric pressure plasma (PLA), sandblasting (SAN), silanization (SIL) and hydrophobic bonding resin (HBR) on the micro-shear bond strength (MSBS) of fresh nanofilled (NF) or microhybrid (MH) composites to water-aged nanofilled composite.

MATERIALS AND METHODS

NF plates were fabricated and stored in distilled water for 4 months. The aged plates were assigned to the groups (n = 6): 1- untreated; 2- SAN + SIL + HBR; 3- HBR; 4- PLA + HBR; 5- SAN + HBR; 6- SAN + PLA + HBR; and 7- PLA. Two fresh composite cylinders were constructed on each plate with NF or MH composites and tested after 24 h or 1 year of water-storage, using the MSBS testing. Data were analyzed by three-way ANOVA and Tukey test (α = 0.05).

RESULTS

NF yielded better outcomes than MH at 24 h, which was not observed at 1 year. HBR showed the highest MSBS results, while untreated and PLA groups yielded the lowest one. MSBS reduced for all groups after 1 year.

CONCLUSIONS

Only HBR can obtain good MSBS results, while PLA alone was not beneficial. After 1 year, a reduction in repair MSBS was observed and the type of composite did not influence the results.

CLINICAL RELEVANCE

The repair technique can be simplified with the use of only an adhesive and macromechanical retentions in the old composite, regardless the type of fresh composite.

New Experimental Zirconia-Reinforced Rice Husk Nanohybrid Composite and the Outcome of Its Surface Roughness and Microhardness in Comparison with Commercialized Nanofilled and Microhybrid Composite Resins

Background:

An ideal composite resin should demonstrate smooth surface after polishing and high hardness value to provide long-term success. Thus, this study aimed to compare the surface roughness and microhardness of new experimental zirconia-reinforced rice husk nanohybrid composite (Zr-Hybrid) with commercialized nanofilled (Filtek-Z350-XT) and microhybrid composite (Zmack-Comp) resins before and after artificial ageing.

Methods:

One hundred and eighty standardized disc samples were prepared, of which ninety samples each were used for surface roughness and microhardness test, respectively. They were divided equally into: Group 1 (Filtek-Z350-XT), Group 2 (Zmack-Comp), and Group 3 (Zr-Hybrid). For surface roughness test, all samples were polished with aluminium oxide discs and further subdivided into aged and unaged subgroups, in which composite samples in aged subgroups were subjected to 2500 thermal cycles. Next, all the samples were subjected to surface roughness test using a contact stylus profilometer. As for microhardness test, all the aged and unaged samples were tested using a Vickers hardness machine with a load of 300 kgf for 10 s and viewed under a digital microscope to obtain microhardness value. Data were analyzed using two-way ANOVA followed by post hoc Tukey's honestly significant difference and paired sample t-test with significance level set at P = 0.05.

Results:

In both the aged and unaged groups, Zr-Hybrid showed statistically significantly lower surface roughness (P < 0.05) than Filtek-Z350-XT and Zmack-Comp, but no statistically significant difference was noted between Filtek-Z350-XT and Zmack-Comp (P > 0.05). A similar pattern was noted in microhardness test, whereby Zr-Hybrid showed the highest value (P < 0.05) followed by Filtek-Z350-XT and lastly Zmack-Comp. Besides, significant differences in surface roughness and microhardness were noted between the aged and unaged groups.

Conclusion:

Zr-Hybrid seems to demonstrate better surface roughness and microhardness value before and after artificial ageing.

Influence of commercial adhesive with/without silane on the bond strength of resin-based composite repaired within twenty-four hours

Background/purpose

It is not clear whether the ground surface of resin-based composite (RBC) polymerized requires the application of an adhesive with/without a silane to improve bond strength. This study investigated the bond strength of RBC repaired within 24 h via the application of adhesive with/without a silane.

Materials and methods

Seventy RBC blocks were prepared and assigned to either 0 or 24 h repair stage. Each stage was divided into seven groups: a control group with no surface roughening or applied adhesive, a surface-roughened group with no applied adhesive, two surface-roughened groups treated with a G-aenial Bond adhesive and a BeautiBond Multi adhesive, two surface-roughened groups treated with the previously-mentioned adhesives as well as silane coupling agents, and one group treated with a Single Bond Universal silane-containing adhesive. Microtensile bond strength (μTBS) measurements were performed after the repaired RBC blocks of each group (n = 5) had been immersed in a 37 °C water bath for 24 h. The failure mode of each sample was determined, and the data were analyzed via one-way analysis of variance and Dunnett's test (p = 0.05).

Results

Regardless of the repair stage, the μTBS values of the adhesive-only and silane-adhesive groups did not differ significantly from those of the control group (p > 0.05). Only the no-adhesive groups exhibited a significantly time-dependent increase in adhesive failure rate.

Conclusion

Our results suggest that the application of adhesives either with or without silane can significantly increase the bond strength of repairs to RBCs polymerized within 24 h.

Chemical and Mechanical Roughening Treatments of a Supra-Nano Composite Resin Surface: SEM and Topographic Analysis

Background: Repairing a restoration is a more advantageous and less invasive alternative to its total makeover. The aim of this study was to analyze the effects of chemical and mechanical surface treatments aimed at increasing the roughness of a supra-nano composite resin. Methods: 27 cylindrical blocks of microhybrid composite were made. The samples were randomly divided into nine groups (n = 3). The samples’ surface was treated differently per each group: acid etching (35% H3PO4, 30 s and 60 s), diamond bur milling, sandblasting and the combination of mechanical treatment and acid etching. The samples’ surface was observed by a scanning electron microscope (SEM) and a confocal microscope for observational study, and surface roughness (Ra) was recorded for quantitative analysis. Results: The images of the samples sandblasted with Al2O3 showed the greatest irregularity and the highest number of microcavities. The surfaces roughened by diamond bur showed evident parallel streaks and sporadic superficial microcavities. No significant roughness differences were recorded between other groups. The difference in roughness between the control group, diamond bur milled group and sandblasted group was statistically significant. (p < 0.01). Comparison between the diamond bur milled group and the sandblasted group was also significant (p < 0.01). Conclusion: According to our results, sandblasting is the best treatment to increase the surface roughness of a supra-nano composite.

Effect of different cement systems and aging on the bond strength of chairside CAD-CAM ceramics

STATEMENT OF PROBLEM

The bond strength of different chairside computer-aided design and computer-aided manufacturing (CAD-CAM) restorative materials to dentin with different resin cements needs to be evaluated.

PURPOSE

The purpose of this in vitro study was to investigate the effect of 3 different cementation systems after thermal aging on the shear bond strength of different CAD-CAM materials.

MATERIAL AND METHODS

The occlusal surfaces of 63 molar teeth of similar size were removed, and 21 zirconia-reinforced lithium disilicate (Vita Suprinity-VS), 21 polymer infiltrated ceramic (Vita Enamic-VE), and 21 resin nanoceramic (GC Cerasmart-GC) rectangular specimens of 2.5 mm in thickness were obtained. The ceramics were cemented using total etch (TE), self-etch (SE), and self-adhesive (SA) cement systems. Half of the specimens were subjected to thermal aging with 5000 cycles. The shear bond strength test of all the specimens was measured. Fractured ceramic surfaces were examined by scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDX) analysis. The Shapiro-Wilk test, 3-way analysis of variance (ANOVA), and Fisher Least Significant Difference (LSD) tests were used to analyze the shear bond strength test data (α=.05).

