Influence of polymerization time on properties of dual-curing cements in combination with high translucency monolithic zirconia

Investigating the impact of post-curing cycles on surface hardness and color stability in 3D printed resin crowns

This study evaluated the effect of different post-curing cycles on the Vickers hardness, color change, and translucency value of 3D printed methacrylic acid ester-based temporary and permanent crown resins. A total of 300 samples were printed in disk shape (ø:8 mm, thickness: 2 mm) using VarseoSmile Crown Plus (VSC) and VarseoSmile Temp (VST) materials from a 3D printer. These disks were divided into five subgroups (n = 30 each) based on flash-curing cycles (0, 750, 1500, 2250, and 3000). Surface hardness tests and color tests were conducted on both the green state and flash-cured groups. The data were analyzed using univariate analysis of variance (ANOVA). The hardness of 3D printed temporary and permanent crown resin increased with post-curing time. Compared to the post-curing cycle recommended by the manufacturer, no clinically significant color change (ΔE00 ≥ 2.25) was observed in any of the polymerized groups. It was determined that permanent crown material had a more translucent structure than temporary crown material. The interaction between material and post-curing had significant effects on surface hardness, color (ΔE00), and translucency of 3D printed methacrylic acid ester-based resins.

Shear bond strength of dual-cured resin cements on zirconia: The light-blocking effect of a zirconia crown

Abstract Background/purpose

The presence of restorative material between resin cement and the light-curing unit can reduce light transmission. This study aimed to evaluate the effect of the light-blocking effect of zirconia crown on shear bond strength (SBS) between three dual-cured resin cements and the zirconia surface.

Materials and methods

Sixty zirconia specimens were prepared and divided into three groups according to the type of resin cement [RXU (RelyX Ultimate); SC2 (SmartCem2); MEC (Maxcem Elite Chroma)]. Each group was further divided into two subgroups, with or without a 1-mm-thick zirconia crown (n = 10). The specimens were light-cured from five different directions for 20 s each. All specimens were thermocycled 5000 times and subjected to SBS testing, followed by scanning electron microscope examination.

Results

The presence of a 1-mm-thick zirconia crown had no significant effect on the SBS in all resin cements. However, the SBS was significantly affected by type of resin cement. RXU showed the highest SBS (8.35 MPa with crown; 8.57 MPa without crown), followed by SC2 (5.48 MPa with crown; 5.57 without crown) and then MEC (3.37 MPa with crown; 4.04 MPa without crown. Fractured surfaces exhibited varying degrees of mixed failure patterns.

Conclusion

A 1-mm-thick zirconia crown material between the light source and the dual-cured resin cement did not significantly influence the SBS of the resin cements on the zirconia substrates. RXU exhibited the highest SBS regardless of zirconia crown coverage. With sufficient light-curing, dual-cured resin cements can be a good choice for zirconia crown cementation.

A brief review on fatigue test of ceramic and some related matters in Dentistry

The characteristics of dental ceramics have been extensively studied over the years to provide highly qualified materials for use in prosthetic restorations. The ability to adhere to dental substrates, outstanding aesthetics (translucency, color, and substrate masking ability) and improved mechanical properties provide these materials with optical features and high strength to withstand masticatory stimuli. Different classifications are adopted, and it is generally considered that glass-ceramics have better optical characteristics due to the high glass content, and polycrystalline ceramics have superior strength favored by their densified and organized crystals, hampering crack growth. This knowledge was largely built-up during years of scientific research through different testing methodologies, but mainly employing static loads. It is important to not only take into account the intensity of loads that these materials will be exposed to, but also the effect of the intermittence of cyclic load application leading to mechanical fatigue and the influence of factors related to the crack origin and their propagation under this condition. Furthermore, the bonding surface of ceramic restorations requires surface treatments that improve the bond strength to luting agents; however, these treatments require caution because of their potential to produce defects and affect the structural behavior. Moreover, ceramic restorations often require internal adjustments for proper seating or external adjustments for fitting the occlusal contact with the antagonist. In this sense, finishing/polishing protocols may alter the defect population, as luting agents may also interact by filling in the superficial defects on the restoration intaglio surface. Thus, the balance among all these factors will define the performance of a restorative setup, as well as the posterior exposure to the humid environment and the masticatory stimuli (cyclical loading), which may favor developing slow and subcritical growth of cracks in ceramic materials and the degradation of the bond interface. Therefore, it is essential that the concepts which explain the fatigue mechanism are understood, as well as the crack propagation and failure patterns of restorative ceramic materials.

