Durable bonding to mechanically and/or chemically pre-treated dental zirconia

Shear bond strength between standard or modified zirconia surfaces and two resin cements incorporating or not 10-MDP in their matrix

OBJECTIVE

This study aimed first to compare the shear bond strength between zirconia samples luted to enamel with a 10-MDP- containing resin cement (Panavia F2.0, Kuraray, Japan) and those luted with a resin cement using a separated 10-MDP monomer-containing bottle (Panavia V5, Kuraray, Japan). The second objective was to evaluate the bond stability after 150 days of aging in water, between enamel and zirconia ceramic surface enhanced with a glass-ceramic coating.

MATERIALS AND METHODS

80 specimens composed of ceramic cylinders and enamel disks were obtained, within eight experimental groups (n = 10). 60 zirconia cylinders (Katana STML zirconia, Kuraray, Japan) were assigned to 3 groups according to their surface treatment: milled/sintered surface (ZRCT), tribochemical silica-coating (Cojet™ Sand, 3 M ESPE, Seefeld, Germany) (ZRTC), and glass-ceramic coating (IPS e.max Zirpress) (ZRZP). 20 cylinders of lithium disilicate had a milled surface (IPS e.max CAD, Ivoclar-Vivadent, Schaan, Liechtenstein) (ECAD). The cylinders of each group were further divided into two subgroups according to the resin cement used: Panavia F2.0 (-PF) and Panavia V5 (-PV). All specimens were stored in distilled water for 150 days before shear bond strength (SBS) tests. The fracture mode was analyzed, and data were statistically computed (two-way ANOVA, post hoc Tukey test, p < 0.05, SPSS, IBM, v26).

RESULTS

The ECAD-PF group recorded the highest SBS values (31.75 ± 2.2), and the ZRCT-PF group recorded the lowest values (5.59 ± 1.1). The two-way ANOVA test showed that ceramic surface treatment had a statistically significant effect on SBS (F (3,72) = 38.95, p < 0.001) while the type of ARC did not (F (1,72) = 2.40, p = 0.126). Tukey's post hoc test revealed no statistical difference between the ZRZP and the ZRTC or ECAD groups.

CONCLUSION

Within the limitations of this study, the PV resin achieved similar shear bond strength results between tribocoated zirconia and enamel compared to the one for glass-ceramic and enamel. Furthermore, a long-term durable bond, similar to the glass-ceramic one, was achieved with the heat pressed ceramic coated specimens. Thus, this new surface treatment could be recommended for anterior cantilever bridges for its fracture resistance and bonding ability.

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

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

MDP-salts as an adhesion promoter with MDP-primers and self-adhesive resin cement for zirconia cementation

PURPOSE

To evaluate the effect of zirconia priming with MDP-Salt before MDP containing primers and self-adhesive cement on the shear bond strength.

MATERIALS AND METHODS

Fully sintered high translucent zirconia specimens (n = 120) were assigned into 2 groups (n = 60 each): Control (No Pretreatment) and Methacryloyloxydecyl dihydrogen phosphate salt (MDP-Salt) pretreated. Each group was divided into 3 subgroups (n = 20) according to cementation protocol: 1) MDP + Silane primer and conventional resin cement, 2) MDP+ Bisphenyl dimethacrylate (BPDM) primer and conventional resin cement, and 3) MDP containing self-adhesive resin cement. Shear bond strength (SBS) was measured after 10,000 thermocycling. Contact angle was measured for tested groups. Surface topography was assessed using a 3D confocal laser scanning microscope (CLSM). Weibull analysis was performed for SBS and one-way ANOVA for contact angle and surface topography measurements (α = 0.05).

RESULTS

The use of MDP-Salt significantly improved the SBS (p < .05) for all tested subgroups. Self-adhesive cement showed an insignificant difference with MDP + Silane group for both groups (p > .05). MDP + BPDM showed a significantly lower characteristic strength compared to self-adhesive resin cement when both were pretreated with MDP-Salt. No difference between all tested groups in the surface topographic measurements while MDP-Salt showed the highest contact angle.

CONCLUSION

MDP-Salt pretreatment can improve bonding performance between zirconia and MDP containing products.

Comparative analysis of bonding strength between enamel and overlay of varying thicknesses following an aging test

Abstract

Background/purpose: Overlay restorations can be used clinically as a treatment option to preserve natural dentine. However, whether the residual enamel thickness and overlay thickness affect the adhesion between the restoration and tooth is still unknown. This study was to investigate effects of the overlay thickness and residual enamel thickness on bonding strength.

Materials and methods

Overlays of different thicknesses were prepared with natural teeth which had 2, 4, and 6 mm of occlusal reduction (n = 10). Specimens were subjected to 10,000 cycles in water at 5-55 °C, and finally compressive strength tests were used to evaluate the bonding strength.

Results

All groups showed good bond strength (P > 0.05). The overlay restorations of different thicknesses reduced the preparation amount by 30.3%-7.2% and significantly preserved more of the tooth structure (P < 0.005). Compared to the control group, the overlay restoration increased the marginal fitness by about 0.67-0.88 times. The thermal cycling indicated that the decrease in the maximum bearing stress was due to the aging of the ceramic itself. Therefore, the thickness of the overlay had a greater influence on the compressive strength than the bond strength.

Conclusion

Based on the above this study recommends an overlay thickness of at least 2 mm in clinical practice. The aging test confirmed that adhesion between the overlay and teeth was quite firm and stable. This shows that a stable adhesive effect of the overlay can be used as a treatment option for preserving a greater amount of a tooth's structure.

Appropriate Immediate Dentin Sealing to Improve the Bonding of CAD/CAM Ceramic Crown Restorations

This study aimed to use quantitative and qualitative evaluations based on micro-tensile bond strength (μTBS) to clarify the appropriate immediate dentin sealing (IDS) approach for improving the bonding of CAD/CAM ceramic crown restorations. Forty-eight extracted human molars were prepared to obtain standardized abutment specimens and divided into three groups: no IDS (group C: control), IDS performed by a single application of an all-in-one adhesive system (group A), and IDS performed by the combined application of an adhesive system and a flowable resin composite (group F). All specimens were restored with a ceramic crown fabricated by a chair-side CAD/CAM system and were divided into no-stress and stressed groups. After cyclic loading (78.5 N; total, 3 × 105 cycles; 90 cycles/min) on the specimens in the stressed group, all specimens were sectioned. The μTBS values for the occlusal and mesioaxial walls were measured (n = 16) and analyzed statistically. The quantitative bonding performance of groups A and F were superior to that of group C, regardless of the cyclic loading and abutment wall conditions. Group F showed the maximum bond strength and the highest bond durability in the qualitative bonding performance even under the cyclic loading condition simulating clinical mastication.

