Shear strength of the composite bond to etched porcelain

Characteristic fatigue strength and reliability of dental glass-ceramics: Effect of distinct surface treatments - Hydrofluoric acid etching and silane treatment vs one-step self-etching ceramic primer

The aim of this study was to mechanically characterize through flexural fatigue test two CAD-CAM glass-ceramics according to distinct surface etching protocols. To do so, feldspathic (FELD) and lithium disilicate (LD) glass ceramics were subjected to different surface treatments: (1) control - no treatment (Ctrl); (2) conventional protocol etching with 5% hydrofluoric acid followed by silane coupling agent application (HF + SIL; Monobond N, Ivoclar); or (3) using a self-etching ceramic primer (E&P; Monobond Etch & Prime, Ivoclar). Ceramic discs (N = 120; Ø = 12 mm; thickness = 1.2 mm) were produced from CAD-CAM blocks, with 60 being from FELD (VITABLOCS Mark II, Vita Zahnfabrik) and 60 from LD (IPS e.max CAD, Ivoclar). Next, 20 disks of each ceramic were allocated into three groups: Ctrl, HF + SIL, or E&P. Surface roughness data were collected on all samples before and after surface treatments (except for Ctrl). Cyclic fatigue (n = 15) biaxial flexural strength tests were performed by the piston-on-three-balls geometry (ISO 6872) considering the test parameters established from a monotonic test (n = 5). The monotonic test was carried out at a 1 mm/min loading rate and 500 kgf loading cell until fracture to obtain the failure data. The cyclic fatigue test was executed underwater at a frequency up to 20 Hz, with the first stress being 25% of the monotonic test for 5000 cycles, followed by increments of 5% of the monotonic test at each step of 10,000 cycles until failure (fracture). Complementary fractography, topography and Atomic Force Microscopy (AFM) analyses were performed. Characteristic Fatigue Strength (CFS) and Weibull modulus were analyzed by Weibull analysis using the fatigue test data. Roughness and complementary analysis data were analyzed by one-way ANOVA. The statistical results exhibited similar CFS among Ctrl, HF + SIL and E&P for both glass-ceramics. The survival analysis corroborates the findings, however the Weibull modulus pointed out superior structural reliability of FELD treated with the E&P group compared to HF + SIL. According to the complementary analyses, HF + SIL exhibited a higher surface area than E&P and Ctrl for FELD (p = 0.001). Roughness showed statistically significant differences among conditions for FELD (E&P < Ctrl = HF + SIL; p < 0.05) and no difference for LD (p > 0.05). Therefore, the CFS were not influenced by any condition evaluated for FELD and LD glass-ceramics; however, superior structural reliability (higher Weibull modulus) for the feldspathic ceramic treated with the E&P was observed.

Different surface treatment strategies on etchable CAD-CAM materials: Part 1-Effect on the surface morphology

STATEMENT OF PROBLEM

Polymer-based computer-aided design and computer-aided manufacturing (CAD-CAM) materials have either a high content of ceramic filler particles or a ceramic network structure. Proper etching of these materials is challenging. Therefore, it is relevant to assess different surface etching strategies and morphological alterations as a result of these techniques.

PURPOSE

The purpose of this 2-part in vitro study was to evaluate different etching strategies on the surface roughness and its relationship to the surface contact angle with a subsequent morphological characterization of different CAD-CAM materials.

MATERIAL AND METHODS

Two CAD-CAM polymer-based materials and 1 CAD-CAM ceramic material were selected for this study. The materials were treated with different strategies, including a combination of airborne-particle abrasion and an application of 9% hydrofluoric acid etching. After the surface treatment, roughness measurements (Sa) were assessed by using an optical profilometer on an area of 1.47 mm2. Subsequently, the contact angle on the surface was examined by means of the sessile drop technique and an optical contact angle meter. The data were analyzed by using a 2-way analysis of variance, the post hoc Tukey test (α=.05), and the Pearson correlation coefficient.

RESULTS

The 3 materials tested showed an increase in surface roughness when treated with surface airborne-particle abrasion. However, the materials with polymer in their composition concomitantly increased the contact angle. More hydrophilic surfaces were observed when hydrofluoric acid was applied, regardless of the composition of the materials. The surface roughness presented a strong positive linear tendency in the surface treatments used.

CONCLUSIONS

The application of airborne-particle abrasion on the surface of the polymer-based CAD-CAM materials increased the roughness and contact angle. However, the application of acid etching after the airborne-particle abrasion decreased the contact angle for polymer-based CAD-CAM materials, resulting in considerable enhancement of the surface quality for proper bonding.

Survival assessment of fractured porcelain-fused-to-metal crowns surface roughened by sandblasted and repaired by composite resin after in vitro thermal fatigue

Background/purpose

Intraoral repair usually takes the convenience of the patient's daily life as the starting point, taking into account the bonding strength, operational feasibility, and safety. This study aimed to evaluate the survival of composite resin by simulating cavity fracture repair in porcelain-fused-to-metal (PFM) crowns and referring to the G.V. Black classification of caries as ceramic- and metal-site exposure.

Materials and methods

Mechanical sandblast experimental and a nonsandblast control groups comprised 120 samples, and interfacial locking was enhanced through acid etching, bonding, and light-curing composite resin restoration. Classes of VI buccal (B), III mesial (M), and IV mesiobuccal (MB) types, were investigated. Load tests were performed on two sets, with one set at room temperature for 24 h and the other via thermal cycling at 5 °C/50 °C 720 times. Loading was gradually applied to the samples until a maximum of 450 N was reached.

