The influence of temporary cements on dental adhesive systems for luting cementation

Influence of the Composition of Provisional Luting Materials on the Bond Strength of Temporary Single-Tooth Crowns on Titanium Abutments

In addition to zinc oxide-based cements, resin-based materials are also available for temporary cementation. The aim of this in vitro study was to determine the influence of the different material compositions on temporary bonds. In nine test series (n = 30), temporary bis-acrylate single-tooth crowns were bonded onto prefabricated titanium abutments with nine different temporary luting materials. After simulating an initial (24 h, distilled water, 37 °C), a short-term (7 days, distilled water, 37 °C) and a long-term provisional restoration period (12h, distilled water, 37 °C; thermocycling: 5000 cycles) in subgroups (n = 10), the bond strength was examined using a combined tensile-shear test. Statistical analysis was performed by univariate analysis of variance or a non-parametric Kruskal-Wallis test, followed by post hoc tests. Of the three resin-based materials, two showed significantly higher bond strength values compared to all other materials (p < 0.001), regardless of the storage procedure. The resin-based materials were followed by eugenol-free and eugenol-containing zinc oxide materials. Significant intragroup differences were observed between the composite-based materials after all storage periods. This was only observed for some of the zinc oxide-based materials. The results show that under in vitro conditions, not only the composition of the temporary luting materials but also the different storage conditions have a significant influence on temporary bonds.

Biological interaction, esthetics, handling, and loss rate of temporary luting cements - a clinical single-blind randomized controlled trial

OBJECTIVES

To evaluate three temporary luting cements in terms of their restoration loss rates, biological interactions, esthetic properties, and handling characteristics.

MATERIALS AND METHODS

75 adults requiring fixed prosthodontics voluntarily participated in a single-blind, randomized controlled trial. After preparation, temporary restorations were luted with a randomly selected temporary luting cement (either Provicol QM Plus (PQP), Bifix Temp (BT), or Provicol QM Aesthetic (PQA)). Clinical examinations were performed one to two weeks after cementation. The following criteria were evaluated: tooth vitality, percussion, hypersensitivity, gingival bleeding, odor formation, esthetics, cement handling, removability, cleanability, and retention loss. Antagonistic teeth served as controls. Statistical analysis was performed using the paired t-test, one-way ANOVA, Pearson's chi-square and Fisher's exact test, where appropriate.

RESULTS

The overall loss rate of temporary restorations was 16.0%, showing no cement-specific differences. Postoperative hypersensitivity occurred in 8% of cases regardless of cement type. Esthetic impairment was reported by 31% of the PQP-fixed restorations, compared with 4.0% and 4.2% of the BT and PQA-bonded restorations. Cement application was reported to be easy in 100% of cases, excess removal in 88-96%, depending on the cement used.

CONCLUSIONS

The choice of luting material affects the esthetic appearance of a temporary restoration and should be considered, particularly in restorations in esthetically demanding areas. No significant differences between the cements were identified regarding biocompatibility, handling, and loss rate.

CLINICAL RELEVANCE

Translucent cements can help to reduce color interferences, resulting in a more appealing appearance of the temporary restoration.

A comparative evaluation of the effect of eugenol exposure time on the bond strength of an etch-and-rinse and a self-etch adhesive to dentin: An in vitro study

Aim

The study aimed to comparatively evaluate the effect of eugenol exposure time on the micro-shear bond strength (μ-SBS) of etch-and-rinse and a self-etch adhesive to dentin.

Materials and Methods

One hundred and twelve teeth samples were prepared from bisectioning 56 freshly extracted human mandibular molars and were randomly divided into 14 subgroups of 8 samples each (n = 8). Three subgroups containing eugenol and a noneugenol-based restorative material were placed on the dentin surface and left for 24 h, 7 days, and 14 days, respectively, and were compared to a control. Two bonding systems were evaluated: one being etch-and-rinse and the other self-etch adhesive. The μ-SBS were calculated and expressed in MPa.

Statistical Analysis

The data were analyzed using mixed model analysis of variance. The level of statistical significance was set at 5%.

Results

There was a statistically significant reduction in the μ-SBS values when the self-etch adhesive was used, after the removal of eugenol-containing cement placed for 24 h. However, the reduction in the μ-SBS values after 7 days or 14 days was not significant.

Conclusion

Exposure to eugenol containing temporary cement for 24 h significantly reduces the μ-SBS of self-etching adhesives to dentin. However, exposure for 1 week or more has minimal effects.