Stress distribution in pediatric zirconia crowns depending on different tooth preparation and cement type: a finite element analysis

BACKGROUND

In clinical settings, tooth preparation for prefabricated zirconia crowns (PZCs) in the primary dentition varies widely. However, knowledge about the biomechanical behavior of PZCs in various clinical settings is limited. This study was conducted to evaluate the biomechanical behavior of PZCs in different clinical settings using 3-dimensional finite element analysis.

METHODS

3-dimensional models of the PZC, cement, and tooth with six different conditions were simulated in primary molar teeth, incorporating cement thickness (100, 500, and 1000 μm) and cement type (resin-modified glass ionomer cement and resin cement). A total of 200 N of occlusal force was applied to the models, both vertically and obliquely as representative cases. A general linear model univariate analysis with partial eta-squared (ηp²) was performed to evaluate the relative effects of the variables.

RESULTS

The overall stress of tooth was increased as the cement space increases under oblique loading. The von Mises stress values of the resin cements were significantly higher than those of the resin-modified glass ionomer cements for all cement thicknesses (p < .05). The effect size of the cement type (η_p² = .519) was more dominant than the cement thickness (η_p² = .132) in the cement layer.

CONCLUSIONS

Within the limits of this study, cement type has a greater influence on the biomechanical behavior of PZCs than cement thickness.

Factory Crystallized Silicates for Monolithic Metal-Free Restorations: A Flexural Strength and Translucency Comparison Test

Flexural strength (FS) and translucency (Contrast Ratio-CR) of three different factory crystallized silica-based glass ceramics, Celtra Duo (CD), N!ce (NI) and Li-Si Block, a lithium disilicate, IPS e.max CAD (LD), and a leucite-reinforced feldspathic ceramic, Empress CAD (EM), in two different translucencies (HT and LT) for use in chairside dental restorations have been compared. CAD blocks of the materials were cut into beams and tiles and processed following manufacturers’ instructions. The beams were tested (3-PBT) to determine flexural strength, Weibull characteristic strength, and Weibull modulus; and tiles were tested to determine CR. All data were statistically analyzed. In addition, SEM analysis of the materials was performed. Differences in flexural strength (FS) and translucency (CR) between the materials were found to be statistically significant. FS decreased as follows (MPa): LDHT 350.88 ± 19.77 (a) = LDLT 343.57 ± 18.48 (a) > LSLT 202.15 ± 17.41 (b) = LSHT 196.93 ± 8.87 > NIHT 186.69 ± 13.06 (c) = CDLT 184.73 ± 13.63 (c) = CDHT 174.15 ± 21.76 (c) = NILT 172.12 ± 11.98 (c) > EMHT 131.16 ± 13.33 (e) = EMLT 127.65 ± 11.09. CR decreased as follows (mean ± sd): CDLT 74.1 ± 1.1 (a); LSLT 74.0 ± 1.1 (ab); NILT 73.3 ± 0.8 (ab); EMLT 73.0 ± 1.5 (ab); NIHT 72.4 ± 1.0 (bc); LDLT 71.3 ± 1.1 (bc); LTHT 65.2 ± 0.9 (de); LSHT 63.8 ± 1.1 (def); EMHT 636 ± 1.2 (ef); CDHT 62.2 ± 0.8 (f). Our findings show that factory-crystallized lithium silicate glass ceramics fulfill ISO standards for Classes 1 and 2. Therefore, they can be considered viable alternatives to produce single-unit restorations with a chairside procedure not requiring thermal treatment.

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.

