Mechanical properties of dental luting cements

Influence of pretreating radicular dentin with different polyacrylic acids and isopropanol on the retention of posts

STATEMENT OF PROBLEM

The optimal pretreatment of radicular dentin before cementing a post with glass ionomer cement is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the retention of prefabricated tapered titanium posts to endodontically treated teeth after applying different pretreatment protocols on the radicular dentin.

MATERIAL AND METHODS

The coronal part of 32 single-rooted human teeth was removed 1-mm coronally to the cemento-enamel junction. All specimens received endodontic treatment, and the root canals were prepared with an instrument to a depth of 10 mm to receive a titanium post. The dentin walls of each specimen were roughened with a hand-held diamond cutting instrument. The specimens were randomly divided according to the surface treatments into 4 groups (n=8): KW: etched with 20% to 30% polyacrylic acid (PAA) (Ketac Conditioner) and rinsed with water; KWI: etched with 20% to 30% PAA, rinsed with water and 70% isopropanol; DW: etched with 30% to 50% PAA (Durelon Liquid) and rinsed with water; DWI: etched with 30% to 50% PAA, rinsed with water and 70% isopropanol. The prefabricated titanium posts were airborne-particle abraded and cemented with glass ionomer cement. The specimens were fixed in custom-made brass cylindrical holders with autopolymerizing acrylic resin with the holder parallel to the long axis of the post. All specimens were stored in water for 3 days at 37 °C. Retention was evaluated using a tensile test with a universal testing machine (Zwick Z010) at a crosshead speed of 2 mm/min. Data were statistically analyzed with a 1-way ANOVA, followed by the Tukey post hoc test for pairwise comparisons between groups (α=.05).

RESULTS

Mean ±standard deviation retention values ranged from 201.8 ±55.5 N (KW) to 328.1 ±70.9 N (DWI). Groups DWI and KWI (316 ±58.3 N) showed statistically higher retention values than group KW (P<.05) but did not significantly differ from retention values obtained in group DW (P>.05).

CONCLUSIONS

An additional final rinse with isopropanol after using PAA increased the retention of the post significantly for all groups. Although group DWI achieved the highest retention values, pretreatment of radicular dentin as in group KWI may also be considered.

Effect of bacterial resistant zwitterionic derivative incorporation on the physical properties of resin-modified glass ionomer luting cement

Biofilms induce microbial-mediated surface roughening and deterioration of cement. In this study, zwitterionic derivatives (ZD) of sulfobetaine methacrylate (SBMA) and 2-methacryloyloxyethyl phosphorylcholine, were added in concentrations of 0, 1, and 3% to three different types of commercially available resin-modified glass ionomer cement (RMGIC) (RMC-I: RelyX Luting 2, RMC-II: Nexus RMGI, and RMC-III: GC FujiCEM 2). The unmodified RMGICs served as the control group for comparison. The resistance of Streptococcus mutans to ZD-modified RMGIC was evaluated with a monoculture biofilm assay. The following physical properties of the ZD-modified RMGIC were assessed: wettability, film thickness, flexural strength, elastic modulus, shear bond strength, and failure mode. The ZD-modified RMGIC significantly inhibited biofilm formation, with at least a 30% reduction compared to the control group. The addition of ZD improved the wettability of RMGIC; however, only 3% of the SBMA group was statistically different (P < 0.05). The film thickness increased in proportion to the increasing ZD concentrations; there was no statistical difference within the RMC-I (P > 0.05). The experimental groups' flexural strength, elastic modulus, and shear bond strength showed an insignificant decrease from the control group; there was no statistical difference within the RMC-I (P > 0.05). The mode of failure differed slightly in each group, but all groups showed dominance in the adhesive and mixed failure. Thus, the addition of 1 wt.% ZD in RMGIC favorably enhanced the resistance to Streptococcus mutans without any tangible loss in flexural and shear bond strength.

Effect of resin cement elastic modulus on the biaxial flexural strength and structural reliability of an ultra-thin lithium disilicate glass-ceramic material

OBJECTIVES

Photo- and dual-polymerized resin-based luting agent was evaluated for elastic moduli effects on ultra-thin lithium disilicate (LD) glass-ceramic strengthening, structural reliability, and stress distribution.

MATERIALS AND METHODS

One hundred-sixty LD discs (IPS e.max CAD, Ivoclar/Vivadent) were produced in ultra-thin thicknesses (half with 0.3 mm and the other half with 0.5 mm). The ultra-thin ceramic disks were coated with two different cement types (Variolink Veneer - V and Panavia F 2.0 - P). Two positive control groups were tested following hydrofluoric (HF) acid etching (LDt3, LDt5) and two negative control groups were tested for untreated ceramic (LD 3, LD 5). Biaxial flexural strength (BFS), characteristic strength (σ0) and Weibull modulus (m) were the response variables (n = 20) at the ceramic/resin cement interface (z = 0). Finite element analysis (FEA) was used to calculate maximum principal stress. Data were analyzed using two-way ANOVA, and Tukey's test. Scanning electron microscopy (SEM) was used to analyze the failed specimens using fractography and surface morphology.

RESULTS

The BFS of LD at either thickness was not affected by cement types, as also demonstrated by FEA. Structural reliability significantly improved in the positive control group (LDt5).

CONCLUSION

The cementation of ultra-thin LD with a resin-cement of varying elastic moduli did not influence BFS. LD surface modification by HF acid-etching increased the reliability.

CLINICAL RELEVANCE

Ultra-thin anterior veneer designs made from lithium disilicate have been widely proposed and the apparent success of LD ultra-thin veneers was not influenced by the cement choice in the current studies albeit the elastic moduli luting agents used were of similar values.