A new method of adhesive system application improves the bond strength between fiber post and root dentin

This study evaluated a new method of adhesive system application on the bond strength between fiber post and root dentin using two adhesive systems. The canals of sixty bovine incisors were prepared and obturated. The roots were divided into six groups (n=10) according to the adhesive system (Clearfil SE - CSE and Single Bond Universal - SBU) and the application strategy (microbrush - MB; rotary brush - RB; and ultrasonic tip - US). The glass fiber posts were cemented with resin cement (RelyX ARC). The roots were sectioned perpendicularly to their long axis, and three slices per root were obtained. Previously to the push-out test, confocal laser scanning microscopy (CLSM) was performed to illustrate the interfacial adaptation of the cement to the root canal walls. Failure patterns were analyzed with 40x magnification. Shapiro-Wilk indicated a normal distribution of the data. The bond strength values were compared using one-way ANOVA and Tukey's tests. Student's T test analyzed the differences between the adhesive systems within each third and protocol. A significance level of 5% was used. CSE with RB showed higher mean bond strength values compared to MB (conventional technique) (P < 0.05). US application resulted in intermediate bond strength values for CSE (P > 0.05). The application of SBU using RB generated higher mean bond strength values compared to MB and US (P < 0.05). Adhesive failures were predominant (65.5%). CSE and SBU application with the new rotary brush improved the bond strength of fiber posts to root dentin compared to the conventional strategy.

Knowledge of Saudi dental students and interns towards luting cements and their applications in fixed prosthodontics

BACKGROUND

Enhancement of students' knowledge is essential in improving their clinical skills and performance. Thus, the curriculum should be prepared to achieve a better outcome. The current study aimed to determine the dental students' and interns' basic knowledge towards dental luting cements and their application in dental practice to improve the theoretical and clinical training sections.

MATERIALS AND METHODS

A cross-sectional study was conducted among dental students and interns at three Colleges of Dentistry in the Kingdom of Saudi Arabia between September 2019-June 2020. An online questionnaire was used which included demographic data, questions about luting cement usage, cementation techniques, and commonly used cements in dental clinics. Descriptive analysis and chi-square test were used to show the association between level of dental education and the use of dental cements using SPSS software. The significance level was set at 5%.

RESULTS

The total respondents were 626 dental students/interns of whom 78.8% were undergraduate dental students. Participants who reported undergraduate studies as the source of information were 79.7%. The type of restoration was the main factor in luting cement selection (62.6%). Concerning the isolation technique in cementing laminate veneers, 49.7% used dri-angles, cotton rolls and saliva ejectors. Dual-cure resin cement was the most common cement used in all the mentioned restorations except in pressed porcelain laminate veneers and cement-retained implant-supported restorations.

CONCLUSIONS

Students' knowledge and practice in managing dental implants and porcelain laminate veneers need to be improved. The selection of a luting agent for a given restoration by students and interns was based on the basic knowledge, available cement, and the type of restoration. Awareness towards the management of short prepared teeth and custom-made cast posts and cores is also limited.

Effect of Temporary Cement, Surface Pretreatment and Tooth Area on the Bond Strength of Adhesively Cemented Ceramic Overlays-An In Vitro Study

Several viewpoints have been reported regarding the effect of temporary cements, different surface pretreatment protocols before adhesive cementation, and predictive factors. This in vitro study tested if temporary cement, pretreatment of the tooth surface, the size of enamel or dentine influence adhesive cementation to zirconia ceramics. Twenty premolars were prepared for determination of enamel and dentin area, bond strength test and failure analysis. The samples were divided into two groups: untreated prior adhesive cementation (n = 10) and with temporary cementation done, pretreated prior adhesive cementation (n = 10). Zirconia overlays (Katana Zirconia STML) were cemented on the grounded flat teeth surfaces using Panavia V5. An additional six premolars underwent dentine tubule analysis with SEM to detect temporary cement residues after temporary cementation on an untreated tooth surface (n = 3) and on a pretreated surface (n = 3). The independent sample t-test was used to compare the two groups and the means of the total tooth, dentin or enamel areas did not differ significantly between the untreated and pretreated specimens. The mean tensile bond strength was significantly (p = 0.005) higher in the pretreated specimens (337N) than in the untreated ones (204N). The overall multivariable linear regression model with three predictors (surface pre-treatment, enamel area and dentine area) was significant (p = 0.003), among which the size of enamel was the strongest predictor (β = 0.506; p = 0.049), followed by the pretreatment effect (β = 0.478; p = 0.001) and the size of dentin area (β = -0.105; p = 0.022).

Update on Dental Luting Materials

A dental luting material aids in the retention and stability of indirect restorations on the prepared tooth structure. In dentistry, clinicians are using a wide range of luting materials for the cementation of indirect restorations. Zinc oxide eugenol and non-eugenol cements, zinc phosphate cement, zinc polycarboxylate cement, glass ionomer cement and resin cements are common dental cements used in dentistry. Each luting material or cement possesses unique properties and clinical implications. An ideal luting cement should be biocompatible, insoluble, resistant to thermal and chemical assaults, antibacterial, aesthetic, simple and easy to use. It should have high strength properties under tension, shear and compression to resist stress at the restoration-tooth interface, as well as adequate working and setting times. So far, no luting material possesses all of these properties of an ideal cement. Scientists have been modifying the conventional luting cements to improve the material's clinical performance and developing novel materials for clinical use. To achieve the best clinical outcome, clinicians should update their knowledge and gain a good understanding of the luting materials so that they can make a wise clinical decision on the material selection and obtain an insight into the development of luting cements. Therefore, the objective of this study is to provide a discussion on the physical, chemical, adhesive and aesthetic properties of common luting materials. The clinical indications of these luting materials are suggested based on their properties. In addition, overviews of the modification of the conventional luting materials and the newly developed luting materials are provided.

