Self-Adhesive Resin Cements: A Clinical Review

Influence of light-polymerizing units and zirconia on the physical, chemical and biological properties of self-adhesive resin cements

BACKGROUND

Self-adhesive resin cements (SARCs) are widely used for fixed prostheses, but incomplete cleaning near the gingival margin can cause inflammation. However, the factors influencing cement properties and the biological response of gingival fibroblasts to cement eluates are not well understood. This study examines the impact of two light-polymerizing units (LPUs) on the physical and chemical properties of two SARCs under simulated clinical conditions, as well as the subsequent response of human gingival fibroblasts (hGFs) to these eluates.

METHODS

Dental cement discs of SARCs were polymerized using Kerr DemiPlus and 3 M Elipar DeepCure-S LED LPUs with or without a 2-mm thick zirconia screen. Physical properties (microhardness, surface roughness, residual monomers) were evaluated. hGFs' cell viability, wound healing potency, and gene expression were assessed.

RESULTS

Both Maxcem and RelyX exhibited reduced microhardness and increased surface roughness when polymerized through zirconia or with DemiPlus LPU. Higher residual monomers (HEMA and GDMA in Maxcem; TEGDMA in RelyX) concentration was observed with DemiPlus and zirconia polymerization. Maxcem polymerized with DemiPlus exhibited lower cell viability, impaired healing, and altered gene expression in hGFs compared to those polymerized with Elipar LPU. Gene expression changes included downregulated NRF2 and HO-1 and upregulated CCR-3.

CONCLUSIONS

Light-polymerizing Maxcem through zirconia with DemiPlus LPU compromised SARCs' properties, leading to higher residual monomers and negatively impacting hGFs' viability, healing, and gene expression. Careful material selection and polymerization techniques are crucial to minimize adverse effects on surrounding tissues.

CLINICAL SIGNIFICANCE

Clinicians should exercise caution when using LPUs and SARCs, especially when polymerizing through zirconia. This will help optimize the physical and chemical properties of SARCs and minimize potential adverse effects on the surrounding gingival soft tissues.

Fracture resistance of CAD/CAM tooth-colored versus cast metal post-and-core restorations in root filled teeth: An in vitro study

Purpose

This study investigated the fracture resistance and failure modes of custom-fabricated post- and core dental restorations using various CAD/CAM materials.

Materials and Methods

Seventy-five mandibular second premolars were allocated to five groups (n = 15) and prepared for standardized post and core restorations. The groups included a control group comprising cast metal and four CAD/CAM materials: Vita Enamic, Shofu HC, Trilor, and PEKK. Fracture resistance was assessed using a compressive force at a crosshead speed of 1 mm/min until failure occurred. Data were analyzed using one-way analysis of variance (ANOVA) and chi-square tests.

Results

The metal group had the highest fracture resistance (244.41 ± 75.20 N), with a significant variance compared to that in the CAD/CAM groups (p < 0.001). No significant differences were observed among the non-metallic groups.

Conclusions

While several CAD/CAM materials displayed satisfactory flexural properties, cast metal posts showed superior fracture resistance in endodontically treated teeth but were mostly associated with catastrophic failure. The clinical application of CAD/CAM materials for post-core restorations presents a viable alternative to traditional metal posts, potentially reducing the risk of unfavorable fractures.

The Influence of Cement Thickness within the Cap on Stress Distribution for Dental Implants

The purpose of this finite element analysis (FEA) was to evaluate the stress distribution within the prosthetic components and bone in relation to varying cement thicknesses (from 20 to 60 μm) utilized to attach a zirconia crown on a conometric cap. The study focused on two types of implants (Cyroth and TAC, AoN Implants, Grisignano di Zocco, Italy) featuring a Morse cone connection. Detailed three-dimensional (3D) models were developed to represent the bone structure (cortical and trabecular) and the prosthetic components, including the crown, cement, cap, abutment, and the implant. Both implants were placed 1.5 mm subcrestally and subjected to a 200 N load at a 45° inclination on the crown. The results indicated that an increase in cement thickness led to a reduction in von Mises stress on the cortical bone for both Cyroth and TAC implants, while the decrease in stress on the trabecular bone (apical zone) was relatively less pronounced. However, the TAC implant exhibited a higher stress field in the apical area compared to the Cyroth implant. In summary, this study investigated the influence of cement thickness on stress transmission across prosthetic components and peri-implant tissues through FEA analysis, emphasizing that the 60 μm cement layer demonstrated higher stress values approaching the material strength limit.

The Effect of the Initiator/Activator/Accelerator Ratio on the Degree of Conversion, Film Thickness, Flow, and Cytotoxicity of Dual-Cured Self-Adhesive Resin Cements

Although self-adhesive resin cements are convenient and less technique-sensitive materials for dental clinicians, they exhibit a lower degree of conversion due to acidic components in their composition. Supplementation of the initiator, accelerator, and activator in self-adhesive resin cements has been suggested to compensate for the lower degree of conversion. This study aimed to evaluate the effects of different combinations of self-curing initiators, self-curing activators, and accelerators on the degree of conversion (DC) of self-adhesive resin cements. A dual-cured self-adhesive resin was prepared using six combinations of initiators, activators, and accelerators. The change in the DC over time was evaluated with and without light curing. The film thickness, flow properties, and cytotoxicity of each formulation were assessed. The results showed that all supplemental components had an effect on increasing the DC, but a greater increase in the DC was observed in the following order: activator, accelerator, and initiator. The cytotoxicity of the resin cements was related to the DC values, as resin cements with lower DC values exhibited higher cytotoxicity. The film thickness met the ISO standards for all groups. The results suggest that utilizing an activator is the most effective approach to enhance the DC in self-adhesive resin cement and that cytotoxicity tended to increase with lower DC values, whereas film thickness and flow properties demonstrated no correlation with DC values.

Touch-cure activation by marketed universal resin luting cements of their associated primer to dentin

PURPOSE

The aim of this study was to investigate the dentin shear bond strength (SBS) and bonding interface of three recently developed "universal" resin luting cements based on different modalities.