RESULTS

The highest bond strength value was found in the nonthermal aged VS-TE and the lowest in the thermal aged VE-TE. Significant interaction was found between TE and SE cemented ceramics (P<.001). For specimens cemented with the SA system, significant interaction was found among ceramics with thermal aged specimens (P<.001). Thermal aging significantly decreased the mean bond strength (P<.05).

CONCLUSIONS

Differences in bond strength were observed in chairside CAD-CAM ceramics when cemented with TE, SE, and SA systems. Additionally, thermal aging significantly reduced the bond strength values of all the ceramic materials, regardless of the cementation procedure. Clinicians should consider these variables and choose the most suitable cementation systems for the material used.

Evaluation of the Surface Characteristics of Dental CAD/CAM Materials after Different Surface Treatments

Computer-aided design/computer-aided manufacturing (CAD/CAM) technology was developed to ensure the sufficient strength of tooth restorations, to improve esthetic restorations with a natural appearance and to make the techniques easier, faster and more accurate. In the view of the limited research on the surface treatments of the CAD/CAM materials and the need to evaluate the ideal surface characteristics of a material to achieve the best adhesion to tooth tissues, this study aimed to investigate the surface roughness and morphology of four different CAD/CAM materials using four different surface treatments. The CAD/CAM materials used in this study were three composites (Shofu Block HC, Lava Ultimate and Brilliant Crios) and a hybrid ceramic (Enamic). The surface of the specimens of each material received one of the following treatments: no surface treatment, sandblasting with 29 μm Al₂O₃ particles, 9% hydrofluoric acid etching and silane application, and the tribochemical method using CoJet System. Surface roughness was evaluated using optical profilometry, and surface morphology was observed by means of scanning electron microscopy. All surface treatments resulted in higher surface roughness values compared to the control group. Different treatments affected the surface properties of the materials, presumably due to discrepancies in their composition and structure.

Sealability of Different Root Canal Nanosealers: Nano Calcium Hydroxide and Nano Bioactive Glass

Background:

The success of the endodontic treatment is largely dependent on the sealing achieved by root canal obturation. The application of sealer fills imperfections and increases adaptation of the root filling to the canal walls.

Aim:

To evaluate the sealability of experimental nanosealers (nano calcium hydroxide and nano bioactive glass) and to compare it with the commercial zinc oxide eugenol sealer using a dye penetration method.

Materials and Methods:

Sixty single-rooted mandibular premolars were selected. The tooth crowns were removed so as to obtain standardized 15-mm-long root specimens. The root canal was instrumented with Protaper Ni-Ti rotary file and the final file size was up to # F4/.06 (in vitro study). They were then randomly allocated into 3 groups of 20 specimens each (n=20) according to the sealer used for obturation, and all samples were filled with single cone gutta-percha (#40/06) and one of the tested sealers. All teeth were coated with nail polish and then suspended in 2% methylene blue dye for 7 days. Stereo-microscope (x10) was used to evaluate the sealability of newly introduced nanosealers. The data were statistically analyzed by ANOVA test followed by post hoc analysis (P < 0.05).

Results:

Significant improvement shown by the presented study suggests that nano calcium hydroxide sealer showed significantly less dye leakage than nano bioactive glass sealer and zinc oxide eugenol sealer.

Conclusion:

The results of this study showed that the synthesized nano-powder sealers are suitable for use in root canal therapy to prevent leakage.

The root canal can be sealed better by using smaller nano-powder particle sizes. In addition, the two groups exhibited significant differences in leakage in comparison with commonly used ZOE sealer.

A randomised controlled study on the effects of different surface treatments and adhesive self-etch functional monomers on the immediate repair bond strength and integrity of the repaired resin composite interface

OBJECTIVES

To evaluate the effects of different surface conditioning methods on the immediate repair bond strength and integrity of the repaired composite interface.

METHODS

One hundred and five resin composite blocks made of a nanohybrid resin composite were randomly assigned to one of the following surface conditioning groups (n = 15/group): Group 1: Gluma Self Etch™ adhesive system, Group 2: Tokuyama Bond Force II™ adhesive system, Group 3: non-roughened and non-conditioned surfaces, Group 4: sandblasting and Gluma Self Etch™, Group 5: sandblasting and Tokuyama Bond Force II™, Group 6: sandblasting only. A positive control group was also used. Resin composite identical to the substrate was applied and the repaired specimens were subjected to shear bond strength (SBS) testing. Representative samples from all groups were subjected to scanning electron microscopy and surface profilometry to determine their mode of failure. The data were analysed statistically using Analysis of Variance (ANOVA) and two independent sample t-test (α = 0.05).

RESULTS

The mean SBS of all test groups ranged between 1.92 and 5.40 MPa and varied with the degree of composite surface roughness and the type of adhesive system employed. Significantly highest SBS values (5.40 ± 0.36 MPa) were obtained in Group 5 (p = 0.017) which were comparable to the coherent strength of the resin composite in the positive control group (p > 0.05).

CONCLUSIONS

Under the tested conditions, significantly greater SBS of repaired resin composite was achieved when the substrate surface was conditioned by sandblasting followed by the application of the Tokuyama Bond Force II™ adhesive system.

CLINICAL SIGNIFICANCE

Effecting a repair of a nanohybrid composite restoration with sandblasting and the application of TBF II would seem to enhance the interfacial bond strength and integrity of the repaired resin composite interface. Clinical trials are necessary to determine the usefulness of this technique.

Effect of Different Surface Treatments and Roughness on the Repair Bond Strength of Aged Nanohybrid Composite

Objective and background: Different surface treatments have been tested in composite repair studies. However, there is still no consensus on the most effective repair protocol. The aim of this study is to measure the roughness values of eight different surface treatments for the repair procedure, to examine the effect of each surface treatment and three different composites on the repair bond strength with and without silane, and to evaluate whether there is a correlation between bond strength and roughness. Methods: The blocks were prepared with Filtek Z550 (3M ESPE) for the roughness measurements and divided into eight groups according to surface treatments. The roughness values of the surface treatments were measured by a 3D scanning contact profilometer (Nanomap LS). For the shear test, further samples were prepared, aged, and divided into three subgroups for the repair procedure with Filtek Z550 (3M ESPE), Vertise Flow (Kerr, USA), and G-aenial Flo (GC, Japan) after the surface treatments. Then, the shear test was performed. The Kruskal-Wallis and Spearman's Correlation tests were used for statistical evaluation of the data. Results: Significant differences were found between surface treatments and composite resins in terms of bond strength (p < 0.05). There is no correlation between the roughness and bond strength values. Conclusions: In bond strength, surface topography is more important than the numerical value of roughness. In the repair of composite restorations, methods that are already in clinical practice and more practical can be used instead of methods that require additional costs and devices.