The impact of provisional intraradicular retainers cementation with temporary methacrylate-based resin in the bond strength of glass fiber posts to root dentin

Chemical composition of temporary cements interferes in the bond strength and quality of the bond interface of glass fiber posts to root dentin. The aim of the present study was to evaluate the influence of different temporary cements on the bond strength of fiberglass posts and resin cement. Thirty-two maxillary central incisor roots were standardized at 15 mm length. The root canals were prepared with Reciproc R50 and filled with a R50 single cone and AH Plus. Ten mm of filling material was removed with a heated Schilder condenser, leaving 5 mm of apical filling material. The roots were randomly distributed into 4 groups (n = 8). In the control group, the root canal was prepared with a standard drill according to the post diameter (DC #1, FGM, Joinville, Brazil), irrigated with 5 mL of distilled water and immediately received the fiberglass post cemented with self-adhesive resin cement. For the other groups, cores were made with temporary intraradicular retainers cemented with different temporary cements: methacrylate-based resin (Bifix Temp - Voco), calcium hydroxide-based (Provicol - Voco) and zinc oxide-based - eugenol-free (Relyx Temp NE - 3M). After 7 days, mechanical removal of the temporary retainers, preparation, irrigation of the root canal and cementation of the fiberglass post were performed, following the same protocol that had been performed in the control group. The roots were sectioned to obtain 3 slices per root third. The most cervical section of each third was used for the push-out test and failure pattern analysis, while the most apical section was subjected to analysis of the adhesive interface by scanning electron microscopy (SEM). The BS data were compared between groups using the two-way ANOVA and Tukey post-test. The failure pattern results were expressed in percentage and compared between groups using the chi-square test and the material adaptation data at the bond interface were evaluated using the Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. The results showed higher BS in the cervical third, with a higher value in the control group (10.8 ± 0.94) and Bifix Temp group (9.78 ± 0.71), with no statistically significant difference between these groups (P > .05). The middle and apical thirds showed no statistically significant difference (P > .05). As regards the type of failure, a higher percentage of mixed adhesive failures was observed for all groups. Analysis of the adhesive interface by SEM showed that the temporary cement Bifix Temp showed greater adaptation at the bond interface. It was concluded that the methacrylate-based resin temporary cement showed the highest bond strength values and best adaptation to root dentin than the zinc oxide-based and calcium hydroxide-based temporary cements.

The effect of different cleansing methods for removing temporary cement on the tensile bond force of permanently cemented implant-supported metal copings: An in vitro study

Objectives

Complete cleaning of temporary cement before permanent cementation of cement‐retained implant‐supported prosthesis (CISP) when recementing the crown is critical. This study evaluated the effect of different cleaning methods for removing traces of temporary cement on the final tensile bond force (TBF) of CISP recemented with resin cement.

Materials and Methods

Seventy computer‐aided design/computer‐aided manufacturing metal implant‐supported copings were prepared and distributed into seven groups (N = 10). Copings of six groups (60 samples) were cemented with temporary cement with eugenol and subjected to 5000 thermocycling. After debonding by a universal testing machine, the internal surfaces of the copings were cleaned using one of the six following methods: 1‐an ultrasonic water bath (UW), 2‐sandblasting, then washing with water (SW), 3‐sandblasting and an ultrasonic water bath (SUW), 4‐an ultrasonic isopropyl alcohol bath (UA), 5‐sandblasting, then washing with isopropyl alcohol (SA) or 6‐sandblasting and an ultrasonic isopropyl alcohol bath (SUA). Then the subjects were subsequently cemented by dual‐cure self‐adhesive resin cement. In the seventh group (control, N = 10), the copings were cemented by dual‐cure self‐adhesive resin cement without the temporization phase. The TBF was tested using a universal testing machine with a cross‐head speed of 1 mm/min. Two‐way analysis of variance (ANOVA) and post‐hoc Tamhane tests were used for statistical analysis at a significance level of α = .05.

Results

The maximum mean of TBF value was observed in SUA group (845 ± 203 N), and the minimum was observed in the temporary cement group (49 ± 20 N). All groups which were cleaned with isopropyl alcohol showed significantly higher TBF values compared with those cleaned with water.

Conclusions

Cleaning of the inner surface of metal copings after debonding with sandblasting and isopropyl alcohol results in the highest value of TBF by eliminating the effect of remaining eugenol and removing traces of temporary cements.

