Influence of tooth surface roughness and type of cement on retention of complete cast crowns

A comparison of mount of preparation and finish lines used by dental students in Damascus University and Al Baath University using (CAD/CAM) scanner

Introduction

Fixed prosthodontics is considered one of the most vital dental treatments that patients receive. Sometimes, however, complication is encountered along with limited information regarding the quality and precision of preparation. Which that led to the conception of this study in order to highlight the shortcomings and obstacles in an attempt to avoid them. This study aims to evaluate the quality of preparation by students of the faculty of dentistry in Damascus University and Al-Baath University by assessing the finish lines.

Materials and methods

The specimen of this study consists of 244 prepared abutments divided into two groups: the first group consists of 122 clinically prepared abutments conducted by fifth year students in Damascus University. The second group consists of 122 clinically prepared abutments conducted by fifth year students in Al-Baath University. The specimen also consists of gypsum casts containing replicas of the clinically prepared teeth in addition to the primary casts. All casts – primary casts and post preparation casts – were collected and 3D scans were conducted to each abutment – before and after preparation – and a 3D image was acquired. Statistical analysis was conducted using SPSS v.26 (IBM, USA) with a P-Value of 0.05.

Results

The preparation with a simple finishing line at Al-Baath University was 103% greater than it with a statistically significant difference at 56% at Damascus University, by 38%, and the percentage of preparation with a semi-shoulder finish line at Al-Baath University was 5% and at Damascus University was 3% without there being a statistically significant difference Between the two universities, the percentage of preparation with a shoulder finish line in Al-Baath University 14% was lower by a statistically significant difference than in Damascus University 63% by 40% (P < 0.001).

Conclusion

The percentage of preparation with a simple finishing line at Al-Baath University was 103% greater than it with a statistically significant difference at 56% at Damascus University, by 38%, and the percentage of preparation with a semi-shoulder finish line at Al-Baath University was 5% and at Damascus University was 3%.

[Clinical pathway and preparation method of high-precision tooth shoulder platform]

A clear shoulder platform that can be easily identified by doctors and technicians or machines (mouth scan and warehouse scan) is important to obtaining a good long-term and stable fixed prosthesis treatment effect. At present, the pre-paration of the shoulder platform is usually based on free hands, and the practical operation is mainly guided by experience. Moreover, no comprehensive and objective preoperative design, intraoperative verification, and final test are available. Thus, the accuracy of shoulder platform preparation needs to be improved. In this study, the clinical pathway of "three determination, three selection, and three steps" with high accuracy of preparation and the precise shoulder preparation method of "bur-tip guidance" are proposed in detail.

Management of short clinical crowns by utilizing horizontal groove retentive technique in crown/tooth or both with different luting cements - An analysis on extracted teeth

Purpose:

The aim of the present study was to compare and evaluate the retention of dislodged crowns by addition of one horizontal circumferential groove (HCG) to preparation and/or casting and with two luting cements.

Materials and Methods:

A total of 80 recently extracted human maxillary first molar teeth of appropriate sizes were collected and mounted in the resin blocks using surveyor. Standardized full coverage tooth preparations were prepared and impressions were obtained. Dies were prepared for casting and were then subjected to tensile loading using UTM. The data obtained was statistically analyzed.

Results:

Obtained values were statistically analyzed using ANOVA, STUDENT “t” TEST and BONFERRONI TEST. The results showed that the mean tensile force (TF) was in the range from 49.05 to 264.87 for group A and 255.06 to 588.60 for group B. The highest TF was recorded for subgroup 3B, whereas the lowest for subgroup 1A.

Conclusion:

Within the limitations of the study, it was concluded that by addition of one HCG to tooth preparation or casting and to both showed significant increase in retention, when compared to control groups. The highest retention value was obtained for sample with groove on the internal surface of crown luted with SARC.

Digital versus conventional techniques for pattern fabrication of implant-supported frameworks

Objective

The aim of this experimental study was to compare retention of frameworks cast from wax patterns fabricated by three different methods.

Materials and Methods

Thirty-six implant analogs connected to one-piece abutments were divided randomly into three groups according to the wax pattern fabrication method (n = 12). Computer-aided design/computer-aided manufacturing (CAD/CAM) milling machine, three-dimensional printer, and conventional technique were used for fabrication of waxing patterns. All laboratory procedures were performed by an expert-reliable technician to eliminate intra-operator bias. The wax patterns were cast, finished, and seated on related abutment analogs. The number of adjustment times was recorded and analyzed by Kruskal-Wallis test. Frameworks were cemented on the corresponding analogs with zinc phosphate cement and tensile resistance test was used to measure retention value.

Statistical Analysis Used

One-way analysis of variance (ANOVA) and post hoc Tukey tests were used for statistical analysis. Level of significance was set at P < 0.05.

Results

The mean retentive values of 680.36 ± 21.93 N, 440.48 ± 85.98 N, and 407.23 ± 67.48 N were recorded for CAD/CAM, rapid prototyping, and conventional group, respectively. One-way ANOVA test revealed significant differences among the three groups (P < 0.001). The post hoc Tukey test showed significantly higher retention for CAD/CAM group (P < 0.001), while there was no significant difference between the two other groups (P = 0.54). CAD/CAM group required significantly more adjustments (P < 0.001).

Conclusions

CAD/CAM-fabricated wax patterns showed significantly higher retention for implant-supported cement-retained frameworks; this could be a valuable help when there are limitations in the retention of single-unit implant restorations.

Evaluation of the effect of dentin surface treatment by air abrasion and Er:YAG laser on the retention of metal crowns luted with glass ionomer cement in teeth with reduced crown height: An in vitro study

Aim and Objectives

The purpose of this study was to investigate the effect of dentin surface treatment with aluminum oxide air abrasion and Er:YAG laser on tensile bond strength of metal crowns. Metal crowns were luted with conventional glass ionomer cement (GIC) in the teeth with reduced crown height, where preparation geometry did not provide optimal retention form.

Materials and Methods

Forty-eight human premolars were prepared to receive metal crowns and were randomly divided into four groups for tensile bond strength testing. Group A: Untreated dentin luted with self-adhesive composite resin cement as positive control; Group B: Untreated dentin luted with GIC as negative control; Group C: Surface treatment with 50 μm aluminum oxide air abrasion and luted with GIC; Group D: Surface treatment with Er:YAG laser (λ =2.94 mm) with a total energy 84.88 J/cm² of (60 mJ/pulse, 10 Hz, 60 pulses, and 100 μs pulse width) and luted with GIC. The cemented specimens were thermocycled and later subjected to axial load in a universal testing machine at 0.5 mm/min cross-head speed for tensile testing. Scanning electron microscopic evaluation of dentin surface treatment and cement-dentin interface was also done in representative specimens.

Results

One-way analysis of variance showed statistically significant difference among/within the groups (P < 0.001). Tukey's post hoc test presented significant increased tensile bond strength of Er:YAG laser group. Air abrasion group showed no significant increase in tensile bond strength values (P = 0.033).

Conclusion

Dentin surface treatment with Er:YAG laser significantly improved the tensile bond strength of luting GIC compared to air-abraded and untreated dentin.

What is the changing frequency of diamond burs?

PURPOSE

The purpose of this study was to determine the changing frequency of a diamond bur after multiple usages on 3 different surfaces.