Experimental synthesis of size-controlled TiO2 nanofillers and their possible use as composites in restorative dentistry

The aim of this work was to obtain an efficient protocol with a green, fast and facile way to synthesize TiO2 NPs and its application as fillers for enhancement of desired dental properties of light curing dental composites. A comparative study comprised the fabrication of light curing restorative composite materials with incorporating different fillers with varying wt%, varying resin material composition, to determine optimal dental restoration by focusing on the physical properties of dental materials. It was observed that the as-prepared green synthesized TiO2 nanohybrid particles contributed to the improvement in physical properties, thus promoting the green and rapid synthesis of nanohybrid fillers. In addition, mechanical values for experimental cured resin materials with bare and surface modified fillers were obtained. The experimental light curing nanocomposites with 5 wt% (wt%) nanohybrid surface modified filler particles with BisGMA (60 wt%), TEGDMA (20 wt%) and UDMA (20 wt%) resin composition provided increased physical strength and durability with higher compressive stress 195.56 MPa and flexural stress 83.30 MPa. Furthermore, the dental property, such as polymerization shrinkage (PS) obtained from volumetric method was decreased up to 3.4% by the addition of nano-hybrid fillers. In addition to this, the biocompatible and antimicrobial nature of TiO2 and its aesthetics properties such as tooth-like color makes TiO2 favorable to use as fillers. This study presents a green and facile method for the synthesis of TiO2 nanohybrid particles that can be successfully used as fillers in an experimental light curing resin matrix for enhancing its dental properties. This describes the potential of the green synthesized TiO2 nanohybrid particles to use as fillers in restorative dentistry.

Biofilm composition and composite degradation during intra-oral wear

OBJECTIVES

The oral environment limits the longevity of composite-restorations due to degradation caused by chewing, salivary and biofilm-produced enzymes and acids. This study investigates degradation of two resin-composites in relation with biofilm composition in vitro and in vivo.

METHODS

Surface-chemical-composition of two Bis-GMA/TEGDMA composites was compared using X-ray-Photoelectron-Spectroscopy from which the number ester-linkages was derived. Composite-degradation was assessed through water contact angles, yielding surface-exposure of filler-particles. Degradation in vitro was achieved by composite immersion in a lipase solution. In order to evaluate in vivo degradation, composite samples were worn in palatal devices by 15 volunteers for 30-days periods in absence and presence of manually-brushing with water. PCR-DGGE analysis was applied to determine biofilm composition on the samples, while in addition to water contact angles, degradation of worn composites was assessed through surface-roughness and micro-hardness measurements.

RESULTS

In vitro degradation by lipase exposure was highest for the high ester-linkage composite and virtually absent for the low ester-linkage composite. Filler-particle surface-exposure, surface-roughness and micro-hardness of both resin-composites increased during intra-oral wear, but filler-particle surface-exposure was affected most. However, based on increased filler-particle surface-exposure, the high ester-linkage composite degraded most in volunteers harvesting composite biofilms comprising Streptococcus mutans, a known esterase and lactic acid producer. This occurred especially in absence of brushing.

SIGNIFICANCE

Degradation during intra-oral wear of a low ester-linkage composite was smaller than of a high ester-linkage composite, amongst possible other differences between both composites. S. mutans herewith is not only a cariogenic, but also a composite-degradative member of the oral microbiome.

Effect of Argon Plasma Surface Treatment on Bond Strength of Resin Composite Repair

Objectives:

This study evaluated the effect of argon plasma treatment (PLA) and its combination with sandblasting (SAN), silanization (SIL), and hydrophobic bonding resin (HBR) application on the micro-shear bond strength of water-aged restorative resin composite to a newly placed composite, simulating restoration repair.

Methods and Materials:

Forty-five light-cured composite plates (20-mm long × 20-mm wide × 4-mm thick) were fabricated using a hybrid composite and stored at 37°C in distilled water for six months. The aged composite surfaces were treated according to the following experimental groups, varying both treatment and order of application: 1) SAN + SIL + HBR (control), 2) SAN + PLA for 30 seconds + SIL + HBR, 3) SAN + SIL + PLA + HBR, 4) PLA + SIL + HBR, 5) PLA + SIL, 6) PLA + HBR, 7) SIL + PLA + HBR, 8) SIL + PLA, and 9) PLA. After the surface treatments, four fresh resin composite cylinders (1.5-mm high × 1.5-mm diameter) of the same composite were built on each aged composite surface using a silicone mold. After water storage for 24 hours or one year, the specimens were submitted to shear bond strength testing. Data were statistically analyzed by two-way analysis of variance and Tukey's test (5%).

Results:

Groups 1, 2, and 4 presented significantly higher bond strength means at 24 hours, although group 4 did not differ from group 7. Groups 5, 8, and 9 demonstrated significantly lower means than the other groups. Even though groups 1 and 2 had a significant bond strength reduction after 1 year, they still demonstrated higher bond strength at one year of storage.

Conclusions:

While PLA application combined with surface treatment methods demonstrated high bond strength results, this treatment alone was not as beneficial as other methods that included SAN, SIL and HBR.

Effects of different etching strategies on the microtensile repair bond strength of beautifil II giomer material

Background

Considering the differences in the filler particles between giomer and conventional composite resins and the importance of these fillers in the repair bond strength, the aim was to evaluate the effects of different etching strategies with phosphoric acid (PA) and hydrofluoric acid (HF) on the microtensile repair bond strength (µTRBS) of giomer.

Material and Methods

Ten giomer blocks were randomly assigned into 10: 1) control; 2) 37%PA-20s; 3) 3%HF-20s; 4) 3%HF-120s; 5) 9.6%HF-20s; 6) 9.6%HF-120s; 7) 37%PA-20s + 3%HF-120s; 8) 37%PA-20s + 9.6%HF-120s; 9) 3%HF-120s + 37%PA-20s; 10) 9.6%HF-120s + 37%PA-20s. In all groups, the One-Step Plus bonding system was applied and the new giomer block was bonded to the existing giomer. After cross-sectional cutting, 18 samples were prepared from each block and the µTRBS of the samples was measured at a strain rate of 0.5 mm/min. Data were analyzed with one-way ANOVA and post hoc Tukey tests (P<0.05).

Results

The µTRBS in groups 4, 5, 6, 7, 8 and 10 were significantly higher than that in the control group (P<0.05). The µTRBS in group 2 was even less than that in the control group (P<0.001). The highest µTRBS was recorded in group 10, which was significantly different from those in groups 3, 4 and 9 (P<0.05). In addition, the differences between group 9 and groups 6, 7 and 8 were significantly different (P<0.05).

Conclusions

Etching with PA resulted in a decrease in µTRBS. Etching with HF, except for 3%HF-20s and HF after etching with PA, resulted in a significant increase in giomer`s µTRBS. An increase in the application time of 3%HF resulted in a significant increase in the µTRBS.

Key words:Dental restoration repair, Hydrofluoric acid, Phosphoric acid, etching.