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

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

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

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

Effects of Substrate and Cement Shade on the Translucency and Color of CAD/CAM Lithium-Disilicate and Zirconia Ceramic Materials

The aim of this in vitro study was to evaluate the effects of substrate and cement shades on the translucency and color of lithium-disilicate and zirconia CAD/CAM materials. Two light-cured resin cements (RelyX Veneer Cement; 3M; Choice 2 Veneer Cement; Bisco Dental) with a standardized thickness (0.1 mm) were tested in combination with two different monolithic CAD/CAM materials (E-Max CAD (LI2SI2O5); Ivoclar Vivadent; Katana (ZrO2); Kuraray-Noritake Dental) on two different colored composite substrates used as a dentin (Filtek Supreme XTE; 3M); for a total of 12 combinations (n = 10). The specimens’ color was measured with a spectrophotometer (Spectroshade; MHT). Measurements were taken using the CIELAB color coordinate system (L*a*b*) against black and white backgrounds. L*a*b* values were statistically analyzed for the variables Substrate, Ceramic, and Cement by applying a Three-Way ANOVA followed by the Tukey Test for post-hoc comparison (p < 0.05). Translucency Parameter (TP) and Constant Ratio (CR) were assessed to evaluate translucency; acceptability and perceptibility thresholds (ΔE00 1.8 and 0.8) were used. Statistically significant influence was found for factors ceramic material, cement shade, and substrate color (p < 0.05). Unacceptable color differences were reported for Li2Si2O5. Opacity was significantly higher when white opaque cement shade was employed. Ceramic type and cement shade significantly influenced L*a*b* color coordinates. The final translucency and color of ceramic restorations can, therefore, be influenced by ceramic material, cement shade, and substrate color.

Effect of Light-Sources and Thicknesses of Composite Onlays on Micro-Hardness of Luting Composites

The aim of this study was to compare three different light-curing-units (LCUs) and determine their effectiveness in the adhesive cementation of indirect composite restorations when a light-curing resin cement is used. Two resin composites were selected: Enamel Plus HRI (Micerium) and AURA (SDI). Three thicknesses (3 mm, 4 mm and 5 mm) were produced and applied as overlays and underlays for each resin composite. A standardized composite layer was placed between underlay and overlay surfaces. Light curing of the resin-based luting composites was attained through the overlay filters using LCUs for different exposure times. All specimens were allocated to experimental groups according to the overlay thickness, curing unit and curing time. Vickers Hardness (VH) notches were carried out on each specimen. Data were statistically evaluated. The curing unit, curing time and overlay thickness were significant factors capable of influencing VH values. The results showed significantly decreased VH values with increasing specimen thickness (p < 0.05). Significant differences in VH values were found amongst the LCUs for the various exposure times (p < 0.05). According to the results, a time of cure shorter than 80 s (with a conventional quartz–tungsten–halogen LCU) or shorter than 40 s (with a high-power light-emitting diode (LED) LCU) is not recommended. The only subgroup achieving clinically acceptable VH values after a short 20 s curing time included the 3 mm-thick overlays made out of the AURA composite, when the high-power LED LCU unit was used (VH 51.0). Composite thickness has an intense effect on polymerization. In clinical practice, light-cured resin cements may result in insufficient polymerization for high thickness and inadequate times. High-intensity curing lights can attain the sufficient polymerization of resin cements through overlays in a significantly shorter time than conventional halogen light.

Could light-curing time, post-space region and cyclic fatigue affect the nanomechanical behavior of a dual-curing cement for fiber post luting?

OBJECTIVE

To evaluate the effects of curing time, post-space region and cyclic fatigue on the micromechanical properties of a fiber-post luting cement. The null hypotheses were that (1) curing time, (2) fatigue and (3) post-space region does not affect the nanoindentation modulus and hardness of the dual-curing cement.

MATERIALS AND METHODS

48 premolars were endodontically treated and a class I cavity and 8 mm deep post space was prepared. Fiber posts were luted with a universal, dualized adhesive system and a dual-curing cement following manufacturer's instructions. Specimens were divided into three groups (16 specimens for each group) according to light-curing time (no light-curing, 20 s light-curing and 120 s light-curing), which was performed with a LED lamp at 1000 mW/cm 2. The coronal part of the cavity was restored using a nano-filled resin composite. After 24 h, 8 specimens for each group were randomly extract in order to undergo to fatigue test in wet condition through a chewing simulator, while the other specimens were kept in distilled water as benchmark. All the restored teeth were then sectioned in 1 mm thick slices perpendicularly to the fiber post axis. Specimen slices were classified in coronal and apical to be tested through a nanoindenter. Data were analyzed through Kruskal-Wallis test with a significance level of 1%, in order to evaluate the influence of treatments (i.e., curing time and cyclic loading) on the micromechanical properties of the tested luting cement.