MATERIALS AND METHODS

Human premolar teeth (N = 26), disc shaped direct metal laser sintered CoCr (N = 3) and zirconia specimens (N = 3) were used in this study. Groups named basically as Group T for teeth, Group M for CoCr, and Group Z for zirconia. Round tapered black-band diamond bur was used. The specimens were randomly divided into three groups and placed with a special assembly onto the surveyor. 1, 5, and 10 preparation protocols were performed to the first, second, and third sub-groups, respectively. The subgroups were named according to preparation numbers (1, 5, 10). The mentioned bur of each group was then used at another horizontal preparation on a new tooth sample. The same procedure was used for CoCr and zirconia disc specimens. All of the bur surfaces were evaluated using roughness analysis. Then, horizontal tooth preparation surfaces were examined under both stereomicroscope and SEM. The depth maps of tooth surfaces were also obtained from digital stereomicroscopic images. The results were statistically analyzed using One-Way ANOVA, and the Tukey HSD post-hoc tests (α=.05).

RESULTS

All of the groups were significantly different from the control group (P<.001). There was no significant difference between groups Z5 and Z10 (P=.928). Significant differences were found among groups T5, M5, and Z5 (P<.001).

CONCLUSION

Diamond burs wear after multiple use and they should be changed after 5 teeth preparations at most. A diamond bur should not be used for teeth preparation after try-in procedures of metal or zirconia substructures.

The Effect of Temporary Cement Cleaning Methods on the Retention of Crowns

PURPOSE

To evaluate the effect of temporary cement cleaning methods on the retention of cemented crowns using zinc phosphate cement and resin-modified glass ionomer cement.

MATERIALS AND METHODS

Forty titanium specimens were fabricated to simulate prepared molars with minimally retentive taper. The Ni-Cr cast crowns were fabricated, temporarily cemented, and separated. The specimens were divided into four groups according to the temporary cement cleaning method (n = 10) as follows: control group (no temporary cementation), orange solvent group, ultrasonic cleaning group, and air-abrasion group. After the cleaning procedures, the specimens were cemented with definitive cements (zinc phosphate cement and resin-modified glass ionomer, RMGI, cement) and subjected to thermocycling (5000 cycles, 5-55°C, dwell time, 10 seconds). The tensile bond strength of each specimen was measured using a universal testing machine, and the results were analyzed using the Kruskal-Wallis and Mann-Whitney U test (α = 0.05).

RESULTS

When cemented with zinc phosphate cement, the statistical analysis showed that the value of the air-abrasion group was significantly higher than those of the other groups (p < 0.01). There was no statistically significant difference among the other groups. When cemented with RMGI cement, the air-abrasion group showed the lowest value, and the control group showed the highest value (p < 0.01). The difference between the ultrasonic cleaning group and the orange solvent group was not statistically significant.

CONCLUSION

The use of temporary cement did not have a significant influence on retention of permanently cemented crowns when zinc phosphate cement was used for permanent cementation. Airborne-particle abrasion after provisional cementation improved retention of crowns cemented with zinc phosphate cement; however, the use of temporary cement significantly decreased retention of permanently cemented crowns when RMGI cement was used regardless of the temporary cement cleaning method.

Effect of dentin surface roughness on the shear bond strength of resin bonded restorations

PURPOSE

This study aimed to investigate whether dentin surface preparation with diamond rotary instruments of different grit sizes affects the shear bond strength of resin-bonded restorations.

MATERIALS AND METHODS

The buccal enamel of 60 maxillary central incisors was removed with a low speed diamond saw and wet ground with silicon carbide papers. The polished surfaces of the teeth were prepared with four groups of rotary diamond burs with super-coarse (SC), coarse (C), medium (M), and fine (F) grit sizes. Following surface preparation, 60 restorations were casted with nickel-chromium alloy and bonded with Panavia cement. To assess the shear bond strength, the samples were mounted on a universal testing machine and an axial load was applied along the cement-restoration interface at the crosshead speed of 0.5 mm/min. The acquired data was analyzed with one way ANOVA and Tukey post hoc test (α=.05).

RESULTS

The mean ± SD shear bond strengths (in MPa) of the study groups were 17.75 ± 1.41 for SC, 13.82 ± 1.13 for C, 10.40 ± 1.45 for M, and 7.13 ± 1.18 for F. Statistical analysis revealed the significant difference among the study groups such that the value for group SC was significantly higher than that for group F (P<.001).

CONCLUSION

Dentin surface roughness created by diamond burs of different grit sizes considerably influences the shear bond strength of resin bonded restorations.

A tooth preparation technique in fixed prosthodontics for students and neophyte dentists

PURPOSE

The aim of this study was to evaluate a novel technique of tooth preparation in fixed prosthodontics suitable for dental students and neophyte dentists.

MATERIALS AND METHODS

Twenty-four dental students of the sixth-year class were recruited to verify the predicibility of this technique. Each student prepared two mandibular second premolars on a typodont for a dental crown with a 90° shoulder finishing line. One tooth was prepared using standard procedures taught in the prosthodontic dental course; the other tooth was prepared with the new technique. Three Professors of Prosthodontics of the same University evaluated the result on the basis of 10 criteria.

RESULTS

A statistically significant difference between the two techniques was found in 8 out of 10 criteria. The new technique showed higher values (p<0.05) in 7 criteria, while the conventional technique had better results in just 1 criterion. Moreover, the total sum of values was higher for the new technique (total 41.2±3.98, p<0.05) compared to the conventional technique (total 38.12±5.18, p<0.05).

CONCLUSIONS

This study showed that the results were less dependent on manual abilities and personal experience with the novel technique. It could helps dental students and neophyte dentists in their learning curve.

Comparative evaluation of bond strength of all-metal crowns with different luting agents after undergoing various modes of surface treatments: An in-vitro study

AIM

This study includes a comparative evaluation of the various surface treatments of the intaglio surface of crowns in combination with various luting agents for maximal retention.

MATERIALS AND METHODS

Totally, 150 dies of a standard complete crown preparation were fabricated. Wax pattern with a loop on the occlusal surface was prepared on each die using standard procedures, and then crowns were cast with nickel-chromium alloy. These crowns were randomly divided into five groups as per the surface of the intaglio surface of the metal copings. The crowns in each group were again subdivided randomly into three groups as per the luting agents used resin-modified glass ionomer cement, glass ionomer cement, and zinc phosphate cement. Retention was measured (MPa) by separating the metal crowns from the metallic die under tension on a Universal testing machine.

STATISTICAL ANALYSIS USED

The data were recorded and statistically analyzed using one-way analysis of variance followed by Tukey's test.

RESULTS

The retention differed both with surface treatment and type of luting agents. Untreated group showed the least bond strengths < sandblasting with 50 µm alumina < sandblasting with 50 µm alumina with ultrasonic cleaning < sandblasting with 110 µm alumina < sandblasting with 110 µm alumina along with ultrasonic cleaning. For luting agents, glass ionomer cement showed least bond strength because there was no chemical bonding present between metal crown and metallic die, followed by zinc phosphate cement and maximum bond strength were found for resin-modified glass ionomer cement.

CONCLUSION

Among all types of surface treatments used in this study, maximum bond strength was yielded by sandblasting with 110 µm alumina + ultrasonic cleaning and the best luting agent was resin-modified glass ionomer cement.

