Comparison of bond strength to three restorative materials after contamination and the use of two cleaning agents

Effects of stamp material and restoration depth on the accuracy of direct composite resin restorations using stamp technique

OBJECTIVES

To evaluate the effects of different stamp materials and restoration depths on the accuracy of direct composite resin restorations using stamp technique.

METHODS

Eighty standard resin teeth were divided into four groups based on different stamp materials: flowable composite resin (FR), vinyl polydimethyl siloxane (VPS) for bite registration (VB), VPS for impression (VI) and transparent VPS (TV). Each material group was further divided into two subgroups based on restoration depth (1 and 2 mm; n = 10). Standardized Class I cavities were prepared and restored with the corresponding stamps. Pre- and post-treatment scans of each tooth were fitted using Geomagic Control X software, generating deviation distribution maps of the occlusal surface. The accuracy indicators, including mean height variation (MHV), root mean square (RMS), and proportions of height variation with different ranges (PHVrange), were recorded to evaluate the accuracy of restorations. Analysis of variance (ANOVA) were used for statistical analysis (α=0.05).

RESULTS

The type of stamp material significantly affected all accuracy indicators, while restoration depth did not show a significant effect on any of the indicators. MHV values ranged from 29.70 ± 5.88 μm to 63.52 ± 9.58 μm, and RMS values ranged from 62.78 ± 8.76 μm to 101.79 ± 13.17 μm, displaying a trend of FR0.2mm values (0.70 ± 0.50 % for 1 mm, 0.94 ± 0.47 % for 2 mm). In contrast, the TV groups exhibited the lowest PHV<0.05mm values (59.69 ± 10.23 % for 1 mm, 59.67 ± 5.70 % for 2 mm), while the VI groups showed the highest PHV>0.2mm values (7.34 ± 1.58 % for 1 mm, 8.20 ± 3.16 % for 2 mm).

CONCLUSIONS

The accuracy of direct composite resin restorations using stamp made of flowable composite resin was higher than that of all tested VPS materials, thereby reducing the need for occlusal adjustment and improving clinical efficiency. Besides, restoration depth had no significant impact on the accuracy of stamp technique, regardless of the stamp material used.

CLINICAL SIGNIFICANCE

The accuracy of direct composite resin restorations using stamp technique with different stamp materials varies. The flowable composite resin stamp exhibits higher accuracy compared with VPS stamps, reducing the need for occlusal adjustments.

Bonding Effectiveness of Saliva-Contaminated Monolithic Zirconia Ceramics Using Different Decontamination Protocols

Objective

This research study investigated the effect of new decontamination protocols on the bonding capacity of saliva-contaminated monolithic zirconia (MZ) ceramics cemented with two different monomer-containing self-adhesive resin cements.

Materials and Methods

Standardized tooth preparations (4 mm. axial height) were performed for eighty human maxillary premolars under constant water cooling system. Eighty monolithic zirconia crowns (Whitepeaks Supreme Monolith) (n = 8/10 groups) were manufactured by CAD-CAM. Specimens were kept in the artificial saliva at pH = 7.3 for 1 minute at 37°C except control groups. The specimens have not been prealumina blasted and grouped according to cleaning methods and resin cements: control groups (C) (no saliva contamination + GPDM + 4-META (N) (CN) and 10-MDP (M) containing resin cement (CM), alumina blasted (AL) + GPDM + 4-META (ALN) and 10-MDP containing resin cement (ALM), zirconium oxide containing universal cleaning agent (IC) applied + GPDM + 4-META (N) (ICN) and 10-MDP containing resin cement (ICM), pumice (P) applied + GPDM + 4-META (PN) and 10-MDP containing resin cement (PM), and air-water spray (AW) applied + GPDM + 4-META (AWN) and 10-MDP containing resin cement (AWM)). Monobond Plus was applied to all surfaces for 40 seconds before cementation. The thermal cycle was applied at 5,000 cycles after cementation. The crowns were tested in tensile mode at a speed of 1 mm/min. The mode of failure was recorded. SEM examinations were carried out at different magnifications. Data were analyzed using rank-based Kruskal-Wallis and Mann-Whitney tests.

Results

No significant differences were found between the surface treatments and between the two types of resin cements. Interaction effects between surface treatments and resin cements were found to be significant by two-way ANOVA analysis. ICM group resulted in significantly better bond strength results compared with CN. ICM was found to result in better bond strength results compared with PM. The combination of universal cleaning agent and 10-MDP containing resin cement had significantly the highest cementation bond strength values. The increasing order of mean tensile bond strength values of decontamination protocols was C < AW < P < AL < IC. The mean tensile bond strength of 10-MDP containing resin cement was slightly higher than GPDM + 4-META containing resin cement.