Enhancing Resin Cement Adhesion to Zirconia by Oxygen Plasma-Aided Silicatization

The combinations of alumina particle air abrasion (AA) and a 10-methacryloyloxyidecyl-dihyidrogenphosphate (MDP) primer and a tribochemical silica coating (TSC) and a silane-base primer are contemporary pre-cementation treatments for zirconia restorations for bonding with resin cements. However, the stability of zirconia resists the mechanical or chemical preparations. The purpose of this study was to develop an atmospheric-pressure oxygen plasma (OP)-aided silicatization method to enhance the adhesion of resin cements to zirconia. Zirconia discs were prepared to receive surface treatments of different combinations: (1) AA or TSC (2) with or without OP treatment, and (3) a chemical primer (no primer, silane, or a silane-MDP mixture). The surface morphology, hydrophilicity, and chemical compositions were characterized, and the resin-zirconia bond strengths were examined either after 24 h or a thermocycling test. The results indicated that the OP treatment after the TSC facilitated the homogeneous distribution of silane and crosslinking of silica particles, and effectively improved the hydrophilicity. The OP increased the O and Si and reduced the C elemental contents, while the combination of TSC, OP, and silane induced SiO_x generation. Among the groups, only the TSC-OP-silane treatment effectively enhanced the bond strength and maintained the adhesion after thermocycling. With these results, the OP aided the silicatization protocol effectively, generated silane crosslinking, and resulted in superior resin-zirconia bond strength and durability compared to the current treatments.

Retention strength of monolithic zirconia crowns cemented with different primer-cement systems

BACKGROUND

The purpose of this in vitro study was to assess the influence of different cement systems with different ceramic primers on the retention strength of zirconia crowns.

METHODS

Thirty extracted molars were prepared with flat occlusal surfaces, 20 degrees taper, and 3 mm axial wall height. A zirconia crown with an occlusal bar was fabricated for each tooth. All specimens were divided (n = 10) into; Group M: Multilink Speed/Monobond N, Group P: Panavia V5/Clearfil Ceramic Primer Plus, Group D: Duo-Link universal/Z-Prime Plus. The intaglio surfaces of crowns were air-abraded using 50 µm alumina at 2.5 bar for 10 s. Then each crown was cemented onto its corresponding tooth. All specimens were thermocycled for 10,000 cycles between 5 and 55 °C. Each crown was subjected to gradually increasing vertical load along the path of insertion through hooks engaging the occlusal bar using a universal testing machine until failure. The force at dislodgment was recorded and retention strength was calculated for each specimen. The failure modes were recorded for each specimen. The data were statistically analyzed using one way ANOVA test followed by Tukey HSD test (α = .05).

RESULTS

Group D showed lowest strength (1.42 ± 0.23 MPa) and differed significantly (P < .001) from Group M (2.71 ± 0.45 MPa) and Group P (2.47 ± 0.41 MPa). There was no significant difference (P = .34) between Group M and Group P. The failure modes for Groups M and Group P were mainly cohesive, while Group D showed adhesive failure.

CONCLUSIONS

The retention strength of zirconia crowns was improved with Multilink Speed and Panavia V5 cement systems, while the use of the Duo-Link Universal cement system only showed half of those retention strength values.

In Vitro Performance of Different Universal Adhesive Systems on Several CAD/CAM Restorative Materials After Thermal Aging

OBJECTIVE

To evaluate the microshear bond strength (mSBS) of 10 universal adhesive systems applied on five different CAD/CAM restorative materials, immediately and after thermal aging.

METHODS AND MATERIALS

Five CAD/CAM materials were selected: 1) feldspathic glass ceramic (FeCe); 2) pre-polymerized reinforced resin composite (ReRC); 3) leucite-reinforced glass ceramic (LeGC); 4) lithium disilicate (LiDi); and 5) yttrium-stabilized zirconium dioxide (ZiDi). For each material, 15 blocks were cut into four rectangular sections (6 × 6 × 6 mm; n=60 per group) and processed as recommended by the respective manufacturer. For each indirect material, the following adhesive systems were applied according to the respective manufacturer's instructions: 1) AdheSE Universal [ADU]; 2) All-Bond Universal [ABU]; 3) Ambar Universal [AMB]; 4) Clearfil Universal Bond [CFU]; 5) Futurabond U [FBU]; 6) One Coat 7 Universal [OCU]; 7) Peak Universal Bond [PUB]; 8) Prime&Bond Elect [PBE]; 9) Scotchbond Universal Adhesive [SBU]; 10) Xeno Select [XEN, negative control]. After the application of the adhesive system, cylinder-shaped transparent matrices were filled with a dual-curing resin cement (NX3) and light cured. Specimens were tested in shear mode at 1.0 mm/ min (mSBS), after 24 hours and 10,000 thermal cycles (TC). All data were submitted to statistical analysis (α=0.05).

RESULTS

For FeCe, there was no significant decrease in mean mSBS for AMB, FBU, and SBU after TC when compared at 24 hours. For ReRC, AMB and SBU showed higher mean mSBS when compared to CFU and XEN, after 24 hours and TC. For LiDi, FBU and OCU showed higher mean mSBS when compared to CFU and XEN, after 24 hours and TC. For LeGC, AMB and PUB showed higher mean mSBS when compared to XEN, after 24 hours and TC. For ZiDi, OCU and SBU showed higher mean mSBS when compared to XEN, after 24 hours and TC. In addition, PBE and XEN showed the lowest mean mSBS after TC with higher percentage of bond strength reduction.

CONCLUSIONS

The mean mSBS among the different universal adhesives varied widely for each CAD/ CAM material used. In addition, most universal adhesives underwent a statistically significant bond strength reduction after TC.

MDP Salts: A New Bonding Strategy for Zirconia

Durable resin-ceramic adhesion may influence the clinical success of ceramic restorations, which has been one of the challenging issues in dentistry. The present study assessed the bond strength and chemical interaction of 10-methacryloxydecyl dihydrogen phosphate (MDP), MDP+silane, and MDP-salt primers to alumina-blasted zirconia ceramic by tensile bond strength test, surface elemental composition with x-ray photoelectron spectroscopy analysis, contact angle measurement, surface morphology with scanning electron microscopy, and surface topography with 3-dimensional confocal laser scanning microscope analyses. MDP-salt showed the highest tensile bond strength before and after thermocycling when compared with MDP and MDP+silane (P < 0.05). The measured contact angle values differed significantly (P < 0.001) in the order of MDP-salt > control (no chemical pretreatment) > MDP+silane > MDP. There was no difference in surface roughness (P = 0.317) and surface topography among all tested groups. Zirconia treated with MDP-salt showed phosphorus peaks in addition to zirconia and alumina peaks. MDP-salt has zirconia priming properties, which improves bonding performance to resin cement.

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

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

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

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

The effects of different silicatization and silanization protocols on the bond durability of resin cements to new high-translucent zirconia

OBJECTIVE

The aim of this study was to assess the influence of different silicatization protocols with various silane treatment methods on the bond performance to high-translucent zirconia.

MATERIALS AND METHODS

High-translucent zirconia specimens were assigned to five groups according to mechanical surface pretreatment: as-sintered (Con), 0.2 MPa alumina sandblasting (AB2), tribochemical silica coating (TSC), 0.2 and 0.4 MPa glass bead air abrasion (GB2) and (GB4). Each group was subjected to 4 different cementation protocols: Panavia SA Universal (SAU), Panavia SA plus (SAP), silane + SAP (S-SAP), and Universal adhesive + SAP (U-SAP). Tensile bond strength (TBS) was measured after 24 h and 10,000 thermocycling (TC). Surface topography, surface energy, and elemental composition of the abraded zirconia surface analyses were completed. TBS data was analyzed using the Weibull analysis method. Surface roughness and surface energy were compared by one-way ANOVA analysis of variance (α = 0.05).

