Effect of incorporating BisGMA resin on the bonding properties of silane and zirconia primers

Effect of trialkoxysilane/aminosilane-containing universal adhesive on resin-ceramic microtensile bond strength and ceramic wettability: An in-vitro study

Background

The dual-silane (trialkoxysilane/aminosilane) universal adhesive (UA) is claimed for its enhanced priming capacity of glass-ceramics.

Objective

This study evaluated the effect of organofunctional trialkoxysilane- and organofunctional trialkoxysilane/aminosilane-containing UAs on the long-term resin-ceramic microtensile bond strength (μTBS) and wettability of ceramic.

Methods

Hydrofluoric acid-etched lithium disilicate discs were distributed into four groups as follows: (control), no priming was performed; (MBN), primed using a silane-based primer (Monobond N); (SBU), primed using a trialkoxysilane-containing UA (Single Bond Universal Adhesive) and (SBP), primed using a trialkoxysilane/aminosilane-containing UA (Scotchbond Universal Plus Adhesive). Ceramic discs were cemented into blocks then sectioned into microbeams stored in distilled water at 37° for 1 year. The μTBS was evaluated followed by assessment of the failure modes. The contact angle of the two UAs was measured with a goniometer using the sessile drop technique.

Results

MBN significantly improved the resin-ceramic μTBS (31.71 ± 6.33 MPa) compared to the control group. The resin-ceramic μTBS obtained after priming using SBP (22.83 ± 3.42 MPa) was comparable to those of MBN. SBU showed significantly inferior resin-ceramic μTBS (16.02 ± 6.28 MPa) compared with MBN. Mixed failures mode patterns were the most frequent in the groups. The ceramic wettability of both UAs did not significantly differ.

Conclusion

Ceramic priming using a UA with dual-silane monomers (organofunctional trialkoxysilane/aminosilane) resulted in long-term adhesion comparable to a silane-containing primer. Incorporating aminosilane monomer in UA formulation did not affect the wetting of characteristics of the UA solution and enhanced its glass-ceramic priming capacity.

Clinical significance

The use of UA with optimized silane content as a primer for glass-ceramics simplifies clinical adhesive procedures including resin cementation and repair of ceramic restorations.

Influence of Varied Silane Commercial Brands and Adhesive Application on Bond Strength and Stability to Lithium Disilicate Glass Ceramic

OBJECTIVES

This study aimed to evaluate the impact of various commercial silane brands with varied chemical compositions with or without the application of an adhesive layer on the microshear bond strength and durability of a resin luting agent to lithium disilicate glass ceramic.

METHODS AND MATERIALS

Lithium disilicate glass ceramic discs (EMX, IPS e.max Press, Ivoclar Vivadent) measuring 10 mm in diameter and 3 mm in thickness were fabricated (n=240). Surfaces were etched using 5% hydrofluoric acid and randomly assigned to 10 groups based on the commercial brand of silane used (n=24): [RP] RelyX Ceramic Primer (3M ESPE); [PS] Prosil (FGM); [SA] Silano (Angelus); [SM] Silano (Maquira); [SU] Silane (Ultradent); [GL] GLUMA Ceramic Primer (Kulzer); [CB] Ceramic Bond (VOCO); [MB] Monobond N (Ivoclar Vivadent); [CP] Clearfil Ceramic Primer (Kuraray); and [DE] 2-step silane (Dentsply Sirona). Half of the EMXs (n=12) received a thin adhesive layer (+) after the silane and prior to resin luting agent, while the other half (n=12) did not receive an adhesive layer (-). For the microshear bond strength test (μSBS), four light-cured resin luting agent cylinders (1 mm in diameter) were created on each EMX surface. Half of these specimens were tested after 24 hours, while the other half were stored in deionized water for 6 months. The μSBS test was conducted using a universal testing machine (DL 500, EMIC) at a crosshead speed of 1 mm/min until failure. The obtained data underwent statistical analysis using analysis of variance (ANOVA) and the Tukey test (α=0.05).

RESULTS

There was significant influence of the silane commercial brand on bond strength. Notably, "universal primers" yielded lower bond strength results compared to "pure" silane solutions. Water storage had a detrimental effect on microshear bond strength for certain silane commercial brands. Additionally, the application of an adhesive layer negatively impacted bond strength results for all silanes.

CONCLUSIONS

This study confirms the importance of both silane commercial brand and chemical composition in relation to bond strength of resin luting agents to lithium disilicate glass ceramic. Furthermore, the application of an adhesive layer may have an adverse effect on bond stability over time.

Effect of universal adhesives and self-etch ceramic primers on bond strength to glass-ceramics: A systematic review and meta-analysis of in vitro studies

STATEMENT OF PROBLEM

To simplify dental procedures, multicomponent products such as universal adhesives and self-etch ceramic primers have been recommended for glass-ceramic bonding; however, studies have shown a wide range of results.

PURPOSE

The purpose of this systematic review and meta-analysis was to analyze the in vitro bond strength promoted by hydrofluoric acid+silane-containing universal adhesives and a self-etch ceramic primer to glass-ceramics and compare it with that of conventional treatments.

MATERIAL AND METHODS

A systematic search was conducted in the PubMed/Medline, Scopus, LILACS, and ISI Web of Science databases up to April 2021. In vitro studies assessing the resin-mediated bond to glass-ceramics by using a self-etch ceramic primer and hydrofluoric acid+silane-containing universal adhesives and/or compared with traditional hydrofluoric acid+glass-ceramic primers were included. Selection of studies, data extraction, and risk-of-bias analysis were performed. Statistical analysis was performed by using a review management software program using a random effects model (α=.05).

RESULTS

A total of 33 studies were included in the qualitative analysis and 26 studies in the quantitative analysis. Bond strength to lithium disilicate ceramic was higher when a hydrofluoric acid+glass-ceramic primer was used than when using a hydrofluoric acid+silane-containing universal adhesive (P<.05), except when 9% to 10% acid concentration was used in combination with static aging (P=.100). A self-etch ceramic primer promoted bond strength values to lithium disilicate that were similar to those of the hydrofluoric acid+glass-ceramic primer (P>.100).

CONCLUSIONS

Hydrofluoric acid+silane-containing universal adhesive was not as effective as the hydrofluoric acid+glass-ceramic primer in promoting bond strength to glass-ceramic. Bond strength values generated by a self-etch ceramic primer to glass-ceramic were similar to those generated by the conventional treatment.

Does the use of antioxidant agents after dental bleaching compromise the aesthetic results of ceramic laminate veneers?

PURPOSE

This in vitro study aimed to evaluate the aesthetic compromise generated in adhesive interface of ceramic laminate veneer luted after tooth bleaching and the use of antioxidant agents. Thus, the chromatic coordinates and whitening index (WID) were evaluated, comparing whiteness changes (ΔWID) results to perceptibility and acceptability thresholds.

MATERIAL AND METHODS

In total, 88 bovine enamel samples (7 × 8 × 4 mm; n = 8) were submitted to the ceramic laminate veneer luting protocol according to surface treatment (unbleached and bleached enamel), antioxidant agents (control; 10% ascorbic acid and 10% α-tocopherol), and luting periods (after 24 h and after 14 days). To lute IPS e.max ceramic restorations (7 × 8 × 0.6 mm), Tetric N-Bond Universal adhesive system and Variolink Aesthetic LC resin cement were used. An ultraviolet-visible spectrophotometer (UV-VIS) was utilized to measure CIE L*a*b* coordinates prior to and after UV-B artificial accelerated aging for 252, 504, and 756 h. L*, a*, and b* axes were evaluated separately, and the whitening stability (ΔWID) effect was assessed by varying the whiteness index for dentistry (WID). The 50:50% visual threshold was used to evaluate ΔWID values (whiteness perceptibility [WPT] and whiteness acceptability [WAT]). Color parameters changes (ΔL*Δa*Δb*), WID, and ΔWID data were subjected to 2-way repeated measures ANOVA followed by Tukey's test (α = 0.05).