METHODS

The dentin SBS and interfacial analysis of three recently launched "universal" resin luting cements, namely, G-Cem One, RelyX Universal and Panavia SA cement universal, were studied. All bonding protocols, including the previous use of their dedicated primer or universal adhesive in touch-cure mode or light-cure mode were performed. Variolink Esthetic LC used in conjunction with Scotchbond Universal Plus was used as a control group. For each group (n = 9), 10 specimens were tested for dentin SBS and two were examined by scanning electron microscopy. SBS were analyzed by two-way ANOVA followed by Dunnett's test.

RESULTS

SBS values showed that the three "universal" resin luting cements tested exhibit different adhesive behaviors. G-Cem One with its touch-cure activated primer had a greater SBS to dentin (25.5 MPa) than that of the control group (22.1 MPa).

CONCLUSION

"Universal" resin luting cements have variable efficacy when used in self-curing mode. The touch-curing mode is also of concern but may show high potential for some formulations.

Effect of pretreatment of root dentin surface with cold atmospheric plasma on improving the bond strength of fiber post and resin cement: In vitro study

INTRODUCTION

Achieving stable adhesion between fiber post and interradicular dentin is a challenging process in the restoration of endodontically treated teeth. This study was conducted to investigate the effect of surface pretreatment with cold atmospheric plasma (CAP) on improving the bond strength between them.

MATERIALS AND METHODS

Forty-eight single-canal mandibular premolars were cut 1 mm above the cementoenamel junction to keep the root length of 14 mm or more. After endodontic treatment and preparation of the post space, the teeth were divided into four groups regarding the pretreatment of dentin surfaces, including normal saline, ethylenediaminetetraacetic acid (EDTA), CAP, and CAP + EDTA groups. The data were analyzed using paired and independent t-test and one-way analysis of variance and the significance level was set at p < .05.

RESULTS

The bond strength was significantly higher in the coronal third than in the apical third in all the groups. Moreover, the bond strength was significantly higher in the CAP + EDTA-treated group. The bond strength increased significantly in the CAP group compared to the normal saline group. In addition, the bond strength increased significantly in the CAP or EDTA groups compared to the control group. The lowest bond strength belonged to the control group (normal saline).

CONCLUSION

The surface pretreatment with CAP (alone or in combination with EDTA) played a significant role in improving the bond strength of fiber post and root canal dentin.

Effect of the Viscosity and Application Time of Different Phosphoric Acids on the Bond Strength and Nanoleakage of Fiber Posts to Root Dentin

PURPOSE

To evaluate the effect of application time and viscosity of meta-phosphoric acid (MPA) and ortho-phosphoric acid (OPA) on the push-out resin-dentin bond strength (PBS) and nanoleakage (NL) at the adhesive-root dentin interface.

METHODS AND MATERIALS

Ninety-six roots of premolars were endodontically prepared and randomly assigned into groups according to the (i) acid (OPA and MPA), (ii) viscosity (gel and liquid), and (iii) application time (7 and 15 seconds). Fiber posts were cemented to the roots, which were then transversally sectioned into serial slices. The slices (cervical, medium, and apical) were subjected to PBS or NL. Analysis of the dentin etching pattern was performed using scanning electron microscopy (SEM). The PBS (MPa) and NL (%) data were subjected to three-way repeated-measures analysis of variance (ANOVA) and Tukey's test (α=0.05).

RESULTS

The cross-product interaction was significant for both PBS and NL (p<0.001). No significant difference in the PBS was observed with the use of OPA compared to MPA (p>0.05). Higher PBS values were observed in the groups etched for 15 seconds compared to 7 seconds, regardless of the acid, viscosity, or root third (p<0.05). Lower NL was observed for MPA etching when compared to OPA etching (p<0.05), and these values were not affected by increasing the application time or acid viscosity (p>0.05). A more pronounced etching pattern was observed with OPA than MPA regardless of the acid viscosity.

CONCLUSION

The use of 40% meta-phosphoric acid promoted adequate bond strength without increasing dentin demineralization or void spaces in the hybrid layer.

Fourteen years clinical evaluation of leucite-reinforced ceramic inlays luted using two different adhesion strategies

OBJECTIVES

Aim of the present prospective study was to clinically evaluate the long-term performance of two different luting-materials for leucite-reinforced glass-ceramic inlays/onlays after 14 years.

METHODS

A total of 83 IPS-Empress-inlays/onlays were placed in 30 patients. Restorations were luted according to two different strategies: 43 restorations were fixed with a self-adhesive resin-cement (RelyXUnicem, RX), 40 restorations were inserted with VariolinkII-low (SV) after pretreatment with an etch-and-rinse multi-step adhesive. Recalls were performed after two weeks (n=83), two years (n= 82), four years (n=74) and 14 years (n=54). Two independent calibrated examiners evaluated all restorations using modified USPHS-criteria. Statistical analysis was performed using pairwise Mann-Whitney-U-test and Friedman-test (p < 0.05).

RESULTS

After 14 years, 54 restorations in 22 patients were evaluated (eight patients equalling 29 inlays not available). Ten restorations had to be replaced (failure rate 12%); four (SV-group) showed bulk fractures and two (RX-group) exhibited marginal fractures at the 14-year recall. Overall, the SV-group revealed significantly better results regarding discoloration of the luting gap (p<0.05) compared to the RX-group. No statistically significant differences were computed between SV and RX for the remaining criteria at the respective recalls (p>0.05). However, statistically significant deteriorations were detected for both luting procedures over 14 years regarding "colour match", "marginal integrity" and "tooth integrity" (p<0.05).

CONCLUSIONS

The self-adhesive resin-cement RelyXUnicem showed similar clinical performance to a conventional multi-step luting-procedure after 14 years for most of the test parameters with a slightly inferior performance of RelyXUnicem regarding discoloration of the luting gap.

CLINICAL SIGNIFICANCE

The current study presents unique in-vivo long-term data on two adhesion-strategies for indirect ceramic single-tooth restorations. Differences in performance of the two luting methods after being challenged for 14 years in the oral environment are highlighted. However, the overarching survival rate justifies the recommendation of both methods for clinical routine.