RESULTS

After 24 h, higher TBS was achieved with all cementation protocols in AB2 and TSC, also, in GB2 with all protocols except U-SAP, and in GB4 with SAU and S-SAP. After aging, GB4/S-SAP, GB2/S-SAP, AB2/U-SAP, and TSC/S-SAP showed the highest bond strength. GB groups showed the lowest surface roughness and highest surface energy.

CONCLUSION

Glass bead abrasion achieved the durable bond strength to high-translucent zirconia using a separate silane coupling agent while altered surface chemistry, surface energy, and roughness without effect on morphology.

CLINICAL RELEVANCE

Glass bead air abrasion is an alternative to alumina sandblasting and tribochemical silica coating and improves bond strength to high translucent zirconia.

Bonding States of In Vitro Class 2 Direct Resin Composite Restoration Applied by Various Incremental Techniques

Incremental techniques are always required for clinical cases of deep and/or large cavities restored with resin composite materials. The purpose of this study was to examine the bonding states of class 2 direct resin composite restoration applied by various incremental techniques after cyclic loading to simulate the intra-oral environment to define the appropriate technique. Three types of resin composites, namely, bulk-fill (B), flowable (F), and conventional resin composite (C), were applied to standardized class 2 cavities by incremental techniques with single- or bi-resin restoratives. After cyclic loading, the micro-tensile bond strength (μ-TBS) of the dentin cavity floor was measured. The Weibull modulus and Weibull stress values at 10%/90% probability of failure were analyzed. Single-resin incremental restorations with B or F and bi-resin incremental restorations with F + B and F + C demonstrated superior μ-TBS (quantitative ability), bonding reliability, and durability (qualitative ability) compared with the single-resin restoration with C (as control). Furthermore, F + B and F + C restoration yielded an excellent performance compared with the single-resin restorations with B, F, and C. In particular, the F + C restoration, which indicates not only the maximum mean µ-TBS, but also the highest values of the Weibull parameters, may be the optimal restoration method, including the esthetic benefits.

Evaluation of the Bonding Strength between Various Dental Zirconia Models and Human Teeth for Dental Posts through In Vitro Aging Tests

In dentistry, root canal treatment reduces support of the tooth, making it necessary to insert a cylindrical body into the treated tooth to strengthen the crown. In the past, metal or fiberglass was often used. However, metal is too different in color from teeth, so the esthetics are poor, and fiberglass is not as strong as metal. Therefore, an alternative is zirconia, which has the characteristics of high light transmittance, esthetics, good biocompatibility, and high breaking strength. The surface morphology and composition of zirconia ceramics are the key to their bond strength with teeth. Therefore, in this study, the surface characteristics of different brands of zirconia commonly used in clinical practice were evaluated in terms of their surface morphology and surface elements. The surface was modified by sandblasting, and its effect on the bonding strength was discussed. Finally, the stability of the material was evaluated through artificial aging. The results showed that the surface roughness of the zirconia specimens increased after sandblasting, whereas the surface microhardness decreased. The shear test results showed that the 3D shape of the zirconia surface could help improve the bonding strength. The bonding strength of DeguDent increased the most after sandblasting. After 20,000 cycles of aging treatment, the shear strength of each specimen decreased. Field emission scanning electron microscopy results showed that the adhesive remained intact on the surface of zirconia, indicating that adhesion failure occurred between the adhesive and the teeth. This confirms that sandblasting can improve the bonding strength of zirconia. Based on the results obtained, it was concluded that the surface roughness of zirconia is the main factor affecting the bond strength.

Novel CAD-CAM zirconia coping design to enhance the aesthetics and strength for anterior PLZ crowns

BACKGROUND

The aesthetics and strength of anterior porcelain layered zirconia (PLZ) crowns are mainly affected by the zirconia (Zr) coping design. There is a need for a modified design to enhance aesthetics with strength.

OBJECTIVES

The purpose of this study was to compare the fracture resistance of anterior PLZ crowns having modified CAD-CAM Zr coping designs (in terms of thickness and marginal collar designs) with standard Zr copings.

METHODS

Fifty PLZ crowns were fabricated and divided into two groups: Gr 1: Standard Zr Coping (SZC) (control gr) with 0.5 mm thickness (Facial-F, Mesial-M, Distal-D, incisal-I, and Palatal-P) without a collar; Gr 2: Collar Zr Coping (CZC) (test gr) with 2.5 mm collar height on M, D, P and 0.2 mm F and variable facial wall thickness. Subgroups: Gr 2a: (CZC-0.5 mm) facial wall thickness 0.5 mm; Gr 2b: (CZC-0.4 mm) facial wall thickness 0.4 mm; Gr 2c: (CZC-0.3 mm) facial wall thickness 0.3 mm; Gr 2d: (CZC-0.2 mm) facial wall thickness 0.2 mm. The fracture load was determined and analysed using One-way ANOVA and Dunnet test.

RESULTS

The minimum fracture load was 927.36 ± 127.80 N observed for Gr 2c (CZC at 0.3 mm) while the maximum fracture load was 1373.61 ± 146.54 N observed for Gr 2a (CZC at 0.5 mm). A highly significant difference in mean fracture load among various Zr coping groups (p< 0.001) was determined.

CONCLUSIONS

Novel Zr coping design for anterior PLZ crowns can provide better aesthetics with strength. Reducing the thickness of Zr coping in the aesthetic zone to 0.2 mm and providing a modified collar design (2.5 mm collar height on M, D, P, and 0.2 mm F) would provide strength without jeopardizing aesthetics.

The effect of space setting values and restorative block materials on the bonding of metal-free CAD/CAM onlay restorations

The effects of space setting values and restorative materials on the bonding of metal-free CAD/CAM onlay restoration were examined quantitatively and qualitatively. Seventy-two standardized MODB onlay cavities, prepared using human molars were restored under nine conditions, based on three space setting values, Increased (IC), Standard (SC, control), Decreased (DC), and three restorative block materials, resin-composites (RC), lithium disilicate glass-ceramics (LD), Feldspar ceramics (FC, control). All the restored specimens were subjected to cyclic loading and thereafter the microtensile bond strength (µ-TBS) was measured and analyzed statistically. The effect of space setting value on the µ-TBS varied with the restorative material. The bonding reliability of RC and the bonding durability of LD were significantly superior to FC. The bonding characteristics of RC under IC and DC were similar to those under SC. LD under DC and FC under IC were effective in obtaining an excellent bonding reliability relative to their SC.

