Influence of multimode universal adhesives and zirconia primer application techniques on zirconia repair

Different surface treatments and adhesive monomers for zirconia-resin bonds: A systematic review and network meta-analysis

This review examined the efficacy of surface treatments and adhesive monomers for enhancing zirconia-resin bond strength. A comprehensive literature search in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library yielded relevant in vitro studies. Employing pairwise and Bayesian network meta-analyses, 77 articles meeting inclusion criteria were analyzed. Gas plasma was found to be ineffective, while treatments including air abrasion, silica coating, laser, selective infiltration etching, hot etching showed varied effectiveness. Air abrasion with finer particles (25-53 µm) showed higher immediate bond strength than larger particles (110-150 µm), with no significant difference post-aging. The Rocatec silica coating system outperformed the CoJet system in both immediate and long-term bond strength. Adhesives containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) were superior to other acidic monomers. The application of 2-hydroxyethyl methacrylate and silane did not improve bonding performance. Notably, 91.2 % of bonds weakened after aging, but this effect was less pronounced with air abrasion or silica coating. The findings highlight the effectiveness of air abrasion, silica coating, selective infiltration etching, hot etching, and laser treatment in improving bond strength, with 10-MDP in bonding agents enhancing zirconia bonding efficacy.

Micro-shear Bond Strength of an Alternative Self-etch Application of "No Wait" Universal Adhesive to Caries-affected and Sound Dentin in Permanent and Primary Teeth

OBJECTIVE

This study aimed to compare the micro-shear bond strength (μSBS) of caries-affected dentin (CAD) and sound dentin (SoD) in primary and permanent teeth using an alternative self-etch application of "no wait" universal adhesive.

METHODS AND MATERIALS

Flat midcoronal dentin surfaces from 72 permanent third molars and 72 second primary molars were distributed randomly into 12 groups according to the substrate SoD and artificially-created CAD (pH cycling for 14 days) and the adhesive system (GLUMA Bond5, a two-step etch & rinse adhesive, GLUMA Bond, a one-step self-etch adhesive, and Tokuyama Universal Bond, a one-step self-etch adhesive) (n=12). Bonded dentin resin discs were put through micro-shear bond strength testing after 10,000 thermocycles. The results were evaluated using two-way ANOVA and the Bonferroni test with a significance level of α = 0.05.

RESULTS

When compared to SoD, the etch & rinse system's test results on artificially created CAD showed a statistically significant poorer bonding performance in both permanent and primary teeth in all groups (p<0.05). While the bond strengths of permanent teeth using total-etch adhesive on sound dentin were statistically significantly higher than those using Tokuyama Universal Bond adhesive (p<0.05), there was no significant difference in sound dentin in primary teeth (p>0.05).

CONCLUSIONS

The etch & rinse system performed the poorest of all adhesive systems on CAD. The Tokuyama Universal Bond's adhesive strength was similar in SoD and CAD on primary teeth. The use of Tokuyama Universal Adhesives can speed up restorative treatment in pediatric dentistry.

Effect of Different Surface Treatment Methods on the Shear Bond Strength of Resin Composite/Zirconia for Intra-oral Repair of Zirconia Restorations

OBJECTIVE

 A durable resin/zirconia bond is essential for successful intra-oral repair of zirconia restorations. The purpose of this study was to evaluate the influence of two mechanical treatments followed by seven chemical treatments on the shear bond strength (SBS) of composite resin to zirconia.

MATERIALS AND METHODS

 In this in vitro study, 280 zirconia blocks (Y-TZP) were either air-abraded or bur roughened and divided into seven experimental groups (n = 20) in terms of primer/resin application: 1) ZPP, Z-Prime Plus; 2) ZPP + GP, Z-Prime Plus followed by G-premio bond; 3) ZPP + ALB, Z-Prime Plus followed by All Bond Universal; 4) ZPP + CLRF, Z-Prime Plus followed by Clearfil SE Bond; 5)GP, G-Premio Bond 6) ALB, All Bond Universal; and 7) CLRF, Clearfil SE Bond. After composite bonding and storage in distilled water (24 hours), half of each group specimen (n = 10) were thermocycled. All specimens were subjected to shear force. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney test (α = 0.05).

RESULTS

 Significant reduction in SBS was observed in all groups after thermocycling(p < 0.05), except for the air-abraded ZPP + CLRF (p = 0.143). After aging, air-abraded CLRF exhibited the highest SBS (13.55 ± 7.8 MPa) and bur roughened ZPP showed the lowest SBS (1.16 ± 1.23 MPa). In the aged specimens, there was a significant difference between air abrasion and bur roughening in all groups (p < 0.05).

CONCLUSION

 Air-abrasion followed by application of adhesive (with/without prior primer application) is the most efficient technique for repair of veneered zirconia restorations with resin composite.

The Shear Bond Strength between Milled Denture Base Materials and Artificial Teeth: A Systematic Review

The data about bond strength between digitally produced denture base resins and artificial teeth are scarce. Several studies investigated shear bond strength values of milled denture base resins and different types of artificial teeth. The purpose of the present study was to compare and evaluate the available evidence through a systematic review. A bibliographic search was conducted in PubMed, Scopus, and Web of Science to assess adequate studies published up to 1 June 2022. This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The appropriate studies that determined the shear bond strength values between milled denture base resins and artificial teeth were selected. The initial search identified 103 studies, which were included in the PRISMA 2020 flow diagram for new systematic reviews. Three studies met the inclusion criteria, and all of them present a moderate risk of bias (score 6). Two studies found no statistical differences between heat-polymerized and CAD/CAM (milled) denture base materials when attached with different types of artificial teeth, while one study showed higher values of CAD/CAM (milled) denture base materials. Bonding agents ensure bonding strength at least similar to the conventional methods. In order to improve the quality of future studies, it would be advantageous to use a larger number of specimens with standardized dimensions and a blinded testing machine operator to decrease the risk of bias.