Results

Results showed that 24 h survival rates of B-, M - , and MB-repaired PFM crowns were 88%, 84%, and 88%, respectively. The repaired PFM survival rates for B, M, and MB were 52%, 44%, and 28%, respectively, after thermal cycling and loading tests. Multiple logistic regression and chi-square test (α = 0.05) showed that the regression results of factors affecting survival assessment were only significant between groups after thermal fatigue (P < 0.05). Survival rate of repairing metal-site in the MB model was significantly higher than that of ceramic-sites repairing in non-blasted samples. For the MB cavity model, sandblasting can significantly improve the survival rate of the repair of ceramic parts in the MB model (P < 0.05).

Conclusion

Our results suggest that sandblasting can be further considered, especially for MB cavity fractures when ceramic-site restorations are required.

The effect of ceramic surface conditioning on bond strength of metallic brackets: An in vitro study

OBJECTIVE

To compare the shear bond strength (SBS) of brackets bonded to three different types of ceramic surfaces (feldspathic ceramic, lithium disilicate ceramic, and zirconia), conditioned with either hydrofluoric acid or sandblasting, using Assure® Plus All bonding agent.

MATERIALS AND METHODS

A total of 72 monolithic CAD/CAM ceramic specimens were divided into six groups of 12 samples. Three groups (G1: feldspathic ceramic, G3: lithium disilicate ceramic, G5: zirconia surfaces) were conditioned with 9.6% hydrofluoric acid, while the remaining three (G2, G4, G6; with ceramic type in the same order as the previous three groups) were prepared with 50 μm aluminum oxide sandblasting. Premolar brackets were bonded using light-cured Assure® Plus All. The SBS and adhesive remnant index (ARI) were recorded and submitted to inferential analysis using one-way analysis of variance and Kruskal-Wallis tests, respectively. The significance level was set at 5% (P ≤ 0.05).

RESULTS

The mean SBS values for the three different ceramic groups conditioned with hydrofluoric acid (G1: 7.2 ± 1.5 MPa, G3: 9.3 ± 2.3 MPa, G5: 8.5 ± 2.0 MPa) were significantly higher than those obtained for the groups prepared by sandblasting before bonding (G2: 7.5 ± 1.8 MPa, G4: 4.4 ± 2.0 MPa, G6: 4.3 ± 2.8 MPa).

CONCLUSIONS

The hydrofluoric acid treatment produced a favorable SBS for all three examined ceramic types before bracket bonding with Assure® Plus All. In comparison, sandblasting yielded a satisfactory SBS only with feldspathic surfaces. Furthermore, the ARI indicated a higher frequency of mixed-adhesive failures except for lithium disilicate conditioned with sandblasting. Therefore, using hydrofluoric acid is likely to be especially recommended when the clinician is not aware of the brand of ceramic restorative material.

Risk Factors with Porcelain Laminate Veneers Experienced during Cementation: A Review

The clinical success of porcelain laminate veneers (PLVs) depends on many clinical and technical factors, from planning to execution, among which adhesive cementation is of significant importance. This procedure carries many risk factors if not optimally executed. The objective of this study was to document the clinical parameters affecting successful cementation procedures with a focus on the adhesive strength, integrity, and esthetics of the PLVs. A literature search was conducted through MEDLINE, complemented by a hand search using predefined keywords. Articles published in English between 1995 and 2023 were selected. According to this review, the success and longevity of PLVs rely in great part on the implementation of a precise cementation technique, starting from field isolation, adequate materials selection for adhesion, proper manipulation of the materials, the seating of the veneers, polymerization, and elimination of the excess cement. Several clinical steps performed before cementation, including treatment planning, preparation, impression, and adequate choice of the restorative material, could affect the quality of cementation. Scientific evidence suggests careful implementation of this process to achieve predictable outcomes with PLVs. The short- and long-term clinical success of adhesively luted PLVs is tributary to a deep understanding of the materials used and the implementation of clinical protocols. It is also contingent upon all the previous steps from case selection, treatment planning, and execution until and after the cementation.

Influence of the thickening agent contained in a phosphoric acid etchant on bonding between feldspar porcelain and resin cement with a silane coupling agent

Phosphoric acid (PA) etchants are widely used for the bonding pretreatment of teeth; however, their influences on the bonding between glass-ceramics and resin cement have not been clarified yet. This study investigated the effect of a thickening agent on the bonding strength between feldspar porcelain treated with a PA etchant and resin cement with a silane coupling agent. The experiments were performed using two PA etchants: commercial one and prepared one consisting a PA aqueous solution and poly(ethylene glycol) thickening agent. The samples were evaluated by shear bond strength testing, scanning electron microscopy, and Fourier-transform infrared spectroscopy. The obtained results revealed that the thickening agent adhered to the porcelain surface and inhibited cement bonding. Meanwhile, PA remained on the surface due to the presence of the thickening agent and activated the silane coupling agent. Overall, the PA etchant did not improve the bond durability.