Effect of Air-Abraded Versus Laser-Fused Fluorapatite Glass-Ceramics on Shear Bond Strength of Repair Materials to Zirconia

Zirconia repair could be a feasible alternative option to total replacement in fractured zirconia-based restorations. Maximising the bond strength by enriching zirconia with fluorapatite glass-ceramics (FGC) powder has been addressed and compared to other surface treatments. Besides resin composite, other repair materials have been proposed and compared. Zirconia blocks received different surface treatments (A-sandblasting with tribochemical silica-coated alumina (CoJet). B-sandblasting with FGC powder (FGC), C-fluorapatite glass-ceramic coat+ neodymium-doped yttrium aluminum garnet laser irradiation (FGC + Nd: YAG), and D-no surface treatment). The surface roughness, topography, and crystallinity were investigated by a profilometer, scanning electron microscopy (SEM), and X-ray diffraction (XRD) analyses, respectively. For each surface treatment, three repair materials (feldspathic porcelain, lithium disilicate, and resin composite) were bonded to zirconia with 10, Methacryloyloxydecyl dihydrogen phosphate (MDP)-Monobond Plus/ Multilink Automix. Bonded specimens were thermocycled for 10,000 cycles and tested for shear bond strength (SBS) at a speed of 1 mm/min, followed by the analysis of the mode of failure. FGC + Nd: YAG laser group reported the highest surface roughness and monoclinic content compared to CoJet, FGC, and control groups. The highest mean SBS was found in FGC-blasted zirconia, followed by FGC + Nd: YAG laser and CoJet treated groups. However, the lowest SBS was found in control groups regardless of the repair material. Sandblasting zirconia with FGC powder increased SBS of resin to zirconia with lower monoclinic phase transformation compared to FGC + Nd: YAG or CoJet groups.

Effect of silica coating and laser treatment on the flexural strength, surface characteristics, and bond strength of a dental zirconia

This study investigated the effect of irradiation with an erbium-doped yttrium aluminium garnet (Er:YAG) laser and coating with silica on the surface characteristics, bond strength, and flexural strength of dental zirconia. Three hundred and forty-three standard zirconia specimens were created, and 49 were assigned to each of seven surface treatment groups: (i) no treatment; Er:YAG laser (80 mJ/2 Hz) with pulse widths of 50 μs (ii), 100 μs (iii), 300 μs (iv), or 600 μs (v); or tribochemical silica coating at the partially sintered stage (vi) or after sintering was complete (vii). All specimens were sintered after the surface treatments, except for the group in which specimens were sintered before treatment. The study outcomes were roughness, surface loss, microshear bond strength (μSBS), and biaxial flexural strength (BFS). Mean roughness and surface loss values were significantly higher in specimens from irradiated groups than in those from silica-coated groups. Regarding μSBS, after aging, specimens from all experimental groups presented very low and similar μSBS values, irrespective of the surface treatment. Silica coating after sintering yielded the highest BFS (1149.5 ± 167.6 MPa), while coating partially sintered specimens with silica resulted a BFS (826.9 ± 60.9 MPa) similar to that of the untreated control group (794.9 ± 101.7 MPa). Laser treatments, irrespective of pulse width used, significantly decreased the BFS. In the group treated with laser at 300 μs pulse width, specimens exhibited the lowest BFS value (514.1 ± 71.5 MPa). Adhesion to zirconia was not stable after aging, regardless of the surface treatment implemented.

Bond strength of metal brackets to feldspathic ceramic treated with different surface conditioning methods: an in vitro study

Purpose:

To compare MEP which is originally manufactured for increasing bond strength between organic resins and ceramic with conventional surface treatment methods in preparation of leucite-reinforced FC surfaces regarding shear bond strength (SBS) of stainless steel brackets and the mode of bond failure.

Materials and methods:

Forty specimens that were fabricated from FC material and glazed were randomly assigned to four surface conditioning methods: (1) CoJet Sand; (2) MEP; (3) HF acid etching followed by silane coupling agent; (4) Diamond bur followed by silane coupling agent. The SBS was determined using universal testing machine. Bond failure sites were classified according to Adhesive Remnant Index (ARI).

Results:

No statistically significant difference (p less than 0.05) was found in SBS between the groups while significant intergroup differences were detected concerning ARI scores (p less than 0.001). Group 1 had ARI score 1 and 2 indicating mode of failure at the adhesive interface with greater percentage of the adhesive left on bracket base. The other groups had higher frequency of ARI score 3 and 2. The quantity of the ARI retained on the ceramic surface was highest in Group 3, followed by Group 4 and Group 2.

Conclusion:

MEP can be a suitable alternative for bonding metal brackets to FC surface.

Influence of Er:YAG laser surface treatment on flexural and bond strengths to glass-infiltrated zirconia-reinforced ceramic

To evaluate the effect of Er:YAG laser conditioning of a glass-infiltrated alumina-based zirconia-reinforced ceramic on its flexural strength and on bonding to a resin cement. Sixteen blocks (5 × 5 × 4 mm) and 50 discs (Ø 12 mm, 1 mm thickness) of In-Ceram Zirconia (ICZ) obtained from CAD-CAM blocks were infiltrated with glass. For the microtensile bond strength (μTBS) test, all blocks were treated with aluminum oxide (AOX) and divided into 4 groups (n = 4): G1 (AOX), no combined surface treatment; G2 (ROC), tribochemical silica-coating; G3 (EY200), Er:YAG laser 200 mJ/15 Hz; and G4 (EY250), Er:YAG laser 250 mJ/10 Hz. The ceramic blocks were silanated and cemented with a resin cement (Panavia F2.0/Kuraray) to composite resin blocks and subjected to the μTBS test. For the flexural strength evaluation, the discs were divided into 5 groups (n = 10) as described above, in addition to a control group (G5 - CTRL, mirror-polished without further treatment). Each surface treatment was submitted to qualitative evaluation under SEM. One-way ANOVA (α = 5%) revealed the highest bond strength value for EY200 with no significant difference from ROC. The groups AOX and EY250 showed similar μTBS values that were statistically lower than those of EY200. For flexural strength, ROC was the only group with significantly lower values when compared with the CTRL. The use of Er:YAG laser at 200 mJ/15 Hz can be considered an innovative and effective alternative for surface conditioning of ICZ since it did not reduce the flexural strength of the ceramic and improved the resin cement bond to this substrate.

Effect of Methacryloyloxydecyl Dihydrogen Phosphate–Containing Silane and Adhesive Used Alone or in Combination on the Bond Strength and Chemical Interaction With Zirconia Ceramics Under Thermal Aging

Clinical Relevance

Achieving durable bonding to zirconia is fundamental for the application of a methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane solution or an MDP-containing silane solution associated with an MDP-containing universal adhesive.

SUMMARY

Objectives: To evaluate the effect of a methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane coupling agent and universal adhesive, used alone or in combination, on the microshear bond strength (μSBS) to zirconia after 24 hours of water storage (24h) and after 10,000 thermocycles (TC), complemented with chemical analysis of the surface to establish the presence of MDP on the surface of the zirconia after bonding procedures.

Methods and Materials: Thirty computer-aided design/computed-aided manufacturing blocks of zirconia were cut into four sections (6×6×6 mm) and sintered. Zirconia sections (n=96) were assigned to 24 groups according to three factors: 1) silane (no silane, Monobond S [MBS], Monobond P [MB+]), 2) adhesive + resin cement (no adhesive + Enforce [ENF], no adhesive + RelyX Ultimate [REX], Prime&Bond Elect + Enforce [PBE/ENF], Scotchbond Universal + RelyX Ultimate [SBU/REX]), and 3) thermocycling (no thermocycling [24h], 10,000 thermocycles [TC]). Upon silane/adhesive application, cylinder-shaped matrices were filled with resin cement and light cured. Specimens were tested in μSBS (1.0 mm/min) after 24h or TC. The μSBS data were analyzed using twoway ANOVA and Tukey’s post hoc test (α=0.05). In addition, micro-Raman spectroscopy was used to analyze the zirconia surface for immediate chemical interaction analysis (n=24).