Biomechanical three-dimensional finite element analysis of monolithic zirconia crown with different cement type

PURPOSE

The objective of this study was to evaluate the influence of various cement types on the stress distribution in monolithic zirconia crowns under maximum bite force using the finite element analysis.

MATERIALS AND METHODS

The models of the prepared #46 crown (deep chamfer margin) were scanned and solid models composed of the monolithic zirconia crown, cement layer, and prepared tooth were produced using the computer-aided design technology and were subsequently translated into 3-dimensional finite element models. Four models were prepared according to different cement types (zinc phosphate, polycarboxylate, glass ionomer, and resin). A load of 700 N was applied vertically on the crowns (8 loading points). Maximum principal stress was determined.

RESULTS

Zinc phosphate cement had a greater stress concentration in the cement layer, while polycarboxylate cement had a greater stress concentration on the distal surface of the monolithic zirconia crown and abutment tooth. Resin cement and glass ionomer cement showed similar patterns, but resin cement showed a lower stress distribution on the lingual and mesial surface of the cement layer.

CONCLUSION

The test results indicate that the use of different luting agents that have various elastic moduli has an impact on the stress distribution of the monolithic zirconia crowns, cement layers, and abutment tooth. Resin cement is recommended for the luting agent of the monolithic zirconia crowns.

Reporting numeric values of complete crowns. Part 1: Clinical preparation parameters

STATEMENT OF PROBLEM

An implemented objective measuring system for measuring clinical tooth preparations does not exist.

PURPOSE

The purpose of this study was to compare clinically achieved tooth preparations for ceramic crowns by general dentists with the recommended values in the literature with an objective measuring method.

MATERIAL AND METHODS

Two hundred thirty-six stone dies prepared for anterior and posterior complete ceramic crown restorations (IPS e.max Press; Ivoclar Vivadent) were collected from dental laboratories. The dies were scanned and analyzed using the coordinate geometry method. Cross-sectioned images were captured, and the average total occlusal convergence angle, margin width, and abutment height for each preparation was measured and presented with associated 95% confidence intervals.

RESULTS

The average total occlusal convergence angles for each tooth type was above the recommended values reported in the literature. The average margin widths (0.40 to 0.83 mm) were below the minimum recommended values (1 to 1.5 mm). The tallest preparations were maxillary canines (5.25 mm), while the shortest preparations were mandibular molars (1.87 mm).

CONCLUSIONS

Complete crown preparations produced in general practice do not achieve the recommended values found in the literature. However, these recommended values are not based on clinical trials, and the effects of observed shortfalls on the clinical longevity of these restorations are not predictable.

In vitro tensile strength of luting cements on metallic substrate

The aim of this study was to determine the tensile strength of crowns cemented on metallic substrate with four different types of luting agents. Twenty human maxillary molars with similar diameters were selected and prepared to receive metallic core castings (Cu-Al). After cementation and preparation the cores were measured and the area of crown's portion was calculated. The teeth were divided into four groups based on the luting agent used to cement the crowns: zinc phosphate cement; glass ionomer cement; resin cement Rely X; and resin cement Panavia F. The teeth with the crowns cemented were subjected to thermocycling and later to the tensile strength test using universal testing machine with a load cell of 200 kgf and a crosshead speed of 0.5 mm/min. The load required to dislodge the crowns was recorded and converted to MPa/mm(2). Data were subjected to Kruskal-Wallis analysis with a significance level of 1%. Panavia F showed significantly higher retention in core casts (3.067 MPa/mm(2)), when compared with the other cements. Rely X showed a mean retention value of 1.877 MPa/mm(2) and the zinc phosphate cement with 1.155 MPa/mm(2). Glass ionomer cement (0.884 MPa/mm(2)) exhibited the lowest tensile strength value. Crowns cemented with Panavia F on cast metallic posts and cores presented higher tensile strength. The glass ionomer cement showed the lowest tensile strength among all the cements studied.

A Comparative Evaluation of the Effect of Resin based Sealers on Retention of Crown Cemented with Three Types of Cement - An In Vitro Study

AIM

In an effort to control postoperative sensitivity, dentin sealers are being applied following crown preparations, with little knowledge of how crown retention might be affected. A previous study demonstrated no adverse effect when using a gluteraldehyde-based sealer, and existing studies have shown conflicting results for resin-based products. This study determined the retention of the casting cemented with three types of cement, with and without use of resin sealers and it determined the mode of failure.

MATERIALS AND METHODS

Extracted human molars (n=60) were prepared with a flat occlusal, 20-degree taper, and 4-mm axial length. The axial surface area of each preparation was determined and specimens were distributed equally among groups (n=10). A single-bottle adhesive system (one step single bottle adhesive system) was used to seal dentin, following tooth preparation. Sealers were not used on the control specimens. The test castings were prepared by using Ni-Cr alloy for each specimen and they were cemented with a seating force of 20 Kg by using either Zinc Phosphate (Harvard Cement), Glass Ionomer (GC luting and lining cement,GC America Inc.) and modified-resin cement (RelyXTMLuting2). Specimens were thermocycled for one month and were then removed along the path of insertion by using a Universal Testing Machine at 0.5 mm/min. A single-factor ANOVA was used with a p value of .05. The nature of failure was recorded and the data was analyzed by using Chi-square test.

RESULTS

Mean dislodgement stress for Zinc phosphate (Group A) was 24.55±1.0 KgF and that for zinc phosphate with sealer (Group D) was 14.65±0.8 KgF. For glass ionomer (Group B) without sealer, the mean value was 32.0±1.0 KgF and mean value for glass ionomer with sealer (Group E) was 37.90±1.0 KgF. The mean value for modified resin cement (Group C) was 44.3±1.0KgF and that for modified resins with sealer (Group F) was 57.2±1.2 KgF. The tooth failed before casting dislodgement in 8 to 10 specimens cemented with modified-resin cement.

CONCLUSION

Resin sealer decreased casting retentive stress by 46% when it was used with Zinc phosphate. However, sealer use resulted in 60% increased retention when it was used with Glass ionomer cement. The modified-resin cement produced the highest mean dislodgement stress, which nearly always exceeded the strength of the tooth.

Influence of oscillating and rotary cutting instruments with electric and turbine handpieces on tooth preparation surfaces

STATEMENT OF THE PROBLEM

Rotary and nonrotary cutting instruments are used to produce specific characteristics on the axial and marginal surfaces of teeth being prepared for fixed restorations. Oscillating instruments have been suggested for tooth preparation, but no comparative surface roughness data are available.

PURPOSE

To compare the surface roughness of simulated tooth preparations produced by oscillating instruments versus rotary cutting instruments with turbine and electric handpieces.

MATERIAL AND METHODS

Different grit rotary cutting instruments were used to prepare Macor specimens (n=36) with 2 handpieces. The surface roughness obtained with rotary cutting instruments was compared with that produced by oscillating cutting instruments. The instruments used were as follows: coarse, then fine-grit rotary cutting instruments with a turbine (group CFT) or an electric handpiece (group CFE); coarse, then medium-grit rotary cutting instruments with a turbine (group CMT) or an electric handpiece (group CME); coarse-grit rotary cutting instruments with a turbine handpiece and oscillating instruments at a low-power (group CSL) or high-power setting (group CSH). A custom testing apparatus was used to test all instruments. The average roughness was measured for each specimen with a 3-dimensional optical surface profiler and compared with 1-way ANOVA and the Tukey honestly significant difference post hoc test for multiple comparisons (α=.05).