Effect of phosphoric acid and sodium hydroxide on cleaning and bonding of saliva-contaminated feldspar porcelain

Purpose Hydrofluoric acid has been used to remove salivary contamination in dental glass-ceramics before bonding treatment. However, alternative methods are required because hydrofluoric acid is harmful. This study examined the cleaning effects of phosphoric acid and sodium hydroxide on glass-ceramics for bonding pre-treatment.Methods Feldspar porcelain was divided into four groups: (C) cleaned porcelain without any contamination, (S) porcelain contaminated with saliva, (SPA) porcelain cleaned with 37% phosphoric acid after saliva contamination, and (SSH) porcelain cleaned with 10% sodium hydroxide after saliva contamination. Each sample was bonded to the resin cement using a silane-containing primer. They were then subjected to a shear bond strength (SBS) test. Each surface was analyzed by scanning electron microscopy (SEM), contact angle measurements, and Fourier transform infrared spectroscopy (FT-IR).Results The SBS of group SSH was comparable to that of group C but significantly higher than that of groups S and SPA. SEM observations showed that saliva-like structures remained on the samples of groups S and SPA, but not on the SSH group. The contact angles of groups C and SSH were comparable and significantly smaller than those of groups S and SPA, respectively. FT-IR analysis also revealed saliva in groups S and SPA, which was absent in the SSH group.Conclusions The saliva remained on the porcelain even after cleaning with phosphoric acid, and SBS was not restored to the same level as before the contamination. In contrast, sodium hydroxide eliminated saliva and restored SBS to the same level as before contamination.

Ceramic Inlays: A Case Report

Aesthetic dentistry continues to evolve via advances in bonding agents, restorative materials, and conservative preparation methods. Alternatives to dental amalgam and gold include ceramic dental restorative materials. The lifespan of ceramic inlay repairs is still up for debate. When it comes to durability, colour matching, and anatomical shape stability, ceramic inlay restorations top the list of options. More predictable long-term performance may be achieved by strategically placing ceramic inlays in teeth that are not subjected to significant occlusal stress. Preparation design for ceramic inlay materials is necessary to avoid flexure. This case report discusses the ceramic inlay practice for functional and aesthetic restoration in a patient.

Resin Cement Residue Removal Techniques: In Vitro Analysis of Marginal Defects and Discoloration Intensity Using Micro-CT and Stereomicroscopy

The objective was to compare marginal defects and evaluate discoloration for adhesively cemented veneers in vitro when using two cement removal techniques. Twenty premolars were prepared with chamfer and borders in enamel. IPS e.max CAD veneers were cemented using Panavia V5 and divided in two groups (n = 10): cement excess removed with a probe after tack-curing for 3–5 s, or cement excess removed with a brush, then completely polymerized. All teeth were stored in alginate gel until micro-CT examination. Scanning was performed twice: directly after cementation and after thermocycling (5000 cycles, between 5 and 55 °C). To analyze discoloration, teeth were colored using 0.5% basic fuchsine and examined under a stereomicroscope. Depth of dye infiltration was scored 0 (no discoloration) to 5 (discoloration along the entire margin). Statistically significant differences of cement defects before thermocycling were reported, where brushing showed more defects than probing (p = 0.0161). After thermocycling, the defects increased for both groups. Extensive discoloration was the most common (55.56%) when removing excess by probing; by brushing, 90% of the specimens exhibited slight discoloration (p = 0.008). Regression analysis showed no relationship between type of defect and degree of discoloration. Removing cement with a brush causes more marginal defects, however less discoloration after thermocycling.

Effect of Hydrofluoric Acid Surface Treatments on Surface Roughness and Three-Point Flexural Strength of Suprinity Ceramic

Objectives

This study aimed to evaluate the effects of hydrofluoric acid (HF) concentration and etching time on the surface roughness (SR) and three-point flexural strength of Suprinity and to analyze the surface elements before and after etching.

Materials and Methods

To measure the SR, 70 specimens of Suprinity (2×4×5mm³) were assigned to seven groups (n=10). Six groups were etched for 20, 60, and 120 seconds with 5% and 10% HF and 7th group was the control group. Specimens were evaluated using atomic force microscopy (AFM). One specimen from each group was used to analyze the surface elements using scanning electron microscopy (SEM). For measuring the three-point flexural strength, 60 specimens were divided into six groups (n=10) and etched as previously described. The flexural strength was measured using a universal testing machine. T-test, one-way analysis of variance (ANOVA), and two-way ANOVA were used for statistical analyses (P<0.05).

Results

The 10% concentration of HF caused higher SR compared to the 5% HF. The effect of HF concentration on the flexural strength was significantly different in the 20- and 60-second etching groups. Different etching times had no significantly different effect on the SR. With 5% HF, the flexural strength was significantly higher for 20-second etching time than for the etching times of 60 and 120 seconds. With 10% HF, there was a significant difference in flexural strength between etching times of 20 and 120 seconds. The atomic percentage (at%) of silica was enhanced by increasing the etching time.

Conclusion

The best surface etching protocol comprises 10% HF used for 20 seconds.

The Effect of Mechanical and Chemical Surface Preparation Methods on the Bond Strength in Repairing the Surface of Metal-Ceramic Crowns with Composite Resin: a Systematic Review and Meta-Analysis

The aim of this study was to find the most effective surface preparation methods to enhance the bond strength between the composite resin and surface remaining from ceramic fracture. In this systematic review and meta-analysis, 39 studies were examined. The information related to the studies was extracted and categorized based on the type of the substrate material and applying or not applying thermal cycles (p<0.05). In the meta-analysis of substrate metal-ceramic samples without aging, application of air abrasion resulted in a significant increase of the bond strength to composite resin when using chemical compounds of the group without the mentioned functional monomers. Application of mechanical and chemical surface preparation methods can result in enhanced bond strength of the composite to the substrate material, which depends on the type of substrate material.

Does a Self-etching Ceramic Primer Improve Bonding to Lithium Disilicate Ceramics? Bond Strengths and FESEM Analyses

OBJECTIVE:

To compare the effect of hydrofluoric acid (HF) vs self-etching ceramic primer on resin cement microshear bond strength (μSBS) and ultramorphology of lithium disilicate (LD) ceramic.