Assessment of Intra-Oral Repair Systems for Veneered Zirconia and Zirconia Only

The aim of this study was to compare bond strength resin composites to porcelain laminate veneers in the indirect repair method to composite resins used in the direct repair method for cases of porcelain veneer fracture of zirconia-based fixed dental prostheses. In the study, the groups were formed with different percentages of areas to be repaired to mimic porcelain fractures in the mouth. The experimental group of veneered zirconia were as follows: Group A = 100% Zr surface; Group B = 70% Zr, 30% porcelain surface; Group C = 50% Zr, 50% porcelain surface; Group D = 30% Zr, 70% porcelain surface; Group E = 100% porcelain surface. The repairs of the specimens were made using composite resin systems in half of the groups and using porcelain laminate veneers in the other half. Specimens were embedded in acrylic blocks before surface treatments and repairs were applied. After surface conditioning, laminate veneers were applied to the first half of the groups, and composite repair systems were applied to the second half of the groups. After all specimens were aged by thermal cycling, their bond strength values were measured using a Universal Testing Machine, and the obtained data were recorded. The specimens were examined with a stereomicroscope and classified according to failure types (adhesive/cohesive/mixed). Bond strength values were evaluated based on independent-samples t-test statistics. According to the comparisons among the groups, the bond strength of the indirect repairs made with the laminate material was higher than the bond strength of the repairs made with the composite. There was a statistically significant difference in favor of the indirect repair groups among all groups except for Group C. The highest bond strength was found in Group A in the indirect repair method, while the lowest bond was found in the direct repair method in Group E. Adhesive failure was mostly seen in the groups that were repaired with the composite.

Investigations of silane-MDP interaction in universal adhesives: A ToF-SIMS analysis

OBJECTIVES

The purposes of this study were to investigate whether the presence of silane in universal adhesives affects the functions of 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and adhesion to zirconia.

METHODS

Two silane-containing universal adhesives (Scotchbond Universal (SBU) and Clearfil Universal-Bond (CUB)) and two silane-free adhesives (All-Bond Universal (ABU) and SE-Bond primer (SE)) were individually applied on zirconia disks. Time-of-flight secondary-ion-mass-spectrometry (ToF-SIMS) examined the distributions of MDP- and silane-related ions, as well as evidence of zirconium phosphate (ZrP) compounds, on the surface and interfacial regions using a depth profiling mode. The hydrophilicity and resin wettability of the treated zirconia were examined using a contact angle test. For the shear bond strength (SBS) test, the zirconia disks were air-blasted, treated with the assigned adhesives, and bonded with pre-cured composite cylinders using a resin cement. These resin-zirconia assemblies received a bond test after 24-h storage.

RESULTS

Both SBU and CUB exhibited silane-related ions and ZrO₂(OH)^-, but fewer PO^- ions in the interfacial regions. CUB had more siloxane-related ions. SE-treated zirconia had abundant PO^- ions and particularly high PO₃^-- and ZrP- related ions in the interfacial regions. The silane-free adhesives exhibited a higher affinity to both water and adhesive liquids. SE showed significantly higher SBSs compared to ABU, while SBU and CUB were not statistically different.

SIGNIFICANCE

The silane content may cause hydroxylation of zirconia and affect MDP adsorption. An acidic pH accelerated the condensation of silanol. The bond performance of the MDP-based adhesive could be influenced by the silane content and other components.

The Durability of Zirconia/Resin Composite Shear Bond Strength using Different Functional Monomer of Universal Adhesives

OBJECTIVE

 This study examined the effectiveness of different functional monomers in universal adhesives on zirconia/resin composite bond strength both before and after thermocycling. Four universal adhesives (G-premio bond universal, GPU; Clearfil Tri-S bond universal, CTB; Optibond Universal, OBU; Tetric N-bond universal; TNU), one adhesive (single bond 2; SB2), and one ceramic primer (Clearfil ceramic primer plus, CCP) were used in this study.

MATERIALS AND METHODS

 Zirconia discs were prepared and embedded in acrylic. Specimens were polished and sandblasted with alumina. The specimens were randomly divided into two groups (24 hours and the thermocycled), and each group was divided into six subgroups (n = 10), according to zirconia surfaces treatments: no Tx, CCP + SB2, GPU, CTB, OBU, TNU. An Ultradent mold was located on top of the treated zirconia surface. The resin composite was filled into the mold and then light-cured. A universal testing device was used to determine the shear bond strength.

STATISTICAL ANALYSIS

 The data were statistically analyzed using one-way ANOVA and Tukey's test.

RESULTS

 After water storage for 24 hours, the shear bond strengths were GPU > CCP + SB2 = CTB = OBU = TNU > no Tx (p < 0.05). After thermocycling, the shear bond strengths were CCP + SB2 = GPU = CTB = TNU > OBU > no Tx (p < 0.05).

CONCLUSION

 The universal adhesives containing 10-MDP exhibited the best performance in the shear bond strength of the zirconia/resin composite interface both before and after thermocycling.

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

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL RELEVANCE

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

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.

Cold Atmospheric Plasma Improves Shear Bond Strength of Veneering Composite to Zirconia

Chipping of veneering is the most common clinical complication for zirconia restorations. Veneering composite could be a promising alternative to renew restorations. Zirconia discs (3-YSZ) were prepared with varying surface treatments and bonded to indirect composite as follows: air abrasion and Scotchbond Universal (A/SU); air abrasion and Clearfil Ceramic Primer (A/C); air abrasion and MKZ Primer (A/M); air abrasion and Monobond Plus (A/MP); silica-coating and Scotchbond Universal (S/SU); air abrasion (AP/SU), additional cold atmospheric plasma treatment, and Scotchbond Universal. An indirect composite material was then applied to the zirconia specimens. Specimens were divided into subgroups for short-term (14 days storage at 37 °C and 5000 thermal cycles) and long-term (250 days storage and 37,500 thermal cycles) artificial aging. Shear bond strength measurement (SBS) was performed, and data were analyzed by Kruskal–Wallis-test and multiple comparison testing with Dunn’s correction (p ≤ 0.05). The median SBS values (MPa) of short- and long-term artificial aging were: 3.09/1.36 (A/SU); 0.77/1.43 (S/SU); 2.82/2.15 (AP/SU); 1.97/1.80 (A/C); 2.01/1.58 (A/M); and 1.70/1.68 (A/MP). For short-term artificial aging A/SU showed the highest median SBS values, whereas in the long-term trial, AP/SU showed the highest values and the difference was significant. A prolonged artificial aging decreased SBS in all groups, except S/SU. In summary, treatment with CAP can improve SBS in the long-term.