Results: For the 24h condition, PBE/ENF resulted in lower mean μSBS than both groups with silane without PBE (MBS and MB+ groups; p&lt;0.001). SBU alone or MB+ alone and MB+ associated with SBU showed the highest mean μSBS (p&lt;0.001). For the TC condition, all groups showed a significant decrease in mean μSBS compared with those of 24h (p&lt;0.001), with the exception of MB+ associated to SBU (p&gt;0.05). However, the application of MB+ alone or MB+ associated to SBU resulted in higher mean μSBS (p&lt;0.001) after TC than the remaining TC groups. In terms of chemical interaction, only the SBU groups, alone or combined with both of the silane agents, were associated with the methacrylate groups after rinsing.

Conclusions: The results of the current study support the use of an MDP-containing silane solution or an MDP-containing silane solution associated with an MDP-containing universal adhesive for bonding to air-abraded zirconia, as a more stable bonding after thermocycling.

Combined application of femtosecond laser and air-abrasion protocols to monolithic zirconia at different sintering stages: Effects on surface roughness and resin bond strength

This study aimed to investigate the effects of femtosecond laser (Fs) and/or air-abrasion protocols on surface roughness (Ra) of zirconia and resin bond strength. Eighty zirconia samples were randomly divided into eight subgroups according to surface treatment protocols: Control (C), Air-abrasion before sintering (ABS), Air-abrasion after sintering (AAS), Air-abrasion before and after sintering (ABS + AAS), Fs laser before sintering (FBS), Fs laser before sintering + air-abrasion after sintering (FBS + AAS), Fs laser after sintering (FAS), and Fs laser after sintering + air-abrasion after sintering (FAS + AAS). Measurements of Ra values were obtained using a surface profilometer. Surface morphological properties were evaluated with scanning electron microscopy (SEM), and crystallographic changes were examined by X-Ray diffractometry (XRD). Self-adhesive resin cement was bonded to zirconia samples, and shear bond strength (SBS) tests were performed. The data were statistically analyzed by one-way ANOVA, followed by Tamhane tests. The control group displayed the lowest Ra and SBS values among all groups. The highest Ra and SBS values were found in the FBS and FBS + AAS groups. Air-abrasion applied before sintering significantly increased the Ra of specimens. FAS, FAS + AAS, and ABS + AAS groups exhibited higher SBS values than AAS and ABS (p < .05). Air-abrasion applied after Fs laser did not produce any significant change in the Ra and SBS compared to Fs laser alone (p > .05). Femtosecond laser application may be a promising method to enhance the surface roughness of zirconia and improve resin bond strength. Air-abrasion at pre- and post-sintered stages may also be a viable surface treatment option.

Shear bond strength of glass ionomer and resin-based cements to different types of zirconia

OBJECTIVE

To investigate the shear bond strength (SBS) of a glass ionomer (GI) cement, an 10-methacryloyloxy-decyl dihydrogen phosphate (MDP)-based adhesive resin cement (MDP-based AC), an MDP-based self-adhesive resin cement (MDP-based SAC), an MDP-free self-adhesive resin cement (MDP-free SAC), and a resin-modified GI (RMGI) cement to a 3 mol% yttria-stabilized (3Y-TZP) and a 5 mol% yttria partially stabilized zirconia (5Y-PSZ).

MATERIALS AND METHODS

Fifty blocks were produced using 3Y-TZP and 5Y-PSZ, assigned to subgroups based on the five cements investigated (n = 10) and luted to cylindrical specimens of the same substrate. Each specimen was loaded in a SBS apparatus to failure. Mean SBS (MPa) values and standard deviations were calculated. Data were analyzed using a two-way analysis of variance and Tukey tests (α = .05). Failed specimens were subjected to fractographic analysis.

RESULTS

MDP-based AC and MDP-based SAC cements displayed the highest SBS values with both the substrates; GI cement showed the lowest. RMGI and MDP-free SAC cements performed better with 3Y-TZP than with 5Y-PSZ. Fractographic analysis revealed only adhesive and mixed failures.

CONCLUSIONS

MDP-based AC and MDP-based SAC cements are suitable for both 3Y-TZP and 5Y-PSZ. MDP-free SAC and RMGI cements are adequate choices for 3Y-TZP, but seem less effective with 5Y-PSZ.

CLINICAL SIGNIFICANCE

MDP-based SACs appear to be as reliable as MDP-based ACs for both 3Y-TZP and 5Y-PSZ cementation. Specifically, for 5Y-PSZ cementation, resin-based MDP-free SACs do not seem to guarantee predictable results in terms of SBS.

Preparation of a Novel Transplant Material, Zirconium Oxide (ZrO₂) Nanotubes, and Characterizations Research

Background

Zirconia is one of the most widely used ceramic materials for transplanting and treating caries. This study aimed to synthesize zirconium oxide (ZrO₂) nanotubes and evaluated their characteristics.

Material/Methods

Zr film was prepared using an ion plating method. Nanoarray film was constructed with anodizing. Photocatalytic properties of nnanotubes were assessed by evaluating decolorization of methyl orange. Elemental analysis and structural morphology for coatings were evaluated using x-ray analysis and scanning electron microscopy (SEM). Dimensions for layers were measured with SEM imaging. X-ray diffraction (XRD) was measured using Empyrean x-ray diffractometry.

Results

There were irregular cavities on the surface of ZrO₂ nanotubes undergoing anodizing of 30V. Anodizing voltage of 45 V (with regular nano-pore arrays and smooth nanotube walls) and anodic oxidation duration of 60 min (ZrO₂ nanotubes clearly formed atop ZrO₂-coated substrate surface) were the optimal condition for ZrO₂ nanotube formation. TEM illustrated tube length of ZrO₂ nanotubes was approximately 2.01 μm. Nanotube diameter was 51.06 nm, and wall thickness was 13 to 14 nm. Annealed nanotubes showed an obvious crystal diffraction pattern. TEM diffraction ring showed nanotube array without obvious transistor structure before annealing, but with good crystallinity post-annealing. Increased annealing temperatures result in enhanced intensity for the monoclinic phase (400–800°C). After annealing at 600°C, the decolorization effect of ZrO₂ nanotubes on methyl orange was better than that post-annealing at 400 and 800°C. ZrO₂ nanotubes demonstrated higher microshear bond strength.

Conclusions

Zirconium nanotubes were successfully synthesized and demonstrated good structural characteristics, which can be applied to transplanting and treating caries.

The Effect of Sandblasting and Coating of Zirconia by Nano Composites on Bond Strength of Zirconia to Resin Cements

Statement of the Problem:

Despite yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) high strength in dental restoration application, Zr- the framework has a low tendency to react chemically with cement which is the main reason of these restoration failures.

Purpose:

The aim of this in vitro study was to evaluate the effect of Y-TZP coating by nanocomposite of silica and aluminosilicate according to the sol-gel dip-coating technique on the bond strength of resin cement to Y-TZP.