RESULTS

Oscillating cutting instruments produced surface roughness values similar to those produced by similar grit rotary cutting instruments with a turbine handpiece. The electric handpiece produced smoother surfaces than the turbine regardless of rotary cutting instrument grit.

CONCLUSION

Rotary cutting instruments with electric handpieces produced the smoothest surface, whereas the same instruments used with a turbine and oscillating instruments achieved similar surface roughness.

Comparison of the effect of implant abutment surface modifications on retention of implant-supported restoration with a polymer based cement

BACKGROUND

In cement-retained implant-supported restoration it is important to gain adequate retention of definitive restoration as well as retrievability of prosthesis. The surface of the abutment, alloy of the restoration and the type of cement used influences the retention of the restoration. There is a need to analyze the influence of surface modifications of abutments on the retentive capabilities of provisional implant cements.

PURPOSE OF STUDY

To compare the effect of implant abutment surface modifications on retention of implant-supported restoration cemented with polymer based cement.

MATERIALS AND METHOD

Thirty solid titanium implant abutments (ADIN), 8mm height, were divided into 3 groups. Ten abutments with retentive grooves (Group I) as supplied by the manufacturer, Ten abutments milled to 20 taper circumferentially (Group II), and Ten abutments milled and air-abraded with 110 μm aluminum oxide (Group III) were used in this study. Ni-Cr coping were casted for each abutment and polymer based cement was used to secure them to the respective abutments. Using a universal testing machine at a crosshead speed of 0.5 cm/minute, tensile bond strength was recorded (N).

RESULTS

Mean tensile bond strength of Group I, II and III were found to be 408.3, 159.9 and 743.8 Newton respectively. The values were statistically different from each other (p<0.001).

CONCLUSION

Abutments with milled and sandblasted surface provide the highest retention followed by abutments with retentive grooves and then by abutments with milled surface when cast copings were cemented to implant abutments with polymer based cement.

CLINICAL IMPLICATIONS

Retention of restoration depends on the surface of the abutment as well as the luting agents used. Incorporation of retentive grooves or particle abrasion can enhance retention especially in situation of short clinical crown.

Retentiveness of metal coping luted to teeth of uremic patients undergoing hemodialysis using five different luting cements

OBJECTIVES

This study aimed to assess the retention of metal copings luted to uremic teeth with five different luting agents.

METHODS

A total of 35 sound natural molars was collected from uremic patients and randomly assigned into five groups (n=7). The teeth were prepared for metal copings using diamond tips and water coolant. Metal copings with a loop on the occlusal surface were fabricated using base metal alloy (Rexillium III). The copings were luted using Fuji I, glass ionomer (GI); Fuji Plus, resin-modified glass ionomer (RMGI); Panavia F 2.0, resin cement; Rely X Unicem, self-adhesive cement (SA); and Adhesor, zinc phosphate cement (ZPh). All specimens were incubated at 37°C for 24 hours, conditioned in artificial saliva for 7 days, and then thermocycled for 5000 cycles (5°C-55°C). The dislodging force was measured using a universal testing machine at a crosshead speed of 2 mm/min. The mode of failure of the loaded adhesive copings was evaluated. Statistical analyses were performed using one-way analysis of variance and Tukey post hoc test.

RESULTS

GI and SA cements had the highest and the lowest mean retentive strength, respectively (580.90±17.3, 406.6±12.7). There was no significant difference between ZPh, SA, and resin cements. These cements were inferior to GI and RMGI cements (p<0.05), which showed statistically similar retentive strengths.

CONCLUSIONS

The results of this study support the use of glass ionomer and resin-modified glass ionomer cements for luting of metal copings to uremic teeth with retentive preparations.

A comparison of retentive strength of implant cement depending on various methods of removing provisional cement from implant abutment

PURPOSE

This study evaluated the effectiveness of various methods for removing provisional cement from implant abutments, and what effect these methods have on the retention of prosthesis during the definitive cementation.

MATERIALS AND METHODS

Forty implant fixture analogues and abutments were embedded in resin blocks. Forty cast crowns were fabricated and divided into 4 groups each containing 10 implants. Group A was cemented directly with the definitive cement (Cem-Implant). The remainder were cemented with provisional cement (Temp-Bond NE), and classified according to the method for cleaning the abutments. Group B used a plastic curette and wet gauze, Group C used a rubber cup and pumice, and Group D used an airborne particle abrasion technique. The abutments were observed using a stereomicroscope after removing the provisional cement. The tensile bond strength was measured after the definitive cementation. Statistical analysis was performed using one-way analysis of variance test (α=.05).

RESULTS

Group B clearly showed provisional cement remaining, whereas the other groups showed almost no cement. Groups A and B showed a relatively smooth surface. More roughness was observed in Group C, and apparent roughness was noted in Group D. The tensile bond strength tests revealed Group D to have significantly the highest tensile bond strength followed in order by Groups C, A and B.

CONCLUSION

A plastic curette and wet gauze alone cannot effectively remove the residual provisional cement on the abutment. The definitive retention increased when the abutments were treated with rubber cup/pumice or airborne particle abraded to remove the provisional cement.

Comparative evaluation of bond strengths of different core materials with various luting agents used for cast crown restorations

The coronal cast restoration continues to be used commonly to restore mutilated, endodontically treated teeth. The tensile bond strength of luting cements is of critical importance as many of failures are at the core and the crown interface. An invitro study with aim to evaluate and compare bond strengths of luting cements between different core materials and cast crowns. A total of 45 extracted identical mandibular second premolars were endodontically treated and divided into 3 groups of 15 each. Specimens in first group were restored with cast post and core (Group C), and specimens in second group were restored with stainless steel parapost and composite core material (Group B) and specimens in third group were restored with stainless steel parapost and glass ionomer core build (Group G). Standardized crown preparation was done for all the specimens to receive cast crowns. Each group was further divided into 3 subgroups and were cemented using 3 different luting cements namely, resin cement, polycarboxylate cement, glass ionomer cement (Type I). The samples of each subgroup (n = 5) were subjected to tensile testing using Universal Testing Machine at a crosshead speed of 2 mm/min till the dislodgement of crown from the core surface was observed. The bond strengths were significantly different according one way ANOVA (F-150.76 and p < 0.0000). The results of the study showed that the specimens cemented with resin cement in cast core, composite core and glass ionomer core exhibited significantly higher bond strengths as compared to specimens cemented with glass ionomer and polycarboxylate cement. Composite resin core and resin cement combinations were superior to all other cement and core combinations tested.

An in vitro assessment of circumferential grooves on the retention of cement-retained implant-supported crowns

STATEMENT OF PROBLEM

Crowns cemented on short implant abutments may have insufficient retention.

PURPOSE

The purpose of this study was to evaluate the effect of circumferential grooves on the retention of cemented cast copings on implant abutments.