Effect of bioceramic root canal sealers on the bond strength of fiber posts cemented with resin cements

This study aimed to evaluate the influence of calcium silicate-based sealers on the bond strength of fiber posts using conventional and self-adhesive resin cement. Sixty single-rooted teeth were selected. The canals were prepared with a reciprocating instrument 40.06. The roots were randomly distributed in six groups (n = 10) according to the strategies for root canal filling and fiber posts cementation: AH Plus/RelyX ARC; AH Plus/RelyX U200; Bio C Sealer/RelyX ARC; Bio C Sealer/RealyX U200; Sealer Plus BC/RelyX ARC; and Sealer Plus BC/RelyX U200. The roots were transversally sectioned, and one slice per post-third was obtained. The push-out test was performed at a crosshead speed of 1mm/min. The failure patterns were described after assessment with a stereomicroscope with a 10× magnification. Bond strength was calculated and analyzed using the ANOVA and Tukey test. AH Plus did not influence the bond strength of fiber posts cemented with conventional (RelyX ARC) or with self-adhesive resin cement (RelyX U200). The lowest bond strength values were obtained when calcium silicate-based sealers were associated with conventional resin cement (Bio C Sealer/RelyX ARC and Sealer Plus BC/RelyX ARC). Except for Sealer Plus BC/RelyX ARC, all groups presented lower bond strength at the apical portion compared to the cervical portion of the post. Adhesive failures between cement and post and cement and dentin were predominant (55.3%). Calcium silicate-based sealers decreased the bond strength of fiber posts cemented with conventional resin cement.

Cement selection criteria for full coverage restorations: A comprehensive review of literature

BACKGROUND

Proper cement selection in fixed prosthesis plays a determinative role in providing long-term serviceability, retention, caries prevention, and patient satisfaction. This study, reviews different luting agent characteristics and their application based on different clinical situations and different types of full coverage restorations.

MATERIAL AND METHODS

An electronic search was conducted through PubMed, Medline, and Google scholar using following keywords or combinations: restoration, full coverage, PFM, porcelain fused to metal, all ceramic, zirconia, ceramic, casting, fixed partial denture, cement*, dental cement, cement selection, and retention. The most related articles were selected for review.

RESULTS

Choosing a proper luting agent is highly dependent on scientific knowledge regarding the characteristics of restorative materials and luting agents. Conventional cements could be indicated in various situations; however, some restorative materials or clinical situations call for resin-cements to provide predictable retention, support, and durability.

CONCLUSIONS

Conscious selection of retentive cement for each type of restoration/material is necessary to provide predictable successful treatment and reduce the potential complications. Key words:Adhesive cement, dental bridgework, dental cements, dental crowns, dental porcelain, prostheses and implants.

Substantial in-vitro and emerging clinical evidence supporting immediate dentin sealing

The application of resin adhesive to freshly cut dentin after teeth preparation, the so-called immediate dentin sealing (IDS) has been suggested as an alternative to the delayed dentin sealing (DDS), a technique in which resin adhesive is applied just before final bonding of indirect restorations.

The aim of this review is to demonstrate the evidence of the claimed advantages made by the proponents of IDS technique.

The results of this review revealed substantial in-vitro evidence supporting the IDS benefits including improved bond strength, reduced dentin permeability, improved restorations’ adaptation, and increased fracture strength of the restorations. Clinical studies have shown that IDS improves survival of ceramic laminate veneers bonded to prepared teeth with increased exposure of dentin. Moreover, it has been shown that IDS reduces post-cementation hypersensitivity in full coverage restorations, which is characterized by exposure of a large number of dentinal tubules. The selection of filled resin adhesive that is capable of producing thick adhesive layer appears to contribute to the success of the technique. Furthermore, careful management of the oxygen inhibition layer before conventional impression making and proper cleaning of the residual temporary cement used with provisional restorations appears to affect the outcome of the restorations.

Immediate Dentin Sealing: A Literature Review

Purpose

The immediate application of a dentin-bonding agent after tooth preparation and before impression-taking (immediate dentin sealing [IDS]) has been suggested to provide several advantages concerning bacterial microleakage, hypersensitivity, and bonding quality. We reviewed the literature and clarified certain aspects related to each step of IDS application.

Materials and Methods

The search strategy comprised an electronic research in MEDLINE, Cochrane, Ovid and Scopus for studies published from January 1990 to December 2020 regarding the IDS technique and including both in vitro and clinical studies.

Results

After exclusion of irrelevant or duplicate articles, 88 articles focusing on aspects of the IDS technique were assessed. IDS seems to be advantageous with regard to bond strength, gap formation, bacterial microleakage, and dentin hypersensitivity. However, issues arising from interaction with impression materials, the provisional phase, and conditioning methods before cementation require further investigation.

Conclusion

There are no documented reasons preventing clinicians applying IDS in their everyday practice. On the contrary, the presented technique seems to be beneficial in certain aspects regarding indirect restorations.

Determining the Effects of Eugenol on the Bond Strength of Resin-Based Restorative Materials to Dentin: A Meta-Analysis of the Literature

The aim of this study was to determine whether the residual presence of eugenol in coronal dentin may compromise the bond strength of resin-based restorative materials. A search was performed on MEDLINE/Pubmed, Scopus, and by hand search for relevant papers. No restriction was applied for language and publication date. The studies selected for analysis tested specimens with reduced size (micro-shear bond strength (µSBS) and micro-tensile bond strength (µTBS)) of adhesive systems and resin-based restorative materials applied to coronary dentin “contaminated” with eugenol-based materials. The search provided 335 articles, but only 10 studies met the inclusion criteria. The pooled global analysis showed a significant influence of eugenol, as it negatively influenced the bond strength of resin-based restorations (5.79 (3.31–8.28) MPa, p < 0.00001). The subgroup analyses for conventional etch-and-rinse (p = 0.003) and self-etch (p < 0.0004) adhesive systems, as well as for µSBS (p = 0.01) and µTBS (p < 0.0001), showed a negative influence of eugenol on the bond strength. Data were statistically heterogeneous. However, it was possible to observe that eugenol could negatively affect the bonding of resin-based restorative materials to dentin. Further evidence is necessary in order to acquire more accurate information about this issue and confirm that the residual presence of eugenol in dentin compromises the bond strength of resin-based materials.