METHODS AND MATERIALS:

LD (IPS e.max CAD, Ivoclar Vivadent) blocks (14×4×2 mm³) were polished to 1200 grit and assigned to nine groups (n=5): CON: control, no LD surface treatment; IVO: 5.0% HF (IPS Ceramic Etching Gel, Ivoclar Vivadent); VIT: 5.0% HF (Vita Ceramics Etch, VITA Zahnfabrik); FGM: 5.0% HF (Condac Porcelana, FGM); ULT: 9.0% HF (Porcelain Etch, Ultradent); PRM: 9.6% HF (Premier Porcelain Etch Gel, Premier); BIS: 9.5% HF (Porcelain Etchant, Bisco Inc); DEN: 10.0% HF (Condicionador de Porcelanas, Dentsply Brazil); and MEP: self-etching ceramic primer (Monobond Etch & Prime, Ivoclar Vivadent). For all HF groups and control, an MDP-containing silane solution (MB⁺, Monobond Plus, Ivoclar Vivadent) was applied on rinsing the HF gel and air drying. Three transparent matrices for each specimen were filled with light-cured resin cement (Variolink Veneer, Ivoclar Vivadent). After storage in water for 48 hours at 37°C, specimens were tested in shear mode to measure μSBS. Mode of failure was analyzed at 50×. Statistical analysis included one-way analysis of variance and the Duncan post hoc test (α=0.05). Thirty-six additional LD specimens were assigned to the same experimental groups (n=4) and observed under a field-emission scanning electron microscope (FESEM) at magnifications ranging from 10,000× to 100,000×.

RESULTS:

IVO resulted in statistically higher mean μSBS than all the other groups. MEP resulted in statistically lower μSBS than all HF groups. The failure mode for MEP was predominantly adhesive. The most frequent failure mode for the HF groups was mixed. CON resulted in 100% pretesting failures. For FESEM, no retentive pattern was observed for CON specimens. MEP resulted in the least pronounced etching pattern, few areas around crystals exhibited a slight increase in retention pattern compared to the control group. All HF gels created microporosities on the LD surface with distinct etching patterns. VIT and DEN resulted in an LD ultramorphology that suggested overetching.

CONCLUSIONS:

HF etching followed by a silane solution resulted in higher bond strengths than a self-etching ceramic primer. Some HF gels may cause overetching of the LD intaglio surface.

Effect of sandblasting, etching and resin bonding on the flexural strength/bonding of novel glass-ceramics

OBJECTIVES

To process novel leucite glass-ceramics and test the effects of surface treatment and resin bonding on the biaxial flexural strength (BFS) and shear bond strength (SBS).

METHODS

Alumino-silicate glasses were ball-milled, and heat treated to form leucite glass-ceramics (LG-C, OLG-C), then sintered into ingots. Ingots were heat extruded into a refractory mould to form disc specimens (1.3×14mm diameter). IPS e.max^® was used as a commercial comparison. Glass-ceramic test groups were sandblasted (Groups. 1, 4, 6), sandblasted, etched and adhesively bonded (Groups. 2, 5, 7) or lapped, etched and adhesively bonded (Groups. 3, 8). Specimens were adhesively bonded with Monobond S, followed by the application of Variolink II^® cement and light curing. BFS testing was at 1mm/min and SBS testing at 0.5mm/min. Samples were characterised using XRD, SEM and profilometry.

RESULTS

XRD confirmed tetragonal leucite in LG-C/OLG-C and lithium disilicate/lithium orthophosphate in IPS e.max^®. Mean BFS (MPa (SD)) were: Gp1 LG-C; 193.1 (13.9), Gp2 LG-C; 217.7 (23.0), Gp3 LG-C; 273.6 (26.7), Gp4 OLG-C; 255.9 (31); Gp5 OLG-C; 288.6 (37.4), Gp6 IPS e.max^®; 258.6 (20.7), Gp7 IPS e.max^®; 322.3 (23.4) and Gp8 IPS e.max^®; 416.4 (52.6). The Median SBS (MPa) were Gp1 LG-C; 14.2, Gp2 LG-C (10s etch); 10.6 and Gp3 IPS e.max^®; 10.8. Mean surface roughness was 5-5.1μm (IPS e.max^®) and 2.6μm (LG-C).

SIGNIFICANCE

Novel leucite glass-ceramics with reduced flaw size and fine microstructures produced enhanced BFS and SBS by resin bonding. These properties may be useful for the fabrication of minimally invasive aesthetic and fracture resistant restorations.

Microleakage of porcelain laminate veneers cemented with different bonding techniques

Background

Porcelain laminate veneers (PLV) are continued to be popular in modern dental practice due to its high aesthetic outcome and conservative tooth preparation. The composite resins are commonly used as luting agents for cementation of PLV. Polymerisation shrinkage induced marginal gap and interfacial leakage is the persistent limitation with the resin luting cements. The objective of the study was to assess the effect of various dentin bonding techniques on the microleakage after accelerated ageing in porcelain laminate veneres.

Material and Methods

Forty intact, premolar teeth were prepared to receive the PLV. The lithium disilicate PLV were fabricated from IPS e.max System. The intaglio surfaces were prepared with hydrofluoric acid and silane. Teeth samples were randomly divided among four groups of ten each according to the tooth surface preconditioning; it included etch-wash light cure, etch-wash dual cure, self-etch and self-adhesive techniques. The Teeth samples were subjected to the accelerated ageing with thermocycling and exposure to xenon light. The microleakage was accessed with die penetration test using 0.5% basic fuchsin. The data was statistically analysed by Kruskal-Wallis and Mann-Whitney U tests.