Comparison of the Mechanical Properties and Push-out Bond Strength of Self-adhesive and Conventional Resin Cements on Fiber Post Cementation

OBJECTIVES

The purpose of this study was to compare the mechanical properties and push-out bond strength of self-adhesive resin cements (SACs) and a conventional resin cement (CRC).

METHODS AND MATERIALS

Eighty bovine incisors were divided into four groups for cementation of a fiberglass post (Whitepost - FGM Dental Group, Coral Springs, FL) with different resin cements: three SACs (Maxcem Elite, MAX - Kerr; Calibra Universal, CAL - Dentsply; and RelyX Unicem 2, RUN - 3M Oral Care) and one CRC (RelyX Ultimate, RXU - 3M Oral Care). The groups were subdivided into two groups each (n=10) for evaluation of the push-out bond strength test (POBS) after 24 hours of water storage or after thermal aging (5000 cycles), following 24 hours of storage. The failure modes were evaluated using a stereomicroscope. Flexural strength (FS) and modulus of elasticity (EM) were determined using a three-point bending. Also, pH of the cements was measured over 48 hours and filler morphology was observed by scanning electron microscopy. Appropriate statistical analyses were performed by SPSS 21.0 (SPSS Inc., Chicago, IL, USA), with a significance level set at 5%. Results: RXU presented the highest POBS at both evaluation times. Among the SACs, RUN and CAL presented significantly lower POBS than MAX in cervical and middle-thirds at the 24-hour evaluation, and in all root regions after thermocycling. Adhesive failure between the cement and dentin were the most prevalent fractures at both times evaluated. MAX presented the lowest FS and RUN showed the highest EM. The pH reached the minimal point at the 30-minute evaluation for RXU and MAX. For RUN and CAL, the minimal pH was observed at the 60-minute evaluation. RXU and RUN presented spherical and regular filler particles, while MAX and CAL presented irregularly shaped and sized filler particles.

CONCLUSIONS

The mechanical behavior of SACs is not superior to CRC; however, among all the SACs evaluated, MAX presented the highest POBS and stability after thermocycling evaluation. MAX also reached the closest neutral pH after 48 hours. Therefore, SACs with low initial pH and strong neutralization reactions are recommended, because these characteristics may lead to better mechanical properties and stability.

Physicochemical Properties of Dentine Subjected to Microabrasive Blasting and Its Influence on Bonding to Self-Adhesive Prosthetic Cement in Shear Bond Strength Test: An In Vitro Study

The aim of this in vitro study was to assess the influence of microabrasive blasting on the physicochemical properties of dentine and shear bond strength (SBS) of self-adhesive resin cement (Maxcem Elite, Kerr, Orange, CA, USA) bonded to the dentine surface. Ninety cylindrical specimens with exposed dentine of human teeth were prepared and divided into three randomized, parallel sample sets A, B, and C. Groups B and C were subjected to abrasive blasting using a micro-sandblasting device (Microetcher IIa, Danville Materials, Carlsbad, CA, USA) with two gradations of Al₂O₃ abrasives (Group B, abrasion with a gradation of 50 μm; group C, abrasion with a gradation of 27 μm). SEM imaging, profilometry, chemical composition analysis, contact angle measurements, surface free energy, and SBS tests were performed. The resulting data were statistically analyzed using the Statistica software (ver. 13.3, Tibco Software Inc., Palo Alto, CA, USA). Microabrasive blasting caused changes in surface topography, structural features, and the connection strength between the dentin surface and self-adhesive prosthetic cement. Air microabrasion through the multifactorial positive reorganization of the treated surface of dentine is recommended as a pretreatment method in fixed prosthodontics adhesive cementation protocols.

Comparison of Bond Strength in the Different Class of Resin Cements to Cast and CAD/CAM Co-Cr Alloys

Objectives

Despite the widespread use of resin cements in cementing dental restorations, their bond strength to CAD/CAM base metal alloys is not widely studied. This study aimed to evaluate the microshear bond strength (μSBS) between cobalt-chrome (Co-Cr) alloys fabricated using casting or CAD/CAM methods with three types of resin cements.

Materials and Methods

Fifty Co-Cr blocks were prepared with CAD/CAM or casting technique. Specimens were divided using primer or not and bonded to three types of resin cements: Panavia F2, RelyX Unicem, and Duo-Link. The differences between the mean μSBS values were analyzed using the two-way ANOVA test and Tukey analysis (α = 0.05). The mode of failure was evaluated using a stereomicroscope. In addition, the specimens were examined by scanning electron microscopy (SEM) based on two received signals: backscattered electrons (SEB) and secondary electrons (SEs). One intact alloy specimen in each group was analyzed by energy-dispersive X-ray spectroscopy (EDX).

Results

Most of the specimens in the no-primer group were prematurely debonded. Statistical analyses showed that the interaction between the alloy substrate and cement type was significant (p=0.001). The bond strength of Panavia F2 was significantly higher than Duo-Link in the CAD/CAM group (p=0.001). SEM evaluation confirmed the difference in grain structures, while EDX showed no remarkable difference in the chemical composition of the alloy substrates.

Conclusion

Alloy fabrication technique may influence the bond strength of resin cements. In the CAD/CAM group, cement containing MDP molecules exhibited higher strength than the etch-and-rinse one.

Effects of NanoAg-ACP Microparticles as Bioactive Fillers on the Mechanical and Remineralization Properties of Dental Resin Cement

PURPOSE

To investigate the potential of adding silver-nanoparticle-containing amorphous calcium phosphate microparticles as bioactive fillers into commercially available non-bioactive dental resin cement.