Materials and Method:

In this experimental study, Y-TZP blocks (10×10×3mm³) were prepared and sintered and assigned into 4 groups (n=10) for coating including control group without any further surface treatment, sandblasted using 110μm alumina particles under 2.5 bar and tip distance of 10 mm, silica sol dip coating+calcination, aluminosilicate sol dip coating+ calcinations. To confirm chemical bonds of sol-gel covers, Fourier transforms infrared spectroscopy (FT-IR) technique was used. The surface of the sample was investigated by scanning electron microscopy (SEM), energy-dispersive spectroscopy detector (EDS) and x-ray diffraction (XRD) methods. Micro-shear bond strengths (µSBS) of zirconia-cement specimens were evaluated. Data were analyzed with a one-way ANOVA test in SPSS version 11.5 software with a confidence interval of 95%.

Results:

µSBS of sandblasting, nano-silica, and nano-aluminosilicate specimens were significantly higher than control. µSBS of nano-silica was higher than other groups but no significant difference was observed in µSBS of sandblasting nano-silica, and nano-aluminosilicate groups (p> 0.05).

Conclusion:

Covering the zirconia surface with non-invasive nano-silica and nano-aluminosilicate using the sol-gel technique leads to improved cement bond strength.

Investigating the shear bond strength of five resin-based luting agents to zirconia ceramics

The present study investigated the bond strength and aging resistance performance of five resin-based luting agents to zirconia. A total of 100 large blocks (10.0 mm × 10.0 mm × 2.5 mm) and 100 small blocks (4.0 mm × 4.0 mm × 2.5 mm) of zirconia were airborne-particle abraded and randomly divided into five groups: (RelyX Ultimate [RUl]; Panavia F [PF]; Clearfil SA Luting [SAC]; Multilink Speed [MS]; and RelyX Unicem [RUn]). The small blocks were bonded to the large blocks using the resin-based luting agents. Shear bond strengths (SBS) and failure mode were determined before and after 5,000 thermocycles. After being stored in water for 24 h, the SBS were MS > PF > RUl > SAC > RUn (P < 0.05). After 5,000 thermocycles, the SBS were MS > SAC ≈ RUl > PF ≈ RUn (P < 0.05); the SBS of the PF, MS, and RUn groups were lower than that before 5,000 thermocycles (P < 0.01). Adhesive failure, cohesive failure, or mixed failure occurred in the specimens. In general, Clearfil SA Luting, a self-adhesive resin-based luting agent containing 10-methacryloxy decyl diphosphate, had good initial and durable SBS to zirconia and was a better adhesive.

Graphene oxide-based experimental silane primers enhance shear bond strength between resin composite and zirconia

Despite various mechanical and chemical surface-pretreatment methods, long-term bonding of resin composite to dental zirconia (ZrO₂ ) remains a major concern. In this study, graphene oxide (GO) sheets were infused into two commercially available primers and the enclosed mould shear bond strength (EM-SBS) of resin composite to ZrO₂ was evaluated. Twelve fully sintered ZrO₂ blanks were pretreated and randomly allocated to four groups according to the primers used: RelyX (RX); GO blended RelyX (RXGO); Monobond-S (MB); and GO blended Monobond-S (MBGO). The resin composite stubs were bonded onto the pretreated ZrO₂ surfaces and analysed at baseline and after storage in distilled water for 2 and 4 months. The experimental primers blended with GO sheets influenced the surface morphology, visualized as increased surface roughness, and slightly increased the water contact angle measurements. Moreover, the infusion of primers with GO increased the mass fraction (wt%) of carbon and oxygen. The highest EM-SBS values were found for RXGO, with mean (SD) EM-SBS values of 26.4 (3.7) MPa and 21.5 (5.1) MPa after 2 and 4 months of storage, respectively. Infusion of silane primers with nanometre- to micrometre-size GO sheets enhanced the SBS between resin composite and ZrO₂ .

Bonding Strength of Luting Cement to Zirconia-Based Ceramic Under Different Surface Treatments

OBJECTIVES

 The aim of this study was to evaluate the bonding strength of self-adhesive luting cement to zirconia under different surface treatments.

MATERIALS AND METHODS

 Thirty-two zirconia samples were randomly divided into eight experimental groups based on the surface treatment employed (Control: no surface treatment; PMM: wear with diamond bur; JAT: blasting with glass beads; PMA: wear with a medium-roughness milling machine; Primer: primer application on the surface without treatment; PMM +Primer: PMM treatment plus primer application; JAT+Primer: JAT treatment plus primer application; and PMA+Primer: PMA treatment plus primer application). Cement cylinders were built on the ceramic surfaces, and the groups were subdivided according to the storage time employed (i.e., 24 hours or 60 days). After storage, the samples were subjected to microshear testing.

STATISTICAL ANALYSIS

 The Kruskal-Wallis test followed by the Dunn test was employed for comparison between the groups (p < 0.05).

RESULTS

 The PMM group yielded the optimal results and the mean values increased after both storage times following the primer application. The Control, PMA, and JAT groups gave similar results after 24 hours, while the JAT group gave superior results following primer application over this storage time. After 60 days of storage, all groups gave improved results following chemical treatment with a primer.

CONCLUSION

 It was concluded that mechanical preparation using the diamond bur followed by primer application significantly improved the bond strength between the ceramic and the luting cement.

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.

Effect of universal adhesives on microtensile bond strength to hybrid ceramic

Background

The aim of this study was to evaluate the effect of universal adhesives (UA) and silane on the microtensile bond strength (μTBS) of resin cement to a hybrid ceramic Vita Enamic (VE).

Methods

VE specimens were acid etched using hydrofluoric acid (HF) and were assigned to three groups (n = 10) based on the applied bonding technique. In group 1 (S), a silane-based primer was used as a surface treatment prior to the application of a resin cement (Variolink Esthetic DC). In group 2, a silane-containing UA, Clearfil Universal Bond (CUB) was used for the surface treatment, and in group 3, A silane-free UA, Tetric N-Bond Universal (TNU) was used for surface treatment. Resin cement build-ups were prepared. The bonded specimens were sectioned into resin-ceramic beams. Half of the beams of each group were stored for 24 h at 37 °C and the other half were subjected to a thermo-cycling aging. The microtensile bond strength (μTBS) was measured at a crosshead speed of 0.5 mm/min. Failure modes were assessed accordingly. Data were analyzed using a) two-way analysis of variance ANOVA followed by one-way ANOVA and Tukey tests between groups and b) independent t-test to detect differences (α = 0.05) for each group. The surface topographies of the ceramic surface were evaluated using scanning electron microscopy.

Results

The results showed that silane-based primer (S) application resulted in significantly higher (p < 0.05) μTBS values after 24 h and after thermocycling compared to both silane-containing UA (CUB) and silane-free UA (TNU). The μTBS values of all groups were significantly reduced after thermocycling. No statistically significant difference was observed between the μTBS of CUB and TNU after 24 h. However, TNU showed significantly higher μTBS after thermocycling. Different failure modes were observed, and adhesive failure was the most common in all groups. Marked surface topographic changes were observed following HF etching.

Conclusion

It is concluded that, the UAs tested cannot be recommended as substitutes to the silanization of Hybrid ceramic.