Evaluation of Efficacy of Various Surface Conditioning Methods on the Repair Bond Strength of Composite to Different Fracture Types of Zirconia Ceramics

The aim of this study was to investigate the effects of different surface treatment methods on shear bond strength between composite resin and different levels of zirconia ceramic. Laser surface-conditioning procedures have been reported as effective method to increase repair bond strength of composite to zirconia ceramics. Detailed information of effects of Er,Cr:YSGG laser treatment with different pulse rates on the zirconia ceramics is lacking in the literature. 120 disc-shaped specimens were prepared including zirconia, veneering ceramic, and 50% veneering ceramic-50% zirconia surfaces. Four different surface treatments were applied to the specimens. These were grinding with diamond bur, sandblasting, and short and long pulse rates of Er,Cr:YSGG laser irradiation. An intraoral ceramic repair kit was used to repair specimens, and shear bond strength was performed on the composite resin to each specimen. The highest mean bond strength was seen in the veneering ceramic surface that was ground using a diamond bur, and the lowest mean bond strength value was observed in the same surface that was treated with long pulse laser irradiation. The sandblasting with alumina particles exhibited lower mean repairing bond strength among the rest of used methods in this study for the group which contained half of the veneering ceramic and half of the zirconia. Sandblasting and Er,Cr:YSGG laser using surface treatment procedures obtained appropriate bond strength for the group that included 50% veneering ceramic-50% zirconia, because of no significant differences observed among the applied surface conditioning methods in this group.

Clinical performance of two different adhesive strategies for metal-ceramic cracks repairing and related in vitro study

To evaluate the bonding reliability of a universal adhesive compared to a commercial ceramic repair system for metal-ceramic cracks. In vitro part: sixty specimens with porcelain, metal and porcelain-metal substrate were fabricated. Half specimens were bonded by Singlebond Universal adhesive and Filtek Z350 resin composite. The other were processed by Ceramic Repair N. Shear bond strength was tested. In vivo part: forty patients with sixty ceramic fractured porcelain-fused-metal restorations were involved. Half were repaired by Singlebond Universal and Filtek Z350. The other were restored by Ceramic Repair N. The mean observation period was 65 weeks. Results showed the bond strength ranged from 13.97 MPa to 15.85 MPa using two different repair system on different substrate with no statistical difference. There was no statistical difference between the two adhesive system in survival rate according to Kaplan-Meier analysis. The universal adhesive had a similar repair performance compared to commercial ceramic repair system.

Adhesion between zirconia and resin cement: A critical evaluation of testing methodologies

This study aimed to analyze different methodologies (tensile, microtensile, shear, microshear, and interfacial toughness) for evaluation of the bond strength between zirconia (Y-TZP) and resin cement. Zirconia ceramic blocks (VITA in-Ceram® YZ, VITA Zahnfabrik, Germany) were obtained, substrate surfaces were air-abraded with aluminum oxide (50 μm) for 10 s (2 bar pressure, distance: 10 mm, angle: 90°). Then, the specimens were washed with distilled water, dried, and coated with Clearfil Ceramic Primer that was actively applied with a microbrush for 20 s. The specimens were then cemented with resin cement under a load of 750 g, followed by photo-polymerization (40 s on each surface). After cementation, the specimens were aged in thermocycling (8000 cycles, 5-55 °C, 30 s for each bath) and subjected to tensile, microtensile, shear, microshear or interfacial toughness tests. All specimens were inspected for failure modes. The microtensile test showed the highest bond value (18.29 N/mm²). The microshear tests showed the highest coefficient of variation (0.59) and highest number of pre-test failures. The interfacial energy to fracture test showed that as the shear stress increased its interaction in the adhesive interface, the coefficient of variation also increased. The bond strength of Y-TZP showed different results according to the methodology, as well as its interfacial energy to fracture varied according to the angulation/type of stress specimen was submitted. The lower the shear stress at the adhesive interface of the mixed tests (interfacial energy to fracture), the lower was the variability of the test.

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

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

Influence of surface treatments and cyclic fatigue on subsurface defects and mechanical properties of zirconia frameworks

OBJECTIVES

To evaluate the effect of laser fused and air abraded fluorapatite particles on flexural strength σf and fracture toughness (K_IC) of Yttria tetragonal zirconia polycrystal (Y-TZP).

METHODS

160 polished Y-TZP bars received one of the following surface treatments: airborne particle abrasion (APA) with fluorapatite glass-ceramics (FGC), APA with tribochemical silica-coated alumina (CoJet), laser fused FGC using Nd:YAG Laser (FGC + Laser), while as-sintered polished specimens served as control. Initial flexural strength σfI was measured to half of the specimens, while the rest underwent cyclic fatigue (1,000,000 cycle of 15N load and 3 s contact time) followed by measuring residual flexural strength σfR. Fractographic analysis was performed and K_IC was calculated. The effect of surface treatment and fatigue on flexural strength was statistically analysed using 2-way ANOVA (α = 0.05). Weibull probability was measured to assess the reliability of flexural strength.

RESULTS

The highest σf before or after the fatigue was reported for the control group while the lowest was for FGC + Laser group. Cyclic fatigue significantly decreased the flexural strength of all groups except for FGC + Laser group. There was no significant difference between the K_IC between the control and FGC groups, however, a significant reduction of K_IC was found in the CoJet group, while FGC + Laser reported the significant lowest value compared to all groups (P = 0.00).

SIGNIFICANCE

Fluorapatite glass-ceramic powder offers a promising alternative for particle abrasion of zirconia-based frameworks.

Effect of Different Application Techniques of Universal Bonding System on Microtensile Bond Strength of Bulk-Fill Composites to Primary and Permanent Dentin

Objectives

This study aimed to determine the microtensile bond strength (μTBS) of a bulk-fill composite to permanent and primary coronal dentin using a universal adhesive in self-etch and total-etch modes.