Zirconia Nanoparticles as Reinforcing Agents for Contemporary Dental Luting Cements: Physicochemical Properties and Shear Bond Strength to Monolithic Zirconia

Nanofillers in resin materials can improve their mechanical and physicochemical properties. The present work investigated the effects of zirconia nanoparticles (NPs) as fillers in commercial dental luting cements. Two dual-cured self-adhesive composites and one resin modified glass ionomer (RMGI) luting cement were employed. Film thickness (FT), flexural strength (FS), water sorption (W_sp), and shear bond strength (SBS) to monolithic zirconia were evaluated according to ISO 16506:2017 and ISO 9917-2:2017, whereas polymerization progress was evaluated with FTIR. Photopolymerization resulted in double the values of DC%. The addition of 1% wt NPs does not significantly influence polymerization, however, greater amounts do not promote crosslinking. The sorption behavior and the mechanical performance of the composites were not affected, while the film thickness increased in all luting agents, within the acceptable limits. Thermocycling (TC) resulted in a deteriorating effect on all composites. The addition of NPs significantly improved the mechanical properties of the RMGI cement only, without negatively affecting the other cements. Adhesive primer increased the initial SBS significantly, however after TC, its application was only beneficial for RMGI. The MDP containing luting cement showed higher SBS compared to the RMGI and 4-META luting agents. Future commercial adhesives containing zirconia nanoparticles could provide cements with improved mechanical properties.

Update on Dental Luting Materials

A dental luting material aids in the retention and stability of indirect restorations on the prepared tooth structure. In dentistry, clinicians are using a wide range of luting materials for the cementation of indirect restorations. Zinc oxide eugenol and non-eugenol cements, zinc phosphate cement, zinc polycarboxylate cement, glass ionomer cement and resin cements are common dental cements used in dentistry. Each luting material or cement possesses unique properties and clinical implications. An ideal luting cement should be biocompatible, insoluble, resistant to thermal and chemical assaults, antibacterial, aesthetic, simple and easy to use. It should have high strength properties under tension, shear and compression to resist stress at the restoration-tooth interface, as well as adequate working and setting times. So far, no luting material possesses all of these properties of an ideal cement. Scientists have been modifying the conventional luting cements to improve the material's clinical performance and developing novel materials for clinical use. To achieve the best clinical outcome, clinicians should update their knowledge and gain a good understanding of the luting materials so that they can make a wise clinical decision on the material selection and obtain an insight into the development of luting cements. Therefore, the objective of this study is to provide a discussion on the physical, chemical, adhesive and aesthetic properties of common luting materials. The clinical indications of these luting materials are suggested based on their properties. In addition, overviews of the modification of the conventional luting materials and the newly developed luting materials are provided.

Effects of Cuspal Inclination and Luting Agent on Fracture Load Values in Composite Resin CAD/CAM Crowns

The purpose of this study was to evaluate whether change in cuspal inclination influences the fracture load values of composite resin computer-aided design/computer-aided manufacturing (CAD/CAM) crowns. Abutment teeth and CAD/CAM crowns were prepared as they would be for treating a mandibular first premolar with two cusps. The CAD/CAM crowns were designed so that 1) the principal stress lines would be radially distributed from the two points of contact with the indenter to the occlusal area of the abutment (Type I), or 2) the principal stress lines would pass outside the occlusal area of the abutment (Types II and III). The CAD/CAM crowns were mounted on the abutments using one of two types of resin or polycarboxylate cement. Fracture load values were measured using a universal tester. The Type I CAD/CAM crowns exhibited the highest mean fracture load value, followed by the Type II crowns and then the Type III crowns, with significant differences seen between all types (p<0.05). The luting agent used (resin or polycarboxylate cement) showed no effect on the fracture load value. With the Type II and Type III crowns, significant differences in the fracture load value were observed between the Super-Bond and Hy-Bond polycarboxylate cement groups (p<0.05).

Cement selection criteria for full coverage restorations: A comprehensive review of literature

BACKGROUND

Proper cement selection in fixed prosthesis plays a determinative role in providing long-term serviceability, retention, caries prevention, and patient satisfaction. This study, reviews different luting agent characteristics and their application based on different clinical situations and different types of full coverage restorations.

MATERIAL AND METHODS

An electronic search was conducted through PubMed, Medline, and Google scholar using following keywords or combinations: restoration, full coverage, PFM, porcelain fused to metal, all ceramic, zirconia, ceramic, casting, fixed partial denture, cement*, dental cement, cement selection, and retention. The most related articles were selected for review.

RESULTS

Choosing a proper luting agent is highly dependent on scientific knowledge regarding the characteristics of restorative materials and luting agents. Conventional cements could be indicated in various situations; however, some restorative materials or clinical situations call for resin-cements to provide predictable retention, support, and durability.

CONCLUSIONS

Conscious selection of retentive cement for each type of restoration/material is necessary to provide predictable successful treatment and reduce the potential complications. Key words:Adhesive cement, dental bridgework, dental cements, dental crowns, dental porcelain, prostheses and implants.

Comparative evaluation of the effect of thermocycling on the mechanical properties of conventionally polymerized, CAD-CAM milled, and 3D-printed interim materials

STATEMENT OF PROBLEM

Studies on the energy absorption characteristics by means of elastic and plastic material deformation of interim materials are lacking.

PURPOSE

The purpose of this in vitro study was to compare the effect of different thermocycling periods on the flexural strength (σ_fs), resilience (U_r), and toughness (U_T) of conventionally polymerized, computer-aided design and computer-aided manufacturing (CAD-CAM) milled, and 3-dimensionally (3D) printed interim materials.

MATERIAL AND METHODS

Rectangular specimens (n=30 for each material) were fabricated from autopolymerized polymethyl methacrylate (PMMA), bis-acryl resin (Bis-acryl), CAD-CAM polymethyl methacrylate-based polymer (CAD-CAM/Milled), and 3D-printed composite resin (3D-Printed). Each material was divided into 3 groups (n=10) according to the applied thermocycling (5 °C to 55 °C) procedure: control (0 cycles), 2500, and 10 000 cycles. Parameters of the materials such as σ_fs, U_r, and U_T were tested in a 3-point bend test according to International Organization for Standardization (ISO) 10477. Data were statistically analyzed with the Shapiro-Wilk test followed by Kruskal-Wallis test, the Mann-Whitney U test, the Friedman test, and Wilcoxon signed-rank test (α=.05).

RESULTS

The tested material and thermocycling had a statistically significant influence on the σ_fs, U_r, and U_T values (P<.05). PMMA showed the lowest mean σ_fs, U_r, and U_T values (P<.05), and CAD-CAM/Milled showed σ_fs values similar to those of 3D-Printed at all thermocycling periods. CAD-CAM/Milled showed the highest U_r values at 10 000 cycles and the highest U_T values at all thermocycles. No significant differences were found in the mean change of σ_fs and U_r of CAD-CAM/Milled among different thermocycling periods.