MATERIALS AND METHODS

Experimental cement was formulated by adding 7.5% silver-nanoparticle-containing amorphous calcium phosphate microparticles to Multilink Automix resin cement (Ivoclar Vivadent). The experimental cement was evaluated for shear bond strength (N=11 per group) and demineralization/remineralization (N=16 per group), with BioCem^® Universal BioActive cement (NuSmile) as the positive control and Multilink Automix cement as the negative control. One-way analysis of variance and post hoc tests were used to assess the significance of differences among or between the groups RESULTS: : The addition of silver-nanoparticle-containing amorphous calcium phosphate microparticles at the level of 7.5% by weight into Multilink Automix did not have a statistically significant effect on the shear bond strength (p>0.05), but statistically significantly increased the depth of remineralization on both dentin and enamel (p=0.01 and p<0.001, respectively.) when compared to Multilink Automix alone. The experimental cement prepared in the present study was comparable to BioCem^® on the depths of remineralization on both dentin and enamel (p=0.59 and p=0.99, respectively).

CONCLUSION

When incorporated into non-bioactive commercial dental resin cements as bioactive fillers at the level of 7.5% by weight, silver-nanoparticle-containing amorphous calcium phosphate microparticles could provide remineralization potential without affecting the shear bond strength. This article is protected by copyright. All rights reserved.

Impact of adhesive primer and light-curing on polymerization kinetics of self-adhesive resin cement in association with free radical reaction

This study analyzed the impact of adhesive primer and light-curing on the polymerization kinetics of urethane dimethacrylate-based self-adhesive resin cement combined with free radical reaction. Specimens were prepared by mixing the cement paste with or without adhesive primer. Subsequently, specimens were light-cured or set without light-curing. The degree of conversion (DC), Vickers hardness (Hv), and free radical concentrations were repeatedly measured up to 168 h after the curing initiation. Irrespective of the curing procedures, DC, Hv, and free radical concentration rapidly increased during the initial 30 min of curing. The specimens cured with adhesive primer and/or light-curing generally showed higher values of DC, Hv, and radical concentration than those set by chemical curing alone, especially during the initial polymerization phase. Kinetic analysis using a linear mixed model revealed that the adhesive primer had a higher coefficient estimate than light-curing, indicating that the former had a higher impact on the polymerization. Additionally, the adhesive primer alleviated the Hv reduction caused by water and air during the initial polymerization phase, although light-curing hardly prevented the polymerization inhibition. Therefore, we suggest that application of adhesive primer is beneficial to achieve higher degree of conversion and better mechanical properties of self-adhesive resin cements by enhancing free radical reactions.

Immediate and long-term microshear bond strength of resin-based cements to core build-up materials

Background

To evaluate the microshear bond strength (μ-SBS) between resin-based cements and core build-up materials after water storage.

Material and Methods

Cylinders (1x1 mm) of conventional dual-cure resin cement (RelyX ARC, 3M ESPE), universal dual-cure resin cement (RelyX Ultimate, 3M ESPE) or self-adhesive resin cement (RelyX U200, 3M ESPE) were adhered to disks (6x2 mm) made with commercial core build-up materials (Bis-Core, Bisco or LuxaCore Z, DMG) or conventional nanocomposite resin (Filtek Z350 XT, 3M ESPE). The specimens (n=10) were submitted to μ-SBS test using a universal testing machine and fracture pattern analysis at 48 hours or after 9 months of water storage. The data were evaluated by three-way ANOVA for repeated measures and Tukey’s test (α=0.05).

Results

After 48 hours, regardless of the resin-based cement used, the μ-SBS to the conventional resin composite (Filtek Z350 XT) was greater compared to other materials. However, after 9 months, there was a statistically significant decrease in μ-SBS values between the conventional resin composite and evaluated luting agents. The μ-SBS values of core build-up commercial materials (Bis-Core and LuxaCore Z) did not change over time. Regardless of the composite used and storage time, there was no statistically significant difference between the resin-based cements. After 48 h, the most prevalent failure was mixed for all groups. However, after 9 months, the core build-up materials showed a predominantly mixed fracture pattern whereas the resin composite presented an adhesive pattern.

Conclusions

Commercial core build-up materials achieved stable bonding performance with resin-based cements over time.

Key words:Composite resins, resin cement, dental restoration failure.

Influence of the resin-coating technique on the bonding performance of self-adhesive resin cements in single-visit computer-aided design/computer-aided manufacturing resin restorations

OBJECTIVE

This in vitro study investigated the influence of resin coating on the bonding performance of self-adhesive resin cements in single-visit computer-aided design (CAD)/computer-aided manufacturing (CAM) resin restorations.

MATERIALS AND METHOD

CAD/CAM resin (1.5-mm thick) was mounted on 20 noncoated and 20 resin-coated human dentin surfaces using dual-cured self-adhesive resin cements (Panavia SA Cement Plus or Panavia SA Cement Universal, Kuraray Noritake Dental) in either self-curing or dual-curing mode. These specimens were sectioned into beam-shaped sticks and subjected to microtensile bond strength tests after 24 h of water storage. The obtained data were statistically analyzed with three-way analysis of variance (ANOVA) and t tests (α = 0.05).

RESULTS

The three-way ANOVA results revealed the significant influence of resin coating, resin cement, and curing mode. Resin coating and light curing led to higher bond strengths in almost all groups. Resin-coated dentin with Panavia SA Cement Plus exhibited a mean bond strength greater than 35 MPa in both self-curing and dual-curing modes.

CONCLUSIONS

In single-visit CAD/CAM resin restorations, resin coating, resin cement selection, and curing mode influenced the bonding performance of self-adhesive resin cements. In addition, resin coating and light curing increased the bond strength of self-adhesive resin cements. Resin coating and light curing are encouraged for predictable bonding performance of dual-cured self-adhesive resin cements in single-visit CAD/CAM resin restorations.