RESULTS

Both fatigue and curing time significantly influenced nanoindentation modulus and hardness of dual-curing cement (p < 0.01). No significant differences were reported for post space region. A significant interaction was found among the analyzed factors (p < 0.01).

SIGNIFICANCE

120 s light-curing time is recommended in order to achieve optimal mechanical proprieties, independently from post space region and cyclic fatigue. As matter of fact, 120 s light-curing allowed to prevent strain hardening induced by the fatigue simulation.

Microhardness of resin cements after light activation through various translucencies of monolithic zirconia

PURPOSE

This study aimed to investigate the Vickers Hardness Number (VHN) of light- and dual cured resin cements cured through monolithic zirconia specimens (VITA YZ) of various translucencies: translucent (T); high translucent (HT); super translucent (ST); and extra translucent (XT) at 0, 24, and 48 h after curing.

MATERIALS AND METHODS

Four zirconia specimens from each translucency were prepared. Two light-cured resin cements (Variolink N LC; VL and RelyX Veneer; RL) and two dual-cured resin cements (Variolink N DC; VD and RelyX U200; RD) were used. The cement was mixed and loaded in a mold and cured for 20 s through the zirconia specimen. The upper surface of cements was tested for VHN using a microhardness tester at 0, 24, and 48 h after curing. The VHN were analyzed using two-way repeated, Brown-Forsythe ANOVA with Games Howell post-hoc analysis and independent t-tests (P < .05).

RESULTS

All cements showed significantly higher VHN from 0 h to 24 h (P < .001). At 48 h, the VHN of light-cured cements were significantly lower when cured under the T groups than under XT groups (P = .001 in VL, P = .014 in RL). At each post curing time of each translucency, VD showed higher VHN than VL (P < .05), and RD also showed higher VHN than RL (P < .05).

CONCLUSION

The translucency of zirconia has an effect on the VHN for light-cured resin cements, but has no effect on dual-cured resin cements. Dual-cured resin cement exhibited higher VHN than the light-cured resin cement from the same manufacturer. All resin cements showed significantly higher VHN from 0 h to 24 h.

Do Chemical-Based Bonding Techniques Affect the Bond Strength Stability to Cubic Zirconia?

This study evaluated the effectiveness of chemical-based adhesive techniques on promoting immediate and aged bond strength between zirconia and luting cement. A total of 128 discs of zirconia were divided into 4 groups (n = 32) according to the adhesive treatment: tribochemical silica-coating followed by silane (Silane Primer, Kerr) and bonding (Optibond FL, Kerr), Signum Zirconia Bond (Hereaus), Z-Prime Plus (Bisco), and All-Bond Universal (Bisco). Composite cylinders were cemented on the zirconia sample with Duo-Link Universal (Bisco). Eight specimens per group were subjected to 10,000 thermocycles and subsequently bond strength was tested with shear-bond strength test. ANOVA test showed that artificial aging significantly affected the bond strength to zirconia. Bonferroni test highlighted a significant influence of adhesive treatment (Signum) on bond strength after thermocycling. It was concluded that 10-MDP-based bonding systems showed no improvement in initial bond strength compared with tribochemical treatment. All chemical bonding techniques tested in this study were influenced by thermocycling.