Influence of immediate dentin sealing and temporary restoration on the bonding of CAD/CAM ceramic crown restoration

This study examined the influences of clinical application of immediate dentin sealing (IDS) and temporary restoration (TR) on prepared abutment surfaces on the bonding of computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic crown restorations after cyclic loading. Standardized abutments were prepared in 60 human mandibular premolars. Dentin surfaces of half of the specimens were sealed with adhesive and flowable composite, while those of the other half were not sealed. A half of both sealed and non-sealed specimens were restored using a temporary cement and temporary crown. Each individual CAD/CAM ceramic crown was fabricated and cemented to an individual abutment. The restored specimens were subjected to cyclic loading, and the micro tensile bond strengths (μ-TBS) were measured. IDS contributed to an increase in the bond strength, whereas TR did not affect the bond strength. IDS restoration without TR yielded the maximum bond reliability in achieve specific μ-TBS values for the restoration and ensuring durability against debonding.

Influence of immediate dentin sealing and interim cementation on the adhesion of indirect restorations with dual-polymerizing resin cement

STATEMENT OF PROBLEM

Dentin surface contamination before the cementation of indirect restorations may impact bonding effectiveness.

PURPOSE

The purpose of this in vitro study was to analyze the influence of immediate dentin sealing (IDS) and interim cementation on the adhesion of indirect restorations with a dual-polymerizing resin cement.

MATERIAL AND METHODS

Composite resin inlays were placed in class V cavities prepared in the buccal and lingual surfaces of 30 extracted human molars with a dual-polymerizing resin cement in 3 different ways (n=10): CG, directly on dentin; PG, after 14 days interim cementation; SG, after IDS and 14 days interim cementation. Buccal restorations were sectioned into sticks and submitted to the microtensile bond strength (μTBS) test. Lingual restorations were submitted to micro-Raman spectroscopy (MRS). Data were analyzed with 1-way ANOVA and the Tukey-Kramer post hoc test (α=.05).

RESULTS

Significantly higher μTBS results were found for SG (35.7 ±8.2 MPa) when compared with CG (23.1 ±7.1 MPa) and PG (17.0 ±6.0 MPa) (P<.05), but no differences were observed between CG and PG. MRS showed that the diffusion zone in SG (3.7 ±0.5 μm) was significantly thicker than that of CG (1.8 ±1.2 μm) or PG (1.5 ±0.3 μm) (P<.05). Additionally, a new interface peak (at approximately 1330 cm^-1) was found in SG, indicating a chemical interaction.

CONCLUSIONS

The use of IDS before cementation resulted in a chemical interaction at the interface and significantly higher μTBS and diffusion zone thickness values. Interim cementation did not interfere with adhesion quality when compared with the control group.

Effect of cement application techniques on the adaptation and retention of provisional crowns

BACKGROUND

A well-made and properly cemented provisional restoration is essential for the health of abutment teeth and periodontium. Few focused studies are available on the effect of cementation techniques on the fit as well as on the retention of the provisional crowns.

OBJECTIVE

To investigate the effect of six cement application techniques on the adaptation and retention of provisional crowns.

METHODS

Seventy-two provisional crowns (Bisacryl resin) were fabricated over identical self-cured resin dies and were divided into six groups (N= 72; 6 ×n= 12) of cement application techniques (Temp Bond NE, Kerr Corporation). Group-A (Bulk Fill); Group-B (Cement on inner walls); Group-C (Cement on axial walls); Group-D (Cement on crown margin); Group-E (Cement on tooth margin); Group-F (Cement with vent-holes). Adaptation was assessed before and after cementation with digital caliper (0.001 mm). Universal testing machine was used for retention measurement in Mega Pascal's (MPa). Data was analyzed by SPSS using Paired T-Test and Tukey's test (p< 0.05).

RESULTS

The highest and lowest difference between the two measurements was observed for the Group A (0.095 mm) and Group C (0.030 mm) respectively. Paired T-Test revealed significance (p< 0.05) between before and after cementation. Group-F (0.6094 MPa) and Group-E (0.1858 MPa) showed the highest and lowest retention respectively. Group-E (Cement on tooth margin) with lowest retention significantly differed (Tukey's Test; p< 0.05) from other groups.

CONCLUSIONS

Bulk filling of the provisional crown with luting cement significantly increases the adaptation discrepancies. Discrepancies are more when luting cement is applied on the occlusal surface of the crowns. However, it didn't influence the retention of the crowns. Cement application on axial walls and cervical third of intaglio surface of crowns was the method of choice with regards to adaptation and retention combined. Addition of vent-holes improved the adaptation with best possible retention.