RESULTS

Different UV-aging periods influenced the chromatic coordinates, WID, and ΔWID of the ceramic restorations regardless of the bleaching treatment, antioxidant solutions and luting periods (P < .05). In general, ΔWID values after UV-aging periods were above perceptibility and acceptability thresholds (WPT = 0.72 and WAT = 2.62, respectively) for all experimental groups (P < .05). Unbleached and 10% ascorbic acid-treated enamels luted after 14 days of the antioxidant action exhibited lower ΔL* and Δb* values, while control group showed lower Δa* values. All experimental groups showed similar performance on ΔWID compared to the control group, regardless of the UV-aging period analyzed (P > .05).

CONCLUSION

α-tocopherol is a suitable antioxidant solution to be used 24 h post enamel bleaching not compromising clinical acceptability of ceramic laminate veneers.

CLINICAL RELEVANCE

The adhesive interface of ceramic laminate veneers may appear darker after the use of antioxidant agents affecting the clinical acceptability of the restorations.

Effect of Bonding Protocols on the Performance of Luting Agents Applied to CAD-CAM Composites

This in vitro study aimed to evaluate the effect of different bonding strategies on the micro-shear bond strength (μSBS) of luting agents to CAD−CAM composites. Surface scanning electron microscopy (SEM) and spectroscopy by energy-dispersive X-ray spectroscopy (EDS) were performed to analyze the surfaces of the composite before and after bonding treatment. Three CAD−CAM composites were evaluated: Lava Ultimate restorative (LU), Brava Blocks (BR), and Vita Enamic (VE). The LU and BR surfaces were sandblasted using aluminum oxide, while the VE surfaces were etched using a 5% hydrofluoric acid gel according to the manufacturers’ recommendations. All surfaces were subjected to the following bonding strategies (n = 15): adhesive with silane and MDP (ScotchBond Universal, 3M Oral Care, St Paul, MI, USA); adhesive with MDP (Ambar Universal, FGM, Joinville, Brazil); adhesive without silane or MDP (Prime&Bond Elect, Dentsply Sirona, Charlotte, NC, USA), pure silane without MDP (Angelus, Londrina, Brazil), and pure silane with MDP (Monobond N, Ivoclar Vivadent, Schaan, Liechtenstei). Afterwards, tygons were filled with RelyX Ultimate (3M Oral Care), AllCem (FGM), or Enforce (Dentsply Sirona), which were light-cured and subjected to the μSBS test. Data were analyzed using two-way ANOVA and Bonferroni’s post hoc test (α = 0.05). Additional blocks (n = 15) were subjected to scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) before and after the surface treatment. The μSBS values on VE surfaces were higher than those observed on LU and BR surfaces (p < 0.001). Silane without MDP (Allcem) promoted the highest μSBS values, while silane with MDP (RelyX Ultimate) provided the highest values among all bonding strategies (p < 0.001). Enforce promoted no significant difference in μSBS values. SEM and EDS analyses detected noticeable changes to the surface morphology and composition after the surface treatment. The effectiveness of the bonding strategy may vary according not only to the CAD−CAM composite but also to resin cement/bonding agent/silane used.

Bonding of Clear Aligner Composite Attachments to Ceramic Materials: An In Vitro Study

Background: We aim to evaluate the effect of surface conditioning, bonding agents and composite types on surface roughness (SR) and shear bond strength (SBS) of clear aligner composite attachments bonded to ceramics. Methods: One hundred and eighty IPS e.max CAD specimens were prepared. For SR, 60 specimens were divided according to surface conditioning (n = 15) into four groups: control, 9.6% hydrofluoric acid (HFA), 37% phosphoric acid (PhA), air abrasion (AA). SR was measured using a Profilometer and Atomic Force Microscopy. For SBS, 120 specimens were divided according to conditioning methods (n = 40) (9.6% HFA and 37% PhA or AA), then according to bonding agents (n = 20) (Assure universal bond (AUB) or Single bond universal (SBU)) and then according to composite type (n = 10): Filtek™ Z350 and Filtek™ Z350 XT flowable composite. SBS was measured using Instron testing machine. Descriptive and group comparison were calculated (p < 0.05). Results: AA had the highest SR, while the control had the lowest SR (p < 0.05). HFA had the highest, but insignificant SBS, followed by AA (p > 0.05). AUB had higher SBS than SBU (p < 0.001). Filtek™ Z350 produced higher SBS than Filtek™ Z350 XT flowable composite (p < 0.01). Conclusion: The combination of AA, AUB, and Filtek Z350 produced the highest SBS, followed by HFA, AUB, and Filtek Z350.

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.

Composite repair: On the fatigue strength of universal adhesives

OBJECTIVES

To determine whether the composition of universal adhesives and the use of silane coupling agents could affect the fatigue strength of composite repair.

METHODS

Composite samples were aged in water at 37 °C for 90 days and bonded to fresh composite to produce twin-bonded bar-shaped composite specimens (2 × 2 × 12 mm). Five universal adhesives, a multistep composite repair system and a hydrophobic solvent-free resin associated to a separate silane coupling agent application were used for bonding. Composite samples were tested under 4-pointflexure initially at quasi-static loading (n = 12) followed by cyclic loading (n = 25). The stress-life fatigue behavior was evaluated following the staircase method at 4 Hz. The unfractured side of cyclic loaded beams were evaluated under SEM to determine crack initiation sites. Fatigue data was analyzed by ANOVA and Tukey test and Wilcoxon Rank Sum Test (α = 0.05).

RESULTS

Bonding protocols were unable to restore the cohesive strength of the nanofilled composite (p < 0.05). Fatigue testing was more discriminative to reveal discrepancies in composite repair than conventional quasi-static loading. While the composition of universal adhesives affected composite repair potential, the highest endurance limits occurred for the separate silane coupling agent application. Crack propagation sites were mostly located on the aged composite surface.

SIGNIFICANCE

Although a trend for simplification invariably overruns current adhesive dentistry, composite repair using solely universal adhesives may result in inferior repair potential. The additonal use of silane coupling agents remains as an important procedure in composite repairs.

Surface Treatment Effect on Shear Bond Strength between Lithium Disilicate Glass-Ceramic and Resin Cement

OBJECTIVE

 The study aimed to evaluate the shear bond strength (SBS) of lithium disilicate glass-ceramic (LDGC) and resin cement (RC) using different surface treatments.

MATERIALS AND METHODS

 LDGC blocks (Vintage LD Press) were prepared, etched with 4.5% hydrofluoric acid, and randomly divided into seven groups (n = 10), depending on the surface treatments. The groups were divided as follows: 1) no surface treatment (control), 2) Silane Primer (KS), 3) Signum Ceramic Bond I (SGI), 4) Signum Ceramic Bond I/Signum Ceramic Bond II (SGI/SGII), 5) experimental silane (EXP), 6) experimental silane/Signum Ceramic Bond II (EXP/SGII), and 7) Experimental/Adper Scotchbond Multi-purpose Adhesive (EXP/ADP). The specimens were cemented to resin composite blocks with resin cement and stored in water at 37 °C for 24 hours. The specimens underwent 5,000 thermal cycles and were subjected to the SBS test. Mode of failure was evaluated under the stereo microscope.

STATISTICAL ANALYSIS

 Data were analyzed with Welch ANOVA and Games-Howell post hoc tests (α = 0.05).