Temporary cement residues affect the bond strength and dentin penetration of self-adhesive resin cement in fiberglass post cementation

This study evaluated the persistence of eugenol-containing (PR, Provy) or eugenol-free (RT, Relyx Temp, and TB, Temp Bond) temporary cement residues and its effects on push-out bond strength and dentinal penetration of the self-adhesive resin cement (Relyx U200). Eighty human roots were endodontically treated and post space prepared. Fourty specimens were distributed in four groups (n = 10): Control (CO), without any clinical procedure, PR, RT, and TB, where a metallic post was cemented with one of the temporary cements. After metallic post removal, hemi sections post space were submitted to SEM analysis. Another specimens were distributed in similar groups, but fiberglass post was cemented using Relyx U200 cement and submitted to push-out bond strength and dentinal penetration cement analysis, in post space thirds. SEM analysis were evaluated by Kruskal-Wallis and Dunn tests, while bond strength and dentinal penetration were evaluated by ANOVA One-Way and Tukey test (p < .05). Only in apical thirds, PR, RT, and TB showed higher persistence of residues than CO. In bond strength, PR, RT, and TB showed lower values than CO, in all post space thirds (p < .05). But to dentinal penetration, PR, RT, and TB presented lower values than CO only in apical thirds (p < .05). There is the greatest persistence of temporary cement residues only in apical post space third, providing less dentinal penetration of the self-adhesive resinous cement. However, the previous use of temporary cements has negative effects on the bond strength cementation system, regardless of the third evaluated.

Comparative Analysis of Static and Viscoelastic Mechanical Behavior of Different Luting Material Categories after Aging

The longevity of indirect restorations is primarily determined by the appropriate selection of the luting material. The function of a luting material is to seal the restoration and hold it in place for the time required for service. The mechanical behavior of luting materials and in particular their aging behavior, therefore, play a decisive role. The study provides a comparative analysis of the static and dynamic mechanical behavior of the most commonly used luting material categories-zinc phosphate cement, glass-ionomer cement, resin-modified glass-ionomer cement, resin-based composites, and self-adhesive resin-based composites-and their aging behavior. It also takes into account that luting materials are viscoelastic materials, i.e., materials that respond to external loading in a way that lies between an elastic solid and a viscous liquid. Flexural strength and modulus were determined in a three-point bending test followed by fractography analysis. The quasi-static and viscoelastic behavior was analyzed by a depth-sensing indentation test provided with a dynamic mechanical analysis (DMA) module at 20 different frequencies (1-50 Hz). The fracture toughness was evaluated in a notchless triangular prism (NTP) test. Material type exhibits the strongest influence on all measured properties, while the effect of aging becomes more evident in the material reliability. The variation of the viscoelastic parameters with aging reflects cement maturation or polymer plasticization.

Influence of different cleaning procedures on the shear bond strength of 10-methacryloyloxydecyl dihydrogen phosphate-containing self-adhesive resin cement to saliva contaminated zirconia

PURPOSE

To evaluate the effect of different cleaning methods on the shear bond strength (SBS) of a 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing self-adhesive resin cement to zirconia after saliva contamination.

METHODS

Sixty zirconia specimens were randomly divided into four groups (n=15) according to treatment surface. Except for the control group, all samples were contaminated with saliva and were then rinsed with water-spray and air-dried. Subsequently, the specimens were either treated with a cleaning paste (CP), with argon plasma (AP), or did not undergo an additional cleaning process (WS). An MDP-containing self-adhesive resin cement was applied onto the ceramic surfaces. Specimens were stored in water (24 hours) followed by thermocycling (5°C to 55°C for 10.000 cycles). SBS tests were performed in a universal testing machine, and the results (MPa ± SD) were statistically analyzed using ANOVA and Bonferroni post-hoc test. Fractured surfaces were examined to identify the failure types using a stereomicroscopy and SEM.

RESULTS

The surface cleaning treatment (p < 0.05) significantly affected the results. The highest SBS values were observed in the control group (12.16 ± 1.22 MPa) and were statistically comparable to values for the CP group (11.38 ± 1.65 MPa). The AP group (9.17 ± 1.06 MPa) showed significantly higher bond strength than the WS group (6.95 ± 1.20 MPa), but it showed significantly lower strength than the control and CP groups.

CONCLUSIONS

The CP application was the most effective method in removing saliva contamination. The AP treatment could not restore the SBS to the same level as uncontaminated specimens.

Influence of Propolis, Ozone and Photodynamic therapy in root canal disinfection on resin bond strength to radicular dentin

AIM

The aim of the present study was to assess post space disinfection using different irrigants and their effect on radicular dentin bond to SERC.

MATERIALS AND METHODS

Forty single rooted mandibular 2nd premolars were collected and disinfected. All samples were decoronated maintaining root length of 12 mm and embedded vertically in acrylic resin. Shaping of the canal was performed using reciprocating system. Canals were dried using paper points and obturated with gutta percha via lateral condensation. Peso-reamers were used to create post space up to 10 mm. The post space was irrigated with 1% NaOCl before being randomly allocated into four groups (n = 10) according to different methods of canal disinfection. Samples in group 1 were subjected to photoactivated disinfection (PAD), group 2 irrigated with ethanol based propolis group 3 disinfected using ozone and group 4 irrigated with 2.25 % NaOCl with 17 % EDTA and ECL. GFP was fitted using SERC. Each sample was cut into 1 mm from coronal, middle and apical and subjected to pushout bond strength (PBS) via universal testing machine. Fracture analysis were confirmed by stereomicroscope at 40x magnification. For comparison of means, Analysis of variance (ANOVA) and Tukey multiple comparison test was used maintaining the level of significance at p <  0.05.

RESULTS

The highest PBS at all three levels were found in group 4, canal disinfected with 2.5 % NaOCl with 17 % EDTA and ECYL. Whereas, the lowest PBS was observed in group 1. Inter group comparison, prosthetic space disinfected with propolis extract showed no significant difference to group 4 canal disinfected with 2.5 % NaOCl with 17 % EDTA and ECYL at all three levels (p > 0.05). Intra group comparison in all experimental groups showed no significant difference was noted in coronal and middle thirds of group 1, group 2 and group 3 respectively (p > 0.05).

CONCLUSION

2.5 % NaOCl with EDTA and ECL treatment (group 4) remains the gold standard when used as a final canal irrigant. Propolis can be used as potential irrigant for canal disinfectant provided if the composition becomes standardized.