Original and Repair Bulk Fracture Resistance of Particle Filler and Short Fiber-Reinforced Composites

OBJECTIVE

This study aimed to evaluate the original (OR) and repair (RR) fracture resistance of a semi-interpenetrating polymer network (semi-IPN)-based short fiber-reinforced composite compared to dimethacrylate-based composite materials by means of the V-notch test.

METHODS AND MATERIALS

Circular specimens (5×2 mm) with a centrally machined 90° V-shaped notch were prepared. Four bulk fill (Filtek Bulk Fill, Venus Bulk Fill, TetricEvo Ceram Bulk Fill, SDR), three microfilled hybrid (GC-Anterior, GC-Posterior, Z250), one nanofilled (SupremeXTE), and two short fiber-reinforced (Alert, everX Posterior) composites were selected. EverX Posterior was the semi-IPN material. Specimens (n=12/group) were either dry or water stored for 7 and 30 days, respectively, at 37°C and then loaded in two-point load until fracture. One-half of each tested specimen was used for the repair procedure. Repairing surfaces were diamond-bur ground, etched, and treated with silane containing universal adhesive (Scotchbond Universal) before repair.

RESULTS

Three-way analysis of variance revealed a significant statistical difference between the groups ( p<0.05). The fracture resistance of dry-stored groups was greater than that of water-stored groups. The highest OR was observed for dry-stored Alert (23.4 N/mm), which significantly deteriorated in water (17.4 N/mm) ( p<0.05). The highest RR was observed for everX Posterior (20.0 N/mm), which did not deteriorate in water significantly (19.0 N/mm) ( p>0.05). The everX Posterior preserved the specimens' integrity at the final fracture load (ductile fracture), whereas all other materials fractured into two halves at the interface (adhesive failure).

CONCLUSIONS

The only material that provided enhanced repair strength that was close to the original cohesive strength of the material was everX Posterior. The endurance of repaired restorations can be improved by using semi-IPN-based filling material.

Repair bond strength of nanohybrid composite resins with a universal adhesive

Objective: To investigate the repair bond strength of fresh and aged nanohybrid and hybrid composite resins using a universal adhesive (UA).

Materials and methods: Fresh and aged substrates were prepared using two nanohybrid (Venus Pearl, Heraus Kulzer; Filtek Supreme XTE, 3 M ESPE) and one hybrid (Z100, 3 M ESPE) composite resin, and randomly assigned to different surface treatments: (1) no treatment (control), (2) surface roughening with 320-grit (SR), (3) SR + UA (iBOND, Heraus Kulzer), (4) SR + Silane (Signum, Ceramic Bond I, Heraeus Kulzer) + UA, (5) SR + Sandblasting (CoJet, 3 M ESPE) + Silane + UA. After surface treatment, fresh composite resin was added to the substrates at 2 mm layer increments to a height of 5 mm, and light cured. Restored specimens were water-stored for 24 h and sectioned to obtain 1.0 × 1.0 mm beams (n = 12), and were either water-stored for 24 h at 37 °C, or water-stored for 24 h, and then thermocycled for 6000 cycles before microtensile bond strength (µTBS) testing. Data were analyzed with ANOVA and Tukey’s HSD tests (p = .05).

Results: Combined treatment of SR, sandblasting, silane and UA provided repair bond strength values comparable to the cohesive strength of each tested resin material (p < .05). Thermocycling significantly reduced the cohesive strength of the composite resins upto 65% (p < .05). Repair bond strengths of UA-treated groups were more stable under thermocycling.

Conclusions: Universal adhesive application is a reliable method for composite repair. Sandblasting and silane application slightly increases the repair strength for all substrate types.

Adhesive system affects repair bond strength of resin composite

Purpose:

This study evaluated the effects of different adhesive systems on repair bond strength of aged resin composites.

Materials and Methods:

Ninety composite discs were built and half of them were subjected to thermal aging. Aged and non-aged specimens were repaired with resin composite using three different adhesive systems; a two-step self-etch adhesive, a two-step total-etch adhesive and a one-step self-etch adhesive; then they were subjected to shear forces. Data were analyzed statistically.

Results:

Adhesive type and aging significantly affected the repair bond strengths (p<0.0001). No statistical difference was found in aged composite groups repaired with two-step self- etch or two-step total-etch adhesive. One-step self-etch adhesive showed lower bond strength values in aged composite repair (p<0.0001).

Conclusion:

In the repair of aged resin composite, two-step self-etch and two-step total-etch adhesives exhibited higher shear bond strength values than that of one-step self-etch adhesive.

A Retrievable, Efficacious Polymeric Scaffold for Subcutaneous Transplantation of Rat Pancreatic Islets

OBJECTIVE

We aim on developing a polymeric ectopic scaffold in a readily accessible site under the skin.

SUMMARY BACKGROUND DATA

The liver as transplantation site for pancreatic islets is associated with significant loss of islets. Several extrahepatic sites were tested in experimental animals, but many have practical limitations in the clinical setting and do not have the benefit of easy accessibility.

METHODS AND RESULTS

Functional survival of rat islets was tested during 7 days of culture in the presence of poly(D,L-lactide-co-ε-caprolactone) (PDLLCL), poly(ethylene oxide terephthalate)/polybutylene terephthalate (PEOT/PBT) block copolymer, and polysulfone. Tissue responses were studied in vivo after subcutaneous implantation in rats. Culture on PEOT/PBT and polysulfone profoundly disturbed function of islets, and induced severe tissue responses in vivo. Modification of their hydrophilicity did not change the suitability of the polymers. PDLLCL was the only polymer that promoted functional survival of rat islets in vitro and was associated with minor tissue reactions after 28 days. Rat islets were transplanted in the PDLLCL scaffold in a diabetic rat model. Before islet seeding, the scaffold was allowed to engraft for 28 days to allow the tissue response to dampen and to allow blood vessel growth into the device. Islet transplantation into the scaffold resulted in normoglycemia within 3 days and for the duration of the study period of 16 weeks.

CONCLUSIONS

In conclusion, we found that some polymers such as PEOT/PBT and polysulfone interfere with islet function. PDLLCL is a suitable polymer to create an artificial islet transplantation site under the skin and supports islet survival.

Effect of Surface Treatment, Silane, and Universal Adhesive on Microshear Bond Strength of Nanofilled Composite Repairs

Purpose: The aim of this study was to evaluate the effect of surface treatment and universal adhesive on the microshear bond strength of nanoparticle composite repairs.

Methods: One hundred and forty-four specimens were built with a nanofilled composite (Filtek Supreme Ultra, 3M ESPE). The surfaces of all the specimens were polished with SiC paper and stored in distilled water at 37°C for 14 days. Half of the specimens were then air abraded with Al2O3 particles and cleaned with phosphoric acid. Polished specimens (P) and polished and air-abraded specimens (A), respectively, were randomly divided into two sets of six groups (n=12) according to the following treatments: hydrophobic adhesive only (PH and AH, respectively), silane and hydrophobic adhesive (PCH, ACH), methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane and hydrophobic adhesive (PMH, AMH), universal adhesive only (PU, AU), silane and universal adhesive (PCU, ACU), and MDP-containing silane and universal adhesive (PMU, AMU). A cylinder with the same composite resin (1.1-mm diameter) was bonded to the treated surfaces to simulate the repair. After 48 hours, the specimens were subjected to microshear testing in a universal testing machine. The failure area was analyzed under an optical microscope at 50× magnification to identify the failure type, and the data were analyzed by three-way analysis of variance and the Games-Howell test (α=0.05).