CONCLUSIONS

The results suggested that digitally fabricated interim materials had better mechanical properties than conventionally polymerized materials and that milled materials had the highest stability in maintaining their initial capacity to absorb energy.

The relation between impact strength and flexural strength of dental materials

AIM

The aim of this study was to investigate whether there is a relation between impact strength and flexural strength of different composite and ceramic materials used in dental restorations.

MATERIALS AND METHODS

The three-point-bending test was used to determine the flexural strength and flexural modulus, and the Dynstat impact test was used to determine the impact strength of different composite and ceramic dental materials. The relation between the flexural strength and impact strength was mathematically investigated and a three-dimensional finite element analysis model of the impact test set-up was created to verify these results.

RESULTS

We found a relation between the impact strength, a_dU, the flexural strength, σ, and the flexural modulus, E, which can be represented by the formula: a_dU=λ_DK(σ²⁄E), where λ_DK is a constant dependent on the test set-up.

CONCLUSION

The obtained impact strength of materials is specific to the test set-up and dependent on the geometric configuration of the test set-up and the specimen thickness. The clinical significance of this investigation is that roughness and fatigue have far more influence on the impact strength than the flexure strength.

Effect of Direct and Indirect Materials on Stress Distribution in Class II MOD Restorations: A 3D-Finite Element Analysis Study

The aim of this study is to investigate the stress distributions of different restoration options for class II mesio-occluso-distal (MOD) cavities. A class II MOD cavity with proximal box gingival floor 1 mm below cementoenamel junction was designed in a mandibular first molar tooth model. 3D finite-element analysis (FEA) and 3D-CAD modelling were used to examine the occlusal stresses distributed to the remaining buccal enamel (RBE), remaining lingual enamel (RLE), adhesive surfaces, and restorative materials by direct and indirect materials resulting from a 600 N of static occlusal load stimulating foodstuff. von Mises (VM) and maximum principal (Pmax) stresses were evaluated for two CAD/CAM materials and three direct materials. CAD/CAM materials exerted less stress than the direct restorative materials. Significant von Mises and Pmax stress value differences were seen among all restoration models on RBE. Reducing RLE and including it into the cavity would be a more effective option for this model in this scenario. As VM and Pmax stresses of PIHC CAD/CAM material for RBE and dentin were significantly lower than other tested materials, it may be the choice of material for indirect MOD restorations.

Comparative evaluation of microleakage of metallic copings luted with three different commercially available luting cements: An in vitro study

Aim

To evaluate the microleakage of metallic copings luted with three different commercially available luting cements.

Setting and Design

Comparative evaluation in vitro study.

Materials and Methods

Thirty replicas of abutment analog were milled and divided into 3 groups. Nickel chromium copings were fabricated; marginal gap was evaluated with optical microscope and luted with Zinc Oxide Non Eugenol cement, Zinc Polycarboxylate cement and Zinc Phosphate cement. After Thermocycling, cemented specimens were placed into 0.5% aqueous solution of basic fuchsin solution for 24 hours for dye penetration. Copings were longitudinally sectioned and microleakage scores were evaluated.

Statistical Analysis Used

Kruskal-Wallis analysis of variance (ANOVA) followed by Chi-Square test. Pairwise comparison of groups with Mann Whitney U test.

Result

Mean microleakage score was least for Zinc Phosphate cement (1.075 ± 0.85) followed by Zinc Polycarboxylate cement (1.80± 0.23) and most for Zinc Oxide Non Eugenol (2.1± 0.37). The results of the study were statistically significant, P < 0.05.

Conclusions

Within the limitations of the study, it was found that all cements exhibited certain amount of microleakage. Zinc Phosphate cement exhibited a mean microleakage score that was significantly lower than Zinc Oxide Non Eugenol cement and Zinc Polycarboxylate cement. When microleakage scores of Zinc Oxide Non Eugenol cement and Zinc Polycarboxylate cement were compared, the difference was found to be insignificant indicating that microleakage in these cements is similar.

Evaluation of marginal and internal fit of lithium disilicate CAD-CAM crowns with different finish lines by using a micro-CT technique

STATEMENT OF PROBLEM

Whether the precision of fit of computer-aided design and computer-aided manufacturing (CAD-CAM) complete crowns is affected by the finish line configuration is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the marginal and internal fit of CAD-CAM ceramic crowns made from lithium disilicate based on 3 different finish lines (rounded shoulder, chamfer, feather-edge).

MATERIALS AND METHODS

Thirty anterior lithium disilicate complete crowns (n=10 per finish line group) were fabricated by following a completely digital workflow based on digital scans made with the TRIOS scanner. The crowns were adhesively cemented on duplicate dies of the respective prepared Typodont teeth, and the marginal gap, absolute marginal discrepancy, and internal gap were evaluated by using microcomputed tomography (μCT). A total of 66 values were obtained for each specimen from sagittal and transaxial sections, and a rendering software program was used to calculate the volume of the cement gap for each specimen by means of 3D region growing. Two-way ANOVA, Tukey post hoc tests with Bonferroni correction, and the Kruskal-Wallis test were used to compare the values between the experimental groups (α=.05).

RESULTS

Marginal gap and absolute marginal discrepancy values were statistically significantly different between groups. In ascending order, marginal gap values were 23 ±14 μm for rounded shoulder, 54 ±28 μm for chamfer, and 96 ±36 μm for feather-edge finish lines. Absolute marginal discrepancy values were 96 ±34 μm for rounded shoulder, 124 ±37 μm for chamfer, and 157 ±34 μm for feather-edge finish lines. Internal gap values were 111 ±14 μm for feather-edge, 136 ±22 μm for chamfer, and 168 ±25 μm for rounded shoulder finish lines. The differences in cement volume between groups were not statistically significant (P=.200).

CONCLUSIONS

All 3 finish lines produced marginal gaps within the range of clinically accep table values. Lithium disilicate CAD crowns with a rounded shoulder finish line had the best marginal fit but the poorest internal fit, and lithium disilicate CAD crowns with a feather-edge finish line had the best internal fit but the poorest marginal fit.