Shear bond strength of a self-adhesive resin cement to dentin surface treated with Nd:YAG and femtosecond lasers

This study aims to evaluate the effect of Nd:YAG and femtosecond lasers irradiation on the shear bond strength (SBS) of a self-adhesive resin cement to the human dentin surface. One hundred extracted third molar teeth were randomly divided into 10 experimental groups according to dentin surface treatments; with and without the bonding agent, Nd:YAG 302 J/cm² and 440 J/cm², femtosecond 4 J/cm² and 7 J/cm², and control groups were prepared. After surface treatments, a self-adhesive resin cement was luted by using a bonding jig (Ultradent Products Inc.). The specimens were then subjected to shear test at a crosshead speed of 0.5 mm/min, and failure loads were recorded as megapascal (MPa). Two-way analysis of variance and Tukey HSD tests were performed (p ˂ 0.05). Representative specimens from each experimental subgroup were examined by means of SEM. The highest SBS values were obtained in Group 302 J/cm² Nd:YAG with bonding agent, and there is no statistical difference between Group 440 J/cm² Nd:YAG with bonding and Group 7 J/cm² femtosecond with bonding (p > 0.05). The lowest SBS values were observed in Group control without bonding agent. Nd:YAG and femtosecond laser treatments improved the adhesion between the dentin surface and the self-adhesive resin cement.

Effect of Etching Procedures on the Adhesion of Biofilm-Coated Dentin

Oral biofilms coat all surfaces in the oral cavity including the exposed dentin surface. This study aimed to investigate biofilm removal by acid etching procedures and the effects of the residual biofilm on dentin surfaces on composite-dentin adhesion. Dentin discs were assigned to five groups: no biofilm formation (C); biofilm formation and no surface treatment (BF); biofilm formation and acid etching (BF-E); biofilm formation and acid etching followed by chlorhexidine soaking (BF-EC); and biofilm formation and rubbing with pumice, followed by acid etching (BF-RE). Biofilms were formed on saliva-precoated dentin discs by soaking the discs in Streptococcus mutans (S. mutans) suspension. Biofilm removal from the dentin surface was evaluated quantitatively and qualitatively by confocal laser scanning microscopy and scanning electron microscopy, respectively. To compare the bond strength of the biofilm-coated dentin discs with the surface treatments, specimens were assigned to four groups: no biofilm formation and acid etching (C-E); BF-E; BF-EC; and BF-RE. Assessments of the micro-shear bond strength and subsequent failure modes were performed. BF-E and BF-EC did not remove the biofilm, whereas BF-RE partially removed the biofilm attached to the dentin (p < 0.05). The bond strength of BF-RE was significantly higher than those of BF-E and BF-EC, but lower than that of C-E (p < 0.05). In conclusion, mechanical biofilm removal is recommended before etching procedures to enhance adhesion to the biofilm-coated dentin.

Bond durability when applying phosphate ester monomer-containing primers vs. self-adhesive resin cements to zirconia: Evaluation after different aging conditions

PURPOSE

This study aimed to evaluate bond durability when applying 2 phosphate ester monomer-containing self-adhesive resin cements alone, versus a combination of phosphate ester monomer-containing primer conditioning plus 2 conventional resin cements requiring primers, to zirconia after different artificial aging methods.

METHODS

We cemented air-abraded zirconia plates to composite resin cylinders with self-adhesive resin cements (MS; RU) alone or cemented them with traditional resin cements (ZRV; ZVN) after pre-conditioning with a zirconia primer. A shear bond strength (SBS) test were performed after subjecting them to 19 different aging conditions (n = 15) comprising 30,000× thermocycles, air storage at room temperature (RT), water storage at RT, or at 37 °C for 24 h, 1 week, 1, 3, 6, and 12 months. Zirconia powders mixed with zirconia primer or 2 self-adhesive resin cements were characterized by X-ray photoelectron spectroscopy.

RESULTS

Groups MS and ZVN obtained the highest SBS after all of aging methods. SBS after 6 months of storage was similar to SBS after 24 h of storage, while both were higher than SBS after 1 year of storage. Water storage at 37 °C provided higher SBS than RT water storage did. We detected a Zr-O-P bond in both self-adhesive resin cement/zirconia powder mixtures.

CONCLUSIONS

Application of self-adhesive resin cements alone could be an alternative to pre-conditioning with a zirconia primer followed by the application of conventional resin cements. Formation of Zr-O-P bonds contributed to the bonding improvement of self-adhesive resin cements. Different aging conditions affected SBS values.

Comparison of Bond Strength of Monolithic CAD-CAM Materials to Resin Cement Using Different Surface Treatment Methods

Objective:

To compare the bond strength of monolithic CAD-CAM materials to resin cement using different surface treatment methods.

Materials and Methods:

Lithium disilicate glass ceramic (IPS e-max CAD), zirconia-reinforced lithium silicate ceramic (Vita Suprinity), resin nanoceramic (Lava Ultimate), and hybrid ceramic (Vita Enamic) were used. Five groups of CAD-CAM blocks were treated as follows: control (C), HF etching (HF), HF etching + silanization (HF + S), sandblasting (SB), and sandblasting + silanization (SB + S). After surface treatments, SEM analyses were conducted. Specimens were cemented with self-adhesive resin cement (Theracem) and stored in distilled water at 37°C for 24 h. Shear bond strength (SBS) was measured, and failure types were categorized. Results were analyzed using two-way ANOVA and the post-hoc Tukey test.

Results:

Statistical analysis revealed significant differences between SBS values obtained for different surface treatments and CAD-CAM block types ( P < .001). Among the CAD-CAM materials, the highest SBS was reported in the HF + S group for Vita Enamic. Although IPS e.max CAD, Vita Suprinity, and Vita Enamic showed higher bond strength when treated with HF + S, Lava Ultimate has the highest bond strength value when treated with SB + S.

Conclusions:

The bond strength of CAD-CAM materials was influenced by surface treatment. Additionally, silanization significantly improved the bond strength of all materials except Lava Ultimate.

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.