Materials and Methods

This in-vitro study was performed on 52 occlusal dentinal surfaces of human primary and permanent teeth. The crowns were cut to the gingival level. The 48 prepared dentin sections were randomly assigned to the following groups (n=13): A: Primary/Total-etch, B: Primary/Self-etch, C: Permanent/Total-etch, and D: Permanent/Self-etch. In groups A and C, after etching for 15 seconds, two layers of a universal bonding (Futurabond U) were applied and cured for 10 seconds. All samples were filled with a bulk-fill composite (x-trafil; VOCO) and cured for 40 seconds. The samples were cut to a bar-shaped dentin block with the dimensions of 1×1×1 mm³, and after 10,000 thermocycles, the μTBS test was accomplished at a crosshead speed of 1 mm/minute. The mean and standard deviation (SD) of μTBS were calculated, and the data were analyzed using two-way analysis of variance (ANOVA) and Fisher's exact test.

Results

The mean μTBS was as follows: A: 15.03±2.0279, B: 11.11±2.4423, C: 23.50±4.8165, and D: 16.26±6.3200 MPa. Futurabond U showed a higher μTBS in the total-etch mode (P<0.001). The permanent teeth had greater μTBS than the primary teeth (P<0.001). Similar percentages of failure modes were observed in the total-etch groups but in the self-etch groups, most failures were in the form of adhesive and mixed.

Conclusion

Greater μTBS was observed in the permanent teeth with the total-etch technique.

Comparison of shear bond strengths of different types of denture teeth to different denture base resins

PURPOSE

To determine the shear bond strengths of different denture base resins to different types of prefabricated teeth (acrylic, nanohybrid composite, and cross-linked) and denture teeth produced by computer-aided design/computer-aided manufacturing (CAD/CAM) technology.

MATERIALS AND METHODS

Prefabricated teeth and CAD/CAM (milled) denture teeth were divided into 10 groups and bonded to different denture base materials. Groups 1-3 comprised of different types of prefabricated teeth and cold-polymerized denture base resin; groups 4-6 comprised of different types of prefabricated teeth and heat-polymerized denture base resin; groups 7-9 comprised of different types of prefabricated teeth and CAD/CAM (milled) denture base resin; and group 10 comprised of milled denture teeth produced by CAD/CAM technology and CAD/CAM (milled) denture base resin. A universal testing machine was used to evaluate the shear bond strength for all specimens. One-way ANOVA and Tukey post-hoc test were used for analyzing the data (α=.05).

RESULTS

The shear bond strengths of different groups ranged from 3.37 ± 2.14 MPa to 18.10 ± 2.68 MPa. Statistical analysis showed significant differences among the tested groups (P<.0001). Among different polymerization methods, the lowest values were determined in cold-polymerized resin.There was no significant difference between the shear bond strength values of heat-polymerized and CAD/CAM (milled) denture base resins.

CONCLUSION

Different combinations of materials for removable denture base and denture teeth can affect their bond strength. Cold-polymerized resin should be avoided for attaching prefabricated teeth to a denture base. CAD/CAM (milled) and heat-polymerized denture base resins bonded to different types of prefabricated teeth show similar shear bond strength values.

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

Clinical Relevance

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

SUMMARY

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

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

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

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

Dentin microshear bond strength of various resin luting agents to zirconia-reinforced lithium silicate ceramics

STATEMENT OF PROBLEM

The performance of adhesive and resin luting cements used to bond zirconia-reinforced lithium silicate (ZLS) ceramics to dentin has not been well established.

PURPOSE

The purpose of this in vitro study was to examine the microshear bond strength (μSBS) of an etch-and-rinse adhesive system, a universal adhesive, and a self-adhesive resin cement that were used to bond ZLS to dentin.

MATERIAL AND METHODS

VITA Suprinity (VS) and Celtra Duo (CD) blocks were sectioned into 36 and 72 microbars (1×1×3 mm). All VS were crystallized, while half of CD were additionally fired and defined as fired-Celtra Duo (FCD). The others were defined as unfired-Celtra Duo (UCD). Each microbar was cemented to each flat occlusal dentin surface of a human first premolar, following the adhesive luting systems: Scotchbond Multi-purpose (SM), Single Bond Universal (SU) combined with RelyX Ultimate, and RelyX Unicem (U2) (n=12 per group). μSBS at 24 hours was then determined, and the data were analyzed by using 2-way ANOVA and a Tukey post hoc test (α=.05). Failure modes were analyzed under a stereomicroscope at ×40 magnification.

RESULTS

Two-way ANOVA revealed that the type of ZLS had no influence on μSBS (P=.699). However, the kinds of adhesive luting cements and their interaction had a statistically significant effect on μSBS (P<.001 and P=.002). U2 had a statistically significant lower mean μSBS, regardless of the type of ZLS, than SM and SU (P≤.05), while UCDU2 did not show a statistically significant difference in μSBS from UCDSU (P=.478).

CONCLUSIONS

Resin cement used with an etch-and-rinse and a universal adhesive agent demonstrates higher bond strength for the cementation of zirconia-reinforced lithium silicate ceramics to dentin than a self-adhesive resin cement.

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.

Repair bond strength of composite resin to zirconia restorations after different thermal cycles

PURPOSE

This in vitro study investigated the repair bond strength of the zirconia ceramic after different aging conditions.

MATERIALS AND METHODS

In order to imitate the failure modes of veneered zirconia restorations, veneer ceramic, zirconia, and veneer ceramic-zirconia specimens were prepared and were divided into 4 subgroups as: control (37℃ distilled water for 24 hours ) and 3000, 6000, 12000 thermal cycling groups (n=15). Then, specimens were bonded to composite resin using a porcelain repair kit according to the manufacturer recommendation. The repair bond strength (RBS) test was performed using a universal testing machine (0.5 mm/min). Failure types were analyzed under a stereomicroscope. Two-way ANOVA and Bonferroni test were used for statistical analysis.