Pediatric Stainless-Steel Crown Cementation Finite Element Study

Objective  To study the effect of using different cement types under pediatric stainless-steel crown (SSC) around mandibular second primary molar using three-dimensional (3D) finite element analysis.

Materials and Methods  A 3D finite element model was built for pediatric mandibular molar by laser scanning of natural extracted tooth. Four types of cement (zinc phosphate, glass ionomer, resin-modified glass ionomer, and resin) of 200 μm layers thickness were tested under a stainless-steel crown of 130-μm thickness. Twelve case studies were reported within this research, as the applied load of 330 N was tested with three angulations: vertical, oblique at 45°, and laterally.

Results  Linear static stress analysis was performed. The resultant stresses and deformations' distribution patterns did not change with cement type, while the values were altered. All deformations and stresses were found within the normal range.

Conclusions  Analysis results indicated that using stiffer cement material increases tooth structure stresses and reduces crown body stresses and deformations, while bone was nearly insensitive to cement type.

Effect of airborne-particle abrasion and polishing on novel translucent zirconias: Surface morphology, phase transformation and insights into bonding

PURPOSE

The purpose this study was to investigate the effect of Kern´s air-borne particle abrasion protocol (KAPA) and polishing on two translucent zirconias (4Y, 5Y-zirconias) compared to a traditional zirconia (3Y-zirconia).

METHODS

Two different surface treatments were analysed by X-ray diffraction (XRD) and interferometry 1) KAPA (0.1 MPa, 50 μm alumina, 10-12 mm distance, 15 sec and 30 sec and cleaning in ultrasound using isopropyl alcohol 99%) and 2) Clinical-delivery polishing paste (Zircon Brite, Dental Ventures, USA). Shear-bond strength tests (SBS's) were performed with a highly polished and virtually flat surface in combination with a 10-MDP based cement and a surface modified by KAPA in combination with zinc phosphate cement. The SBS was expressed in terms of MPa.

RESULTS

The mean values for monoclinic content were 13 wt%, 7 wt% and 2 wt% for 3Y-, 4Y- and 5Y-zirconias respectively, no differences were found between 15 and 30 seconds. Polishing did not result in phase transformation to monoclinic phase in any of the zirconias. The rhombohedral phase was identified in all types of zirconias regardless of surface treatment. Shear-bond strength tests showed 5 MPa for polished/10-MDP based cement and 3 MPa for KAPA/ Zinc phosphate. Statistically significant differences were found between the two different surface treatments but not between the types of zirconias.

CONCLUSIONS

KAPA for 15 sec seems to be equal to 30 sec regarding morphology and phase transformation. Sole micro-retention appears not to be fully responsible for the bonding phenomena of 10-MDP and zirconia that underwent KAPA.

Effect of gallic acid addition on some mechanical properties of self-adhesive resin cements

Self-adhesive resin cements (RCs) activate matrix metalloproteinase (MMP) and cathepsin-related collagen degradation, and gallic acid (GA) inhibits the activity of both MMPs and cysteine cathepsins. The purpose of this study was to evaluate the setting time, biaxial flexural strength, and Vickers hardness of self-adhesive RCs after the addition of two different concentrations of GA. RelyX U200 (3M ESPE) and Panavia SA (Kuraray) were modified with 0.5 and 1 wt% GA. The setting time of five samples in each RC group was assessed using a thermocouple apparatus as described in the ISO 4049 test. Biaxial flexure strength was measured using a universal testing machine until failure. Vickers hardness was measured with three randomized indentations on the surface of each resin disc. RCs without GA were used as control. Data were analyzed using a one-way analysis of variance and Tukey's HSD test (α = 0.05). The setting times ranged from 2.4 to 4.6 min for RelyX and from 4.9 to 6.0 min for Panavia. The biaxial flexure strength ranged from 76.5 to 109.7 MPa for RelyX and from 73.3 to 108.2 MPa for Panavia. Vickers hardness values ranged from 41.6 to 58.6 for RelyX and 27.2 to 33.6 for Panavia. The addition of 0.5 and 1 wt% GA to improve durability of resin-dentin bonds had no adverse effects on setting time, whereas the biaxial flexure strength and Vickers hardness values for the tested materials were significantly reduced.

A Review of Dental Cements

This review provides an in-depth comparison of advantages and disadvantages of different types of dental cements as they are used for cementing base metal alloy crowns in dogs.

The Influence of Aging in Solvents on Dental Cements Hardness and Diametral Tensile Strength

Prosthetic materials must exhibit adequate resistance to the oral environment. The aim of this paper was to study the resistance of selected cements used for cementing restorations (Breeze-composite, Adhesor Carbofine-zinc-polycarboxylate and IHDENT-Giz type II-glass-ionomer) against ethanol, soda and green tea solutions. The highest values of hardness and DTS (diametral tensile strength) were obtained by composite cement (HV = 15-31, DTS = 34-45 MPa). Ethanol solution had the greatest impact on the hardness value of composite cement, and soda solution on zinc-polycarboxylate cement. No significant differences were noted in the DTS values of composite cements after immersion in solvents; however, the DTS value of zinc-polycarboxylate cement increased after prolonged immersion time in ethanol and the DTS of glass-ionomer cement (IHDENT Giz type II) clearly decreased after submersion in soda solutions. Variation in pH across the range of 6 (tea) to 9 (soda solution) had a low impact on the properties of dental cements. Extended exposure to solvents appears to worsen the properties of cements.

Accuracy of marginal fit and axial wall contour for lithium disilicate crowns fabricated using three digital workflows

STATEMENT OF PROBLEM

Comparative assessment of the effectiveness of computer-aided design and computer-aided manufacturing (CAD-CAM) technologies used to fabricate complete-coverage restorations is needed. A quantitative assessment requires precise documentation of the marginal adaptation and external surface contour of fabricated restorations. Limited information is currently available regarding the effects of milling mode on marginal adaptation and reproduction of the external surface contour for CAD-CAM-fabricated restorations.

PURPOSE

The purpose of this in vitro study was to evaluate the outcomes for 3 different digital workflows on the marginal gap and the external surface contour reproducibility of CAD-CAM-fabricated lithium disilicate complete-coverage restorations.