RESULTS

 The highest mean SBS showed in group EXP/ADP (45.49 ± 3.37 MPa); however, this was not significantly different from group EXP/SGII (41.38 ± 2.17 MPa) (p ≥ 0.05). The lowest SBS was shown in the control group (18.36 ± 0.69 MPa). This was not significantly different from group KS (20.17 ± 1.10 MPa) (p ≥ 0.05).

CONCLUSIONS

 The different surface treatments significantly affected the SBS value between LDGC and RC. The application of pure silane coupling agent with or without the application of an adhesive improved the SBS value and bond quality.

Surface roughness and shear bond strength to composite resin of additively manufactured interim restorative material with different printing orientations

STATEMENT OF PROBLEM

Additive manufacturing (AM) is a technology that has been recently introduced into dentistry for fabricating dental devices, including interim restorations. Printing orientation is one of the important and influential factors in AM that affects the accuracy, surface roughness, and mechanical characteristics of printed objects. However, the optimal print orientation for best bond strength to 3D-printed interim restorations remains unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of printing orientation on the surface roughness, topography, and shear bond strength of AM interim restorations to composite resin.

MATERIAL AND METHODS

Disk-shaped specimens (Ø20×10 mm) were designed by a computer-aided design software program (Geomagic freeform), and a standard tessellation language (STL) file was obtained. The STL file was used for the AM of 60 disks in 3 different printing orientations (0, 45, and 90 degrees) by using E-Dent 400 C&B material. An autopolymerizing interim material (Protemp 4) was used as a control group (CNT), and specimens were fabricated by using the injecting mold technique (n=20). Surface roughness (Sa, Sz parameters) was measured by using a 3D-laser scanning confocal microscope (CLSM) at ×20 magnification. For shear bond testing, the specimens were embedded in polymethylmethacrylate autopolymerized resin (n=20). A flowable composite resin was bonded by using an adhesive system. The specimens were stored in distilled water at 37 °C for 1 day and thermocycled 5000 times. The shear bond strength (SBS) was measured at a crosshead speed of 1 mm/min. The data were analyzed by 1-way ANOVA, followed by the Tukey HSD test (α=.05).

RESULTS

The 45-degree angulation printing group reported the highest Sa, followed by the CNT and the 90-degree and 0-degree angulations with significant difference between them (P<.001). The CNT showed the highest Sz, followed by the 45-degree, 90-degree, and 0-degree angulations. The mean ±standard deviation SBS was 28.73 ±5.82 MPa for the 90-degree, 28.21 ±10.69 MPa for the 45-degree, 26.21 ±11.19 MPa for the 0-degree angulations and 25.39 ±4.67 MPa for the CNT. However, no statistically significant difference was found in the SBS among the groups (P=.475).

CONCLUSIONS

Printing orientation significantly impacted the surface roughness of 3D-printed resin for interim restorations. However, printing orientation did not significantly affect the bond strength with composite resin.

Effect of Silane-Containing Universal Adhesives on the Bonding Strength of Lithium Disilicate

The purpose of this study was to investigate the effect of silane-containing universal adhesives on the bonding strength of lithium disilicate. Two-hundred-and-forty lithium disilicate blocks were divided into 16 groups according to the following surface treatments: hydrofluoric acid (HF)-treated or not, silane-treated or not, and the type of universal adhesive used (All-Bond Universal (ABU); Prime & bond (PB); Clearfil Universal Bond (CU); Single bond Universal (SBU)). After surface treatment, resin discs were bonded to each lithium disilicate using dual-cure resin cement. Bonded specimens were stored in distilled water for 24 h and then subjected to microtensile bond strength (μTBS) test. Failure modes were examined under stereomicroscope. Microscopic observation of bonded interfaces was analyzed using scanning electron microscopy. The μTBS data were statistically analyzed. Regardless of silane treatment, all groups treated with HF showed higher bonding strengths compared to those that were not treated with HF (p < 0.05). In groups treated with HF, the bonding strength increased after silane application (p < 0.05) except PB and CU (p > 0.05). Adhesive failures were dominant in all groups, but some mixed failures were observed in ABU treated with HF and silane. While most of the specimens that were not treated with silane after HF application only showed loose bonding between the ceramic and resin cement due to partial gaps, the specimens treated with silane application after HF showed a tight ceramic–resin interface. In conclusion, the silane in universal adhesives did not effectively improve the bonding strength between lithium disilicate and resin cement.

Effect of different surface treatments of presintered or sintered zirconia on bond strength to dentine

Aim:

To compare the effect of different zirconia surface treatments on cement bond strength to dentine.

Materials and Methods:

Stick-shaped pre-sintered zirconia (N = 128) were prepared and divided into eight groups (n = 16). Three surface treatments (sandblasting, neodymium-doped yttrium aluminum garnet [Nd:YAG] or carbon dioxide laser irradiation) were applied, either before (later to be sintered) or after sintering. The last test group was sintered zirconia coated with feldspathic veneering ceramic. Sintered zirconia without surface treatment was tested as the control group. Zirconia samples were cemented to dentine using Panavia F2 cement. The micro-shear bond strength was measured after 24 h (n = 8) or 10,000 thermocycling (n = 8).

Statistical Analysis:

Data were analyzed using one-way analysis of variances and Student's t-tests.

Results:

Zirconia coated with feldspathic ceramic revealed the highest bond strength (P < 0.001). Presintered zirconia treated with Nd: YAG laser showed a significantly improved bond strength compared to the control group before and after thermocycling. The bond strength after thermocycling was significantly reduced in presintered zirconia treated with Nd: YAG or sandblasting. Adhesive failure at the zirconia-cement interface was the dominant failure type.

Conclusions:

Surface treatment of presintered zirconia by Nd:YAG laser or coating of the sintered specimens with feldspathic veneering ceramic increased the zirconia-cement bond strength.

Effect of zirconia decontamination protocols on bond strength and surface wettability

OBJECTIVE

To evaluate the effects of human saliva decontamination protocols on bond strength of resin cement to zirconia (Y-PSZ), wettability, and microbial decontamination.

MATERIALS AND METHODS

Zirconia plates were sandblasted and divided into (a) not contaminated, (b) contaminated with human saliva and: (c) not cleaned, (d) cleaned with air-water spray, (e) cleaned with 70% ethanol, (f) cleaned with Ivoclean, or (g) cleaned with nonthermal atmospheric plasma (NTAP). The wettability and microbial decontamination of the surfaces were determined after saliva contamination or cleaning. Monobond Plus (Ivoclar Vivadent) was applied after cleaning, followed by Variolink LC (Ivoclar Vivadent). The samples were stored 1 week before shear bond strength (SBS) testing, and data (SBS and wettability) were analyzed by one-way analysis of variance and Tukey test (α = .05).

RESULTS

Saliva contamination reduced SBS to zirconia compared to not contaminated. Both Ivoclean and NTAP produced higher SBS compared to not cleaned and were not significantly different from the not contaminated. Ivoclean produced the highest contact angle, and NTAP the lowest. With the exception of using just water-spray, all cleaning protocols decontaminated the specimens.

CONCLUSIONS

Both Ivoclean and NTAP overcame the effects of saliva contamination, producing an SBS to zirconia comparable to the positive control.

CLINICAL SIGNIFICANCE

Dental ceramics should be cleaned prior to resin cementation to eliminate the effects of human saliva contamination, and Ivoclean and NTAP are considered suitable materials for this purpose.

Influence of different surface treatments and universal adhesives on the repair of CAD-CAM composite resins: An in vitro study

STATEMENT OF PROBLEM

The repairability of computer-aided design and computer-aided manufacturing (CAD-CAM) composite resins might be adversely affected by the high degree of matrix polymerization that occurs during their manufacturing process. However, information on their repairability is lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the microtensile bond strength of CAD-CAM composite resins subjected to simulated repair procedures by using varying surface treatments and universal adhesives.