In Vitro Cytotoxicity of Self-Adhesive Dual-Cured Resin Cement Polymerized Beneath Three Different Cusp Inclinations of Zirconia

The aim of the present study was to evaluate the in vitro cytotoxicity of self-adhesive dual-cured resin cement (SADRC) polymerized beneath three different cusp inclinations of zirconia with different light curing time. A commercial SADRC (Multilink Speed) was polymerized beneath zirconia (ZrO₂) with three different cusp inclinations (0°, 20°, and 30°) for 20 s or 40 s. After being stored in light-proof box for 24 h, the ZrO₂-SADRC specimens were immersed in DMEM for 72 h and then we got the extract solution, cultured the human gingival fibroblasts (HGF, 8 × 10³ per well) with 100% or 50% concentrations of the extract solution for 24 h, 72 h, and 120 h, respectively, and evaluated cytotoxicity of the polymerized SADRC with CCK-8 assay in optical density (OD) values, relative growth rates (RGR), and cytotoxicity grades. Statistical analysis was conducted using a two-way ANOVA followed by post hoc Student–Newman–Keuls test. The OD values varied from 0.8930 to 3.2920, the RGR varied from 33.93% to 98.68%, and the cytotoxicity grades varied from 0 to 2. There was significant difference in the OD values among the different cusp inclinations of zirconia (P < 0.001), and there was significant difference in the OD values between the different light curing times in some situations (P < 0.05). The cusp inclination of zirconia affects the in vitro cytotoxicity of SADRC. Prolonging the light curing time from 20 s to 40 s can reduce the in vitro cytotoxicity of SADRC when the cusp inclination of zirconia is smaller than 20°.

Effect of silane coupling treatment and airborne-particle abrasion on shear bond strength between photo-cured bulk-fill flowable composite resin and silverpalladium-copper-gold alloy using self-adhesive resin cement

The purpose of the present study was to examine the effects of silane coupling treatment and airborne-particle abrasion (APA) on shear bond strength (SBS) between photo-cured bulk-fill flowable composite resin and 12% silver-palladium-copper-gold (Ag-Pd-CuAu) alloy using self-adhesive resin cement. The six experimental groups were compared using two-way analysis of variance (ANOVA) followed by Tukey Kramer's post-hoc test to compare SBS values among the six groups at a 95% confidence level. The SBS of APA groups was significantly higher than non-APA groups. The SBS of the specimens with silane coupling treatment increased slightly compared with specimens without silane coupling treatment. The combination of resin coating with bulk-fill resin and self-adhesive resin cement could be clinically useful when restoring a cavity with a noble metal.

Cytotoxicity of Self-Adhesive Resin Cements on Human Periodontal Ligament Fibroblasts

The aim of this study was to evaluate the potential cytotoxicity of self-adhesive resin cements with or without light irradiation on human periodontal ligament fibroblasts (HPDLFs) in vitro. Three self-adhesive resin cements (RelyX U200, Maxcem Elite and Multilink Speed) were cured with light or not. Cured cements were stored at 37°C for 24 h in water or Dulbecco's modified eagle medium (DMEM) medium. Their chromatographic analysis of water-based extract solution was made and then the DMEM-based extract solution was diluted in complete DMEM {1:5, 1:10, 1:20, 1:40, 1:80 (v/v)} for evaluating cell relative growth rate and cell apoptosis/necrosis rate of HPDLFs. The data was analyzed by one-way ANOVA and independent T test. Regardless of light irradiation, cell relative growth rate increased, and the apoptosis/necrosis rate of each resin cement decreased with the increase of gradient dilution. Regardless of gradient dilution, the cell relative growth rate and apoptosis/necrosis rate of RelyX U200 and Maxcem Elite with light irradiation were higher than those without light irradiation. Besides, without light irradiation, Multilink Speed showed higher cell relative growth rate and lower apoptosis/necrosis rate than other cements. Light irradiation and composition difference of self-adhesive resin cements could affect their cytotoxicity on HPDLFs.

Dental Cements for Luting and Bonding Restorations: Self-Adhesive Resin Cements

Self-adhesive resin cements combine easy application of conventional luting materials with improved mechanical properties and bonding capability of resin cements. The presence of functional acidic monomers, dual cure setting mechanism, and fillers capable of neutralizing the initial low pH of the cement are essential elements of the material and should be understood when selecting the ideal luting material for each clinical situation. This article addresses the most relevant aspects of self-adhesive resin cements and their potential impact on clinical performance. Although few clinical studies are available to establish solid clinical evidence, the information presented provides clinical guidance in the dynamic environment of material development.

Effect of Dentin Preparation Mode on the Bond Strength Between Human Dentin and Different Resin Cements

Abstract The aim was to evaluate the influence of different dentin preparation mode in the smear layer characteristics (SL), hybrid layer (HL), and microtensile bond strength (µTBS) to dentin with two resin cements. The occlusal dentin of 120 third molars was exposed. The teeth were divided into 4 groups (n=30) according to the dentin preparation mode: 1- fine grain diamond bur; 2- coarse grain diamond bur; 3- multi laminate carbide steel bur; and, 4- ultrasonic CV Dentus diamond bur. Each treated dentin group was divided into 2 sub-groups (n=15) according to the resin cement: (1) RelyX U200 and (2) RelyX ARC. Resin composite blocks were cemented on dentin. After storage at 37o C for 24 h, beams with a cross section area of 1.0 mm2 were obtained, and tested in a universal testing machine at a crosshead speed of 0.5 mm/min. Two additional teeth for each sub-group were prepared to analyze the SL and HL on a scanning electron microscopy. According to Kruskal-Wallis test and Dunn tests, there was no significant difference in µTBS among the rotary instruments within each resin cement group. RelyX ARC obtained higher µTBS values compared to RelyX U200 (p<0.05). RelyX ARC formed evident HL, which was not observed for RelyX U200. The dentin mode preparation did not influence the µTBS of the resin cements. The SL was different for all instruments. The cementing agent is more determinant in the hybrid layer formation and bond strength to dentin than the instruments applied on dentin.