RESULTS

The RBS values of zirconia specimens were statistically significant and higher than veneer ceramic and veneer ceramic-zirconia specimens in control, 3000 and 6000 thermal cycling groups (P<.05). When 12000 thermal cycles were applied, the highest value was found in zirconia specimens but there was no statistically significant difference between veneer ceramic and veneer ceramic-zirconia specimens (P>.05). Veneer ceramic specimens exhibited cohesive failure types, zirconia specimens exhibited adhesive failure types, and veneer ceramic-zirconia specimens exhibited predominately mixed failure types.

CONCLUSION

Thermal cycling can adversely affect RBS of composite resin bınded to level of fractured zirconia ceramics.

[Effects of universal adhesives and resin cement on the shear bond strength of zirconia]

OBJECTIVE

To study the effects of universal adhesives and resin cement on the shear bond strength and durability of zirconia ceramics.

METHODS

Zirconia ceramics were sintered into 20 mm×10 mm×10 mm and 10 mm×10 mm×10 mm specimens. The experiment was divided into 12 groups. The two types of specimens were bonded using two variants of resin cement (RelyX Ultimate and Clearfil SAC self-adhesive resin cement), universal adhesives (non-adhesive, Scotchbond uni-versal adhesive, and Clearfil SE One adhesive), and storage conditions (water bath and water bath-thermal cycling). The shear bond strengths were tested, and the fracture morphologies were analyzed.

RESULTS

The cement (F=8.41, P<0.01) and adhesive (F=30.34, P<0.01) exerted a significant effect on the shear bond strength of zirconia, whereas storage condition showed no significant effect on this property (F=1.83, P=0.18). The lowest shear bond strength (14.02 MPa±6.86 MPa) was exhibited by the group treated with RelyX Ultimate resin cement, non-adhesive, and water bath-thermal cycling, whereas the highest shear bond strength (54.12 MPa±8.37 MPa) was displayed by the group treated with RelyX Ultimate resin cement, Scotchbond universal adhesive, and water bath-thermal cycling.

CONCLUSIONS

Universal adhesives can improve the durability of the bonding of resin cement to zirconia. If non-self-adhesive resin cement is used without a universal adhe-sive, the durability of the bond will be greatly reduced.

Can universal adhesive systems bond to zirconia?

OBJECTIVE

To measure the bond strength to zirconia subjected to different surface treatments of universal bonding agents.

MATERIALS AND METHODS

Eighty blocks of zirconia were obtained by CAD/CAM milling. The blocks were embedded into PVC tubes, polished sequentially with increasing granulation sandpapers and divided into two groups according to surface treatment: polished or grit-blasted with alumina particles. Each group was then subdivided by bonding agent employed: Z-Prime Plus (control); Scotchbond Universal; All Bond Universal; and Z-Prime Plus + All Bond Universal. Cylindrical composite resin build-ups were constructed atop the blocks using a two-part metal die. Specimens were stored for 24 hours and subjected to microshear bond strength testing. Statistical analyses were performed by means of the F-test (ANOVA), Student's t and Tukey's test. After sputter coating, zirconia surfaces and adhesive interfaces were analyzed by scanning electron microscopy (SEM).

RESULTS

Bond strength was superior for grit-blasted zirconia. In specimens with this surface treatment, there were no significant differences between experimental groups. On SEM, blasted surfaces exhibited areas of micromechanical retention and adhesive interfaces exhibited areas of zirconia-adhesive interlocking.

CONCLUSION

Universal adhesive systems were able to bond to zirconia. The interlocking promoted by grit-blasting enhanced bond strength.

CLINICAL SIGNIFICANCE

Universal adhesive systems simplify bonding to zirconia and enable intraoral repair of fractures.

Reactivity and Bond Strength of Universal Dental Adhesives with Co-Cr Alloy and Zirconia

The aim of this study was to evaluate (a) the reactivity of six universal dental adhesives with polished cobalt-chrome (Co-Cr) alloy and zirconia (3Y-TZP) surfaces; and (b) to assess the shear bond strength (SBS) of a resin composite with polished and alumina-blasted surfaces as mediated by these adhesives. The products tested were Adhese Universal (AD), All-Bond Universal (AB), Clearfill Universal Bond (CB), G-Premio Bond (GP), Prelude One (PO) and Scotchbond Universal (SB). The reactivity on polished substrates was evaluated by reflection infrared microscopy (RFTIRM). The roughness parameters of polished and 50 μm alumina grit-blasted surfaces were assessed by optical profilometry. The SBS of the composite bonded to the substrates treated with each adhesive (n = 10/product) was evaluated after 1 week of storage (H₂O/37 °C) by Weibull statistics. Evidence of phosphate interaction with polished substrates was obtained by FTIRM, with higher peaks on the alloy. Alumina-blasting increased all roughness parameters with higher values on the alloy. AD, CB were the strongest (σ₀) treatments on alloy surfaces and AD, CB, AB, SB on zirconia. GP was the weakest on both substrates and the least reliable (β) on alloy. On polished alloy GP, PO performed better (σ₀), whereas on zirconia there were no significant differences. All adhesives showed more prominent reaction with the Co-Cr alloy than with 3Y-TZP.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

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.

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.

Influence of Primers and Additional Resin Layer on Zirconia Repair Bond Strength

PURPOSE

To evaluate the influence of alloy/zirconia primer and 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing resin layer treatments on the shear bond strength (SBS) of composite resin to zirconia after aging.

MATERIALS AND METHODS

Sixty zirconia (Y-TZP) blocks were air-abraded (35-µm Al₂ O₃ ) and divided into 6 experimental groups (n = 10) in terms of primer/resin layer as follows: (1) control, without any primer or resin; (2) AP, Alloy Primer; (3) ZPP, Z-Prime Plus; (4) PL/ZPP, Z-Prime Plus with light polymerization; (5) AP+SEB, Alloy Primer along with light-cured bonding resin of a self-etch adhesive system (SE Bond); and (6) ZPP+SEB, Z-Prime Plus with SE Bond. After composite resin placement and light polymerization, the specimens were stored in distilled water (37°C for 4 months) and thermal-cycled for 6000 cycles. The SBS was tested with a universal testing machine. Statistical analysis of the SBS data was performed with one-way ANOVA, followed by HSD Tukey test (α = 0.05).