MATERIAL AND METHODS

Sixty similarly-shaped implant abutments were divided into 4 groups (n=15): without grooves, with 1 groove, with 2 grooves, and with 3 grooves. Fifteen identical NiCr cast copings were prepared to fit all 60 abutments. The castings were cemented to each group of abutments with a noneugenol provisional cement (Tempbond NE) and a zinc phosphate cement (Harvard). After thermal cycling and storage for 6 days in a water bath, retention tests were conducted with a tensile testing machine (Instron) (5 mm/min) and retentive forces were recorded. Data were subjected to 1 way-ANOVA, Tukey's (HSD) test, and repeated measures ANOVA (α=.05).

RESULTS

For the noneugenol temporary cement, group retention values were increased according to the number of grooves (P<.001). For the zinc phosphate cement, the first groove increased the retention by approximately 60% (P<.001). The retentive values were higher for the zinc phosphate cement than the provisional cement. The influence of the grooves depended on the type of cement used (P<.001). Cement remnants were found primarily on the castings for provisional cement and for the plain abutments cemented with zinc phosphate cement. Remnants were found primarily on the abutments for the grooved abutments cemented with zinc phosphate cement.

CONCLUSIONS

The addition of circumferential grooves to implant abutments increased the retention of cement-retained castings. For zinc phosphate cement, 1 groove was as effective as several, whereas for the provisional cement, the retention increased gradually with additional grooves.

Crown pull-off test (crown retention test) to evaluate the bonding effectiveness of luting agents

OBJECTIVE

The purpose of this review was to assess the influencing factors which affect laboratory tests that evaluate the effectiveness of luting agents on the retention of crowns in prepared dentin and - based on the results of the review - to propose a reasonable experimental setup.

MATERIALS AND METHODS

The database MEDLINE was systematically searched for laboratory methods that evaluated the effectiveness of luting agents by pulling off crowns from prepared extracted teeth.

RESULTS

Eighteen studies were included into the systematic review. The studies varied largely with regard to tooth type (molars, premolars), number of specimens (9-25), stump height (3-6mm), convergence angle (4.8-33 degrees ), standardization and measurement of preparation surface, seating force (25-200N), artificial ageing, crosshead speed for tensile force and statistical analysis. The coefficient of variation of the test results varied from 3% to 100%. The most important influencing factors for the crown dislodgement were stump height and convergence angle as well as the luting agent. Panavia and RelyX Unicem generally produced the highest values followed by glass ionomer and zinc phosphate cements. When pooling and normalizing the data, the mean difference between glass ionomer and resin-based materials as well as between glass ionomer and zinc phosphate cements was statistically significant (Wilcoxon, p<0.05). Seating force, roughness, type of cutting bur and use of a desensitizing agent had all a negligible effect on the test results. Artificial ageing like thermocycling had no influence with glass ionomer cements whereas for resin-based cements thermocycling and prolonged water storage generated similar a failures stress than thermocycling alone. The comparison with clinical results did not reveal conclusive evidence that the results of the laboratory methods completely reflect the results of prospective clinical trials in conjunction with single crowns and fixed dental prostheses. A reasonable experimental setup includes: at least 20 specimens per group, stump height 3mm, convergence angle 20 degrees , thermocycling of specimens (5000x), avoidance of shearing forces during dislodgement and failure probability statistics (Weibull).

CONCLUSIONS

The results of pull-off tests with crowns that are cemented with luting agents varied largely and reflect only partially the results from clinical trials. The most influencing factors (standardized tooth preparation, avoidance of shearing stress during dislodgement of crown) had to be controlled to get meaningful results.

Factors influencing bonding fixed restorations

INTRODUCTION Crown displacement often occurs because the features of tooth preparations do not counteract the forces directed against restorations. OBJECTIVE The purpose of this study was to evaluate the effect of preparation designs on retention and resistance of fixed restorations. METHOD The study was performed on 64 differently sized stainless steel dies. Also, caps which were used for evaluated retention were made of stainless steel for each die. After cementing the caps on experimental dies, measuring of necessary tensile forces to separate cemented caps from dies was done. Caps, which were made of a silver-palladium alloy with a slope of 60? to the longitudinal axis formed on the occlusal surface, were used for evaluating resistance. A sudden drop in load pressure recorded by the test machine indicated failure for that cap. RESULTS A significant difference was found between the tensile force required to remove the caps from the dies with different length (p<0.05) and different taper (p<0.01). The greatest retentive strengths (2579.2 N and 2989.8 N) were noticed in experimental dies with the greatest length and smallest taper. No statistically significant (p>0.05) differences were found between tensile loads for caps cemented on dies with different diameter. Although there was an apparent slight increase in resistance values for caps on dies with smaller tapers, the increase in resistance for those preparation designs was not statistically significant. There was a significant difference among the resistance values for caps on dies with different length (p<0.01) and diameter (p<0.05). CONCLUSION In the light of the results obtained, it could be reasonably concluded that retention and resistance of the restoration is in inverse proportion to convergence angle of the prepared teeth. But, at a constant convergence angle, retention and resistance increase with rising length and diameter.

Effect of metal type and surface treatment on in vitro tensile strength of copings cemented to minimally retentive preparations

STATEMENT OF PROBLEM

Due to the potential lack of ideal preparation form, the type of alloy and its surface pretreatment may have clinically relevant correlations with the retentive strength of castings to minimally retentive preparations.

PURPOSE

The purpose of this study was to evaluate the effect of alloy type and surface pretreatments of base and noble metal copings on their tensile strength to minimally retentive preparations.

MATERIAL AND METHODS

Minimally retentive, standardized crown preparations were made on recently extracted human third molars (n=68). Noble (IPS d.SIGN 53) and base metal (Rexillium NBF) copings were fabricated. All copings received heat treatment for oxide formation. Three experimental groups were then developed for each metal type (groups ranging from 10 to 12 specimens each): oxide only, airborne-particle abraded, or metal-primed. Copings were cemented using a self-adhesive universal resin cement (RelyX Unicem) and were thermal cycled (500 cycles between 5 and 55 degrees C) and stored (24 hours, 37 degrees C) before debonding using a universal testing machine. Frequency of debond location was compared among specimen groups. A 2-way ANOVA was used to test for interaction between the metal type and surface treatment, and, if no significant interaction was found, to test the main effects for metal type and surface treatment (alpha=.05). A multinomial logit model using the likelihood ratio test was used to describe the effect of metal type and surface treatment on failure site location (alpha=.05).

RESULTS

The 2-way ANOVA indicated no significant influence of any factor on debond load: metal type (P=.885), surface treatment (P=.555), or their interaction (P=.644). The multinomial logit statistical model showed that noble metals and metal primers significantly (P<.05) shifted debond failures to occur more frequently at the resin/tooth interface or within the tooth itself.

CONCLUSIONS

Neither metal type nor surface pretreatment affected bond strength. However, alloy type and surface treatment affected site of debond location. (J Prosthet Dent 2007;98:199-207).

The comparison of provisional luting agents and abutment surface roughness on the retention of provisional implant-supported crowns

STATEMENT OF PROBLEM

In immediate implant loading, it is important to keep provisional restorations in place during early-phase healing. Current luting agents for provisional restorations may provide inadequate retention, creating a clinical challenge.

PURPOSE

This study compared the retention of provisional autopolymerizing acrylic resin implant-supported single restorations with combinations of different implant abutment surface conditions and provisional luting agents.