Bonding to zirconia: Effects of translucency and cusp inclinations using an experimental methodology

Purpose To investigate the effects of translucency and cusp inclination on the micro-shear bond strength (µSBS) of zirconia to self-adhesive resin cement (SARC).Methods Sixty U-shaped zirconia specimens with 1.0 mm thickness consisting of three planes (0°, 20°, and 30°) simulating different cusp inclinations were fabricated from zirconia blocks of high, moderate, and low translucency (n=20). SARC was bonded to the specimen and light-cured for 40 s. The µSBS was tested using a universal testing machine with a cross-head at a speed of 0.5 mm/min and fracture mode was observed using a stereomicroscope (×50). Two-way analysis of variance followed by a post hoc Tukey's honest significant difference test was used for the statistical analyses (α=0.05).Results Varied µSBS values were found in the test groups (7.1-14.9 MPa). Within the zirconia of the same translucency, the µSBS value of the plane 0° specimen was significantly higher than that of the 20° and 30° planes (all p<0.05). Within the zirconia of the same cusp inclination, the µSBS value of highly translucent zirconia was significantly higher than that of moderate and low translucent zirconia (all p<0.05). There was no significant interaction between cusp inclination and translucency (p=0.525). Among the fracture modes, 83.33% were adhesive failure, 11.11% mixed failure, and 5.56% were cohesive failure.Conclusions Translucency and cusp inclination significantly affect the µSBS of zirconia to SARC. The higher the translucency, the greater are the µSBS values; the higher the cusp inclination, the lower are the µSBS values.

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

Aim:

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

Materials and Methods:

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

Statistical Analysis Used:

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

Results:

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

Conclusion:

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

The influence of zirconia veneer thickness on the degree of conversion of resin-matrix cements: an integrative review

OBJECTIVE

The main aim of this study was to conduct an integrative review on the influence of the zirconia veneer thickness on the degree of conversion of resin-matrix cements.

MATERIALS AND METHOD

An electronic search was performed on PubMed using a combination of the following search items: zirconia, thickness, veneer, degree of conversion, resin cement, light curing, and polymerization. Articles published in the English language, up to July 2020, were included regarding the influence of ceramic veneer thickness on the degree of conversion of resin-matrix cements. Randomized controlled trials and prospective cohort studies were also evaluated.

RESULTS

Of the 21 selected studies, 9 investigated the light-curing effect, while five other articles evaluated the ceramic translucency. Three studies evaluated the degree of conversion of the resin-matrix cement while four articles assessed the veneer thickness. Results revealed a significant decrease of light transmission through the zirconia with a thickness ranging from 0.1 up to 1.5 mm. However, the ultra-thin thickness around 0.1 and 0.3 mm allowed a full polymerization of the dual-curing resin-matrix cement resulting in the integrity of the interface properties. The light-curing process of resin-matrix cements is also affected by the shade, chemical composition, and microstructure of zirconia and resin cement. Optimal conditions of light-curing are required to reach the threshold intensity of light and energy for polymerization of resin-matrix cements.

CONCLUSIONS

The increase in zirconia veneer thickness negatively affects the degree of conversion of resin-matrix cements. Also, shade and microstructure are key factor to improve the light curing of resin cements.

CLINICAL RELEVANCE

Clinicians should consider the zirconia thickness on resin-based cementation since a higher veneer thickness can negatively affect the light irradiation intensity towards the dual-curing resin-matrix cement. Thus, the degree of conversion of the resin-matrix cement can decrease leading to a low chemical stability (e.g., color instability) and poor mechanical properties.

Initial curing characteristics of composite cements under ceramic restorations

PURPOSE

To assess the degree of conversion (DC) of dual-curing composite cements when cured through ceramic-veneered zirconia disks.

METHODS

Portions of mixed cement, either G-CEM LinkForce (GC), Panavia V5 (Kuraray Noritake) or ResiCEM (Shofu), were placed on the ATR crystal of a Fourier Transform Infrared Spectroscope (FTIR; iS50, Thermo Scientific) and squeezed to a 100-µm film thickness using a microscopy cover glass. DC (%) of the composite cements applied in self-curing mode was measured in the dark at 37°C. Following the dual-curing mode, the cements were light-cured directly (positive control) or through a ceramic-veneered zirconia disk (0.5-mm thick zirconia with a 1.0-mm thick veneering ceramic) for 40 sec using two light-curing units (G-Light Prima 2, GC; PenCure, Morita). Per experimental group, 5 tests were conducted to measure DC in self-cure and dual-cure mode (n=5). FTIR spectra of the composite cement films were acquired to determine DC every min up to 30 min. DC of the composite cements was statistically compared using two-way repeated-measures ANOVA (α=0.05).