MATERIAL AND METHODS

Twelve Ivorine molars were prepared to receive lithium disilicate crowns. The preparations were digitally recorded using 2 intraoral scanners (TRIOS 3; 3Shape A/S and Planmeca PlanScan; E4D Technologies), and the restorations were designed using their associated design software with reference to the anatomy of an unprepared tooth. The designed restorations were then manufactured from lithium disilicate blocks using a 3-axis milling machine. Twelve restorations were manufactured using the detailed mode (Planmeca PlanScan detailed mode [PPD-D]), and 12 using the standard mode for the Planmeca system (Planmeca PlanScan standard mode [PPD-S]). Restorations from the 3Shape system were fabricated using the detailed mode (TRIOS 3Shape detailed mode [T3S-D]). The restorations were secured on their associated preparation with an elastomeric material. The marginal gap of each restoration was then measured in the ImageJ software using images captured by a stereo microscope at ×20 magnification. External surface reproducibility was evaluated by measuring undercut at 4-line angles using a dental surveyor. Differences in the marginal gaps of restorations fabricated using the 3 different workflows were compared by Brown-Forsythe robust ANOVA, followed by a post hoc test (α=.05). Chi-square analysis (α=.05) was used to evaluate differences in the contours of the external surface of the restorations, resistance form, and marginal integrity produced using the 3 workflows.

RESULTS

The mean marginal gap for restorations fabricated using the T3S-D workflow was 60 μm, a distance significantly lower (P<.05) than that of PPD-D and PPD-S workflows, which yielded a marginal gap of 95 μm for the detailed mode and 124 μm for the standard mode of milling. Restorations fabricated using PPD-D and PPD-S workflows produced a significantly more reproducible external surface contour than those fabricated using the T3S-D workflow.

CONCLUSIONS

Restorations fabricated using the T3S-D workflow produced the smallest marginal gap. However, reproducibility of the external surface contour for this workflow was the worst of the three workflows analyzed.

Impact of Occlusal Intercuspal Angulation on the Quality of CAD/CAM Lithium Disilicate Crowns

PURPOSE

Modification of intercuspal angulation (ICA) influences the amount of tooth structure removal, which may impact the retention and resistance form of the preparation. This study evaluated the impact of ICA on the marginal gap of CAD/CAM crowns and the influence that tooth structure removal, caused by variation of ICA, has on the resistance and retention form of the preparation.

MATERIALS AND METHODS

Sixty ivorine molars were manufactured with various ICAs (100°, 110°, 120°, 140°, 160°, and 180°; 10 per group). The preparations were digitized using an intraoral scanner, and the crowns were designed using a design software. The designed crowns were then manufactured from lithium disilicate using a 3-axis milling machine, with the "detailed mode" selected for the manufacturing. The marginal gap of each crown was evaluated using a stereomicroscope at 20× magnification. Then, the marginal integrity and the resistance form of the preparation were assessed by tactile-visual evaluation, and they were given a categorical score. Crowns were then secured on their associated preparations using a temporary luting agent, and retention force was measured on a universal testing machine under tension with a 0.5 mm/min crosshead speed. Wilcoxon test followed by post-hoc tests (α = 0.05) were used to evaluate the impact of the ICA on the marginal gap and the retention form of the preparation. Fisher's exact test followed by post-hoc tests (α = 0.05) were used to assess the impact of the occlusal preparation design on the marginal integrity and the resistance form of the preparation.

RESULTS

The marginal gap was significantly larger for ICA-180 preparations (72 μm), compared to the other groups (ICA-180 vs ICA-100, ICA-110, ICA-120, and ICA-160 p = 0.0001; ICA-180 vs. ICA-140 p = 0.0017). None of the crowns for ICA-180 preparations had clinically acceptable resistance form. Preparations with ICAs of 100°, 110°, and 120° had a significantly higher value of retention than the other groups (ICA-100 vs. ICA-120 p = 0.0119; ICA-100 vs. ICA-140, ICA-160, and ICA-180 p < 0.0001; ICA-110 vs. ICA-140, ICA-160, and ICA-180 p = 0.0001; ICA-120 vs. ICA-180 p = 0.0017).

CONCLUSIONS

Crowns fabricated for preparations with various ICAs had clinically acceptable marginal adaptation. Variation in ICA impacts the loss of tooth structure. This loss of tooth structure may influence the resistance and retention form of the preparation.

The Influence of Axial Grooves on Dislodgment Resistance of Prosthetic Metal Crowns in Canine Teeth of Dogs

The reported failure rate for full veneer crowns of canine teeth of dogs is suboptimal, particularly in teeth with naturally poor retentive features, such as those with low height/diameter (H/D) ratios or high convergence angles (CAs). The objective of the present study was to evaluate the application of axial grooves in an effort to develop a crown preparation design that enhances the retention of full veneer crowns in dogs. Crown dislodgment testing was performed on cast alloy dies of canine teeth with unfavorable retention features (low H/D and high CA) prepared with (n = 14) and without axial grooves (n = 15) to evaluate the force required to dislodge a cemented full veneer crown. The crown/die units were secured within a universal testing machine and a load was applied at the 45° oblique direction from distal to mesial to replicate the vector encountered during biting-pulling action. The maximum force required to cause crown dislodgment was recorded for each crown. Statistical analysis revealed a significant increase in force required for crown dislodgment when axial grooves were included in the crown preparation design ( P < .001). Crown retention is improved in canine teeth with otherwise poor retention features when axial grooves are made in the labial and palatal/lingual walls during crown preparation.

Reliability, Learnability and Efficiency of Two Tools for Cement Crowns Retrieval in Dentistry

Background:

Tooth-supported fixed dentures are commonly used in restorative dentistry, and have definitely reached a high survival rate; nevertheless, their removal is sometimes required mainly due to caries or other failures (poor fit, poor cementation and so on). Removing a definitive partial denture is not trivial since the used cement is not always known and it may be very resistant; additionally, there are various clinical circumstances in which a conservative disassembly would be desirable.

Objective:

assessing the performance of different tools for cement crowns retrieval in terms of reliability, learnability and efficiency.

Methods:

An experimental study has been performed on two different devices for conservative crown/bridge removal: a manual tool that is a sliding hammer, and an automatic tool, powered by compressed air. Both skilled and unexperienced operators have been considered and an experimental set up has been appositely designed in order to measure force versus time patterns. The peak applied force has been taken as an output variable for the evaluation of tool performance.