RESULTS

There were significant differences between the groups (p < 0.001, F = 116.5). All the groups revealed significantly higher SBS than the control (p < 0.001). ZPP+SEB group exhibited the highest SBS (16.14 ± 2.52 MPa) and AP group the lowest SBS (7.00 ± 1.97 MPa) among experimental groups; both had significant differences with the other groups (p < 0.001). There were no significant differences between ZPP, PL/ZPP, and AP+SEB groups (p > 0.05).

CONCLUSIONS

The bond strength between zirconia ceramic and composite resin was affected by different primers/resin layer. Applying an MDP-containing resin layer along with both primers resulted in significant enhancement of SBS. This improvement for Z-Prime Plus was significantly higher than that of Alloy 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.

Bond to Zirconia Ceramic: Evaluation of Different Primers and a Universal Adhesive

Objective:

The aim of the study was to evaluate the effect of a universal adhesive and different primers on the bond strength to zirconia ceramic.

Materials and Methods:

Seventy-five zirconia ceramic samples were obtained and divided into five groups (n=15): G1–Scothbond Universal (SBU); G2 – silane + SBU; G3 - Signum Zirconia Bond; G4 - Z-Prime Plus; G5 - MZ Primer. A cone of composite resin was built. The specimens were stored in 100% relative humidity with distilled water at 37°C for 48 h and then submitted to a tensile bond strength test in a universal testing machine at a crosshead speed of 0.5 mm/min. The type of failure that occurred during the de-bonding procedure was analyzed.

Results:

The mean results of the bond strength test (MPa) followed by the same letter represent no statistical difference by ANOVA and Tukey’s post-hoc test (p<0.05): G2=27.55a (±6.99), G4=23.71a (±5.65), G1=22.64a (±5.67), G5=13.64b (±5.49), G3=7.54c (±4.75). G2 and G4 exhibited predominantly cohesive failure in the composite resin cone. G1 and G5 had predominantly mixed failures, and G3 exhibited only adhesive failures.

Conclusion:

The SBU and Z-Prime Plus provided higher bond strength to zirconia ceramic.

Effect of Resin Luting Systems and Alumina Particle Air Abrasion on Bond Strength to Zirconia

This study aimed to evaluate the effect of different primer/resin luting agent combinations and alumina air abrasion on the adhesion to zirconia. Eighty blocks (4×4×3 mm) of Lava Frame Zirconia (3M ESPE) were produced and randomly assigned into eight groups (n=10) according to two zirconia surface treatments (untreated or air abrasion with 50-μm alumina particles) and four luting systems (SU: Scotchbond Universal/RelyX Unicem 2; ZP: Z-Prime Plus/Duo-link Universal; MB: Monobond Plus/Variolink II; and AP: Alloy Primer/ED Primer II/Panavia F 2.0). After the conditioning and primer applications, resin luting agents were manipulated and applied on the zirconia, using a matrix, to form a cylinder (2 mm in diameter×2 mm high), followed by photoactivation for 40 seconds. After that, the specimens were stored in distilled water (37 °C) for 120 days and then submitted to shear bond strength testing, followed by failure mode evaluation under an optical microscope (30×). A two-way analysis of variance and Tukey test (α=0.05) were used for data analysis. Alumina air abrasion (Al) promoted higher bond values for the three luting systems, except for SU, which showed the best results without air abrasion, while with air abrasion, Al-SU, Al-ZP, and Al-MB presented higher values compared to Al-AP. We concluded that the alumina air abrasion of zirconia surfaces seemed to be dispensable for the SU group, while air abrasion (topographical alterations) enhanced the adhesion of the ZP, MB, and AP groups.

Can the Application of Multi-Mode Adhesive be a Substitute to Silicatized/Silanized Y-TZP Ceramics?

Abstract This study evaluated the effectiveness of a multi-mode adhesive (SBU-Scotch Bond Universal/3M) as a substitute for silica coating and silane application on the bonding of zirconia ceramics to resin cement. One-hundred and twenty sintered zirconia ceramic blocks (5 x 5 x 5 mm) were obtained, finished by grounding with silicon carbide paper (#600, #800, #1000 and #1200) and randomly divided into 12 groups (n=10) in accordance with the factors “surface treatment” (ScSi - silicatization + silanization; ScSBU - silicatization + SBU; SBU - SBU without photoactivation and SBUp - SBU photoactivated) and “ceramic” (Lava / 3M ESPE, Ceramill Zirconia / Amann Girrbach and Zirkonzahn / Zirkonzahn). Dual resin cement cylinders (RelyX Ultimate/3M ESPE) were subsequently produced in the center of each block using a silicon matrix (Ø=2 mm, h=5 mm) and photoactivated for 40 s (1200 mW/cm2). The samples were stored for 30 days in distilled water (37ºC) and submitted to shear bond strength test (1 mm/min, 100 KgF). Data (MPa) were analyzed under ANOVA (2 levels) and Tukey test (5%). Complementary analyzes were also performed. ANOVA revealed that only the factor “surface treatment” was significant (p=0.0001). The ScSi treatment (14.28A) promoted statistically higher bond strength values than the other ScSBU (9.03B), SBU (8.47B) and SBUp (7.82B), which were similar to each other (Tukey). Failure analysis revealed that 100% of the failures were mixed. The silica coating followed by the silanization promoted higher bond strength values of resin cement and ceramic, regardless of the zirconia ceramic or SBU.

Water-associated attributes in the contemporary dentin bonding milieu

OBJECTIVES

The water-associated attributes of resin-dentin interfaces created by contemporary adhesives are important determinants of bond integrity and stability. In the present work, these attributes were estimated from the perspectives of causality, to examine the behavior of the first and most-recently launched versions of universal adhesives when applied in either the etch-and-rinse mode or the self-etch mode.

METHODS

The immediate cause of interfacial permeability and the time-dependent cause of water sorption were investigated in conjunction with the intermediate effect of interface degradation and the more long-term effect of loss of mechanical strength, before and after thermomechanical cycling. The results were compared with control etch-and-rinse and self-etch adhesives.