Effect of Intraoral Mechanical Cleaning Techniques on Bond Strength of Cast Crowns to Metal Cores

PURPOSE

To evaluate the effect of cleaning of metal cores from provisional cement, using an intraoral airborne-particle abrasion method, on the bond strength of permanent resin cement with cast crowns to cores.

MATERIALS AND METHODS

Thirty stainless steel models of a standard complete crown tooth preparation were fabricated. Thirty Type III gold crowns were fabricated. Each cast crown corresponded to one stainless steel crown preparation model. All crowns were cemented with noneugenol zinc oxide cement and stored for 7 days at 37°C. All crowns were debonded, and the cement was cleaned with airborne-particle abrasion using 50 µm aluminum oxide at 4.1 bar (0.41 MPa) followed by ultrasonic cleaning. Based on the mechanical cleaning technique of the remaining provisional cement on surfaces of cast cores, specimens were equally divided into 3 groups: hand cleaning (HC) with a dental excavator, hand cleaning followed by polishing using a brush and pumice (BP), and hand cleaning followed by intraoral airborne-particle abrasion (APA). All crowns were then cemented to their corresponding cores using universal resin cement. All crowns were stored for 7 days at 37°C. An Instron universal testing machine was used to record the bond strength of crowns.

RESULTS

Airborne-particle abrasion method for intraoral mechanical cleaning revealed a statistically significantly higher bond strength compared to the other two methods.

CONCLUSIONS

When comparing the three methods of provisional cement cleaning from metal cores, airborne-particle abrasion resulted in the highest bond strength for cast crowns.

Traction test of temporary dental cements

BACKGROUND

Classic self-curing temporary cements obstruct the translucence of provisional restorations. New dual-cure esthetic temporary cements need investigation and comparison with classic cements to ensure that they are equally retentive and provide adequate translucence. The objective is to analyze by means of traction testing in a in vitro study the retention of five temporary cements.

MATERIAL AND METHODS

Ten molars were prepared and ten provisional resin restorations were fabricated using CAD-CAM technology (n=10). Five temporary cements were selected: self-curing temporary cements, Dycal (D), Temp Bond (TB), Temp Bond Non Eugenol (TBNE); dual-curing esthetic cements Temp Bond Clear (TBC) and Telio CS link (TE). Each sample underwent traction testing, both with thermocycling (190 cycles at 5-55º) and without thermocycling.

RESULTS

TE and TBC obtained the highest traction resistance values. Thermocycling reduced the resistance of all cements except TBC.

CONCLUSIONS

The dual-cure esthetic cements tested provided optimum outcomes for bonding provisional restorations. Key words:Temporary dental cements, cements resistance.

Effect of the time-point of acid etching on the persistence of sealer residues after using different dental cleaning protocols

Endodontic sealer residues remaining within the pulp chamber dentin after root canal obturation and cleaning with various solvents may compromise the appearance and the durability of dental restorations. Acid etching is routinely performed prior to application of dentine adhesive systems, but is effect on residual sealer material and the optimal time-point for performing etching, are unknown. Here, we evaluated the effect of acid etching on the dentin surface when performed either immediately or 7 days after removal of the endodontic sealer with two solvents, i.e., 95% ethanol or xylol. Forty crowns fragments from bovine incisors were impregnated with sealer and divided into 4 groups (n = 10 each), according to the dentin cleaning protocol and to the acid etching time-point: G1, 95.0% ethanol and immediate acid etching; G2, xylol and immediate acid etching; G3, 95.0% ethanol and acid etching after 7 days; and G4, xylol and acid etching after 7 days. Scanning electron microscopy (SEM) images (2000 ×) were obtained from each specimen and the number of open dentinal tubules counted and compared. Another 40 fragments were similarly prepared, and SEM images were obtained (500 ×) to score and compare the persistence of sealer residues on the dentin. G4 showed the most open dentinal tubules and the least epoxy resin-based sealer residues on the dentin surface (p < 0.05). The least epoxy resin-based sealer residues was obtained when acid etching, using 37% phosphoric acid, was performed after 7 days after cleaning the dentin with xylol.

Effect of interim cement application on bond strength between resin cements and dentin: Immediate and delayed dentin sealing

STATEMENT OF PROBLEM

Despite the advances in materials and techniques, adhesion to dentin is challenging because of the complex composition of dentin's mineral, organic, and fluid phases.

PURPOSE

The purpose of this in vitro study was to evaluate the bond strength of 2 different resin cements (conventional and self-adhesive) with or without previous dentin sealing and the effect of interim cement.