Results

The etch-wash dual cure resin cements recorded the lowest interfacial microleakage score of 0.90 and 0.60 at cervical tooth-composite resin and incisal enamel-composite regions respectively. The highest corresponding values of 3.00 and 1.60 was recorded with self-Adhesive resin luting cements. The microleakage at cervical tooth- composite interface was significantly higher in comparison to incisal enamel-composite interface across all the tested groups. The microleakage values at porcelain-composite interface was considerably less to the tooth- composite interface.

Conclusions

Etch-wash composite resin luting cements for PLV provided the best bonding interface, with the least interfacial microleakage. Key words:Porcelain laminate veneer, Microleakage, Tooth conditioning, Bonding techniques.

CO2 laser dentin surface treatment most effectively increased ceramic shear bond strength

BACKGROUND AND AIMS

The purpose of this study is to determine the effect of CO2 laser irradiation in comparison with sandblasting (Sb), hydrofluoric acid (Hf) and silane coupling agent (Si) on shear bond strength (SBS) of resin cement to CAD/CAM ceramics bonded to dentin.

MATERIAL AND METHODS

Forty-eight (CAD/CAM) ceramic discs were prepared and grouped by material, i.e. lithium disilicate (Emax CAD) and zirconia ceramic (Emax ZirCAD), distributed into four different groups: group A, lithium disilicate (Li) CO2/HF/Si; group B, Li: HF/Si; group C, zirconia (Zr) CO2/Sb/Si; group D, Zr: Sb/Si.

RESULTS

It was shown significant difference between irradiated and non-irradiated groups in terms of shear bond strength for zirconia ceramics (p value = 0.039).

CONCLUSION

CO2 laser irradiation increases shear bond strength for both CAD/CAM ceramics bonded to dentin.

Effect of surface preparation with Nd:YAG and Er,Cr:YSGG lasers on the repair bond strength of lithium disilicate glass ceramic to a silorane-based composite resin

Background. This study was undertaken to evaluate the repair bond strength of lithium disilicate glass ceramic to a silorane-based composite resin after surface preparation with Nd:YAG and Er,Cr:YSGG lasers. Methods. A total of 102 lithium disilicate glass ceramic samples (IPS e.max Press), measuring 5 mm in diameter and 4 mm in thickness, were randomly assigned to 6 groups (n=17): group 1, no surface preparation (control); group 2, acid etching with 9.5% hydrofluoric acid (HF); group 3, surface preparation with 4.5-W Nd:YAG laser; group 4, surface preparation with 6-W Nd:YAG laser; group 5, surface preparation with 1.5-W Er,Cr:YSGG laser; and group 6, surface preparation with 6-W Er,Cr:YSGG laser. After preparation of surfaces and application of silane, all the samples were repaired with the use of a silorane-based composite resin, followed by storage in distilled water at a temperature of 37°C for 24 hours and thermocycling. Finally, the samples were subjected to a shearing bond strength test; the fracture modes were determined under a stereomi-croscope. Results. There were significant differences between the HF group and the other groups (P=0.000). Two-by-two comparisons of the other groups revealed no significant differences (P>0.05). Conclusion. Use of HF proved the most effective surface preparation technique to increase the repair bond strength between lithium disilicate glass ceramic and silorane-based composite resin; compared to the control group.

Acid Etching as Surface Treatment Method for Luting of Glass-Ceramic Restorations, part 1: Acids, Application Protocol and Etching Effectiveness

AIM

The purpose of this review is to represent acids that can be used as surface etchant before adhesive luting of ceramic restorations, placement of orthodontic brackets or repair of chipped porcelain restorations. Chemical reactions, application protocol, and etching effect are presented as well.

STUDY SELECTION

Available scientific articles published in PubMed and Scopus literature databases, scientific reports and manufacturers' instructions and product information from internet websites, written in English, using following search terms: "acid etching, ceramic surface treatment, hydrofluoric acid, acidulated phosphate fluoride, ammonium hydrogen bifluoride", have been reviewed.

RESULTS

There are several acids with fluoride ion in their composition that can be used as ceramic surface etchants. The etching effect depends on the acid type and its concentration, etching time, as well as ceramic type. The most effective etching pattern is achieved when using hydrofluoric acid; the numerous micropores and channels of different sizes, honeycomb-like appearance, extruded crystals or scattered irregular ceramic particles, depending on the ceramic type, have been detected on the etched surfaces.

CONCLUSION

Acid etching of the bonding surface of glass - ceramic restorations is considered as the most effective treatment method that provides a reliable bond with composite cement. Selective removing of the glassy matrix of silicate ceramics results in a micromorphological three-dimensional porous surface that allows micromechanical interlocking of the luting composite.

Effect of hydrofluoric acid surface treatments on micro-shear bond strength of CAD/CAM ceramics

Introduction

Dental ceramics are appreciated as highly esthetic restorative materials that can simulate the appearance of natural dentition better than other materials. The aim of this study was to evaluate the effect of hydrofluoric acid concentration and etching time on micro-shear bond strength (μSBS) to IPS e.max CAD and Vita Mark II of a dual cured resin cement (Panavia F2.0).

Methods

This study was an experimental in vitro study, performed in the dental material research center of Babol University of Medical Sciences in 2016. Two hydrofluoric acid concentrations (5% and 10%) and three different etching times (20, 60 and 120 seconds) were used to etch the specimens respectively. A silane coupling agent (Clearfil porcelain activator) and priming and bonding agent (Clearfil SE bond) were used on the etched surfaces in accordance to the manufacturer’s instructions of use. Then resin cement was applied on the prepared ceramic surfaces and light cured. μSBS between resin cement and the porcelains were measured with a universal testing machine. Mode of failure was observed with 40× magnification by means of a Stereo microscope. Data were analyzed with ANOVA and independent-samples t-test and Chi-square tests.