A Review of Dental Cements

This review provides an in-depth comparison of advantages and disadvantages of different types of dental cements as they are used for cementing base metal alloy crowns in dogs.

Repair bond strength of composite to Er,Cr:YSGG laser irradiated zirconia and porcelain surfaces

BACKGROUND

Fracture or chipping are major concerning failures of an all-ceramic restoration. Repairing of the failure restoration using intra-oral technique is time saving and cost effective treatment modality. The present study was proposed to evaluate effect of Er,Cr:YSGG laser irradiation on shear bond strength between zirconia/porcelain and composite resin.

METHODS

Thirty zirconia and thirty zirconia based porcelain disc shape specimens were prepared. Three different surface treatment procedure were applied the specimens. For control groups (Group ZC and PC), instruction manual of an intra-oral porcelain repair system was followed. Different pulse rates of Er,Cr:YSGG laser irradiation (short and long pulses) were applied to zirconia and porcelain surfaces for other groups (Group ZS, ZL, PS, and PL). Porcelain repair kit was used to repair specimens using standard cylindrical teflon mold (2 × 2 mm). Repair bond strength of the repaired specimens was tested using a universal testing machine.

RESULTS

Highest mean bond strength value was observed at Group PC that was significantly higher than laser applied porcelain groups. Long pulse laser irradiation illustrated that increased mean bond strength compared to short pulse application on to the porcelain surface. Laser applied zirconia groups showed better mean bond strength than Group ZC, but differences between the groups were not statistically significant.

CONCLUSION

Different modes of Er,Cr:YSGG laser irradiation enhanced repair bond strength of the composite resin to zirconia, but these were not significant. Following the instruction manual for surface treatment on the porcelain surface was better method than Er,Cr:YSGG laser surface conditioning.

The effect of air-particle abrasion and a zirconia primer application on resin cement bonding strength to zirconia

BACKGROUND

This study aimed to evaluate the influence of surface treatments on the bond strength between a zirconia-based ceramic and two resin cements.

METHODS

Eighty blocks (5.25×3.74×4.5 mm) of a zirconia-based ceramic were divided into eight groups (N.=10) according to the factors "surface treatment" (air-particle abrasion with Al2O3 or Al2O3/SiO2 and zirconia primer) and "cement" (conventional resin cement and self-adhesive resin cement). After the surface treatments, cylinders of each resin cement (Ø=3.5 mm, height: 3 mm) were built up on the zirconia surface and photo-activated (40 s). The samples were stored in water for 30 days at 37 °C, followed by shear bond strength test in a universal testing machine (1 mm/min). Data were analyzed by ANOVA and Tukey test (α=0.05).

RESULTS

Regarding the surface treatments, all strategies were statistically different from each other. The Cojet achieved the higher bond strength values, followed by Signum Zirconia Bond. The resin cements were also statistically different from each other, since the U200 achieved higher bond strength values. The interaction between the factors was also significant. Most of the failures were adhesive and mixed.

CONCLUSIONS

Regardless of the cement used, the air-particle abrasion with alumina coated by silica particles improved bond strength.

Effect of selective infiltration etching on the bond strength between zirconia and resin luting agents

OBJECTIVE

To evaluate the shear bond strength of resin cements to zirconia treated with the selective infiltration etching technique (SIE).

MATERIALS AND METHODS

Forty-seven zirconia specimens were prepared with a sequence of silicon carbide abrasives, cleaned in an ultrasonic bath. Three samples were separated for atomic force microscope (AFM) analyses (one nontreated for control, one sandblasted, and one selective infiltration etched) and the remaining were randomly distributed in four groups, according to the combination of surface treatment and resin cement: group 1a (sandblasting + Variolink II), group 1b (sandblasting + Panavia SA Plus), group 2a (SIE + Variolink II), group 2b (SIE + Panavia SA Plus). A composite resin cylinder (3 mm × 3 mm) was cemented to the zirconia surface, as per each group's specific protocol. After storing 24 hours in distilled water at 37°C, the specimens were tested for shear bond strength and the results were subjected to statistical analysis.

RESULTS

At 24 hours, the highest SBS values were observed in group 2b, where the SIE technique was used in conjunction with Panavia SA Plus. Lowest values were found in group 1a. Increased surface roughness was observed with SIE.

CONCLUSIONS

SIE significantly enhanced the resin bond strength to zirconia. However, cement selection was also an important factor, for both surface treatments tested.

CLINICAL SIGNIFICANCE

Use of SIE method combined with MDP monomer containing resin cement can provide clinically acceptable bond strength between zirconia and resin cement.

Evaluation of the Effect of Glow Discharge Plasma Surface Treatment on Bonding Cements to Zirconia

Background:

The major difference in the chemical composition of Y-TZP ceramics, as compared with conventional porcelain, led researchers to develop alternative solutions for achieving durable and long term bonding with the zirconia surface.

Objective:

The study aims to evaluate the effects of glow discharge treatment on the bonding between cement and zirconia.

Methods:

The zirconia rings and rods were prepared with the Zirconia Y-TZP powder and TZ-3YSB-E (Tosoh-Zirconia) through auto-mix to investigate the glow discharge and thermo-cycling. An orientation Teflon mold was used to centralize each rod into the zirconia ring, and aided as a cementation jig during the cementation procedure.

Results:

Cohesive failure (2/3 or more of luting agent remained on the zirconia surface) has been majorly observed with RelyX Ultimate, while adhesion failure (less than 1/3 of the luting agent remained on the zirconia surface) has been primarily observed in Ketac-Cem. Mixed failure was observed among the three specimen including Rely X Unicem 2, Multilink Auto-mix and Ceramir.

Conclusion:

The glow discharge surface treatment procedure had a major impact on bond strength to zirconia.

Ultrathin Monolithic Zirconia Veneers: Reality or Future? Report of a Clinical Case and One-year Follow-up

Yttria-stabilized polycrystalline zirconia ceramics have greatly advanced over the past few years. High-translucent zirconia is a newly introduced ceramic that affords high strength and esthetics and that has significantly increased the clinical indications of monolithic zirconia restorations. Thus, the purpose of this case report was to evaluate the performance of ultrathin monolithic zirconia veneers adhesively luted to enamel surfaces after minimally invasive preparations; in addition, we aimed at presenting a clinical protocol for zirconia surface treatment in order to promote bonding effectiveness to resin cement. This type of restoration presented very acceptable esthetic results and decreased the risk of fracturing the veneer during try-in and clinical use. The results were still satisfactory after one-year follow-up. However, randomized, prospective, controlled clinical trials are required to determine the long-term clinical durability of this treatment.

Effect of immediate dentin sealing applications on bonding of CAD/CAM ceramic onlay restoration

The effects of immediate dentin sealing (IDS) applications on the bonding of computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic onlay restorations after cyclic loading were examined. Standardized mesial-distal-occlusal-palatal cavities in 32 extracted human molars were prepared. The cavities were divided into four groups: those receiving thin-layered (T), slope-shaped (S), and base-shaped (B) sealing, and the non-sealing group (N) as a control. The intra-cavity dentin walls of the T, S, and B groups were sealed with an all-in-one adhesive and a flowable composite. All cavities were scanned; hence, CAD/CAM onlays were fabricated using ceramic blocks and bonded with a resin cement system. Cyclic loading was applied and the microtensile bond strength (μ-TBS) was measured. It was found that IDS application improved not only the μ-TBS, but also the bonding reliability and durability of the CAD/CAM restoration. In particular, the S restoration exhibited the highest-performance as regards both robust bond strength and stable bonding.