MATERIAL AND METHODS

Thirty solid titanium implant abutments (ITI), 4 mm high, were divided into 3 groups. Ten abutments were unaltered, 10 were airborne-particle abraded with 50-microm aluminum oxide, and 10 were roughened with a medium-roughness diamond rotary cutting instrument. Thirty implant analogs (ITI) were mounted in autopolymerizing acrylic resin blocks. A solid titanium implant abutment was placed in each implant analog and torqued to 35 N.cm. After fabrication of 4 provisional acrylic resin crowns for each abutment, provisional luting agents TempBond, TempBond NE, Life, and Zone were used to secure the provisional crowns to the respective abutments. All specimens were luted with one of the provisional luting agents for a given test. After ultrasonic cleaning of the abutments, another provisional crown was luted with another luting agent. All specimens were stored in 100% humidity environment for 1 day at 37 degrees C prior to testing. Each provisional acrylic resin crown was pulled from the abutment with a 500-kg load cell in a universal testing machine at a crosshead speed of 0.5 cm/minute, and tensile strength was recorded (N). Data were analyzed using analysis of variance (ANOVA) and the Scheffe test (alpha=.05).

RESULTS

Tensile strength was significantly higher for Life and TempBond NE than for TempBond and Zone, regardless of the surface conditions (P=.0001). The result of the 2-way ANOVA indicated that a significant interaction existed between the provisional luting agents and surface conditions (P=.0039). TempBond NE showed significantly higher tensile strength when combined with airborne-particle-abraded surfaces compared to other combinations (P=.011). However, no difference was found in tensile strength of Life and Zone between different combinations. The tensile strength of TempBond was lower when used with the unaltered surface compared to other combinations (P=.001).

CONCLUSION

Surface modification of an implant abutment by airborne-particle abrasion or diamond rotary cutting instrument did not improve retention of a provisional acrylic crown when Life or Zone was used as the luting agent. Airborne-particle abrasion may be an effective method to increase retention of a provisional acrylic crown when TempBond NE is used.

Load-fatigue performance of gold crowns luted with resin cements

STATEMENT OF PROBLEM

Resin cements have gained popularity over the past few years because of their improved physical properties. There is a need to test these cements under fatigue loading, as there is growing recognition that fatigue testing is more clinically relevant than traditional monotonic static tests.

PURPOSE

This study investigated the load-fatigue performance of complete gold crowns cemented with 4 types of resin cement.

MATERIAL AND METHODS

Four resin cements (C & B Opaque [CBO], Calibra Esthetic [CE], RelyX Unicem [RU], and Panavia F [PF]) and a control, zinc phosphate cement (HY-Bond [HBZPC]) were tested. Fifty human maxillary premolars were prepared to an occluso-cervical dimension of 4 mm and a convergence angle of 20 degrees. Complete gold crowns were cast (Strator 3) and cemented with 1 of the 5 cements (n=10). A fatigue load of 73.5 N was applied at an angle of 135 degrees to the long axis of each tooth-crown specimen. Preliminary failure was defined as the propagation of a crack in or around the crown luting cement layer. The number of cycles to preliminary failure and the cement failure location were determined. Significant differences in cycles to preliminary failure were assessed by the nonparametric Kruskal-Wallis test, with follow-up Mann-Whitney tests (alpha=.05).

RESULTS

Group CE had the highest rank of cycles to preliminary failure, while HBZPC had the lowest cycles to preliminary failure. Group CE had a significantly higher failure cycle count compared to PF (P=.016), RU (P=.001), and HBZPC (P<.001), but was not significantly different from CBO (P=.112). There was no significant difference in the failure cycle count between RU and HBZPC (P=.070).

CONCLUSION

Not all tested resin cements had a superior fatigue life when compared with zinc phosphate cement. Of the 4 resin cement groups, Groups CE, CBO, and PF were significantly superior to HBZPC.

Effect of surface treatment on retention of glass-fiber endodontic posts

STATEMENT OF PROBLEM

The effects of surface treatment on the retention of prefabricated fiber-reinforced epoxy resin posts are not well understood because most studies measure retention shortly after cementation, without artificial aging.

PURPOSE

The purpose of this study was to evaluate the effect of surface treatment on the retention of glass-fiber endodontic posts luted with resin cement and subjected to artificial aging.

MATERIAL AND METHODS

Thirty-two single-rooted teeth were selected, the coronal aspect of each tooth was removed, and the remaining root received endodontic therapy. Specimens were then divided into 4 groups (n = 8). Post spaces were prepared to a depth of 10 mm by using ISO 90 rotary instruments. The tapered posts received 1 of 4 surface treatments: cleaning with alcohol (Alc), cleaning with alcohol and conditioning with ED-Primer material (Alc-ED), airborne-particle abrasion (Air), or airborne-particle abrasion and conditioning with ED-Primer material (Air-ED). All posts were luted with a composite resin luting agent (Panavia F) after conditioning the canal dentin with autopolymerizing dentin primer (ED-Primer) and without acid etching of the canal dentin. After cementation, the specimens were stored in water at 37 degrees C for 30 days and subjected to simulated aging conditions consisting of 7500 thermal cycles (5 degrees C/55 degrees C) and 300,000 mechanical loading cycles with 30 N. Retention (N) of the posts was measured with a universal testing machine with a crosshead speed of 2 mm/min. The data were analyzed using 1-way ANOVA and the Tukey HSD test (alpha = .05). The dislodged posts were also examined microscopically at x8 and x20 magnification to evaluate the mode of failure.

RESULTS

The mean retentive values (N) and SDs of the test groups were as follows: Alc, 375.9 +/- 85.0; Alc-ED, 421.2 +/- 46.8; Air, 534.8 +/- 65.8; and Air-ED, 555.8 +/- 86.9. Airborne-particle-abraded posts had significantly higher retention compared with nonabraded posts (P < .001). Treating the post's surface with ED-Primer material prior to cementation had no significant effect on retention. The failure mode was purely adhesive at the resin cement-post interface for all nonabraded posts. A mixed failure mode, adhesive at the resin cement-dentin interface, at the resin cement-post interface, and cohesive in the resin cement, was observed for airborne-particle-abraded posts.

CONCLUSION

Treating the surface of the posts with ED-Primer material before cementation with Panavia F cement produced no significant improvement in the retention of the posts. Airborne-particle abrasion of the surface of the post significantly improved the retention.

Comparison of titanium dowel retention using four different luting agents

STATEMENT OF PROBLEM

Luting material, surface properties, and loading conditions affect the retention of prefabricated dowels to varying degrees.

PURPOSE

The purpose of this study was to evaluate the effect of roughening of the dentinal walls and artificial aging on the retention of prefabricated tapered titanium dowels, using 4 different luting materials.