Results:

The automatic tool improves both the inter-operator and the intra-operator reliability, respectively from 79% to 95%, and from 69% to 92%. Additionally, the force pattern is significantly different between these two tools: the instrument powered by compressed air, produces a sharper peak force, as required to break fragile materials such as dental crown cement, and its efficiency can be estimated to be 75% higher. Both tools have a high learnability since the performances of experienced and unexperienced operators have not proved to be significantly different.

Conclusion:

A methodology has been set up to compare tools for cement crowns retrieval. The compressed-air tool has been proved to generally provide a better performance unless more ductile cement is to be broken.

Cementation of Full Coverage Metal Crowns in Dogs

This step-by-step article describes the technique for cementation of a full metal prosthodontic crown on the maxillary fourth premolar tooth of a dog using a common resin-based cement.

In vitro fracture strength and patterns in root-filled teeth restored with different base materials

BACKGROUND

There is little research on the effects of an intermediate base on the fracture strength of root-filled teeth. This study compared the fracture strengths and patterns of root-filled teeth restored with intermediate bases of glass-ionomer cement (GIC), zinc polycarboxylate cement (ZPC), dual-cured resin composite (DCRC) and Biodentine^® under resin composite.

METHODS

Standardized cavities were prepared in 100 extracted human maxillary and mandibular premolars, and root canal treatment was performed. The teeth were stratified and randomly allocated to five groups (n = 20): (i) GIC; (ii) ZPC; (iii) DCRC; (iv) Biodentine; and (v) prepared but unrestored (control). The teeth were subjected to an oblique, ramped load until fracture. The fracture loads, level, mode and location were recorded.

RESULTS

Mean fracture strengths of all restored groups were not significantly different amongst the groups. There were significant overall effects on mean fracture strength for tooth type (P = 0.002) and buccolingual width of the crown (P = 0.001).

CONCLUSIONS

The four materials were appropriate intermediate bases. The laminate restorative technique promoted fracture strengths that are likely to withstand normal and maximum masticatory function. The base material can influence failure mode, which may have implications for the clinical presentation of fractures of root-filled teeth.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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.

Titanium dioxide nanotubes addition to self-adhesive resin cement: Effect on physical and biological properties

OBJECTIVES

This study has investigated the influence of Titanium dioxide nanotubes (TiO₂-nt) addition to self-adhesive resin cement on the degree of conversion, water sorption, and water solubility, mechanical and biological properties.

METHODS

A commercially available auto-adhesive resin cement (RelyX U200™, 3M ESPE) was reinforced with varying amounts of nanotubes (0.3, 0.6, 0.9wt%) and evaluated at different curing modes (self- and dual cure). The DC in different times (3, 6, 9, 12 and 15min), water sorption (Ws) and solubility (Sl), 3-point flexural strength (σf), elastic modulus (E), Knoop microhardness (H) and viability of NIH/3T3 fibroblasts were performed to characterize the resin cement.

RESULTS

Reinforced self-adhesive resin cement, regardless of concentration, increased the DC for the self- and dual-curing modes at all times studied. The concentration of the TiO₂-nt and the curing mode did not influence the Ws and Sl. Regarding σf, concentrations of both 0.3 and 0.9wt% for self-curing mode resulted in data similar to that of dual-curing unreinforced cement. The E increased with the addition of 0.9wt% for self-cure mode and H increased with 0.6 and 0.9wt% for both curing modes. Cytotoxicity assays revealed that reinforced cements were biocompatible.

SIGNIFICANCE

TiO₂-nt reinforced self-adhesive resin cement are promising materials for use in indirect dental restorations. Taken together, self-adhesive resin cement reinforced with TiO₂-nt exhibited physicochemical and mechanical properties superior to those of unreinforced cements, without compromising their cellular viability.

Resin Elasticity and the Strengthening of All-ceramic Restorations

Resin luting of all-ceramic restorations results in increased performance; however, the strengthening mechanism and the role of the mechanical properties of the resin are not fully understood. The hypothesis tested is that ceramic strength enhancement is dependent on the elastic modulus of the resin. Three-point flexural moduli of a flowable, luting, and hybrid composite resin were characterized. Two hundred forty porcelain discs were air-abraded. One group acted as a control, and 3 additional groups were coated with 120 ± 20 μm of each resin prior to bi-axial flexure testing. All resins significantly increased in mean strength, and the associated strength increase was related to the elastic modulus of the resin (R2 = 0.9885), so the hypothesis was accepted. The combination of Poisson constraint and the creation of a resin-inter-penetrating layer sensitive to the elastic modulus of the resin may provide an explanation of the strengthening mechanism.

Selected physical properties of new resin-modified glass ionomer luting cements

STATEMENT OF PROBLEM

Two resin-modified glass ionomer (RMGI)-based luting agents have been recently marketed without independent reports of their physical properties.

PURPOSE

The purpose of this in vitro study was to evaluate selected physical properties of 2 newly marketed RMGI luting agents and compare the findings with traditional materials.

MATERIAL AND METHODS

Specimens (N=12) of Nexus RMGI, UltraCem, GC Fuji Cem 2, and RelyX Luting Plus were fabricated using standardized molds for flexural strength and fracture toughness according to manufacturer recommendations and stored in physiologic phosphate-buffered saline solution at 37°C until testing. Specimens were tested at 1 and 24 hours, 1 week, and 1 month. Mean values for flexural strength, flexural modulus, flexural toughness, and fracture toughness were determined. Additionally, film thickness (N=12) for each material was determined following Amerian National Standards Association/American Dental Association (ANSI/ADA) specifications. Mean results were analyzed with Kruskal-Wallis and Mann-Whitney U tests (α=.05).

RESULTS

All luting agents exhibited a similar film thickness that met ANSI/ADA requirements for aqueous-based luting agents. Nexus RMGI surprisingly demonstrated significantly greater flexural strength and fracture toughness at 1 hour, which decreased significantly at 24 hours, making it similar to the other materials evaluated. All materials had similar flexural strength values at 7 days.

CONCLUSIONS

Physical property performance was material dependent. Nexus RMGI demonstrated greater early physical properties that were significantly less at 24 hours. UltraCem, GC Fuji Cem 2, and RelyX Luting Plus demonstrated the increasing physical property development that is normally associated with polyalkenoate-based systems.