MATERIAL AND METHODS

Forty-five molars were embedded into acrylic resin blocks and a flat dentin surface was exposed. Twenty teeth (n=5 per group) were treated with the conventional resin cement associated with etch-and-rinse or self-etch adhesive approaches, applied before (immediate dentin sealing) or after (delayed dentin sealing) the application/removal of interim cement. Another 25 teeth (n=5, per group) were treated with self-adhesive resin cement with (self-etch mode [immediate dentin sealing or delayed dentin sealing]) or without adhesive application. Furthermore, in the self-adhesive resin cement group, the application of polyacrylic acid for dentin etching before cementation was evaluated. Composite resin blocks were cemented onto flat, treated dentin surfaces, and the assemblies were sectioned into bar-shaped specimens for microtensile bond strength testing. The data were subjected to 1-way ANOVA followed by the post-hoc Tukey test (α=.05). The failure patterns were classified as cohesive, adhesive, or mixed.

RESULTS

The application of adhesive before interim cement (immediate dental sealing) promoted the highest values of bond strength for both resin cements (P<.001). For self-adhesive resin cement, polyacrylic acid-enhanced bond strength after the application of interim cement.

CONCLUSIONS

The application of dental adhesive immediately after tooth preparation (immediate dentin sealing) and before the use of an interim cement promoted the highest values of bond strength to dentin with the resin cements tested.

Influence of Temporary Cements on the Bond Strength of Self-Adhesive Cement to the Metal Coronal Substrate

This research evaluated the influence of temporary cements (eugenol-containing [EC] or eugenol-free [EF]) on the tensile strength of Ni-Cr copings fixed with self-adhesive resin cement to the metal coronal substrate. Thirty-six temporary crowns were divided into 4 groups (n=9) according to the temporary cements: Provy, Dentsply (eugenol-containing), Temp Cem, Vigodent (eugenol-containing), RelyX Temp NE, 3M ESPE (eugenol-free) and Temp Bond NE, Kerr Corp (eugenol-free). After 24 h of temporary cementation, tensile strength tests were performed in a universal testing machine at a crosshead speed of 0.5 mm/min and 1 kN (100 kgf) load cell. Afterwards, the cast metal cores were cleaned by scraping with curettes and air jet. Thirty-six Ni-Cr copings were cemented to the cast metal cores with self-adhesive resin cement (RelyX U200, 3M ESPE). Tensile strength tests were performed again. In the temporary cementation, Temp Bond NE (12.91±2.54) and Temp Cem (12.22±2.96) presented the highest values of tensile strength and were statistically similar to each other (p>0.05). Statistically significant difference (p<0.05) was observed only between Provy (164.44±31.23) and Temp Bond NE (88.48±21.83) after cementation of Ni-Cr copings with self-adhesive resin cement. In addition, Temp Cem (120.68±48.27) and RelyX Temp NE (103.04±26.09) showed intermediate tensile strength values. In conclusion, the Provy eugenol-containing temporary cement was associated with the highest bond strength among the resin cements when Ni-Cr copings were cemented to cast metal cores. However, the eugenol cannot be considered a determining factor in increased bond strength, since the other tested cements (1 eugenol-containing and 2 eugenol-free) were similar.

Cytotoxicity of temporary cements on bovine dental pulp-derived cells (bDPCs) using realtime cell analysis

PURPOSE

To evaluate the cytotoxicity of temporary luting cements on bovine dental pulp-derived cells (bDPCs).

MATERIALS AND METHODS

Four different temporary cements were tested: Rely X Temp E (3M ESPE), Ultratemp (Ultradent), GC Fuji Temp (GC), and Rely X Temp NE (3M ESPE). The materials were prepared as discs and incubated in Dulbecco's modified eagle's culture medium (DMEM) for 72 hours according to ISO 10993-5. A real-time cell analyzer was used to determine cell vitality. After seeding 200 µL of the cell suspensions into the wells of a 96-well plate, the bDPCs were cured with bioactive components released by the test materials and observed every 15 minutes for 98 hours. One-way ANOVA and Tukey-Kramer tests were used to analyze the results of the proliferation experiments.

RESULTS

All tested temporary cements showed significant decreases in the bDPCs index. Rely X Temp E, GC Fuji Temp, and Rely X Temp NE were severely toxic at both time points (24 and 72 hours) (P<.001). When the cells were exposed to media by Ultratemp, the cell viability was similar to that of the control at 24 hours (P>.05); however, the cell viability was significantly reduced at 72 hours (P<.001). Light and scanning electron microscopy examination confirmed these results.

CONCLUSION

The cytotoxic effects of temporary cements on pulpal tissue should be evaluated when choosing cement for luting provisional restorations.

Effect of temporary cements on the microtensile bond strength of self-etching and self-adhesive resin cement

OBJECTIVE

The aim of this study was to evaluate the microtensile bond strength (µTBS) of self-etching and self-adhesive resin cement systems to dentin affected by the presence of remnants of either eugenol-containing or eugenol-free temporary cements.

MATERIALS AND METHODS

Thirty extracted teeth were obtained and a flat dentin surface was exposed on each tooth. Acrylic blocks were fabricated and cemented either with one of two temporary cements, one zinc oxide eugenol (ZOE) and one eugenol free (ZOE-free), or without cement (control). After cementation, specimens were stored in water at 37°C for 1 week. The restorations and remnants of temporary cements were removed and dentin surfaces were cleaned with pumice. Resin composite blocks were cemented to the bonded dentin surfaces with one of two resin cements, either self-etching (Panavia F 2.0) or self-adhesive (RelyX U-100). After 24 h, the specimens were sectioned to obtain beams for submission to µTBS. The fracture mode was evaluated under a stereoscopic loupe and a scanning electron microscope (SEM). Data from µTBS were submitted to two-way repeated-measure ANOVA and the Tukey test (alpha = 0.05).