MATERIAL AND METHODS

One-hundred twenty-eight single-rooted teeth were selected, the coronal aspect of each tooth was removed, and the remaining root received endodontic therapy. All specimens were divided into 4 groups (n=32). Dowel spaces were prepared to a depth of 10 mm using ISO 90 rotary cutting instruments. Tapered titanium dowels were luted with the following luting materials: zinc-phosphate cement (Harvard cement), glass-ionomer cement (Ketac Cem EasyMix), resin composite luting agent (Panavia 21) with autopolymerizing dentin primer (ED-Primer), or a self-adhesive composite luting agent (RelyX Unicem). Both composite luting agents were used without acid etching of the canal dentin. Each luting agent was used under 2 conditions: in 1 subgroup (n=16) the dentinal walls were not roughened, and in the other subgroup (n=16), walls were roughened with a diamond rotary cutting instrument. Eight specimens from each subgroup were stored in water at 37 degrees C for 3 days; the other 8 specimens were stored for 150 days and subjected to simulated aging conditions using 37,500 thermal cycles (5 degrees C/55 degrees C) and 300,000 mechanical loading cycles with 30 N. Dowel retention (N) was measured using a universal testing machine with a crosshead speed of 2 mm/min. Data were analyzed using 2- and 3-way ANOVAs and the Tukey HSD test (alpha=.05).

RESULTS

The dislodged dowels were examined microscopically to evaluate mode of failure. The nonroughened dentinal walls showed no significant differences between the different luting agents. Roughening the dentinal walls increased the retention significantly for all groups. This increase was significantly higher for the resin composite groups (P=.0001). Storage for 150 days with thermal cycling and mechanical loading caused a significant decrease in dowel retention (P=.001). The failure mode was purely adhesive at the luting material-dentin interface for all dowels cemented in nonroughened root canals. A mixed failure mode, adhesive at the luting material-dentin interface and cohesive in the luting material, was observed for dowels cemented in roughened root canals.

CONCLUSION

Roughening the dentinal walls and the use of resin luting cements provided statistically significant increases in dowel retention values.

Designing tooth preparations for optimal success

The form of prepared teeth and the amount of tooth structure remove dare important contributors to the mechanical, biologic,and esthetic success of the overlying crown or fixed partial denture.Therefore, it is important to develop clinical guidelines that can be used to optimize success in fixed prosthodontics.

Crown retention with use of different sealing systems on prepared dentine

The purpose of this in vitro study was to evaluate crown retention after using different sealing systems on prepared dentine. Ca(OH)2 suspension was used in comparison with three adhesive bonding systems (Gluma Desensitizer, Optibond FL, Prompt L-Pop). Extracted human premolars were uniformly prepared with the use of a special parallelometer (11 degrees taper, 4 mm axial length). Groups of 20 teeth each were treated with each sealing system. Then crowns were fabricated and temporarily cemented twice. Finally the abutments were cleaned and the crowns were cemented with a glass-ionomer cement Ketac-Cem. Subgroups of 10 crowns were removed with a universal testing machine following storage in distilled water either for 3 days or for 150 days. Prior to dislodging, the crowns of both groups were subjected to chewing simulation. The mean dislodgement stresses in MPa were between 4.9 and 6.9. A range test of Student-Newmann-Keuls revealed significant differences between Ca(OH)2 and Optibond FL (P < 0.05), while the storage time had no significant effect. The level of microleakage increased significantly with storage time (P < 0.05). It is concluded, that the use of Gluma Desensitizer and Prompt L-Pop did not affect crown retention as compared with Ca(OH)2, thus may be used in combination with glass-ionomer cement to desensitize prepared teeth.

The retention of complete crowns prepared with three different tapers and luted with four different cements

STATEMENT OF PROBLEM

The role of adhesive properties of cements on the retentive strength of crowns with different degrees of taper is not clear.

PURPOSE

This study evaluated the retention of full crowns prepared with 3 different tapers and cemented with 2 conventional and 2 adhesive resin cements.

MATERIAL AND METHODS

One hundred twenty sound human molar teeth were assigned randomly to 1 of 12 groups, (n=10). The groups represented the 4 cements: zinc phosphate (Fleck's), a conventional glass ionomer (Ketac-Cem); 2 adhesive resin cements (C&B Metabond and Panavia); and 3 tapers of 6-degrees, 12-degrees, and 24-degrees within each cement. Crowns were cast with a high noble alloy. The 6-degree taper was considered the control within each cement group. Retention was measured (MPa) by separating the metal crowns from the prepared teeth under tension on a universal testing machine. Analysis of variance was used to test the main effects on the retentive strength of full crowns, namely cements, tapers, and failure modes. The Fisher's multiple comparison test was used to evaluate the source of the differences. The chi(2) analyses were used to examine the relationships between failure types, cements, and tapers. All statistical tests were conducted at alpha=.05.

RESULTS

There was a significant difference in the main effect cement (P<.0001) and taper (P=.0002). The mean retentive strength values of both Fleck's and Ketac-Cem were significantly lower than the mean retentive strength values of both C&B Metabond and Panavia (P<.0001). The retention of crowns prepared with 6-degree taper was not significant from the 12-degree taper (P=.0666). The difference in retention was significant between the 6-degree taper and the 24-degree taper (P<.0001) and between 12-degree taper and 24-degree taper (P=.0178). The types of failure were adhesive in the cement (65%), cohesive in the tooth (31%), and assembly failure (fracture of embedding resin) (4%). The type of failure was dependent on the degree of taper (P<.0001) and on the type of cement (P<.0042).

CONCLUSION

Within the limitations of this study, the retentive values of the adhesive resins at 24-degree taper were 20% higher than the retentive values of the conventional cements at 6-degree taper. The use of resin luting agents yielded retention values that were double the values of zinc phosphate or conventional glass ionomer cement.

Effect of cement types on the tensile strength of metallic crowns submitted to thermocycling

The relationship between metallic cast crowns and tensile strength according to cement types submitted to thermocycling was studied. Seventy-two metallic crowns were cast with Verabond II Ni-Cr alloy and cemented in standardized preparations with 10º tapering. Three types of finishing line (45-degree chamfered, 20-degree bevel shoulder and right shoulder) were made with diamond burs on bovine teeth. Twenty-four metallic crowns in each group were randomly subdivided into three subgroups of 8 samples each according to the cement used: SS White zinc phosphate cement, Vitremer resin-modified glass ionomer cement, and Rely X resin cement and were submitted to thermocycling. Retention was evaluated according to tensile load required to displace the metallic cast crowns from tooth preparations with an Instron testing machine. ANOVA and Tukey's test showed a statistically significant difference among luting materials, with greater results for Rely X resin cement (24.9 kgf) followed by SS White zinc phosphate cement (13.3 kgf) and Vitremer resin-modified glass ionomer cement (10.1 kgf). The finishing line types did not influence the tensile resistance of the crowns fixed with the three cements. Increased tensile resistance of metallic crowns fixed on bovine teeth was obtained with resin cement, independent of the finishing line types.

Retentive properties of five different luting cements on base and noble metal copings

STATEMENT OF PROBLEM

The retention of indirectly fabricated restorations can be compromised by short or over-tapered tooth preparations.

PURPOSE

The aim of this study was to evaluate the retentive properties of 5 different luting cements on base and noble metal copings to short and over-tapered preparations.

MATERIAL AND METHODS

Eighty extracted mandibular premolars were prepared to receive full cast copings with a flat occlusal surface, 33 degrees taper, and 3-mm axial length. Half of the standardized metal copings were cast in an AuAgPd alloy, whereas the other half were cast in an NiCr alloy. Cementation was performed with 5 different luting cements through use of 5 kg of pressure in 90% relative humidity. Specimens were stored in distilled water at 37 degrees C for 24 hours and thermocycled between 5 degrees C and 55 degrees C for 5000 cycles, with a dwell time of 30 seconds. After thermocycling, vertical tensile force was applied in a Zwick universal testing machine with a constant speed of 1 mm/min until separation was noted. A 2-factor analysis of variance was used to analyze the data, with a significance level of alpha =.05.