RESULTS

For all cements investigated, the self-curing mode resulted in significantly lower DC at 10, 20 and 30 min than the light-curing mode. When the composite cements were light-cured through the zirconia disk, DC at 30 min dropped significantly for ResiCem (Shofu), while not for Panavia V5 (Kuraray Noritake) and G-CEM LinkForce (GC).

CONCLUSIONS

Self-curing slows down polymerization but does not reach for all composite cements the highest (light-cured) DC. Ceramic-veneered zirconia-based restorations may affect DC of some composite cements.

Effect of photo-polymerization mode on the degree of conversion of resin cement under different ceramic materials

BACKGROUND

This study evaluated the effect of different polymerization modes and duration on the degree of conversion (DC) of resin cement under different types of ceramics.

METHODS

Ceramic materials were divided into 3 groups (N.=60): group 1, Cerasmart; group 2, Vita Enamic; and group 3, Vita Mark II. Each group was then divided into three subgroups (N.=20) according to the polymerization mode (A: low-intensity; B: high-intensity; and C: soft-start). Subgroups were then divided into two further groups according to the polymerization time (I: 10 s; and II: 20 s). DC of light-cured resin cement beneath different kinds of ceramics was tested using FTIR spectroscopy. Results were compared to a control group cured without overlying ceramic.

RESULTS

While the type of ceramic and mode of polymerization showed a significant effect on the DC of resin cement, polymerization duration did not. Vita Mark II group showed the highest DC of resin cement followed by Vita Enamic and Cerasmart. High- and low-intensity polymerization modes did not show significant difference, but both showed significantly lower DC when compared to soft start mode.

CONCLUSIONS

Type of ceramic and polymerization mode showed a direct effect on the DC of resin cement.

Influence of curing modes on the degree of conversion and mechanical parameters of dual-cured luting agents

PURPOSE

To investigate the effects of different curing modes, including tack cure, on the degree of conversion (DC) and mechanical parameters of dual-cured luting agents for all-ceramic restorations.

METHODS

Immediate light curing, intermittent light curing (2-s tack cure and a 1-min interval before the main cure), delayed light cuing (2-min delay) and chemical or no light curing were used to cure two dual-cured luting agents, RelyX Unicem and PermaCem 2.0, through a 1.5-mm thick lithium disilicate ceramic slide. DC (n=3), micro-hardness (n=5), shrinkage strain (n=4) and shrinkage stress (n=3) were measured under the aforementioned curing modes. The data were analyzed using two-way ANOVA and post-hoc Tukey HSD test, with the level of significance set at α=0.05.

RESULTS

For both luting agents, all the light-curing modes produced similar final DC, but using chemical cure only could significantly reduce the DC. The mechanical parameters followed a similar pattern. There were positive but nonlinear correlations between DC and the other mechanical parameters, with the increase in these parameters with DC being slower initially.

CONCLUSIONS

Provided adequate light curing is applied to a dual-cured luting agent, delaying the light curing or using a tack cure first to facilitate seating of a restoration may not have a significant impact on the luting agent's final degree of conversion. However, using chemical cure only may result in inadequate cure of the luting agent and is recommended only for highly opaque restorations.

Mechanical Behavior of Ceramic Monolithic Systems With Different Thicknesses

OBJECTIVES

This study assessed the fully stabilized zirconia (FSZ) Prettau Anterior, the partially stabilized zirconia (PSZ) Prettau, and the lithium disilicate IPS e.max CAD (LD) through microstructural and mechanical characterization and effect of thickness on fracture load of the ceramics.

METHODS AND MATERIALS

Disk-shaped specimens (12 mm diameter and 1.2 mm thickness) were prepared for biaxial flexural strength (BFS) and Weibull statistics (n=30). For the fracture load static test (FLST) and Weibull statistics (n=30), disk-shaped specimens 12 mm in diameter and thicknesses of 0.5 mm, 1 mm, and 1.5 mm were cemented on an epoxy-resin substrate.