Conclusions

Universal cleaning agents can be preferred as an efficient cleaning method with 10-MDP-containing cement after saliva contamination for better adhesive bond strength of 4 mm crown preparation height of monolithic zirconia ceramics.

Impact of try-in paste removal on the fatigue behavior of bonded lithium disilicate ceramics

This in vitro study assessed the effectiveness of three cleaning protocols (air-water spray, 37% phosphoric acid, or Ivoclean) on lithium disilicate restorations' fatigue behavior after try-in paste application, compared to a clean condition. Lithium disilicate discs (IPS e.max CAD, Ivoclar) with Ø-= 12 mm and 1 mm thickness were prepared from prefabricated CAD-CAM blocks, polished, subjected to CAD-CAM milling topography simulation and crystallization. After, etching with 5% hydrofluoric acid and the application of try-in paste (Variolink try-in paste shade white; load of 2.5 N for 5 min) was performed. Discs that received try-in paste were divided into three groups according to the removal protocol: SPRAY - air-water spray for 30 s; HPO - active application of 37% phosphoric acid for 60 s; IVOC - application of Ivoclean for 20 s. Control group (CTRL group) did not receive the try-in paste application. Half of the specimens (n= 15) were tested in the baseline condition (24 h up to 7 days), and the others underwent 25,000 thermal cycles (5 - 55 °C) + 210 days of distilled water storage (37 °C). Additional specimens (n= 3) underwent monotonic testing (1 mm/min). Fatigue testing involved a cyclic fatigue approach (20 Hz, initial load = 100 N - 5000 cycles, step size = 50 N - 10,000 cycles) until a visible crack appeared. Fractographic and topographic analyses were performed. Fatigue data were statistically analyzed with two-way ANOVA, Kaplan-Meier log-rank (Mantel-Cox), and independent t-test (α= 0.05). In the baseline condition, the IVOC group resulted in a superior fatigue behavior compared to the CTRL and SPRAY groups, but similar to the HPO group. The HPO and SPRAY presented a similar fatigue behavior to the CTRL group. It was noticed a decrease in fatigue behavior after aging, which resulted in all the cleaning protocols leading to similar fatigue behavior compared to the CTRL group. On the SPRAY group surface, try-in pastes remnants were noticed. In summary, despite a detrimental impact at baseline conditions, all tested cleaning protocols seem proper to remove the try-in paste from the ceramic's surface in the long-term evaluation.

Durability of Resin Bonding to Dental 3Y-TZP Zirconia Using Different Adhesive Systems

This laboratory study was conducted to evaluate and compare the resin bond strength of different adhesive resin systems in different combinations and the durability of their bonds with zirconia ceramic.

MATERIALS AND METHODS

One hundred and twenty-eight specimens were milled from 3Y-TZP zirconia ceramic. The bonding surfaces of all disks were wet polished, steam cleaned, airborne-particle abraded and ultrasonically cleaned in 99% isopropanol. The specimens were randomly divided into four main groups according to the applied resin system; two conventional and two self-adhesive systems were used. Each group was further subdivided into two subgroups; the first was conditioned with the specified primer for conventional luting resins or not conditioned for the self-adhesive systems, whereas the second subgroup of each was conditioned with the same phosphate monomer-containing primer (Alloy Primer). The zirconia specimens were adhesively bonded, using the allocated luting resin, to plexiglass tubes filled with self-curing composite resin (Clearfil FII). Half of the specimens of each subgroup were stored in distilled water at 37 °C for 3 days, whereas the other half were subjected to artificial aging, 150 days of storage and additional thermal cycling. Thereafter, all specimens were subjected to TBS testing using a universal testing machine. Statistical analysis was conducted using two-way ANOVA followed by separate one-way ANOVAs. The Games-Howell post-hoc test was applied for pairwise comparisons.

RESULTS

All specimens survived storage with thermal cycling. The mean TBS values ranged from a minimum of 43.4 ± 5.0 MPa to a maximum of 66.4 ± 3.5 after 3 days and from a minimum of 13.6 ± 2.5 MPa to a maximum of 50.1 ± 9.4 MPa after 150 days.

CONCLUSIONS

Artificial aging had a significantly negative effect on all test groups. The chosen adhesive-resin system had a significant effect on the resulting TBS values. The highest TBS values were achieved for the self-adhesive luting resin G-Cem One but were statistically comparable to the results obtained for the dual-cure luting resin G-Cem LinkForce.