Results: The variables “surface treatment” and “adhesive” showed statistically significant differences for p&lt;0.05. The highest mean shear bond strength was found in the ACU group but was not statistically different from the means for the other air-abraded groups except AH. All the polished groups except PU showed statistically significant differences compared with the air-abraded groups. The PU group had the highest mean among the polished groups. Cohesive failure was the most frequent failure mode in the air-abraded specimens, while mixed failure was the most common mode in the polished specimens.

Conclusions: While air abrasion with Al2O3 particles increased the repair bond strength of the nanoparticle composite, the use of MDP-containing silane did not lead to a statistically significant increase in bond strength. Silane-containing universal adhesive on its own was as effective as any combination of silane and adhesive, particularly when applied on air-abraded surfaces.

Repair Bond Strength of Aged Resin Composite after Different Surface and Bonding Treatments

The aim of this study was to compare the effect of different mechanical surface treatments and chemical bonding protocols on the tensile bond strength (TBS) of aged composite. Bar specimens were produced using a nanohybrid resin composite and aged in distilled water for 30 days. Different surface treatments (diamond bur, phosphoric acid, silane, and sandblasting with Al₂O₃ or CoJet Sand), as well as bonding protocols (Primer/Adhesive) were used prior to application of the repair composite. TBS of the specimens was measured and the results were analyzed using analysis of variance (ANOVA) and the Student-Newman-Keuls test (α = 0.05). Mechanically treated surfaces were characterized under SEM and by profilometry. The effect of water aging on the degree of conversion was measured by means of FTIR-ATR spectroscopy. An important increase in the degree of conversion was observed after aging. No significant differences in TBS were observed among the mechanical surface treatments, despite variations in surface roughness profiles. Phosphoric acid etching significantly improved repair bond strength values. The cohesive TBS of the material was only reached using resin bonding agents. Application of an intermediate bonding system plays a key role in achieving reliable repair bond strengths, whereas the kind of mechanical surface treatment appears to play a secondary role.

Selection of polymers for application in scaffolds applicable for human pancreatic islet transplantation

The liver is currently the site for transplantation of islets in humans. This is not optimal for islets, but alternative sites in humans are not available. Polymeric scaffolds in surgically accessible areas are a solution. As human donors are rare, the polymers should not interfere with functional survival of human-islets. We applied a novel platform to test the adequacy of polymers for application in scaffolds for human-islet transplantation. Viability, functionality, and immune parameters were included to test poly(D,L-lactide-co-ε-caprolactone) (PDLLCL), poly(ethylene oxide terephthalate)/polybutylene terephthalate (PEOT/PBT) block copolymer, and polysulfone. The type of polymer influenced the functional survival of human islets. In islets cultured on PDLLCL the glucagon-producing α-cells and insulin-producing β-cells contained more hormone granules than in islets in contact with PEOT/PBT or polysulfone. This was studied with ultrastructural analysis by electron microscopy (nanotomy) during 7 d of culture. PDLLCL was also associated with statistically significant lower release of double-stranded DNA (dsDNA, a so called danger-associate molecular pattern (DAMP)) from islets on PDLLCL when compared to the other polymers. DAMPs support undesired immune responses. Hydrophilicity of the polymers did not influence dsDNA release. Islets on PDLLCL also showed less cellular outgrowth. These outgrowing cells were mainly fibroblast and some β-cells undergoing epithelial to mesenchymal cell transition. None of the polymers influenced the glucose-stimulated insulin secretion. As PDLLCL was associated with less release of DAMPs, it is a promising candidate for creating a scaffold for human islets. Our study demonstrates that for sensitive, rare cadaveric donor tissue such as pancreatic islets it might be necessary to first select materials that do not influence functionality before proposing the biomaterial for in vivo application. Our presented platform may facilitate this selection of biomaterials.

Effects of two erbium-doped yttrium aluminum garnet lasers and conventional treatments as composite surface abrasives on the shear bond strength of metal brackets bonded to composite resins

Background:

Bonding brackets to dental surfaces restored with composites are increasing. No studies to date have assessed the efficacy of laser irradiation in roughening of composite and the resulted shear bond strength (SBS) of the bonded bracket. We assessed, for the 1^st time, the efficacy of two laser beams compared with conventional methods.

Materials and Methods:

Sixty-five discs of light-cured composite resin were stored in deionized distilled water for 7 days. They were divided into five groups of 12 plus a group of five for scanning electron microscopy (SEM): Bur-abrasion followed by phosphoric acid etching (bur-PA), hydrofluoric acid conditioning (HF), sandblasting, 3 W and 2 W erbium-doped yttrium aluminum garnet laser irradiation for 12 s. After bracket bonding, specimens were water-stored (24 h) and thermocycled (500 cycles), respectively. SBS was tested at 0.5 mm/min crosshead speed. The adhesive remnant index (ARI) was scored under ×10 magnification. SEM was carried out as well. Data were analyzed using analysis of variance (ANOVA), Kruskal–Wallis, Tukey, Dunn, one-sample t-test/Wilcoxon tests, and Weibull analysis (α =0.05).

Results:

The SBS values (megapascal) were bur-PA (11.07 ± 1.95), HF (19.70 ± 1.91), sandblasting (7.75 ± 1.10), laser 2 W (15.38 ± 1.38), and laser 3 W (20.74 ± 1.73) (compared to SBS = 6, all P = 0.000). These differed significantly (ANOVA P = 0.000) except HF versus 3 W laser (Tukey P > 0.05). ARI scores differed significantly (Kruskal–Wallis P = 0.000), with sandblasting and 2 W lasers having scores inclined to the higher end (safest debonding). Weibull analysis implied successful clinical outcome for all groups, except for sandblasting with borderline results.

Conclusion:

Considering its high efficacy and the lack of adverse effects bound with other methods, the 3 W laser irradiation is recommended for clinical usage.

Effect of different surface treatments on the shear bond strength of nanofilled composite repairs

Background. Repairing aged composite resin is a challenging process. Many surface treatment options have been proposed to this end. This study evaluated the effect of different surface treatments on the shear bond strength (SBS) of nano-filled composite resin repairs.

Methods. Seventy-five cylindrical specimens of a Filtek Z350XT composite resin were fabricated and stored in 37°C distilled water for 24 hours. After thermocycling, the specimens were divided into 5 groups according to the following surface treatments: no treatment (group 1); air abrasion with 50-μm aluminum oxide particles (group 2); irradiation with Er:YAG laser beams (group 3); roughening with coarse-grit diamond bur + 35% phosphoric acid (group 4); and etching with 9% hydrofluoric acid for 120 s (group 5). Another group of Filtek Z350XT composite resin samples (4×6 mm) was fabricated for the measurement of cohesive strength (group 6). A silane coupling agent and an adhesive system were applied after each surface treatment. The specimens were restored with the same composite resin and thermocycled again. A shearing force was applied to the interface in a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests (P < 0.05).