RESULTS

The cross-product interaction was statistically significant (p < 0.0003). The presence of temporary cements reduced the bond strength to Panavia self-etching resin cements only (p < 0.05). Fracture occurred predominantly at the dentin-adhesive interface.

CONCLUSIONS

The presence of eugenol-containing temporary cements did not interfere in the bond strength to dentin of self-adhesive resin cements.

Influence of different conditioning methods on immediate and delayed dentin sealing

STATEMENT OF PROBLEM

Data are needed to evaluate the effect of various conditioning methods on immediate and delayed dentin sealing.

PURPOSE

The purpose of this study was to test bond strength and surface configuration of immediate and delayed dentin sealing surfaces after applying different surface conditioning methods.

MATERIAL AND METHODS

A total of 96 premolars were allocated to the immediate and delayed groups. The groups differed in the timing of dentin sealing. The immediate-group specimens were sealed with a self-etching adhesive immediately after preparation. The delayed-group specimens were sealed before the final ceramic restoration bonding. Provisional restorations were cemented on immediate-group and delayed-group specimens for 1 week. Four conditioning methods were used: polishing with fluoride-free pumice paste, airborne-particle abrasion with silicoated aluminum oxide, glycin, or calcium carbonate. After 24-hour storage, the shear bond strength was tested. The fractured specimens were optically inspected with a stereomicroscope. An optical 3-dimensional surface analysis was performed for quantitative and qualitative evaluation. A 2-way ANOVA with post hoc Tukey honestly significant difference tests for significant effects was performed to investigate effects of the 2 factors, sealing and conditioning, and their interaction (α=.05).

RESULTS

Two-way ANOVA found significant differences between the sealing and conditioning groups. The immediate group had significantly lower bond strengths than the delayed group. In all groups, surface polishing produced the highest bond strengths, and airborne-particle abrasion with calcium carbonate produced the lowest. Fracture analysis found more failures in the adhesive layers in the immediate groups and a prevalence of mixed failures in the delayed groups. The surface analysis found significant abrasion and roughness when airborne-particle abrasion with silicoated aluminum oxide was used for immediate and delayed dentin sealing surfaces.

CONCLUSIONS

Polishing and airborne-particle abrasion with silicoated aluminum oxide or glycin are efficient methods in conditioning immediate and delayed dentin sealing surfaces. Airborne-particle abrasion with silicoated aluminum oxide leaves significant surface alterations on both types of surfaces.

Cytotoxicity testing of temporary luting cements with two- and three-dimensional cultures of bovine dental pulp-derived cells

This study evaluated the cytotoxicity of eugenol-containing and eugenol-free temporary luting cements. For cytotoxicity testing, bovine pulp-derived cells transfected with Simian virus 40 Large T antigen were exposed to extracts of eugenol-containing (Rely X Temp E) and eugenol-free (Provicol, PreVISION CEM, and Rely X Temp NE) temporary luting cements for 24 h. The cytotoxicity of the same materials was also evaluated in a dentin barrier test device using three-dimensional cell cultures of bovine pulp-derived cells. The results of the cytotoxicity studies with two-dimensional cultures of bovine dental pulp-derived cells revealed that cell survival with the extracts of Rely X Temp E, Provicol, PreVISION CEM, and Rely X Temp NE was 89.1%, 84.9%, 92.3%, and 66.8%, respectively. Rely X Temp NE and Provicol showed cytotoxic effects on bovine dental pulp-derived cells (P < 0.05). The results of the dentin barrier test revealed that cell survival with the above-mentioned temporary cement was 101.5%, 91.9%, 93.5%, and 90.6%, respectively. None of the temporary luting cements significantly reduced cell survival compared with the negative control in the dentin barrier test (P > 0.05). Biologically active materials released from temporary luting cements may not influence the dentine-pulp complex if the residual dentine layer is at least 0.5 mm thick.

A review of luting agents

Due to the availability of a large number of luting agents (dental cements) proper selection can be a daunting task and is usually based on a practitioner's reliance on experience and preference and less on in depth knowledge of materials that are used for the restoration and luting agent properties. This review aims at presenting an overview of current cements and discusses physical properties, biocompatibility and other properties that make a particular cement the preferred choice depending on the clinical indication. Tables are provided that outline the different properties of the generic classification of cements. It should be noted that no recommendations are made to use a particular commercial cement for a hypothetical clinical situation. The choice is solely the responsibility of the practitioner. The appendix is intended as a guide for the practitioner towards a recommended choice under commonly encountered clinical scenarios. Again, no commercial brands are recommended although the author recognizes that some have better properties than others. Please note that this flowchart strictly presents the author's opinion and is based on research, clinical experience and the literature.