MATERIAL AND METHODS

Four different CAD-CAM blocks (Brilliant Crios, Lava Ultimate, Shofu Block HC, and Vita Enamic) were thermocycled (5000 times, 5/55 °C) and divided into 4 groups according to the surface treatment: control, 9% hydrofluoric acid etching, aluminum oxide airborne-particle abrasion, and tribochemical silica airborne-particle abrasion. After surface treatments, the surface roughness was measured with a nanoindenter and further examined with scanning electron microscopy. After the application of 3 different universal adhesives (Clearfil Universal Bond, Prime&Bond Universal, and Single Bond Universal), the specimens were subjected to a simulated repair process with composite resin. Bonded specimens were cut into 1 mm² beams, and microtensile bond strength values were determined until failure at a crosshead speed of 0.5 mm/min. The bond strength data were analyzed with 3-way analysis of variance, and surface roughness data were analyzed with 2-way analysis of variance tests. Pairwise analyses were performed with the Tukey test (α=.05).

RESULTS

All surface treatments effectively improved repair microtensile bond strength values compared with the control (P<.05). Aluminum oxide airborne-particle abrasion had similar mean bond strength values compared with tribochemical silica airborne-particle abrasion (P>.05). Among the CAD-CAM blocks treated with hydrofluoric acid etching, Vita Enamic had the highest mean bond strength values. The highest mean microtensile bond strength repair values with the highest cohesive failure rates were found with the silane-containing universal adhesive (Single Bond Universal).

CONCLUSIONS

Surface treatment with aluminum oxide airborne-particle abrasion and tribochemical silica airborne-particle abrasion produced successful repair results for aged resin nanoceramics, whereas hydrofluoric acid etching can be used for aged hybrid ceramic repair. Silane-containing universal adhesive reported increased bond strength. Application of universal adhesive after surface treatment is recommended to increase repair strength.

Effect of surface treatments and universal adhesive application on the microshear bond strength of CAD/CAM materials

PURPOSE

The aim of this study was to evaluate the microshear bond strength (µSBS) of four computer-aided design/computer-aided manufacturing (CAD/CAM) blocks repaired with composite resin using three different surface treatment protocols.

MATERIALS AND METHODS

Four different CAD/CAM blocks were used in this study: (1) flexible hybrid ceramic (FHC), (2) resin nanoceramic (RNC), (c) polymer infiltrated ceramic network (PICN) and (4) feldspar ceramic (FC). All groups were further divided into four subgroups according to surface treatment: control, hydrofluoric acid etching (HF), air-borne particle abrasion with aluminum oxide (AlO), and tribochemical silica coating (TSC). After surface treatments, silane was applied to half of the specimens. Then, a silane-containing universal adhesive was applied, and specimens were repaired with a composite, Next, μSBS test was performed. Additional specimens were examined with a contact profilometer and scanning electron microscopy. The data were analyzed with ANOVA and Tukey tests.

RESULTS

The findings revealed that silane application yielded higher µSBS values (P<.05). All surface treatments were showed a significant increase in µSBS values compared to the control (P<.05). For FHC and RNC, the most influential treatments were AlO and TSC (P<.05).

CONCLUSION

Surface treatment is mandatory when the silane is not preferred, but the best bond strength values were obtained with the combination of surface treatment and silane application. HF provides improved bond strength when the ceramic content of material increases, whereas AlO and TSC gives improved bond strength when the composite content of material increases.

Bonding Strength of Universal Adhesives to Indirect Substrates: A Meta-Analysis of in Vitro Studies

PURPOSE

To evaluate the in vitro bond strength of universal adhesive systems to indirect substrates.

MATERIAL AND METHODS

Two reviewers performed a literature search up to March 2018 in seven databases: PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO. The review included studies that compared the bond strength of universal adhesives and well-established material-specific primers to indirect substrates: lithium disilicate ceramic, yttrium-stabilized zirconium dioxide ceramic, leucite-reinforced ceramic, feldspathic porcelain, polymer infiltrated ceramic material, resin composite or metal alloys. Analyses were carried out using RevMan 5.3.5. A global comparison was performed with the standardized mean difference using a random-effects models at a significance level of p < 0.05.

RESULTS

A total of 45 studies were included in the qualitative analysis, and the meta-analysis was performed with 42 studies. Bond strength to glass-based ceramics and alloys was improved with the use of a specific-primer as separate step before the bonding procedures (lithium disilicate, p < 0.001; alloys, p < 0.001). The bond strength to zirconium substrates was improved with the use of universal adhesives (p < 0.001). For bond strength to composite resin as indirect substrate, universal adhesives performed in a manner similar to that of the material-specific primer (p = 0.11).

CONCLUSIONS

The clinical procedure of luting zirconia and resin composite restorations could be simplified by using single-bottle universal adhesives. However, the ability of universal adhesives to achieve an adequate and durable bond to glass-based ceramics and alloys appears to be limited.

Different bonding agents effect on adhesive bond strength: lithium disilicate glass ceramic

Abstract Introduction The silanization of the ceramic surface prior to applying the adhesive and/or resinous materials plays an important role in bond strength. Nowadays, a new family of adhesive systems has been introduced into the market, aiming to simplify the technique of adhesive procedures during cementation. Objective To investigate the effectiveness of different bonding agents containing silane and primer on Lithium Disilicate Glass Ceramic (LD) surface by shear bond strength tests. Material and method 130 LD ceramic blocks were included in acrylic resin, polished and washed in ultrasound for 10 minutes. The specimens were divided into 2 groups according to surface treatment: Polished Surface (PS); Hydrofluoric Acid 9.5% - 20s (HF). Each group was divided into 5 subgroups (n = 13) according to bonding agent type: metallic primer containing MDP (ZPrimePlus, Bisco Inc); two traditional silanes (MonobondPlus, IvoclarVivadent / Porcelain Prime, Bisco Inc.); mixture of silane and resin (Kerr Silane, Kerr); mixture of silane and universal adhesive (Single-bond Universal, 3M Espe). The specimens were mounted in a standard device for shear testing (UltradentBonding Assembly), cemented with dual resin cement (RelyX UltimateTM, 3M Espe.) and photo-polymerized for 20s. The samples were tested after 24 hours and 3 months of storage in distilled water at ±36 °C. The data were analyzed by 3-Way Anova and Tukey's test (α = 5%). Result Shear bond strength (SBS) was significantly influenced by surface treatment, bonding agent used and storage (p <0.001). Conclusion Adequate adhesive bond strength to Lithium Disilicate Glass Ceramic can be obtained with traditional silanes, combined with HF acid pretreatment surface.

Effect of silane and MDP-based primers on physico-chemical properties of zirconia and its bond strength to resin cement

OBJECTIVE

To evaluate the effect of surface treatments on yttria-tetragonal zirconia polycrystal (Y-TZP) characteristics and on resin-mediated zirconia bond.

METHODS

Y-TZP slabs were grit blasted with 45μm alumina or with 30μm silica-coated alumina particles. The chemical treatments were: no-chemical treatment (NC), silane-containing primer (SP), MDP (10-Methacryloyloxydecyl dihydrogen phosphate) and silane-containing primer (MPS), MDP-containing primer (MP) and MDP and silane-containing adhesive (MPA). Contact angle as a function of surface roughness (θ_m) and surface roughness parameter (Sdr) were measured using Fringe Projection Phase Shifting (FPPS). Surface free energy (γ_s^TOT) was calculated with a goniometer. Chemical interaction between primers/adhesive and zirconia was analyzed using time-of-flight secondary ion mass spectrometry (ToF-SIMS). Resin cement microshear bond strength (μSBS) was analyzed at either 24-h or 8-months water storage (37°C). θ_m values, Sdr values, γ_s^TOT and μSBS values were analyzed using Analysis of variance (ANOVA) and post hoc Tukey test (α=0.05).