Mechanical Properties and Sliding-impact Wear Resistance of Self-adhesive Resin Cements

The present study determined the mechanical properties and impact-sliding wear characteristics of self-adhesive resin cements. Five self-adhesive resin cements were used: G-CEM LinkAce, BeautiCem SA, Maxcem Elite, Clearfil SA Automix, and RelyX Unicem 2. Clearfil Esthetic Cement was employed as a control material. Six specimens for each resin cement were used to determine flexural strength, elastic modulus, and resilience according to ISO specification #4049. Ten specimens for each resin cement were used to determine the wear characteristics using an impact-sliding wear testing apparatus. Wear was generated using a stainless-steel ball bearing mounted inside a collet assembly. The maximum facet depth and volume loss were determined using a noncontact profilometer in combination with confocal laser scanning microscopy. Data were evaluated using analysis of variance followed by the Tukey honestly significantly different test (α=0.05). The flexural strength of the resin cements ranged from 68.4 to 144.2 MPa; the elastic modulus ranged from 4.4 to 10.6 GPa; and the resilience ranged from 4.5 to 12.0 MJ/m3. The results for the maximum facet depth ranged from 25.2 to 235.9 μm, and volume loss ranged from 0.0107 to 0.5258 mm3. The flexural properties and wear resistance were found to vary depending upon the self-adhesive resin cement tested. The self-adhesive cements tended to have lower mechanical properties than the conventional resin cement. All self-adhesive resin cements, apart from G-CEM LinkAce, demonstrated significantly poorer wear resistance than did the conventional resin cement.

The Influence of Axial Grooves on Dislodgment Resistance of Prosthetic Metal Crowns in Maxillary Fourth Premolar Teeth of Dogs

The reported failure rate for full veneer crowns in dogs is suboptimal, particularly in teeth with naturally poor retentive features such as the maxillary fourth premolar tooth of dogs. Although the data regarding crown retention on the maxillary fourth premolar in dogs are limited, there are data that suggest the crown failure rate could be similar to that of the canine tooth. Thus, methods to improve retentive features of the preparation design should be pursued. The objective of the present study is to quantify the influence of axial grooves on the dislodgment resistance of full veneer metal crowns in dogs. Crown dislodgment testing was performed on cast alloy dies of the maxillary fourth premolar tooth with unfavorable retentive features prepared with and without axial grooves, to quantify the difference in force required to dislodge a cemented full veneer crown. The force required to cause crown dislodgment was recorded for each crown. Statistical analysis revealed a significant increase ( P < .001) in the force required for crown dislodgment in teeth prepared with axial grooves compared to those prepared without axial grooves.

Retention of bonded titanium copings fixed to implant abutments

STATEMENT OF PROBLEM

Conical abutments can be laser welded to the abutment base to compensate for differing implant axes. As laser welding requires expensive equipment, alternative methods for bonding the conical abutment part with the abutment base should be considered.

PURPOSE

The purpose of this in vitro study was to evaluate the retention of Ti-6Al-7Nb copings bonded adhesively to Ti-6Al-7Nb abutments and to compare it with the stability achieved by laser welding.

MATERIAL AND METHODS

A total of 104 two-part Ti-6Al-7Nb specimens were prepared and divided into 13 groups with 8 specimens each. In this 2-part study, 3 luting resins (Panavia F 2.0 [PF]; Multilink Automix [MA]; Superbond C&B [SB]) were used with or without metal priming (PR). The laser welding group (LW) served as the control. After storage for 1 or 150 days (150 days with thermal cycling [TC]), push-out retention and welded joint stability were tested. The data were analyzed with ANOVA and the Tukey HSD multiple comparison tests.

RESULTS

The choice of resin, thermal cycling, and metal priming had a significant effect on resin push-out retention. LW provided the strongest retention, followed by PF, MA, and SB. For PF and SB, TC decreased retention. PR did not lead to higher retention but provided better bonding stability when TC was applied.

CONCLUSIONS

The retention values suggest that considering the maximum mastication forces, resin bonding is an appropriate substitute for the laser welding method.

Fatigue Resistance of Y-TZP/Porcelain Crowns is Not Influenced by the Conditioning of the Intaglio Surface

OBJECTIVES

The objective of this study was to investigate the effects of treatments of the intaglio surface of Y-TZP frameworks and luting agents on the fatigue resistance of all-ceramic crowns.

METHODS

A research design was chosen that attempted to reduce the likelihood of Hertzian cracking and to increase the probability of fracture initiation at the intaglio surface of the framework. Ninety identical preparations were machined in a dentin-like epoxy composite. Each preparation was restored with a Y-TZP framework made by a CAD/CAM system and veneered using feldspathic ceramic. Prior to cementation the intaglio surface of the ceramic was treated using one of four treatments: 1) cleaning with isopropyl alcohol; 2) application of an overglaze; 3) sandblasting with 125 μm aluminum oxide powder; and 4) sandblasting with 30 μm silica powder (CJ). One of three luting cements were used: 1) zinc phosphate; 2) glass ionomer; and 3) adhesive resin cement (PN). All three cements were tested against frameworks that were alcohol cleaned. Only the PN cements were tested against frameworks that had been sandblasted or glazed. Altogether, six groups of 15 specimens each were tested. Fatigue resistance was evaluated using stepwise loads at 1.4 Hz until failure: 5000 cycles at maximum load of 200 N, followed by 10,000 cycles at maximum loads of 800, 1000, 1200, and 1400 N. The cement thickness and failure modes were analyzed using a stereomicroscope and scanning electron microscopy. The results were analyzed using the Kaplan-Meier and Mantel-Cox log rank tests (5%), a one-way analysis of variance, Tukey multiple comparison test, and Weibull nonparametric test.

RESULTS

The predominant failure mode was chipping of the veneer. The crowns cemented with the adhesive resin cement exhibited chipping failure at higher mean loads than did crowns cemented with cements that usually do not bond strongly with dentin. When the adhesive cement was used, glazing and sandblasting intaglio framework surface treatments exhibited lower mean loads at chipping than did crowns whose intaglio surface was only cleaned with alcohol. Weibull analysis indicated that all specimens had a high ratio of late-to-early failures.