RESULTS

BFS (MPa) results were PSZ: 683.0 ± 70.23; FSZ: 438.6 ± 64.1; and LD: 248.6 ± 37.3. One-way analysis of variance (ANOVA) for BFS was significant (p<0.001), and the Tukey post hoc test showed differences among all ceramics. There was difference in characteristic strength, but there was no difference in Weibull modulus. Two-way ANOVA for FLST was significant for ceramic (p<0001), thickness (p<0001), and interaction (p<0001). There was no difference among all ceramics at the 0.5 mm thickness. PSZ had higher values for the 1.0 mm and 1.5 mm thicknesses. LD of 1.5 mm thickness exhibited a higher FLST than FSZ.

CONCLUSIONS

PSZ had the highest BFS, but when cemented on a substrate, all ceramics with 0.5 mm thickness behaved similarly. Despite the lower BFS, LD had a fracture load similar or superior to FSZ when cemented on a substrate.

In Vitro Cytotoxicity of Self-Adhesive Dual-Cured Resin Cement Polymerized Beneath Three Different Cusp Inclinations of Zirconia

The aim of the present study was to evaluate the in vitro cytotoxicity of self-adhesive dual-cured resin cement (SADRC) polymerized beneath three different cusp inclinations of zirconia with different light curing time. A commercial SADRC (Multilink Speed) was polymerized beneath zirconia (ZrO₂) with three different cusp inclinations (0°, 20°, and 30°) for 20 s or 40 s. After being stored in light-proof box for 24 h, the ZrO₂-SADRC specimens were immersed in DMEM for 72 h and then we got the extract solution, cultured the human gingival fibroblasts (HGF, 8 × 10³ per well) with 100% or 50% concentrations of the extract solution for 24 h, 72 h, and 120 h, respectively, and evaluated cytotoxicity of the polymerized SADRC with CCK-8 assay in optical density (OD) values, relative growth rates (RGR), and cytotoxicity grades. Statistical analysis was conducted using a two-way ANOVA followed by post hoc Student–Newman–Keuls test. The OD values varied from 0.8930 to 3.2920, the RGR varied from 33.93% to 98.68%, and the cytotoxicity grades varied from 0 to 2. There was significant difference in the OD values among the different cusp inclinations of zirconia (P < 0.001), and there was significant difference in the OD values between the different light curing times in some situations (P < 0.05). The cusp inclination of zirconia affects the in vitro cytotoxicity of SADRC. Prolonging the light curing time from 20 s to 40 s can reduce the in vitro cytotoxicity of SADRC when the cusp inclination of zirconia is smaller than 20°.

Evaluation of Dual-Cure Resin Cement Polymerization under Different Types and Thicknesses of Monolithic Zirconia

Purpose

The aim of the present study was to investigate the effects of the type and thickness of the zirconia material on the microhardness of the underlying dual-cure resin cement.

Materials and Methods

Eight disk-shaped zirconia specimens with a 4-mm diameter and four varying thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were fabricated from two different monolithic zirconia materials: posterior monolithic zirconia (Prettau) and anterior monolithic zirconia (Prettau Anterior). Dual-cure resin cement specimens with a 4-mm diameter and 5-mm height were prepared using Teflon cylinder molds and activated by light beneath the eight zirconia disks and without any zirconia disk for 20 s (n=12). A total of 108 specimens were embedded in acrylic. Vickers hardness of each specimen was measured at three different depths using a microhardness device with a 50-g load. All data were statistically evaluated using three-way ANOVA, one-way ANOVA, independent samples t-tests, and Bonferroni corrected post hoc tests (α=.05).

Results

Dual-cure resin cement's microhardness was significantly higher for the samples polymerized beneath anterior monolithic zirconia compared to posterior monolithic zirconia. The hardness decreased as the thickness increased for both types of zirconia; the latter was attributed to an attenuated curing efficiency.

Conclusion

Microhardness of the dual-cure resin cement is influenced by both the type and the thickness of the monolithic zirconia restoration. Polymerization efficiency for resin cement cured under anterior monolithic zirconia may be superior to cured beneath posterior monolithic zirconia.