RESULTS

Chemical treatment had an effect (p<0.001) on all surface parameters analyzed: θ_m, γ_s^TOT and Sdr. MP-treated group showed higher incidence of P-O-Zr bonds than the other groups, indicating more chemical linkages. Grit blasting (p<0.001) and the interaction chemical treatment*storage (p<0.001) did not affect μSBS; all silane-containing primers showed significant drop in μSBS after aging.

SIGNIFICANCE

MDP and/or silane-based solutions affect the physicochemical properties of blasted-zirconia. An MDP-based primer is fundamental to achieve a stable resin-zirconia bonding, but the chemical reactivity of MDP is impaired when this molecule is present in a multicomponent system.

Physicochemical and morphological characterization of a glass ceramic treated with different ceramic primers and post-silanization protocols

OBJECTIVE

Evaluate the effect of different ceramic primers and post-silanization protocols on physicochemical and morphological characteristics of a lithium disilicate glass ceramic.

METHODS

Lithium disilicate ceramic (IPS e-max CAD) plaques (6 × 10 × 2 mm) were divided into 3 groups according to the ceramic primer used: (1) Silane (RelyX Ceramic Primer-RL); (2) Silane + MDP (Clearfil Ceramic Primer Plus-CP); (3) Self-etching ceramic primer (Monobond Etch and Prime-MB). Specimens from each group were distributed into 5 sub-groups according to post-silanization protocols: (a) Treated as recommended by the manufacturer (MR), (b) MR + Additional drying with air at room temperature for 30 s (RTA), (c) MR + additional drying with hot air for 30 s (HT), (d) MR + Surface rinsing with water at room temperature for 10 s and drying with air at room temperature for 30 s (WT), and (e) Specimens were not silanized (NS). Surface free energy (SFE) was determined using static contact angles measurements with water and diiodomethane. SFE data were submitted to Friedman followed by Wilcoxon post-hoc test (α = 0.05). Morphology was analyzed using scanning electron microscopy. Elemental composition and chemical interactions were determined with X-ray photoelectron spectroscopy analysis.

RESULTS

RL presented the highest SFE (62.4 mN/m) followed by CP (59.7 mN/m). Post-silanization protocols resulted in similar SFE, but WT and HT induced the highest water contact angles when using CP and RL. CP modified ceramics' surface morphology compared to the etched and RL treated groups. The presence of water was identified on CP treated specimen. All analyzed primers formed siloxane bonds with ceramic surface.

SIGNIFICANCE

Ceramic primers resulted in different surface free energy and morphology, but siloxane bonds were identified for all tested solutions. HT and WT protocols should be used with RL and CP primers. MB was not influenced by the different silanization protocols.

Evaluation of shear bond strength of zirconia to composite resin using different adhesive systems

Background

To evaluate shear bond strength of zirconia to composite resin using different universal and conventional adhesives and a zirconia primer.

Material and Methods

Forty zirconia blocks were fabricated of zirconium ingots (10×10×5 mm) and sintered at 1530°C for 2 hours. They were then air-abraded with Al2O3 particles. The specimens were divided into 4 groups and subjected to one of the following bonding agents: Futurabond U (group 1), Clearfil Universal Bond, universal adhesives (group 2), Z-Prime Plus, zirconia primer (group 3) and Adper Single Bond 2, conventional adhesive (group 4). Composite resin was then applied in a diameter of 5 mm and in a thickness of 2 mm. All the specimens were stored in distilled water at 37°C for 24 hours and then thermocycled between 5°C and 55°C for 5000 cycles with a 30-second dwell time. The shear bond strength was then evaluated with a universal testing machine at a crosshead speed of 1 mm/min. Data (MPa) were analyzed using ANOVA and LSD test (P≤0.05). The specimens were evaluated under a stereomicroscope to determine the mode of failure.

Results

The mean shear bond strength was 16,874 MPa in group I, 13.4434 MPa in group II, 11.6500 MPa in group III and 6.8700 MPa in group IV. ANOVA revealed that the shear bond strength in group IV was significantly lower than that in other groups (P≤0.05).

Conclusions

The shear bond strength in group I was significantly higher than that in groups III and IV. So Universal adhesives could provide higher shear bond strength of zirconia to composite resin after thermocycling compared to zirconia primers.

Key words:10-MDP, shear bond strength, universal adhesive systems, zirconia primer.

Universal dental adhesives: Current status, laboratory testing, and clinical performance

Increasing demand for simplified and user-friendly adhesive systems has led to the development of a new class of adhesives termed as Universal Adhesives (UAs). The term "Universal" reflects manufacturers' claims that these adhesives can be applied with any adhesion strategy and offer the versatility of use with a variety of direct and indirect restorative materials. The aim of this review was to synthesize the literature regarding the current status of UAs, their adhesion potential to various substrates and their performance in different restorative situations. In vitro studies, clinical trials and systematic reviews were identified utilizing controlled vocabulary and keyword searches in Medline and EMBASE databases. About 282 studies (272 in vitro studies; 11 clinical studies) were included. Available laboratory and clinical evidence does not support the claim that UAs can be used with any adhesive strategy. Although, they can chemically bond to various tooth and direct/indirect restorative substrates, the stability of this bond is material-dependent and subject to hydrolytic degradation. Hence, additional measures are still needed to ensure long-term durability. which undermines the versatility of UAs. The lack of long-term data regarding the clinical performance of UAs further complicates clinical decision-making. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2121-2131, 2019.

Impact of Recently Developed Universal Adhesives on Tensile Bond Strength to Computer-aided Design/Manufacturing Ceramics

OBJECTIVES

The aim of this investigation was to test the tensile bond strength (TBS) between different computer-aided-design/manufacturing (CAD/CAM) ceramics after conditioning using different universal adhesive systems and resin composite cement.

METHODS AND MATERIALS

Substrates of four CAD/CAM ceramics-1) VITABLOCS Mark II, 2) Initial LRF, 3) Celtra Duo, and 4) IPS e.max CAD (N=648, n=162)-were fabricated. VITABLOCS Mark II and Initial LRF were etched using 9% hydrofluoric acid for 60 seconds, Celtra Duo for 30 seconds, and IPS e.max CAD for 20 seconds. Substrates for conditioning using Monobond Etch & Prime were untreated. The following adhesive systems were used: All-Bond Universal (ABU), Clearfil Universal Bond (CUB), G-Multi Primer (GMP), iBond Universal (IBU), Monobond Etch & Prime (MEP), Monobond Plus (MBP), One Coat 7 Universal (OCU), Prime&Bond Active (PBA), and Scotchbond Universal (SBU). Conditioned substrates were bonded using a resin composite cement (Variolink Esthetic DC), thermal cycled (20,000×, 5°C/55°C), and TBS was measured using a universal testing machine. Data were analyzed using univariate analysis with partial eta-squared, Kolmogorov-Smirnov, Kruskal-Wallis, Mann-Whitney U, and Spearman-Rho tests (α=0.05).

RESULTS

ABU, MEP, and MBP obtained the significantly highest TBS, while CUB, IBU, and OCO resulted in the lowest, regardless of the CAD/CAM ceramic. SBU showed varying TBS results depending on the CAD/CAM ceramic used. ABU, MEP, and MBP showed no impact of CAD/CAM ceramic on TBS values. ABU, GMP, MEP, and MBP showed predominantly cohesive failure types in luting composite, while CUB and OCU demonstrated adhesive failure types.