Results. One-way ANOVA indicated significant differences between the groups (P < 0.05). SBS of controls was significantly lower than the other groups; differences between groups 2, 3, 4, 5 and 6 were not significant. Surface treatment with diamond bur + 35% phosphoric acid resulted in the highest bond strength.

Conclusion. All the surface treatments used in this study improved the shear bond strength of nanofilled composite resin used.

Evaluation of add-on methods for bis-acryl composite resin interim restorations

STATEMENT OF PROBLEM

Interim restoration materials should allow easy add-on for repair and modification; however, bis-acryl composite resins are reported to have unfavorable performance in this regard.

PURPOSE

The purpose of this study was to find a suitably effective add-on method for bis-acryl interim composite resins.

MATERIAL AND METHODS

A control group with a new type of bis-acryl material added to the same bis-acryl disks (n=10) was compared to 9 experimental groups (n=20) divided on the basis of their surface conditions: oxygen-inhibited unpolymerized layer preserved; ground; ground and treated with a light-polymerizing bonding agent, with or without a synthetic polyester film (Mylar) cover strip to control oxygen-inhibited unpolymerized layer; with bis-acryl, bis-GMA flowable composite, or poly-methyl methacrylate (PMMA) resins as add-on materials. PMMA specimens added with PMMA resin served as a parallel control group (n=20). Half of the experimental and PMMA control specimens were thermocycled 2000 times at 5 ±2°C and 55 ±2°C. Shear bond strength (SBS) results were then compared using 2-way and 1-way ANOVA and a Tukey honest significant difference (HSD) test (α=.05).

RESULTS

No significant differences were found between SBS of PMMA and those of bis-acryl controls (21.74 and 17.47 MPa, respectively), with all of the experimental groups exhibiting values comparable to the controls and unaffected by thermocycling. The highest SBS (35.58 MPa) was obtained with the bis-GMA-added group, in which the surface was ground and treated with a bonding agent (P<.05). With the bis-acryl resin and bonding agent group, additional light polymerizing significantly increased the SBS from 15.58 to 23.80 MPa (P<.05).

CONCLUSIONS

Bis-acryl-based interim material has favorable add-on properties, which are improved by additional surface treatment and use of a flowable composite resin.

Failure Strengths of Composite Additions and Repairs

Purpose

When adding composite to a cured composite restoration, the intent is to achieve the same failure strength as the original restorative material. This study evaluated the failure strengths of added or repaired composite using various chemical and/or mechanical surface treatments.

Methods

Failure strengths were determined using a four-point bending test. Beam-shaped specimens were fabricated by adding new composite to cured composite (Filtek Supreme Ultra). The cured composites were either fresh or aged seven days (N=10-14). The composite surfaces were left unground or were ground before treatment with various combinations of roughening, acid etching, silane, and dental adhesives (conventional Adper SingleBond Plus or new multimode Scotchbond Universal) and/or tribochemistry (CoJet system). Monolithic composite specimens were the control. Failure strengths were statistically analyzed using one-way analysis of variance and the Fisher protected least significant difference (α=0.05).

Results

Failure strengths (mean ± standard deviation) when composite was added to unground freshly cured composites (111±25 MPa) and aged composites using a new multimode adhesive with (102±22 MPa) or without (98±22 MPa) tribochemical treatment were not significantly lower than the monolithic specimens (122±23 MPa). Grinding the surfaces of freshly cured composite significantly reduced failure strength, either with (81±30 MPa) or without (86±31 MPa) use of conventional adhesive. Failure strengths of aged composites were also significantly lower (51±21 MPa with SingleBond Plus), even after tribochemical treatment (71±29 MPa with SingleBond Plus; 73±35 MPa with Silane-Visiobond).

Conclusions

Using a new multimode adhesive when adding composite to freshly cured or aged composite substrates recovered the failure strength to that of the original monolithic composite.

Inlays made from a hybrid material: adaptation and bond strengths

The aim of this study was to evaluate the internal fit, marginal adaptation, and bond strengths of inlays made of computer-aided design/computer-aided manufacturing feldspathic ceramic and polymer-infiltrated ceramic. Twenty molars were randomly selected and prepared to receive inlays that were milled from both materials. Before cementation, internal fit was achieved using the replica technique by molding the internal surface with addition silicone and measuring the cement thicknesses of the pulpal and axial walls. Marginal adaptation was measured on the occlusal and proximal margins of the replica. The inlays were then cemented using resin cement (Panavia F2.0) and subjected to two million thermomechanical cycles in water (200 N load and 3.8-Hz frequency). The restored teeth were then cut into beams, using a lathe, for microtensile testing. The contact angles, marginal integrity, and surface patterns after etching were also observed. Statistical analysis was performed using two-way repeated measures analysis of variance (p<0.05), the Tukey test for internal fit and marginal adaptation, and the Student t-test for bond strength. The failure types (adhesive or cohesive) were classified on each fractured beam. The results showed that the misfit of the pulpal walls (p=0.0002) and the marginal adaptation (p=0.0001) of the feldspathic ceramic were significantly higher when compared to those of the polymer-infiltrated ceramic, while the bond strength values of the former were higher when compared to those of the latter. The contact angle of the polymer-infiltrated ceramic was also higher. In the present study, the hybrid ceramic presented improved internal and marginal adaptation, but the bond strengths were higher for the feldspathic ceramic.

Evaluation of Flexural, Diametral Tensile, and Shear Bond Strength of Composite Repairs

Objective

Repairing composite restorations may be a more conservative treatment than replacing the entire restoration. The objective of this in vitro study was to determine the best repair method by measuring flexural, diametral tensile, and shear bond strength of repaired composites in which the surfaces were treated with chemical primers (Add & Bond or Silane Bond Enhancer), a bonding agent (Optibond Solo Plus [OBSP]), or mechanical retention with a bonding agent.

Methods

Filtek Supreme Ultra shade B1B was placed in special molds to fabricate specimens that served to test the flexural, diametral tensile, or shear strength of the inherent resin substrate. The same molds were modified to make specimens for testing repair strength of the resin. Repairs were made immediately or after aging in deionized water at 37°C for seven days. All repair sites were finished with coarse Sof-Lex discs to simulate finishing new restorations or partially removing aged restorations. Repair surfaces were treated with one of the following: 1) phosphoric-acid etching and OBSP; 2) Add & Bond; 3) phosphoric-acid etching, Silane Bond Enhancer, and OBSP; or 4) quarter round bur, phosphoric-acid etching, and OBSP. Specimens were placed back in the original molds to fabricate specimens for diametral tensile or flexural testing or in an Ultradent jig to make specimens for shear bond testing. Composite resin in shade B5B was polymerized against the treated surfaces to make repairs. Two negative control groups for the three testing methods consisted of specimens in which repairs were made immediately or after aging without any surface treatments. Controls and experimental repairs were aged (water 37°C, 24 hours) before flexural, diametral tensile, or shear testing in an Instron Universal testing machine at a crosshead speed of 0.5 mm/min.