Results

In both e.max and Vita Mark II groups, μSBS were not significantly different when different etching times (one-way ANOVA) and HF acid concentrations (Independent-samples t-test) were used (p>0.05), but the highest μSBS was shown in e.max specimens etched 60 s with 5% HF and Vita Mark II specimens etched 20 s with 10% HF. μSBS of e.max was significantly higher than Vita Mark II (p=0.00).

Conclusion

Best surface treatment for e.max and Vita Mark II ceramics is 20 s etch using 5 % hydrofluoric acid.

Comparison of traditional and simplified methods for repairing CAD/CAM feldspathic ceramics

PURPOSE

To evaluate the adhesion to CAD/CAM feldspathic blocks by failure analysis and shear bond strength test (SBSt) of different restorative systems and different surface treatments, for purpose of moderate chipping repair.

MATERIALS AND METHODS

A self-adhering flowable composite (Vertise Flow, Kerr) containing bi-functional phosphate monomers and a conventional flowable resin composite (Premise Flow, Kerr) applied with and without adhesive system (Optibond Solo Plus, Kerr) were combined with three different surface treatments (Hydrofluoric Acid Etching, Sandblasting, combination of both) for repairing feldspathic ceramics. Two commercial systems for ceramic repairing were tested as controls (Porcelain Repair Kit, Ultradent, and CoJet System, 3M). SBSt was performed and failure mode was evaluated using a digital microscope. A One-Way ANOVA (Tukey test for post hoc) was applied to the SBSt data and the Fisher's Exact Test was applied to the failure analysis data.

RESULTS

The use of resin systems containing bi-functional phosphate monomers combined with hydrofluoric acid etching of the ceramic surface gave the highest values in terms of bond strength and of more favorable failure modalities.

CONCLUSION

The simplified repairing method based on self-adhering flowable resin combined with the use of hydrofluoric acid etching showed high bond strength values and a favorable failure mode. Repairing of ceramic chipping with a self-adhering flowable resin associated with hydrofluoric acid etching showed high bond strength with a less time consuming and technique-sensitive procedure compared to standard procedure.

Retentive Strength of Y-TZP Crowns: Comparison of Different Silica Coating Methods on the Intaglio Surfaces

Objective:

To evaluate the effect of different methods of silica deposition on the intaglio surface of yttrium oxide stabilized zirconia polycrystal (Y-TZP) crowns on the retentive strength of the crowns.

Methods:

One hundred simplified full-crown preparations produced from fiber-reinforced polymer material were scanned, and 100 Y-TZP crowns with occlusal retentions were milled. Crown/preparation assemblies were randomly allocated into five groups (n=20) according to the treatment of the intaglio surfaces: TBS = tribochemical silica coating via air-abrasion with 30-μm silica-coated alumina particles; GHF1 = application of thin glaze layer + hydrofluoric acid (HF) etching for 1 minute; GHF5 = glaze application + HF for 5 minutes; GHF15 = glaze application + HF for 15 minutes; NANO = silica nanofilm deposition (5 nm) via magnetron sputtering. All groups received a silane application. The surfaces of the preparations (polymer) were conditioned with 10% HF for 30 seconds and silanized. The crowns were cemented with resin cement, thermocycled (12,000 cycles; 5°C/55°C), stored for 60 days, and subjected to a retentive strength test (0.5 mm/min until failure). The retention data (MPa) were analyzed using one-way analysis of variance, Tukey tests, and Weibull analysis. Failures were classified as 50C (above 50% of cement in the crown) and 50S (above 50% of cement on the substrate).

Results:

The TBS (5.6±1.7 MPa) and NANO groups (5.5±1 MPa) had higher retentive strength than the other groups (p&lt;0.0001) and had the highest values of characteristic strength. There was no difference in Weibull modulus, except for the GHF1 group (lower values). The TBS and GHF15 groups, respectively, had 60% and 70% of their failures classified as 50C, while most of the other groups had 50S failures.

Conclusion:

Tribochemical silica coating and silica nanofilm deposition on the inner surface of zirconia crowns promoted a higher retentive strength.

Does acid etching morphologically and chemically affect lithium disilicate glass ceramic surfaces?

BACKGROUND

This study evaluated the surface morphology, chemical composition and adhesiveness of lithium disilicate glass ceramic after acid etching with hydrofluoric acid or phosphoric acid.

METHODS

Lithium disilicate glass ceramic specimens polished by 600-grit silicon carbide paper were subjected to one or a combination of these surface treatments: airborne particle abrasion with 50-μm alumina (AA), etching with 5% hydrofluoric acid (HF) or 36% phosphoric acid (Phos), and application of silane coupling agent (Si). Stainless steel rods of 3.6-mm diameter and 2.0-mm height were cemented onto treated ceramic surfaces with a self-adhesive resin cement (Clearfil SA Cement). Shear bond strengths between ceramic and cement were measured after 24-hour storage in 37°C distilled water.

RESULTS

SEM images of AA revealed the formation of conventional microretentive grooves, but acid etching with HF or Phos produced a porous surface. Bond strengths of AA+HF+Si (28.1 ± 6.0 MPa), AA+Phos+Si (17.5 ± 4.1 MPa) and HF+Si (21.0 ± 3.0 MPa) were significantly greater than those of non-pretreated controls with Si (9.7 ± 3.7 MPa) and without Si (4.1 ± 2.4 MPa) (p&lt;0.05). In addition, HF etching alone (26.2 ± 7.5 MPa) had significantly higher bond strength than AA alone (11.5 ± 4.0 MPa) (p&lt;0.05). AA+HF, AA+Phos and HF showed cohesive failures.