Bond strength between composite repair and polymer-infiltrated ceramic-network material: Effect of different surface treatments

OBJECTIVE

To evaluate the bond strength of a polymer-infiltrated ceramic-network (PICN) material and to composite repair after different surface treatments.

MATERIALS AND METHODS

Eighteen blocks of the PICN material were obtained from CAD/CAM blocks, aged and randomly divided into 2 groups: 5% hydrofluoric acid (HF) or sandblasting with aluminum oxide particles (SAND). For each condition, three treatments were tested: silane (Sil), silane-containing adhesive (Ad), or silane + silane-containing adhesive (SilAd). The treated PICN surfaces were restored with composite resin. The microtensile bond strength test was performed in a universal testing machine, and data (MPa) were compared with two-way Analysis of variance (anova) and Tukey (α = 0.05). Roughness (Ra) and contact angle (CA) were obtained after HF and SAND conditions.

RESULTS

The greatest bond strength values were obtained for the groups Sil and SilAd, for both HF and SAND pretreatments. The Ra values of SAND were statistically greater than HF. The CA generated by the adhesive on SAND surface was lower than HF surface.

CONCLUSIONS

The use of silane improves the bond strength of the composite repair to PICN substrate compared to the single use of silane-containing adhesive. The HF pretreatment is most indicated when the silane-containing adhesive is applied alone.

CLINICAL SIGNIFICANCE

Fractured PICN restorations can be repaired with composite resin, because the surface is treated with hydrofluoric acid or sandblasting followed by the individual use of silane.

Effect of laser heat treatment on Pull-out bond strength of fiber posts treated with different silanes

Background

This study evaluated the effect of three different silanes and post-silanization treatments on the retentive strength of fiber posts luted with an etch-and-rinse resin cement.

Material and Methods

One hundred intact maxillary central incisors were randomly divided into 10 groups after endodontic treatment and post space preparation (n=10). The fiber posts were etched using 24% hydrogen peroxide. Posts of the control group did not receive silane. In nine experimental groups, each of the three silanes used, Scotchbond Universal adhesive, Bis-Silane and Porcelain Primer, was subjected to three treatments: air-drying at 25°C, warm air-drying and CO2 laser heat treatment. After cementation of the treated posts using One-Step Plus/Duo-Link cement, the specimens were stored for one weak and then subjected to pull-out bond strength (PBS) testing. The data in Newton (N) were analyzed using two-way ANOVA and Tukey tests (α=0.05).

Results

PBS was significantly affected by silane type and post-silanization treatment (p<0.001). The interaction of the two factors was not statistically significant (p=0.15). The effect of Porcelain Primer on PBS was significantly higher than those of universal adhesive (p<0.001) and Bis-Silane (p=0.01), with similar results for the two latter. Warm air-drying and laser treatment significantly increased PBS (p<0.001). The lowest and highest PBS was obtained in the control (no silane) group (190.9±31) and laser-treated/ Porcelain Primer group (377.1±50), respectively.

Conclusions

Warm air-drying and CO2 laser heat treatment had a significantly beneficial effect on retentive strength of fiber posts. Porcelain Primer was significantly more effective than universal adhesive and Bis-Silane.

Key words:Laser heat treatment, Pull-out bond strength, fiber post.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Bonding of Metal Orthodontic Attachments to Sandblasted Porcelain and Zirconia Surfaces

This study evaluates tensile bond strength (TBS) of metal orthodontic attachments to sandblasted feldspathic porcelain and zirconia with various bonding protocols. Thirty-six (36) feldspathic and 36 zirconia disc samples were prepared, glazed, embedded in acrylic blocks and sandblasted, and divided into three groups according to one or more of the following treatments: hydrofluoric acid 4% (HF), Porcelain Conditioner silane primer, Reliance Assure® primer, Reliance Assure plus® primer, and Z Prime™ plus zirconia primer. A round traction hook was bonded to each sample. Static tensile bond strength tests were performed in a universal testing machine and adhesive remnant index (ARI) scoring was done using a digital camera. One-way ANOVA and Pearson chi-square tests were used to analyze TBS (MPa) and ARI scores. No statistically significant mean differences were found in TBS among the different bonding protocols for feldspathic and zirconia, p values = 0.369 and 0.944, respectively. No statistically significant distribution of ARI scores was found among the levels of feldspathic, p value = 0.569. However, statistically significant distribution of ARI scores was found among the levels of zirconia, p value = 0.026. The study concluded that silanization following sandblasting resulted in tensile bond strengths comparable to other bonding protocols for feldspathic and zirconia surface.

Effect of Storage Time on Bond Strength Performance of Multimode Adhesives to Indirect Resin Composite and Lithium Disilicate Glass Ceramic

Purpose: To investigate the bond strength performance of multimode adhesives (MMAs) to indirect resin composite and lithium disilicate glass ceramic after 24 hours or one year of water storage.

Methods and Materials: Thirty flat and polished plates of indirect resin composite (Epricord) and thirty lithium disilicate glass ceramic plates (IPS e.max Press) were prepared. Surfaces were pretreated using sandblasting (indirect resin composite) or hydrofluoric acid (glass-based ceramic). Specimens were bonded with one of two MMAs (Scotchbond Universal [SBU] or All-Bond Universal [ABU]) or ceramic primer and hydrophobic bonding (RelyX Ceramic Primer and Adper Scotchbond Multi-Purpose Bond) as a control (n=10). Resin cement cylinders (0.75 mm in diameter × 0.5 mm in height) were bonded to both substrate surfaces using the respective adhesives. After 24 hours or one year of water storage, bonding performance was measured by microshear bond strength (MSBS) testing. Results were analyzed using three-way ANOVA with Bonferroni post hoc tests (α=0.05).

Results: For indirect resin composite, significantly higher MSBS values were found for ABU after 24 hours (ABU &gt; SBU = control); however, no significant difference among the adhesives was observed after one year (p&gt;0.05). For glass-based ceramic, significantly different bond strengths were observed among the adhesives after 24 hours (control = ABU &gt; SBU) and one year (control &gt; SBU = ABU; p&lt;0.05).

Conclusions: Both MMAs tested can be considered effective alternatives for bonding to sandblasted indirect resin composite after aging, as they showed similar bond performance to that of the control group. However, separate bottles of silane bonding resin showed higher MSBS values and more durable bonding for etched glass–based ceramic.

Effects of mechanical and chemical surface treatments on the resin-glass ceramic adhesion properties

AIM

Intraoral repair of fractured ceramic restorations using resin composite is practical for dental treatment. In the present study, we investigated whether differences in surface treatments for glass ceramic would affect resin adhesion.

METHODS

Leucite-reinforced glass ceramic plates (IPS Empress Esthetic) were ground with 320-grit silicon carbide paper, cleaned using phosphoric acid, and then etched with hydrofluoric acid (IPS Ceramic Etching Gel) or left unetched, and silanized using silane coupling agent (RelyX Ceramic Primer) or kept unsilanized. Either conventional (Adper Scotchbond Multi-Purpose) or universal (Scotchbond Universal) adhesive was used to bond the resin composite to ceramic surfaces. Specimens were subjected to microshear test after 37°C water storage for 24 h, and fractured surfaces were examined. Ceramic surface hydrophobicity after treatments was verified with contact angle measurements. Data were analyzed using anova and Tukey's tests.

RESULTS

Regardless of the adhesive tested, hydrofluoric acid-etched ceramics showed higher bond strengths. Ceramic primer application improved resin bonding, even in non-etched groups, and also influenced fractography (P < 0.001). Contact angles on ceramics treated with ceramic primer were higher than those treated with silane-containing universal adhesive (P < 0.001).