Results

Experimental flexural repair strengths ranged from 26.4% to 88.6% of the inherent substrate strength. Diametral tensile repair strengths ranged from 40% to 80% of the inherent substrate strength, and shear bond strength repairs ranged from 56% to 102%. Geometric means were statistically analyzed with two-way analysis of variance on their log-transformed values. Significant differences were determined using Tukey honestly significant difference (p&lt;0.05).

Conclusions

Depending on the mechanical property being tested, surface treatments produced different results. OBSP produced more consistent results than chemical primers.

Effect of incorporation of silane in the bonding agent on the repair potential of machinable esthetic blocks

OBJECTIVE

To investigate the repair potential of CAD/CAM (computer-aided design/computer-aided manufacturing) ceramic and composite blocks using a silane-containing bonding agent with different repair protocols.

MATERIALS AND METHODS

Twenty-four discs were constructed from CAD/CAM ceramic and composite blocks. The discs were divided into six groups according to surface pre-treatment employed; GI: Diamond stone roughening (SR), GII: SR+ silanization (SR+S), GIII: Hydrofluoric acid etching (HF), GIV: HF+ silanization (HF+S), GV: Silica coating (SC), GVI: SC+ silanization (SC+S). Silane-containing bonding agent (Single Bond Universal adhesive, 3M ESPE) was applied to the pre-treated discs. Prior to light curing, irises were cut from tygon tubes (internal diameter = 0.8 mm and height = 0.5 mm) and mounted on each treated surface. Nanofilled resin composite (Filtek Z350(XT), 3M ESPE) was packed into the cylinder lumen and light-cured (n = 10). The specimens were subjected to microshear bond strength testing (μ-SBS) using universal testing machine. Failure modes of the fractured specimens were analyzed using field emission scanning electron microscope (FESEM). Eight representative discs were prepared to analyze the effect of surface treatments on surface topography using FESEM. μ-SBS results were analyzed using ANOVA and Tukeys post-hoc test.

RESULTS

Three-way ANOVA results showed that the materials, surface pre-treatment protocols, and silanization step had a statistically significant effect on the mean μ-SBS values at P ≤ 0.001. For ceramic discs, the groups were ranked; GIV (24.45 ± 7.35)> GVI ((20.18 ± 2.84)> GV (7.14 ± 14)= GII (6.72 ± 1.91)=GI (6.34 ± 2.21)=GIII (5.72 ± 2.18). For composite discs, groups were ranked; GI (24.98 ± 7.69)=GVI (24.84 ± 7.00) >GII (15.85 ± 5.29) =GV (14.65 ± 4.5)= GIV (14.24 ± 2.95)≥ GIII ((9.37 ± 2.78).

CONCLUSION

The additional silanization step cannot be omitted if the repair protocol comprises of either hydrofluoric acid etching or silica coating for both CAD/CAM esthetic restorative materials. However, this step can be suppressed by using silane-containing adhesive with diamond stone roughened repair protocol.

Bond strengths of silorane- and methacrylate-based composites to various underlying materials

OBJECTIVE

To evaluate shear bond strength (SBS) values of a methacrylate (FZ 250) and a silorane-based (FS) resin composite to various underlying materials.

MATERIALS AND METHODS

A total of 80 samples were prepared with four different underlying materials; a flowable (FLC) and a bulk-fill flowable composite (BFC), and a conventional (CGIC) and resin modified glass-ionomer cement (RMGIC). These underlying materials were laminated plus to methacrylate or silorane-based resin composites (n = 10). To evaluate the specimens SBS values were evaluated with a universal testing machine (cross-head speed; 1.0 mm/min). Statistical comparisons were carried out using two-way ANOVA and Tukey's post hoc test with a significance level of P < 0.05.

RESULTS

SBS values for FZ250 were significantly higher than for FS for all of the underlying materials tested (P < 0.05). SBS values of FZ250 to BFC were significantly higher than to all other materials (P < 0.05), whereas SBS values of FS did not vary significantly according to underlying material (P > 0.05).

CONCLUSION

The use of FS in conjunction with any of the tested materials showed lower SBS than the FZ 250. Also, new low elastic modulus liner BFC presented slightly good interfacial adhesion so, the usage of BFC as an underlying material may be preferable for FZ 250.

Influence of a proximal margin elevation technique on marginal adaptation of ceramic inlays

PURPOSE

Evaluating the effect of a proximal margin elevation technique on marginal adaptation of ceramic inlays.

METHODS

Class II MOD-cavities were prepared in 40 human molars and randomly distributed to four groups (n = 10). In group EN (positive control) proximal margins were located in enamel, 1 mm above the cementoenamel junction, while 2 mm below in groups DE-1In, DE-2In and DE. The groups DE-1In, DE-2In and DE simulated subgingival location of the cervical margin. In group DE-1In one 3 mm and in group DE-2In two 1.5 mm composite layers (Tetric) were placed for margin elevation of the proximal cavities using Syntac classic as an adhesive. The proximal cavities of group DE remained untreated and served as a negative control. In all groups, ceramic inlays (Cerec 3D) were adhesively inserted. Replicas were taken before and after thermomechanical loading (1.200.000 cycles, 50/5°C, max. load 49 N). Marginal integrity (tooth-composite, composite-inlay) was evaluated with scanning electron microscopy (200×). Percentage of continuous margin (% of total proximal margin length) was compared between groups before and after cycling using ANOVA and Scheffé post-hoc test.

RESULTS

After thermomechanical loading, no significant differences were observed between the different groups with respect to the interface composite-inlay and tooth-composite with margins in dentin. The interface tooth-composite in enamel of group EN was significantly better compared to group DE-2In, which was not different to the negative control group DE and DE-1In.

CONCLUSION

Margin elevation technique by placement of a composite filling in the proximal box before insertion of a ceramic inlay results in marginal integrities not different from margins of ceramic inlays placed in dentin.

Effect of Different Adhesion Strategies on Bond Strength of Resin Composite to Composite-dentin Complex