RESULTS

Mean dislodgement forces for AuAgPd crowns and NiCr crowns were 120.88 N and 143.09 N, respectively, for zinc phosphate cement; 135.45 N and 150.38 N for Principle; 145.88 N and 220.71 N for Meron; 276.85 N and 225.61 N for Avanto; and 300.92 N and 381.02 N for Fuji Plus.

CONCLUSION

Within the limitations of this study, Fuji Plus and Avanto showed significantly higher retentive strengths for AuAgPd copings in comparison to the other cements tested (P <.05). The retentive strength of Fuji Plus was significantly higher than those of the other cements tested with NiCr copings (P <.05).

In vivo evaluation of three cleansing techniques for prepared abutment teeth

STATEMENT OF PROBLEM

Residual provisional cement and debris on prepared teeth may have the potential to negatively influence the performance of the definitive luting agent.

PURPOSE

This in vivo study quantified the adherence of provisional cement to abutment teeth prepared with 1 of 2 textures (coarse or fine) and cleaned with 1 of 3 common cleansing techniques.

MATERIAL AND METHODS

One hundred ten provisional restorations in 22 patients were luted to maxillary anterior abutment teeth. The teeth were prepared for complete veneer restorations with either a coarse-grit diamond bur or a coarse-grit diamond bur followed by a fine-grit diamond bur. After removal of the restoration, abutment teeth were randomly cleansed with either a No. 23 dental explorer and air-water spray, a prophy cup with fine flour pumice, or a cotton pellet soaked in chlorhexidine gluconate, 0.12%. After the abutments were cleansed, they were evaluated intraorally under a light microscope (magnification, x64) by 2 blinded examiners. The teeth were given scores based on the number of specks of residual cement found on the surface after the cleansing techniques were performed. Pearson correlation coefficients (alpha=.96), 3-way analysis of variance, and post hoc Scheffé tests (P<.05) were used to analyze the data.

RESULTS

As determined with Pearson correlation coefficient, the interexaminer reliability was alpha=.96. Three-way analysis of variance revealed significant effects for the cleansing techniques but not for the interaction between cleansing techniques and preparation texture. A post hoc Scheffé test showed that the pumice cleansing technique (1.8 specks/tooth) was significantly better than the explorer or the cotton pellet/chlorhexidine gluconate technique (3.6 and 3.5 specks/tooth, respectively) (P<.05).

CONCLUSION

Within the limitations of this study, abutment teeth cleansed with a prophy cup and flour pumice exhibited the least amount of residual provisional cement.

Tooth preparations for complete crowns: an art form based on scientific principles

STATEMENT OF THE PROBLEM

No recent literature has reviewed the current scientific knowledge on complete coverage tooth preparations.

PURPOSE

This article traces the historic evolution of complete coverage tooth preparations and identifies guidelines for scientific tooth preparations.

MATERIAL AND METHODS

Literature covering 250 years of clinical practice was reviewed with emphasis on scientific data acquired during the last 50 years. Both a MEDLINE search and an extensive manual search were used to locate relevant articles written in English in the last 50 years.

RESULTS

Teeth should be prepared so that they exhibit the following characteristics: 10 to 20 degrees of total occlusal convergence, a minimal occlusocervical dimension of 4 mm for molars and 3 mm for other teeth, and an occlusocervical-to-faciolingual dimension ratio of 0.4 or greater. Facioproximal and linguoproximal line angles should be preserved whenever possible. When the above features are missing, the teeth should be modified with auxiliary resistance features such as axial grooves or boxes, preferably on proximal surfaces. Finish line selection should be based on the type of crown/retainer, esthetic requirements, ease of formation, and personal experience. Expectations of enhanced marginal fit with certain finish lines could not be validated by recent research. Esthetic requirements and tooth conditions determine finish line locations relative to the gingiva, with a supragingival location being more acceptable. Line angles should be rounded, and a reasonable degree of surface smoothness is desired.

CONCLUSIONS

Nine scientific principles have been developed that ensure mechanical, biologic, and esthetic success for tooth preparation of complete coverage restorations.

Shear bond strengths of three resin cements to dentine over 3 years in vitro

OBJECTIVES

This study was conducted to evaluate the bond durability of three resin cements bonded to bovine dentine over a period of 3 years.

METHODS

Ten bovine dentine specimens were tested for shear bond strengths with each of the following materials: Panavia 21, BISTITE resin cement, and MASA Bond (experimental resin cement) at 1 day, 6 months, 1 and 3 years after cementation of a composite rod. All specimens were stressed in shear at a crosshead speed of 1mm min(-1) until failure. The means of the bond strengths were compared statistically by two-way ANOVA and Fisher's PLSD test (P<0.05). The mode of failure was classified after fracture of the bonds by SEM observation. Results for the mode of fracture were analyzed using the Mann-Whitney U-test.

RESULTS

The shear bond strengths (MPa+/-SD) for different times (1 day, 6 months, 1 and 3 years) were: Panavia 21 (15.2+/-3.6, 9.3+/-3.2, 8.5+/-2.1, 6.8+/-2.4), BISTITE (15.6+/-2.8, 11.0+/-1.4, 10.4+/-2.2, 9.0+/-2.7) and MASA Bond (29.6+/-9.5, 17.5+/-4.6, 19.6+/-4.5, 16.1+/-5.4). Panavia 21 and BISTITE strengths were significantly lower (P<0.05) at all times compared with MASA Bond, and 1 day strengths for all three materials were significantly higher (P<0.05) than 3 year strengths. Regarding the fracture modes after bond testing, there were statistical differences between the 1 day and the 1 year results for all cements (P<0.05). Although no Panavia 21 specimen showed complete cohesive failure in the demineralized dentine during the experiment, several BISTITE and MASA Bond specimens showed cohesive fracture in the demineralized dentine. For BISTITE, partially or complete demineralized dentine cohesive failures increased over time.

CONCLUSIONS

The type of resin cement seemed to have an influence on the long-term durability of bonding to dentine.

Retentive and compressive strengths of modified zinc oxide-eugenol cements

OBJECTIVES

This investigation sought to improve the handling and physical properties of a commonly used temporary zinc oxide-eugenol cement by changing the base/accelerator (B/A) ratio or combining it with a petroleum jelly or fluoride varnish.

METHODS

Twelve modifications of a temporary cement were evaluated in terms of retentive strength, compressive strength at 24 h, film thickness and by scanning electron microscopy.

RESULTS

Decreasing the B/A mixing ratio increased the retentive and compressive strengths, but reduced the film thickness of the cement. By increasing the percentage of incorporated petroleum jelly or fluoride varnish in the cement, there was a progressive decrease in the retentive and compressive strengths and in film thickness.

CONCLUSIONS

Modifications of a zinc oxide-eugenol temporary cement to change the B/A ratio or to incorporate additives resulted in variations in physical properties. All modified forms of the cement had a film thickness less than 25 microns and a compressive strength below 35 MPa. With a wide range of retentive strength, modified forms of zinc oxide-eugenol cement may be found to have diverse clinical applications.