CONCLUSIONS

Mechanical and chemical retentions contribute to resin adhesion to glass ceramic. Universal adhesive seems to not function in the same manner as a silane coupling agent.

Cleaning Methods for Zirconia Following Salivary Contamination

PURPOSE

To determine the best method of cleaning saliva-contaminated zirconia in preparation for resin bonding.

MATERIAL AND METHODS

Flat blocks of zirconia were particle abraded with aluminum oxide and divided into eight groups (n = 10). Groups 1 to 4 were first treated with one coat of an MDP primer (Z-prime Plus) and groups 5 to 8 were left untreated. A thin coat of fresh whole saliva was painted on all specimens (except the control, group 1) and left in contact for 3 minutes. The specimens were then cleaned by rinsing with water for 20 seconds (groups 2 and 5), or cleaned with 35% phosphoric acid for 20 seconds and rinsed (groups 3 and 6), or cleaned with a zirconia cleaning solution (Ivoclean) for 20 seconds and rinsed (groups 4 and 7), or abraded with aluminum oxide particles and rinsed (group 5). Following the cleaning procedure, groups 5 to 8 were treated with one coat of Z-prime Plus. A 2.5 mm diameter tube was filled with composite (Z100), affixed to the zirconia surface, and light-cured. Specimens were stored in water (37°C for 24 hours) followed by thermocycling (5°C to 55°C for 10,000 cycles). Shear bond strength testing was performed at a crosshead speed of 1 mm/min. Bond strength values were compared to the control using a Dunnett's test (alpha = 0.05). Contact angles of the zirconia specimens with and without Z-prime Plus were measured with water using a goniometer.

RESULTS

Groups 2, 5, and 8 were not significantly different from the control. Application of Z-prime made the zirconia surface more hydrophobic.

CONCLUSIONS

If salivary contamination occurs after MDP application, rinsing off the saliva with water will preserve bond strength. If salivary contamination occurs prior to MDP application, particle abrasion or cleaning with Ivoclean will preserve bond strength.

Analysis of Self-Adhesive Resin Cement Microshear Bond Strength on Leucite-Reinforced Glass-Ceramic with/without Pure Silane Primer or Universal Adhesive Surface Treatment

Objective. To evaluate the microshear bond strength (μSBS) of self-adhesive resin (SA) cement on leucite-reinforced glass-ceramic using silane or universal adhesive. Materials and Methods. Ceramic blocks were etched with 9.5% hydrofluoric acid and divided into three groups (n = 16): (1) negative control (NC) without treatment; (2) Single Bond Universal (SBU); (3) RelyX Ceramic Primer as positive control (PC). RelyX Unicem resin cement was light-cured, and μSBS was evaluated with/without thermocycling. The μSBS was analyzed using one-way analysis of variance. The fractured surfaces were examined using stereomicroscopy and scanning electron microscopy (SEM). Results. Without thermocycling, μSBS was highest for PC (30.50 MPa ± 3.40), followed by SBU (27.33 MPa ± 2.81) and NC (20.18 MPa ± 2.01) (P < 0.05). Thermocycling significantly reduced μSBS in SBU (22.49 MPa ± 4.11) (P < 0.05), but not in NC (20.68 MPa ± 4.60) and PC (28.77 MPa ± 3.52) (P > 0.05). PC and NC predominantly fractured by cohesive failure within the ceramic and mixed failure, respectively. Conclusion. SBU treatment improves μSBS between SA cement and glass ceramics, but to a lower value than PC, and the improvement is eradicated by thermocycling. NC exhibited the lowest μSBS, which remained unchanged after thermocycling.

Zirconia as a Dental Biomaterial

Ceramics are very important in the science of dental biomaterials. Among all dental ceramics, zirconia is in evidence as a dental biomaterial and it is the material of choice in contemporary restorative dentistry. Zirconia has been applied as structural material for dental bridges, crowns, inserts, and implants, mostly because of its biocompatibility, high fracture toughness, and radiopacity. However, the clinical success of restorative dentistry has to consider the adhesion to different substrates, which has offered a great challenge to dental zirconia research and development. This study characterizes zirconia as a dental biomaterial, presenting the current consensus and challenges to its dental applications.

Performance of universal adhesives on bonding to leucite-reinforced ceramic

Background

This study aimed to investigate the microshear bond strength of universal bonding adhesives to leucite-reinforced glass-ceramic.

Methods

Leucite-reinforced glass-ceramic blocks were polished and etched with 9.5% hydrofluoric acid for 1 min. The specimens were assigned to one of four groups based on their surface conditioning (n = 16): 1) NC: negative control with no further treatment; 2) SBU: Single Bond Universal (3M ESPE); 3) ABU: ALL-BOND Universal (Bisco); and 4) PC: RelyX Ceramic Primer and Adper Scotchbond Multi-Purpose Adhesive (3M ESPE) as a positive control. RelyX Ultimate resin cement (3M ESPE) was placed on the pretreated ceramic and was light cured. Eight specimens from each group were stored in water for 24 h, and the remaining eight specimens were thermocycled 10,000 times prior to microshear bond strength evaluation. The fractured surfaces were examined by stereomicroscopy and scanning electron microscopy (SEM).

Results

After water storage and thermocycling, the microshear bond strength values decreased in the order of PC > SBU and ABU > NC (P < 0.05). Thermocycling significantly reduced the microshear bond strength, regardless of the surface conditioning used (P < 0.05). Cohesive failure in the ceramic and mixed failure in the ceramic and resin cement were observed in the fractured specimens. The percentage of specimens with cohesive failure after 24 h of water storage was: NC (50%), SBU (75%), ABU (75%), and PC (87%). After thermocycling, the percentage of cohesive failure in NC decreased to 25%; however, yet the percentages of the other groups remained the same.

Conclusions

Although the bond strength between resin and hydrofluoric acid-etched glass ceramic was improved when universal adhesives were used, conventional surface conditioning using a separate silane and adhesive is preferable to a simplified procedure that uses only a universal adhesive for cementation of leucite-reinforced glass-ceramic.

Shear bond strength between resin cement and colored zirconia made with metal chlorides

STATEMENT OF PROBLEM

Although the application of zirconia in esthetic prostheses has increased, the shear bond strength (SBS) between colored zirconia and resin cement has not been investigated.

PURPOSE

The purpose of this study was to compare the SBS between resin cement and colored zirconia made with metal chlorides.

MATERIAL AND METHODS

Sixty-four zirconia specimens were divided into 2 groups: one in which the specimens were bonded with resin cement, including 4-META (4-methacryloxyethyl trimellitic anhydride), and one in which the specimens were bonded with resin cement (SEcure, Sun Medical) after being processed with zirconia primer (Zirconia Liner), including 4-META. Each group was then divided into 4 subgroups depending on the coloring liquid. The subgroups were noncolored (control), commercial coloring liquid VITA In-Ceram 2000 YZ LL1, aqueous chromium chloride solution 0.1 wt%, and aqueous molybdenum chloride solution 0.1 wt%. Composite resin cylinders (Filtek Z250, 3M ESPE) were fabricated and bonded to the surface of the zirconia specimen with resin cement (SEcure). All specimens were stored in 37°C distilled water for 24 hours, and the SBS was measured with a universal testing machine. All data were analyzed statistically with 2-way ANOVA and tested post hoc with the Tukey test (α=.05).

RESULTS

Significant differences were observed among the SBS values of the colored zirconia depending on the coloring liquid (P<.001) and whether they were processed with zirconia primer (P<.001). The SBS between colored zirconia and resin cement was significantly higher than that of noncolored zirconia and resin cement in groups processed with zirconia primer (P<.05). Colored zirconia immersed in aqueous molybdenum chloride solution showed a significantly higher SBS.