RESULTS

Although the introduction of this new class of universal adhesives has brought forth significant changes to the dental adhesion arena, including more application options, reduced bonding armamentarium and increased user friendliness, the water-associated attributes that are critical for making resin-dentin bonds more durable to environmental challenges and less susceptible to degradation have remained unchanged at large, when compared with benchmarks established by former classes of adhesives.

CONCLUSION

It appears that the current trend of adhesive development has brought forth significant changes but lacks the vigor that demarcates progress and technological sublimity.

CLINICAL SIGNIFICANCE

The advent of the user friendly universal adhesives has brought forth significant changes to the dental adhesion arena. However, the elements that are critical for making resin-dentin bonds more durable to environmental challenges and less susceptible to degradation have remained unchanged at large.

In vitro fracture resistance of composite-resin-veneered zirconia crowns

Aims

The aim of this study is to investigate the fracture load to failure and damage mode of the composite resin-veneered zirconia crowns preparing with two different zirconia surface treatments compared conventional porcelain-veneered zirconia crowns.

Materials and Methods

Metallic molar-shape dies prepared with 10° convergence angle a 1.5 mm deep chamfer finish line were used. Two groups of composite-resin-veneered zirconia crowns were prepared using different surface treatment (Group A - sandblasting and Group B - glaze-on technique). Group C (conventional porcelain-veneered zirconia crowns) was served as control. Load to failure test was performed to evaluate the fracture resistance of the crowns using a universal testing machine. One-way ANOVA was used to evaluate the differences of mean values (P < 0.05) followed by Tukey's honest significance test multiple comparisons.

Results

The mean fracture load to failure of Group A was 1078.45 ± 72.3, Group B was 1215.68 ± 100.76, and Group C (control) was 1203.67 ± 88.05. Modes of failure are 100% bulk fracture of the core through the veneering materials for Group B and C. However, Group A showed 40% delamination of composite veneering leaving zirconia coping exposed.

Conclusions

Group B and C showed significant higher load to failure than Group A. Four specimens of Group A revealed the delamination of composite resin veneering.

Bond durability of universal adhesive to bovine enamel using self-etch mode

OBJECTIVES

The purpose of this study was to examine the enamel bond durability of universal adhesives in the self-etch mode under 2-year water storage and thermal cycling conditions.

MATERIALS AND METHODS

Three commercially available universal adhesives and a gold standard two-step self-etch adhesive were used. Ten specimens of bovine enamel were prepared per test group, and shear bond strength (SBS) was measured to determine the bonding durability after thermal cycling (TC) or long-term water storage (WS). The bonded specimens were divided into three groups: (1) specimens subjected to TC, where the bonded specimens were stored in 37 °C distilled water for 24 h before being subjected to 3000, 10,000, 20,000 or 30,000 TC; (2) specimens stored in 37 °C distilled water for 3 months, 6 months, 1 year or 2 year; and (3) specimens stored in 37 °C distilled water for 24 h, serving as a baseline.

RESULTS

The two-step self-etch adhesive showed significantly higher SBS than the universal adhesives tested, regardless of the type of degradation method. All universal adhesives showed no significant enamel SBS reductions in TC and WS, when compared to baseline and the other degradation conditions.

CONCLUSIONS

Compared to the bond strengths obtained with the two-step self-etch adhesive, significantly lower bond strengths were obtained with universal adhesives. However, the enamel bond durability of universal adhesives was relatively stable under both degradation conditions tested.

CLINICAL RELEVANCE

The present data indicate that the enamel bond durability of universal adhesives in the self-etch mode might be sufficient for clinical use.

Influence of application method on surface free-energy and bond strength of universal adhesive systems to enamel

The aim of the present study was to determine the influence of different adhesive application methods and etching modes on enamel bond effectiveness of universal adhesives using shear bond strength (SBS) testing and surface free-energy (SFE) measurements. The adhesives Scotchbond Universal, All-Bond Universal, Adhese Universal, and G-Premio Bond were used. Prepared bovine enamel specimens were divided into four groups, based on type of adhesive, and subjected to the following surface treatments: (i) total-etch mode with active application; (ii) total-etch mode with inactive application; (iii) self-etch mode with active application; and (iv) self-etch mode with inactive application. Bonded specimens were subjected to SBS testing. The SFE of the enamel surfaces with adhesive was measured after rinsing with acetone and water. The SBS values in total-etch mode were significantly higher than those in self-etch mode. In total-etch mode, significantly lower SBS values were observed with active application compared with inactive application; in contrast, in self-etch mode there were no significant differences in SBS between active and inactive applications. A reduction in total SFE was observed for active application compared with inactive application. The interaction between etching mode and application method was statistically significant, and the application method significantly affected enamel bond strength in total-etch mode.

Anterosuperior rehabilitation with metal-free fixed prosthesis based on zirconia

The loss of upper front dental elements causes functional and psychosocial problems to the affected individuals. In this case report, the treatment planning considered hard and soft tissue loss for a complex fixed partial denture (FPD) rehabilitation. The six-element, all-ceramic FPD was manufactured using a computer-aided design/computer-aided manufacturing system with zirconia framework, veneered with leucite-reinforced ceramic. Ceramic artificial gum was also produced to guarantee tooth-facial proportions as well as lip support, promoting both esthetics and phonetics. The material's mechanical properties allowed for the coupling of the esthetic and mechanical requirements, proving an alternative to the well-established metal-ceramic technology, optimizing biomimetic. One of the endodontic-treated abutment teeth required a radicular retainer with cast metal post, but because of the opacity of zirconia, the esthetics of the prosthesis was not compromised. The low silica content of high resistance ceramics such as zirconia hampers the adhesive cementation, with numerous studies advocating for different cementation protocols, with no clear scientific consensus so far. In the present case, the internal surface of the FPD was initially blasted with aluminum oxide, followed by the application of a universal adhesive system containing 10-methacryloyloxydecyl dihydrogen phosphate. Finally, cementation to the dental structure was conducted with dual-cure self-adhesive resin cement.