Service life of discolored and abraded resin composite restorations could be prolonged by repair or relayering actions. Composite-composite adhesion can be achieved successfully using some surface conditioning methods, but the most effective adhesion protocol for relayering is not known when the composite restorations are surrounded with dentin. This study evaluated the effect of three adhesion strategies on the bond strength of resin composite to the composite-dentin complex. Intact maxillary central incisors (N=72, n=8 per subgroup) were collected and the coronal parts of the teeth were embedded in autopolymerized poly(methyl tfr54methacrylate) surrounded by a polyvinyl chloride cylinder. Cylindrical cavities (diameter: 2.6 mm; depth: 2 mm) were opened in the middle of the labial surfaces of the teeth using a standard diamond bur, and the specimens were randomly divided into three groups. Two types of resin composite, namely microhybrid (Quadrant Anterior Shine; AS) and nanohybrid (Grandio; G), were photo-polymerized incrementally in the cavities according to each manufacturer's recommendations. The composite-enamel surfaces were ground finished to 1200-grit silicone carbide paper until the dentin was exposed. The surfaces of the substrate composites and the surrounding dentin were conditioned according to one of the following adhesion protocols: protocol 1: acid-etching (dentin) + silica coating (composite) + silanization (composite) + primer (dentin) + bonding agent (dentin + composite); protocol 2: silica coating (composite) + acid-etching (dentin) + silanization (composite) + primer (dentin) + bonding agent (dentin + composite); and protocol 3: acid-etching (dentin) + primer (dentin) + silanization (composite) + bonding agent (dentin + composite). Applied primer and bonding agents were the corresponding materials of the composite manufacturer. Silica coating (CoJet sand, 30 μm) was achieved using a chairside air-abrasion device (distance: 10 mm; duration: four seconds in circular motion). After conditioning protocols, the repair resin was adhered to the substrate surfaces using transparent polyethylene molds (diameter: 3.6 mm) incrementally and photo-polymerized. The substrate-adherend combinations were as follows: AS-AS, G-G, AS-G. Shear force was applied to the adhesive interface in a Universal Testing Machine (crosshead speed: 1 mm/min). The types of failures were further evaluated and categorized as follows: 1) cohesive in the composite substrate and 2) adhesive at the interface. Bond strength values (MPa) were statistically analyzed using two-way analysis of variance and least significant difference post hoc tests (α=0.05). Significant effects of the adhesion strategy (p=0.006) and the composite type (p=0.000) were found. Interaction terms were not significant (p=0.292). Regardless of the substrate-adherend combination, protocol 1 (17–22 MPa) showed significantly higher results than did protocols 2 (15–17 MPa) and 3 (11–17 MPa) (p=0.028, p=0.002, respectively). The highest results were obtained from the G-G combination after all three protocols (17–22 MPa). The incidence of cohesive failures was more common when the substrate and the adherend were the same composite type (AS-AS: 87.5%, 87.5%, 75%; G-G: 100%, 75%, 50% for protocols 1, 2, and 3, respectively). When substrate and adherend were used interchangeably, adhesive failures were more frequent (25%, 50%, and 100% for protocol 1, 2, and 3, respectively). When the substrate and the adherend are of the same type, greater repair strength could be expected. In the repair of composites next to the dentin, depending on the composite type, conditioning the composite with silica coating and silanization after etching the dentin adds to the repair strength compared to the results obtained with silane application only.

Effect of Different Surface Treatments on Repair Micro-shear Bond Strength of Silica- and Zirconia-filled Composite Resins

Background and aims

Effect of surface treatments on repair bond strength of aged composite resins might be different due to their dissimilar fillers. The aim was to evaluate the effect of different surface treatments on repair micro-shear bond strength (µSBS) of silica- (Spectrum TPH) and zirconia-filled (Filtek Z250) composite resins.

Materials and methods

Twenty-seven composite resin blocks were made from each type of composite resin: Z250 and Spectrum TPH. After aging, blocks of each type were randomly divided into three groups according to surface treatments: alloy primer, silane, and only surface roughening. Subsequently, each group was further subdivided into 3 subgroups based on the adhesive system used: Single Bond, Clearfil SE Bond, and Margin Bond. Four composite resin columns were added on each block. After thermocycling, µSBStest were done at cross head speed of 0.5 mm/min. Data was analysed using multifactor ANOVA, one-way ANOVA and a post-hoc Bonferroni tests (α = 0.05).

Results

Analysis of data showed that the effect of composite resin type was not significant (p > 0.05), but the effects of the type of surface treatment (p = 0.01) and the type of adhesive system (p = 0.01) were significant on repair µSBS. In addition, the cumulative effect of the composite type-surface treatment and the composite type with the type of adhesive system were not statistically significant (p > 0.05). However, the cumulative effects of the adhesive system-surface treatment (p = 0.03) and the composite type-the adhesive system-surface treatments (p = 0.002) were significant.

Conclusion

Although repair µSBS values of both silica- and zirconia-filled composite resins were similar, use of different combinations of surface treatments and adhesive systems affected their repair µSBS differently.

The effect of surface treatments and bonding regimens on microtensile bond strengths of repaired composite: An in vitro study

Aim:

To assess the microtensile bond strength of repaired composite resin that was surface treated by diamond point or silicon carbide followed by bonding using either only total- etch bonding regimen or silane coupling agent with adhesive resin.

Materials and Methods:

Fourteen composite blocks were aged under deionized water for 14 days. The bonding surface was prepared with coarse diamond point or silicon carbide. Two blocks with no surface treatment were used as control groups. The bonding regimen was either total-etch bonding regimen or silane coupling agent and bonding agent. The aged samples were then bonded to new composite. Five sections per block (each 1mm thick) were prepared; cut to obtain an adhesive zone of approximately 1mm² and subjected to microtensile bond strength testing.

Results:

The highest bond strength was obtained by surface treatment by coarse diamond point and total etch bonding regimen and least by silicon carbide and silane. A statistically significant difference was seen in all the four groups.

Conclusions:

Surface treatment by a coarse diamond point and total-etch bonding regimen provides highest bond strength. Thus, a simpler treatment regimen can contribute to a better bond strength in repaired composites.

Two-year interfacial bond durability and nanoleakage of repaired silorane-based resin composite

OBJECTIVES

To investigate the effect of silane primer application, intermediate adhesive agent/repair composite, and storage period on the interfacial microtensile bond strength (μTBS) of repaired silorane-based resin composite compared with unrepaired composites and on the nanoleakage.

METHODS

Forty-eight 1-month-old substrate specimens from Filtek P90 were roughened, etched, and distributed over two groups (n=24) based on receiving silane (Clearfil Ceramic Primer) or not. Then, half of the specimens (n=12) were repaired with P90 System Adhesive/Filtek P90 and the other half with Adper Scotchbond Multipurpose adhesive/Filtek Z250 resin composite. Within each repair category, repaired specimens were stored in artificial saliva at 37°C for either 24 hours (n=6) or two years before being serially sectioned into sticks (0.6 ± 0.01 mm(2)). From each specimen, two sticks were prepared for nanoleakage determination and four sticks were used for μTBS testing. Additional unrepaired specimens from each composite (n=12) were made to determine the cohesive strength at 24 hours and two years. Mean μTBS were calculated and statistically analyzed. Modes of failure were also determined.

RESULTS

General linear model analysis revealed no significant effect for the silane priming, intermediate adhesive agent/repair composite, and storage period or for their interactions on the μTBS values of the repaired specimens. There was no significant difference between the cohesive strength of Filtek P90 and Filtek Z250; both were significantly higher than all repaired categories. At 24 hours, nanoleakage was not detected when silorane-based composite was repaired with the same material. However, after two years, all repair categories showed nanoleakage.

CONCLUSIONS

Silane application has no effect on μTBS and nanoleakage. Durability of the interfacial bond of repaired silorane-based resin composite appeared successful regardless of the chemistry of the intermediate adhesive agent/composite used for repair. However, nanoleakage was detected early when a different repair intermediate adhesive agent/composite was used.