CONCLUSIONS

The fatigue experiment produced a pattern of failures that is very similar to that observed in clinical trials of Y-TZP crowns that are veneered with feldspathic porcelain. Crowns cemented with an adhesive resin cement exhibited chipping at a significantly higher mean load than those cemented with luting cements that do not usually form strong bonds with dentin. When cemented with adhesive resin cement, glazing or sandblasting the intaglio surface of the framework significantly reduced the mean fatigue loads at which chipping of veneers occurred, as compared to crowns whose intaglio surface had only been cleaned with alcohol. For this cement glazing or sandblasting the intaglio surface of the crown is not recommended.

The influence of implant abutment surface roughness and the type of cement on retention of implant supported crowns

OBJECTIVES

To provide relative data on the retentive characters of the commonly used cements on different implant abutment surfaces.

MATERIALS AND METHODS

A total of 20 implant abutments were divided into 2 groups. Ten implants were unaltered and ten were air borne particle abraded with 50μ aluminium oxide. Three luting agents (Tempbond, IRM and ImProv) were used to secure the crowns to abutments. All the crowns were removed from the abutment with an Instron machine at 0.5mm per minute and tensile bond strengths were recorded. Statistical analysis was performed using Anova, Paired t-test and Post-Hoc tests.

RESULTS

IRM showed the highest mean tensile strength among the three cements when used with treated and untreated implant abutment surfaces. Change in the abutment surface roughness had no effect on the mean tensile bond strength of TempBond and IRM cements, whereas ImProv cement showed reduced tensile strength with sandblasted surface.

CONCLUSION

When increased retention is required IRM cement with either sandblasted or milled surface could be used and when retrievability is required cements of choice could be either TempBond or ImProv.

Conventional glass-ionomer materials: A review of the developments in glass powder, polyacid liquid and the strategies of reinforcement

OBJECTIVES

The development of glass-ionomers (GIs) from the earliest experimental GI formulations to the modern day commercially available GIs was reviewed. The aim of the review was to identify the developments in the glass powder and polyacid liquid constituents of GIs since their inception in the late 1960s.

DATA

The glass powder has undergone major changes from the earliest GI powder formulation (G200) in an effort to enhance the reactivity with the polyacid liquid. The GI liquids have also been optimised by the manufacturers in terms of polyacid composition, molecular weight and concentration to improve the handling characteristics. Despite these developments in the glass powder and polyacid liquid constituents, GIs cannot 'truly' be advocated for the restoration of posterior dentition due to the poor mechanical properties when compared with dental amalgam and resin-based composites (RBCs).

SOURCES

Various attempts to improve the mechanical properties of GIs through substitution of reinforcing fillers to the GI powder or modification of the GI liquid were identified in the dental literature. Despite the claimed improvements in mechanical properties of the modified GIs, a wide variation in mixing and testing conditions was identified which prevented a valid assessment of the reported reinforcement strategies. When investigating a GI reinforcement strategy it is crucial that the mixing and testing conditions are standardised to allow a valid comparison between studies.

STUDY SELECTION

The dental literature reporting the earliest experimental GIs to modern day commercially available GIs (1969-2015) was reviewed. In addition, full-text publications and abstracts published in English reporting various GI reinforcement strategies were included.

CONCLUSION

Nevertheless, major improvements in GI formulations through a reinforcement strategy have yet to be made to enable clinical usage of GIs for the restoration of posterior dentition.

CLINICAL SIGNIFICANCE

GIs chemically are inherently weak but bond to sound tooth structure without the need for preconditioning or removal of sound tooth structure such that improvements in the mechanical properties of GIs would be desirable. Although advances have been made through different GI glass powder and polyacid liquid formulations over the past 40 years, further improvements in the mechanical properties of the current GIs are required to be indicated for the restoration of posterior dentition. The literature is replete with reports on GI reinforcement, however, improved reporting and control of mixing and testing conditions are required for a valid assessment of the reinforcement strategies.

Effect of type of luting agents on stress distribution in the bone surrounding implants supporting a three-unit fixed dental prosthesis: 3D finite element analysis

Background:

Osseointegration of dental implants is influenced by many biomechanical factors that may be related to stress distribution. The aim of this study was to evaluate the effect of type of luting agent on stress distribution in the bone surrounding implants, which support a three-unit fixed dental prosthesis (FDP) using finite element (FE) analysis.

Materials and Methods:

A 3D FE model of a three-unit FDP was designed replacing the maxillary first molar with maxillary second premolar and second molar as the abutments using CATIA V5R18 software and analyzed with ABAQUS/CAE 6.6 version. The model was consisted of 465108 nodes and 86296 elements and the luting agent thickness was considered 25 μm. Three load conditions were applied on eight points in each functional cusp in horizontal (57.0 N), vertical (200.0 N) and oblique (400.0 N, θ = 120°) directions. Five different luting agents were evaluated. All materials were assumed to be linear elastic, homogeneous, time independent and isotropic.

Results:

For all luting agent types, the stress distribution pattern in the cortical bone, connectors, implant and abutment regions was almost uniform among the three loads. Furthermore, the maximum von Mises stress of the cortical bone was at the palatal side of second premolar. Likewise, the maximum von Mises stress in the connector region was in the top and bottom of this part.

Conclusion:

Luting agents transfer the load to cortical bone and different types of luting agents do not affect the pattern of load transfer.

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.

Evaluation of fracture resistance of indirect composite resin crowns by cyclic impact test: influence of crown and abutment materials

This study evaluated the effect of abutment materials on the fracture resistance of composite crowns for premolars. Composite crowns were fabricated using two different indirect composite resin materials (Meta Color Prime Art or Estenia C&B) and cemented onto either a metal (Castwell M.C. 12) or composite resin (Build-It FR and FibreKor) abutment with resin cement (Panavia F2.0). Twenty-four specimens were fabricated for four groups (n=6 each) and subjected to 280-N cyclic impact loading at 1.0 Hz. The number of cycles which caused the composite crown to fracture was defined as its fracture resistance. All data were statistically analyzed using ANOVA and the Bonferroni test (α=0.05). Composite crowns cemented onto resin abutments showed higher fracture resistance than those cemented onto metal abutments.