Evaluation of long-term bond strength and selected properties of self-adhesive resin cements

This study evaluated the shear bond strength (SBS) of self-adhesive resin cements (SARCs) to dentin and their physical-chemical properties. Five commercial SARCs were evaluated [SmartCem®2 - DENTSPLY (SC2); BisCem® - Bisco (BC); SeT PP® - SDI (SeT); Relyx U100® - 3M ESPE (U100) and YCEM® SA - Yller (YCEM)]. The SARCs were evaluated for SBS to dentin (n = 10) after 24 h, 6 months, and 12 months. The dentin demineralization caused by acidic monomers was observed by SEM, and pH-neutralization of eluate was observed for 24 h. Degree of conversion (DC), rate of polymerization (Rp), flexural strength (FS), and elastic modulus (E) were evaluated. Immediate SBS of SC2, SET, U100, and YCEM were statistically higher than that of BC (p < 0.001). After 12 months, all SARCs showed reduced SBS values and U100 showed values similar to those of SET and YCEM, and higher than those of BC and SC2 (p = 0.001). Demineralization pattern of SARCs was similar. At 24h, all SARCs showed no differences in the pH-value, except BC and U100 (p < 0.001). YCEM showed the highest Rp. U100, YCEM, and SC2 showed statistically higher FS (p<0.001) and E (p < 0.001) when compared with SET and BC. U100 and YCEM showed the best long-term bonding irrespective of the storage period. A significant reduction in SBS was found for all groups after 12 months. SBS was not shown to be correlated with physical-chemical properties, and appeared to be material-dependent. The polymerization profile suggested that an increased time of light activation, longer than that recommended by manufacturers, would be necessary to optimize DC of SARCs.

Comparison of temperature change among different adhesive resin cement during polymerization process

Purpose:

The aim of this study was to assess the intra-pulpal temperature changes in adhesive resin cements during polymerization.

Materials and Methods:

Dentin surface was prepared with extracted human mandibular third molars. Adhesive resin cements (Panavia F 2.0, Panavia SA, and RelyX U200) were applied to the dentin surface and polymerized under IPS e.max Press restoration. K-type thermocouple wire was positioned in the pulpal chamber to measure temperature change (n = 7). The temperature data were recorded (0.0001 sensible) and stored on a computer every 0.1 second for sixteen minutes. Differences between the baseline temperature and temperatures of various time points (2, 4, 6, 8, 10, 12, 14, and 16 minute) were determined and mean temperature changes were calculated. At various time intervals, the differences in temperature values among the adhesive resin cements were analyzed by two-way ANOVA and post-hoc Tukey honestly test (α = 0.05).

Results:

Significant differences were found among the time points and resin cements (P < 0.05). Temperature values of the Pan SA group were significantly higher than Pan F and RelyX (P < 0.05).

Conclusion:

Result of the study on self-adhesive and self-etch adhesive resin cements exhibited a safety intra-pulpal temperature change.

Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry

STATEMENT OF PROBLEM

It is clear the contemporary dentist is confronted with a blizzard of information regarding materials and techniques from journal articles, advertisements, newsletters, the internet, and continuing education events. While some of that information is sound and helpful, much of it is misleading at best.

PURPOSE

This review identifies and discusses the most important scientific findings regarding outcomes of dental treatment to assist the practitioner in making evidence-based choices. This review was conducted to assist the busy dentist in keeping abreast of the latest scientific information regarding the clinical practice of dentistry.

MATERIAL AND METHODS

Each of the authors, who are considered experts in their disciplines, was asked to peruse the scientific literature published in 2015 in their discipline and review the articles for important information that may have an impact on treatment decisions. Comments on experimental methodology, statistical evaluation, and overall validity of the conclusions are included in many of the reviews.

RESULTS

The reviews are not meant to stand alone but are intended to inform the interested reader about what has been discovered in the past year. The readers are then invited to go to the source if they wish more detail.

CONCLUSIONS

Analysis of the scientific literature published in 2015 is divided into 7 sections, dental materials, periodontics, prosthodontics, occlusion and temporomandibular disorders, sleep-disordered breathing, cariology, and implant dentistry.

Análise comparativa da resistência de união de um cimento convencional e um cimento autoadesivo após diferentes tratamentos na superfície de pinos de fibra de vidro

Resumo Introdução Os pinos de fibra de vidro são uma alternativa aos núcleos metálicos e apresentam vantagens, tais como: estética, módulo de elasticidade semelhante à dentina e cimentação imediata após o término do tratamento endodôntico. Ainda, apresentam a capacidade de aderir ao cimento resinoso e este, à dentina, por meio de técnicas adesivas. Objetivo Comparar a adesão de um cimento resinoso convencional e um autoadesivo a pinos de fibra de vidro, e os efeitos de diferentes tratamentos de superfície na resistência adesiva dos pinos. Material e método Trinta pinos foram divididos em três grupos: Controle: sem tratamento na superfície; Jateamento: jateamento com óxido de alumínio por 30 segundos, e Peróxido: imersão em peróxido de hidrogênio 24% por um minuto. Em seguida, corpos de prova foram obtidos a partir de cilindros de cimento resinoso contendo o pino de fibra posicionado no centro de seu longo eixo. Em cada grupo, cinco pinos foram associados ao adesivo Âmbar + cimento convencional AllCem Core e os outros cinco pinos, ao cimento autoadesivo RelyX U200. O conjunto pino/cimento foi segmentado e avaliado em relação à resistência de união (RU) por push-out. Os dados foram analisados estatisticamente pelos testes de ANOVA e Tukey (p<0,05). Resultado Os cimentos avaliados exibiram valores de RU semelhantes. Em relação aos tratamentos de superfície, os maiores valores de RU foram encontrados no grupo Jateamento. Conclusão O cimento convencional, AllCem Core, e o cimento autoadesivo, RelyX U200, mostraram valores de resistência de união semelhantes. Ainda, o jateamento com óxido de alumínio favoreceu a adesão dos pinos aos cimentos.