CONCLUSIONS

Etching with HF or Phos yielded higher bond strength between lithium disilicate glass ceramic and self-adhesive resin cement without microcrack formation.

The Effect of Hydrofluoric Acid Etching Duration on the Surface Micromorphology, Roughness, and Wettability of Dental Ceramics

The current laboratory study is evaluating the effect of hydrofluoric acid etching duration on the surface characteristics of five silica-based glass ceramics. Changes in the pore pattern, crystal structure, roughness, and wettability were compared and evaluated. Seventy-five rectangularly shaped specimens were cut from each material (IPS e-max™, Dentsply Celtra™, Vita Suprinity™, Vita mark II™, and Vita Suprinity FC™); the sectioned samples were finished, polished, and ultrasonically cleaned. Specimens were randomly assigned into study groups: control (no etching) and four experimental groups (20, 40, 80 and 160 s of etching). The etched surfaces’ microstructure including crystal structure, pore pattern, pore depth, and pore width was studied under a scanning electron microscope, and the surface roughness and wettability were analyzed using a non-contact surface profilometer and a contact angle measuring device, respectively. The results were statistically analyzed using one-way analysis of variance (ANOVA) and the post hoc Tukey’s test. The results showed a significant change in the pore number, pore pattern, crystal structure, surface roughness, and wettability with increased etching duration. Etching for a short time resulted in small pores, and etching for longer times resulted in wider, irregular grooves. A significant increase in the surface roughness and wettability was observed with an increase in the etching duration. The findings also suggested a strong association between the surface roughness and wettability.

Effect of Curing Mode on Shear Bond Strength of Self-Adhesive Cement to Composite Blocks

To overcome the disadvantages of computer-aided design/computer-aided manufacturing (CAD/CAM) processed indirect restorations using glass-ceramics and other ceramics, resin nano ceramic, which has high strength and wear resistance with improved polish retention and optical properties, was introduced. The purpose of this study was to evaluate the shear bond strength and fracture pattern of indirect CAD/CAM composite blocks cemented with two self-etch adhesive cements with different curing modes. Sand-blasted CAD/CAM composite blocks were cemented using conventional resin cement, Rely X Ultimate Clicker (RXC, 3M ESPE, St. Paul, MN, USA) with Single Bond Universal (SB, 3M ESPE, St. Paul, MN, USA) for the control group or two self-adhesive resin cements: Rely X U200 (RXU, 3M ESPE, St. Paul, MN, USA) and G-CEM Cerasmart (GC, GC corporation, Tokyo, Japan). RXU and GC groups included different curing modes (light-curing (L) and auto-curing (A)). Shear bond strength (SBS) analyses were performed on all the specimens. The RXC group revealed the highest SBS and the GC A group revealed the lowest SBS. According to Tukey's post hoc test, the RXC group showed a significant difference compared to the GC A group (p < 0.05). For the curing mode, RXU A and RXU L did not show any significant difference between groups and GC A and GC L did not show any significant difference either. Most of the groups except RXC and RXU L revealed adhesive failure patterns predominantly. The RXC group showed a predominant cohesive failure pattern in their CAD/CAM composite, Lava^TM Ultimate (LU, 3M ESPE, St. Paul, MN, USA). Within the limitations of this study, no significant difference was found regarding curing modes but more mixed fracture patterns were showed when using the light-curing mode than when using the self-curing mode.

Porcelain repair - Influence of different systems and surface treatments on resin bond strength

PURPOSE

The purpose of this study was to evaluate the bond strength of composite resin on the fracture surface of metal-ceramic depending on the repair systems and surface roughening methods.

MATERIALS AND METHODS

A total of 30 disk specimens were fabricated, 15 of each were made from feldspathic porcelain and nickel-chromium base metal alloy. Each substrate was divided into three groups according to the repair method: a) application of repair system I (Intraoral Repair Kit) with diamond bur roughening (Group DP and DM), b) application of repair system I with airborne-particle abrasion (Group SP and SM), and c) application of repair system II (CoJet Intraoral Repair System, Group CP and CM). All specimens were thermocycled, and the shear bond strength was measured. The data were analyzed using the Kruskal-Wallis analysis and the Mann-Whitney test with a significance level of 0.05.

RESULTS

For the porcelain specimens, group SP showed the highest shear bond strength (25.85 ± 3.51 MPa) and group DP and CP were not significantly different. In metal specimens, group CM showed superior values of bond strength (13.81 ± 3.45 MPa) compared to groups DM or SM.

CONCLUSION

Airborne-particle abrasion and application of repair system I can be recommended in the case of a fracture localized to the porcelain. If the fracture extends to metal surface, the repair system II is worthy of consideration.

Evaluation of adhesive bonding of lithium disilicate ceramic material with duel cured resin luting agents

PURPOSE

The purpose of this vitro study was to comparatively evaluate the adhesive bonding of dual cured resin luting agents with lithium disilicate ceramic material.