Chemical interaction mechanism of 10-MDP with zirconia

Currently, the functional monomer 10-methacryloyloxy-decyl-dihydrogen-phosphate (10-MDP) was documented to chemically bond to zirconia ceramics. However, little research has been conducted to unravel the underlying mechanisms. This study aimed to assess the chemical interaction and to demonstrate the mechanisms of coordination between 10-MDP and zirconium oxide using 1H and 31P magic angle spinning (MAS) nuclear magnetic resonance (NMR) and two dimensional (2D) 1H → 31P heteronuclear correlation (HETCOR) NMR. In addition, shear bond-strength (SBS) tests were conducted to determine the effect of 10-MDP concentration on the bonding effectiveness to zirconia. These SBS tests revealed a 10-MDP concentration-dependent SBS with a minimum of 1-ppb 10-MDP needed. 31P-NMR revealed that one P-OH non-deprotonated of the PO3H2 group from 10-MDP chemically bonded strongly to zirconia. 1H-31P HETCOR NMR indicated that the 10-MDP monomer can be adsorbed onto the zirconia particles by hydrogen bonding between the P=O and Zr-OH groups or via ionic interactions between partially positive Zr and deprotonated 10-MDP (P-O-). The combination of 1H NMR and 2D 1H-31P HETCOR NMR enabled to describe the different chemical states of the 10-MDP bonds with zirconia; they not only revealed ionic but also hydrogen bonding between 10-MDP and zirconia.

Interfacial Characteristics and Bond Durability of Universal Adhesive to Various Substrates

Objective: This study investigated the interfacial characteristics and bond durability of universal adhesives to various substrates.

Methods and Materials: Two universal adhesives were used: 1) Scotchbond Universal and 2) G-Premio Bond. The substrates used were bovine enamel and dentin with or without phosphoric acid etching, resin composite, lithium disilicate and leucite-reinforced glass ceramics, zirconia, and metal alloys. The surface free energy and the parameters of various substrates and of substrates treated by adhesive after light irradiation were determined by measuring the contact angles of three test liquids. Resin composite was bonded to the various substrates to determine shear bond strength after 24 hours water storage and 10,000 thermal cycles. A one-way analysis of variance (ANOVA) and the Tukey post hoc test were used for the surface free energy data, and a two-way ANOVA and the Tukey post hoc test were used for analysis of shear bond strength data (α=0.05).

Results: The interfacial characteristics of the various substrates show significant differences depending on the type of substrate, but the interfacial characteristics of substrate treated by adhesive after light irradiation did not show any significant differences regardless of the substrate used. The bond durability of two universal adhesives to various substrates differs depending on the type of substrate and the adhesive.

Conclusions: The results of this study suggest that universal adhesives modify the interfacial characteristics of a wide range of substrates and create a consistent surface, but the bond durability of universal adhesive to various substrates differs depending on the type of substrate and the adhesive.

Effect of water storage on ultimate tensile strength and mass changes of universal adhesives

Background

The aim of the present study was to evaluate the influence of water storage on micro tensile strength (µTS) and mass changes (MC) of two universal adhesives.

Material and Methods

10 disk-shaped specimens were prepared for each adhesive; Scotchbond Universal (SCU) All-Bond Universal (ABU) and Adper Single Bond 2 (SB2). At the baseline and after 1 day and 28 days of water storage, their mass were measured and compared to estimate water sorption and solubility. For µTS test, 20 dumbbell shaped specimens were also prepared for each adhesive in two subgroups of 1 day and 28 days water storage.

Results

MC was significantly lower for SCU and ABU than SB2 (P < 0.05) at both time intervals. In all three adhesives, the MC was significantly lower at 28 days compared to that at 1 day (P < 0.05). Similarly, µTS was significantly higher for SCU and ABU than SB2 at both storage intervals (P < 0.05). After 28 days, µTS increased significantly for universal adhesives (P < 0.05).

Conclusions

MC and µTS of adhesives were both material and time dependent when stored in water; both universal adhesives showed less water sorption and higher values of µTS than the control group.

Key words:Absorption, dental adhesives, dentin-bonding agents, solubility, tensile strength.

A microcomputed tomography evaluation of the marginal fit of cobalt-chromium alloy copings fabricated by new manufacturing techniques and alloy systems

STATEMENT OF PROBLEM

Although new digital manufacturing techniques are attracting interest in dentistry, few studies have comprehensively investigated the marginal fit of fixed dental prostheses fabricated with such techniques.

PURPOSE

The purpose of this in vitro microcomputed tomography (μCT) study was to evaluate the marginal fit of cobalt-chromium (Co-Cr) alloy copings fabricated by casting and 3 different computer-aided design and computer-aided manufacturing (CAD-CAM)-based processing techniques and alloy systems.

MATERIAL AND METHODS

Single Co-Cr metal crowns were fabricated using 4 different manufacturing techniques: casting (control), milling, selective laser melting, and milling/sintering. Two different commercial alloy systems were used for each fabrication technique (a total of 8 groups; n=10 for each group). The marginal discrepancy and absolute marginal discrepancy of the crowns were determined with μCT. For each specimen, the values were determined from 4 different regions (sagittal buccal, sagittal lingual, coronal mesial, and coronal distal) by using imaging software and recorded as the average of the 4 readings. For each parameter, the results were statistically compared with 2-way analysis of variance and appropriate post hoc analysis (using Tukey or Student t test) (α=.05).

RESULTS

The milling and selective laser melting groups showed significantly larger marginal discrepancies than the control groups (70.4 ±12.0 and 65.3 ±10.1 μm, respectively; P<.001), whereas the milling/sintering groups exhibited significantly smaller values than the controls (P=.004). The milling groups showed significantly larger absolute marginal discrepancy than the control groups (137.4 ±29.0 and 139.2 ±18.9 μm, respectively; P<.05). In the selective laser melting and milling/sintering groups, the absolute marginal discrepancy values were material-specific (P<.05). Nonetheless, the milling/sintering groups yielded statistically comparable (P=.935) or smaller (P<.001) absolute marginal discrepancies to the control groups.

CONCLUSIONS

The findings of this in vitro μCT study showed that the marginal fit values of the Co-Cr alloy greatly depended on the fabrication methods and, occasionally, the alloy systems. Fixed dental prostheses produced by using the milling/sintering technique can be considered clinically acceptable in terms of marginal fit.