CONCLUSIONS

Coloring liquid enhanced the SBS between resin cement and zirconia processed with zirconia primer. In particular, colored zirconia immersed in aqueous molybdenum chloride solution showed the highest SBS.

Microshear Bond Strength of Resin Cements to Lithium Disilicate Substrates as a Function of Surface Preparation

OBJECTIVES

To investigate the effect of hydrofluoric acid (HF) etching, silane solution, and adhesive system application on the microshear bond strength (μSBS) of lithium disilicate glass-ceramic (LD) to three resin cements.

MATERIALS AND METHODS

Circular bonding areas were delimited on the lithium disilicate surfaces using a perforated adhesive tape. Specimens were assigned to 18 subgroups (n=12) according to surface treatment: NT = no treatment; HF = 4.8% HF for 20 seconds; silane solution: (1) no silane; (2) Monobond Plus, a silane/10-methacryloyloxydecyl dihydrogen phosphate solution for 60 seconds; (3) Monobond Plus+ExciTE F DSC, a dual-cure adhesive; and resin cement: (1) Variolink II, a bisphenol A diglycidyl ether dimethacrylate (bis-GMA)-based, hand-mixed, dual-cure resin cement; (2) Multilink Automix, a bis-GMA-based, auto-mixed, dual-cure resin cement; (3) RelyX Unicem 2, a self-adhesive, auto-mixed, dual-cure resin cement. Tygon tubes (Ø=0.8 mm) were used as cylinder matrices for resin cement application. After 24 hours of water storage, the specimens were submitted to the μSBS test. Mode of failure was evaluated under an optical microscope and classified as adhesive, mixed, cohesive in resin cement, or cohesive in ceramic. Data were statistically analyzed with three-way analysis of variance and Dunnett test (p<0.05).

RESULTS

When means were pooled for the factor surface treatment, HF resulted in a significantly higher μSBS than did NT (p<0.0001). Regarding the use of a silane solution, the mean μSBS values obtained with Monobond Plus and Monobond Plus+ExciTE F DSC were not significantly different but were higher than those obtained with no silane (p<0.001). Considering the factor resin cement, Variolink II resulted in a significantly higher mean μSBS than did RelyX Unicem 2 (p<0.03). The mean μSBS for Multilink Automix was not significantly different from those of Variolink II and RelyX Unicem 2. According to Dunnett post hoc test (p<0.05), there was no significant difference in μSBS between the different resin cements for HF-etched and silanized (with or without adhesive application) LD surfaces.

CONCLUSION

LD may benefit from pretreatment of the inner surface with HF and silanization, regardless of the resin cement used.

Effect of different temporary crown materials and surface roughening methods on the shear bond strengths of orthodontic brackets

OBJECTIVE

The aim of this study was to evaluate the effect of different temporary crown materials (TCMs) and surface roughening methods on the shear bond strength (SBS) of orthodontic brackets.

BACKGROUND DATA

TCMs are widely used during orthodontic treatment in teeth in need of prosthetic treatment, to prevent damage to the final restoration. However, there is no consensus considering the best method for roughening of the surface of TCMs.

METHODS

Five different TCMs [Dentalon Plus-(D), Basworth Trim II-(B), Voco Structure Premium-(V), 3M ESPE Protempt 4-(P), and Revotek LC-(R)] were used in this study. Different surface roughening methods (37% phosphoric acid, sandblasting, and Er:YAG laser) were employed in three subgroups (n=20). The SBS test was used to assess the durability of all groups. Scanning electron microscopy (SEM) analysis was performed on a representative specimen in each group.

RESULTS

The highest mean SBS value was observed in group V, followed by groups D and P, regardless of the surface treatment. The lowest SBS values were observed in group B. The laser-irradiated groups had higher SBS values than the sandblasted and acid-etched groups. Furthermore, a significant difference in SBS values was observed between the laser-irradiated group V and all other groups (p<0.005).

CONCLUSIONS

The effects of the chemical nature of TCMs on the SBS values appeared to be clinically negligible, whereas the type of surface treatments had a significant influence on bond strengths. Er:YAG laser irradiation caused a significant increase in bond strength between the TCMs and orthodontic brackets.

Bonding of resin cement to zirconia with high pressure primer coating

Objectives

To investigate the effect of air-drying pressure during ceramic primer coating on zirconia/resin bonding and the surface characteristics of the primed zirconia.

Methods

Two ceramic primers (Clearfil Ceramic Primer, CCP, Kuraray Medical Inc. and Z-Prime Plus, ZPP, Bisco Inc.) were applied on the surface of air-abraded zirconia (Katana zirconia, Noritake) and dried at 4 different air pressures (0.1–0.4 MPa). The primed zirconia ceramic specimens were bonded with a resin-based luting agent (SA Luting Cement, Kuraray). Micro-shear bond strengths of the bonded specimens were tested after 3 days of water storage or 5,000× thermocycling (n = 12). Failure modes of the fractured specimens were examined with scanning electron miscopy. The effects of air pressure on the thickness of the primer layers and the surface roughness (S_a) of primed zirconia were evaluated using spectroscopic ellipsometry (n = 6), optical profilometry and environmental scanning electron microscopy (ESEM) (n = 6), respectively.

Results

Clearfil Ceramic Primer air-dried at 0.3 and 0.4 MPa, yielding significantly higher µSBS than gentle air-drying subgroups (p<0.05). Compared to vigorous drying conditions, Z-Prime Plus air-dried at 0.2 MPa exhibited significantly higher µSBS (p<0.05). Increasing air-drying pressure reduced the film thickness for both primers. Profilometry measurements and ESEM showed rougher surfaces in the high pressure subgroups of CCP and intermediate pressure subgroup of ZPP.

Conclusion

Air-drying pressure influences resin/zirconia bond strength and durability significantly. Higher air-drying pressure (0.3-0.4 MPa) for CCP and intermediate pressure (0.2 MPa) for ZPP are recommended to produce strong, durable bonds between resin cement and zirconia ceramics.

The influence of experimental silane primers on dentin bond strength and morphology: a laboratory and finite element analysis study

STATEMENT OF PROBLEM

The inconsistency of dentin bonding affects retention and microleakage.

PURPOSE

The purpose of this laboratory and finite element analysis study was to investigate the effects on the formation of a hybrid layer of an experimental silane coupling agent containing primer solutions composed of different percentages of hydroxyethyl methacrylate.

MATERIAL AND METHODS

A total of 125 sound human premolars were restored in vitro. Simple class I cavities were formed on each tooth, followed by the application of different compositions of experimental silane primers (0%, 5%, 25%, and 50% of hydroxyethyl methacrylate), bonding agents, and dental composite resins. Bond strength tests and scanning electron microscopy analyses were performed. The laboratory experimental results were validated with finite element analysis to determine the pattern of stress distribution. Simulations were conducted by placing the restorative composite resin in a premolar tooth by imitating simple class I cavities. The laboratory and finite element analysis data were significantly different from each other, as determined by 1-way ANOVA. A post hoc analysis was conducted on the bond strength data to further clarify the effects of silane primers.

RESULTS

The strongest bond of hybrid layer (16.96 MPa) was found in the primer with 25% hydroxyethyl methacrylate, suggesting a barely visible hybrid layer barrier. The control specimens without the application of the primer and the primer specimens with no hydroxyethyl methacrylate exhibited the lowest strength values (8.30 MPa and 11.78 MPa) with intermittent and low visibility of the hybrid layer. These results were supported by finite element analysis that suggested an evenly distributed stress on the model with 25% hydroxyethyl methacrylate.

CONCLUSIONS

Different compositions of experimental silane primers affected the formation of the hybrid layer and its resulting bond strength.