Incremental and Bulk-fill Techniques With Bulk-fill Resin Composite in Different Cavity Configurations

PURPOSE:

To compare the microtensile bond strengths of incremental and bulk-fill techniques under different C-factor and compliance conditions.

METHODS AND MATERIALS:

Extracted human third molars were divided into three experimental groups. For group I, Class I cavities were prepared. For group II, MOD cavities of the same size were prepared. For group III, the cavities were prepared the same way as group II only with high compliance cavity walls. The cavity wall compliance of the specimens was evaluated. Each of these groups was divided into four subgroups. The teeth were restored using two different materials: TB (Tetric N-Ceram Bulk Fill; Ivoclar Vivadent, Hanau, Germany) and VB (Venus Bulk Fill; Heraeus Kulzer, Armonk, NY, USA), and two methods, either an incremental or bulk-fill technique. Then, the microtensile bond strengths (μ-TBSs) were measured and compared. The polymerization stresses of the composites were calculated using a custom-made device. The results were statistically analyzed using the Kruskal-Wallis test and Weibull analysis.

RESULTS:

In group I, the μ-TBS obtained using the incremental technique was significantly higher than that obtained by the bulk-fill technique ( p<0.05). In contrast, no difference of the μ-TBS value was observed between the two techniques in groups II and III. The μ-TBS value of group I was significantly lower than those of groups II and III ( p<0.05). No statistical difference in the μ-TBS was observed when the cavities were filled with either TB or VB ( p>0.05).

CONCLUSIONS:

The incremental technique showed higher bond strength than did the bulk-fill technique in high C-factor cavities. However, no difference was found between the two techniques in the low C-factor cavities. The bond strength in the high C-factor cavities was significantly lower than that of the low C-factor cavities.

Acid Etching as Surface Treatment Method for Luting of Glass-Ceramic Restorations, part 1: Acids, Application Protocol and Etching Effectiveness

AIM

The purpose of this review is to represent acids that can be used as surface etchant before adhesive luting of ceramic restorations, placement of orthodontic brackets or repair of chipped porcelain restorations. Chemical reactions, application protocol, and etching effect are presented as well.

STUDY SELECTION

Available scientific articles published in PubMed and Scopus literature databases, scientific reports and manufacturers' instructions and product information from internet websites, written in English, using following search terms: "acid etching, ceramic surface treatment, hydrofluoric acid, acidulated phosphate fluoride, ammonium hydrogen bifluoride", have been reviewed.

RESULTS

There are several acids with fluoride ion in their composition that can be used as ceramic surface etchants. The etching effect depends on the acid type and its concentration, etching time, as well as ceramic type. The most effective etching pattern is achieved when using hydrofluoric acid; the numerous micropores and channels of different sizes, honeycomb-like appearance, extruded crystals or scattered irregular ceramic particles, depending on the ceramic type, have been detected on the etched surfaces.

CONCLUSION

Acid etching of the bonding surface of glass - ceramic restorations is considered as the most effective treatment method that provides a reliable bond with composite cement. Selective removing of the glassy matrix of silicate ceramics results in a micromorphological three-dimensional porous surface that allows micromechanical interlocking of the luting composite.

Clinical Results and Technical Complications of Posterior Implant-Supported Modified Monolithic Zirconia Single Crowns and Short-Span Fixed Dental Prostheses: A 2-Year Pilot Study

PURPOSE

The purpose of this clinical trial was to investigate the clinical outcomes of implant-supported modified monolithic zirconia single crowns (SCs) and short-span fixed dental prostheses (FDPs) after a follow-up of 2 years.

MATERIALS AND METHODS

Twenty-seven patients in need of implant-supported SCs or 3-unit FDPs in the posterior maxilla or mandible were consecutively selected for this study. A total of 56 modified monolithic zirconia prostheses including 44 SCs (8 screw-retained, 36 cement-retained) and twelve 3-unit FDPs (5 screw-retained, 7 cement-retained) were included in this study. All patients were followed at 6 months, 12 months, 18 months, and 2 years after placement of the modified monolithic zirconia prostheses. During the follow-up period, all prostheses were evaluated with clinical and radiographic examinations. The following technical parameters were assessed: framework fracture, fracture of veneering porcelain, screw loosening, loss of retention because of prosthesis de-cementation and opposing tooth fracture.

RESULTS

No implant was lost during the follow-up period, yielding a 2-year implant survival of 100%. One FDP failed because of framework fracture. The overall prosthesis survival rate was 98.2% after 2 years of clinical service. During the study, 5 complication events were observed in 3 SCs and one FDP, including one fracture of veneering porcelain and 2 screw loosenings in 3 SCs, and loss of retention and opposing tooth fracture in the same FDP. Therefore, the complication-free rate of prostheses was 91.1%.

CONCLUSION

According to the results of this study, the modified monolithic zirconia design used in this study resulted in a favorable short-term outcome for posterior implant-supported SCs and 3-unit FDPs.

Retentive Strength of Y-TZP Crowns: Comparison of Different Silica Coating Methods on the Intaglio Surfaces

Objective:

To evaluate the effect of different methods of silica deposition on the intaglio surface of yttrium oxide stabilized zirconia polycrystal (Y-TZP) crowns on the retentive strength of the crowns.

Methods:

One hundred simplified full-crown preparations produced from fiber-reinforced polymer material were scanned, and 100 Y-TZP crowns with occlusal retentions were milled. Crown/preparation assemblies were randomly allocated into five groups (n=20) according to the treatment of the intaglio surfaces: TBS = tribochemical silica coating via air-abrasion with 30-μm silica-coated alumina particles; GHF1 = application of thin glaze layer + hydrofluoric acid (HF) etching for 1 minute; GHF5 = glaze application + HF for 5 minutes; GHF15 = glaze application + HF for 15 minutes; NANO = silica nanofilm deposition (5 nm) via magnetron sputtering. All groups received a silane application. The surfaces of the preparations (polymer) were conditioned with 10% HF for 30 seconds and silanized. The crowns were cemented with resin cement, thermocycled (12,000 cycles; 5°C/55°C), stored for 60 days, and subjected to a retentive strength test (0.5 mm/min until failure). The retention data (MPa) were analyzed using one-way analysis of variance, Tukey tests, and Weibull analysis. Failures were classified as 50C (above 50% of cement in the crown) and 50S (above 50% of cement on the substrate).

Results:

The TBS (5.6±1.7 MPa) and NANO groups (5.5±1 MPa) had higher retentive strength than the other groups (p&lt;0.0001) and had the highest values of characteristic strength. There was no difference in Weibull modulus, except for the GHF1 group (lower values). The TBS and GHF15 groups, respectively, had 60% and 70% of their failures classified as 50C, while most of the other groups had 50S failures.

Conclusion:

Tribochemical silica coating and silica nanofilm deposition on the inner surface of zirconia crowns promoted a higher retentive strength.

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.