MATERIALS AND METHODS

Porcelain laminate veneers were prepared with lithium disilicate ceramic material i.e. IPS Empress II( E-Max Press). These laminates were bonded with RelyX ARC, Panavia F 2.0, Variolink II, Duolink and Nexus NX3.The porcelain laminates were etched with 9.6% hydrofluoric acid (Pulpdent Corporation) for one minute, washed for 15 sec with three way syringe and dried for 15 sec with air syringe. The silane (Ultradent) was applied with the help of applicator tip in a single coat and kept undisturbed for one minute. The prepared surfaces of the premolars were treated with 37% phosphoric acid (Prime dent) for 15 sec, thoroughly rinsed and dried as per manufactures instructions. The shear bond test was carried out on all samples with the Universal testing machine (Instron U.S.A.) The scanning electron microscopic study was performed at the fractured interface of representative samples from each group of luting agents.

RESULT

In this study, the highest value of shear bond strength was obtained for NEXUS NX3 and the lowest for VARIOLINK II.

CONCLUSION

The difference in bond strength can be interpreted as the difference in fracture resistance of luting agents, to which shearing load was applied during the shear bond strength test. It is inferred from this study that the composition of the luting agent determines the adhesive characteristics in addition to surface treatment and bonding surface area.

Effect of different temporary crown materials and surface roughening methods on the shear bond strengths of orthodontic brackets

OBJECTIVE

The aim of this study was to evaluate the effect of different temporary crown materials (TCMs) and surface roughening methods on the shear bond strength (SBS) of orthodontic brackets.

BACKGROUND DATA

TCMs are widely used during orthodontic treatment in teeth in need of prosthetic treatment, to prevent damage to the final restoration. However, there is no consensus considering the best method for roughening of the surface of TCMs.

METHODS

Five different TCMs [Dentalon Plus-(D), Basworth Trim II-(B), Voco Structure Premium-(V), 3M ESPE Protempt 4-(P), and Revotek LC-(R)] were used in this study. Different surface roughening methods (37% phosphoric acid, sandblasting, and Er:YAG laser) were employed in three subgroups (n=20). The SBS test was used to assess the durability of all groups. Scanning electron microscopy (SEM) analysis was performed on a representative specimen in each group.

RESULTS

The highest mean SBS value was observed in group V, followed by groups D and P, regardless of the surface treatment. The lowest SBS values were observed in group B. The laser-irradiated groups had higher SBS values than the sandblasted and acid-etched groups. Furthermore, a significant difference in SBS values was observed between the laser-irradiated group V and all other groups (p<0.005).

CONCLUSIONS

The effects of the chemical nature of TCMs on the SBS values appeared to be clinically negligible, whereas the type of surface treatments had a significant influence on bond strengths. Er:YAG laser irradiation caused a significant increase in bond strength between the TCMs and orthodontic brackets.

Plasma in dentistry

This review describes the contemporary aspects of plasma application in dentistry. Previous studies on plasma applications were classified into two categories, surface treatment and direct applications, and were reviewed, respectively according to the approach. The current review discussed modification of dental implant surface, enhancing of adhesive qualities, enhancing of polymerization, surface coating and plasma cleaning under the topics of surface treatment. Microbicidal activities, decontamination, root canal disinfection and tooth bleaching were reviewed as direct applications with other miscellaneous ones. Non-thermal atmospheric pressure plasma was of particular focus since it is gaining considerable attention due to the possibility for its use in living tissues. Future perspectives have also been discussed briefly. Although it is still not popular among dentists, plasma has shown promises in several areas of dentistry and is now opening a new era of plasma dentistry.

Evaluation of Resin Bond Strength to Yttria-stabilized Tetragonal Zirconia and Framework Marginal Fit: Comparison of Different Surface Conditionings

The purpose of this study was to evaluate the effect of different surface treatments of yttria-stabilized tetragonal zirconia (Y-TZP) on bond strength durability and marginal discrepancies. For adhesion testing, 144 specimens of VITA In-Ceram YZ ceramic for InLab were obtained (5.25×3.75×4.5 mm) and divided into six groups (n=24) according to the surface treatment: 1) Control (CRTL): untreated; 2) SIL: tribochemical silica coating (CoJet system, 3M/ESPE AG); 3) V1+HF: spray application of low-fusing porcelain glaze (V1, VITA Akzent Spray Glaze) followed by etching with hydrofluoric acid (HF) (one minute); 4) V1+SIL: V1 glazing (VITA Akzent Spray Glaze) followed by tribochemical silica coating; 5) V2+HF: brush application of low-fusing porcelain glaze (VITA Akzent Glaze) plus etching with HF (one minute); and 6) V2+SIL: V2 glazing (VITA Akzent Glaze) plus tribochemical silica coating. After all treatments, the surfaces were silanized for five minutes (ESPE-SIL) and cementation was performed using Panavia F (Kuraray). Half of the specimens in each treatment were tested 24 hours after cementation (dry), with the other half subjected to storage (150 days) and thermocycling (12,000×) (aging), and then a shear test was carried out (1 mm/min). The micromorphological (digital optical profilometry and scanning electron microscopy) and elemental analyses of the treated surfaces were performed. The inner surfaces of 60 Y-TZP infrastructures were conditioned and marginal fit was evaluated. The statistical analysis revealed that the groups treated via surface glaze application followed by hydrofluoric acid etching and silanization showed the highest bond strength (in dry and aging conditions), but the bond strengths were affected by aging. The highest marginal discrepancies were observed in the groups receiving glaze (117.4 ± 29.6 to 105.8 ± 12.2 μm) when compared to other groups (55.3 ± 8.7 and 55 ± 8.5 μm). Low-fusing porcelain glaze + hydrofluoric acid etching changed the morphology of the Y-TZP ceramic and improved the adhesion to the resin cement, but obtaining high and stable bond values to Y-TZP remains challenging. Marginal discrepancies increased with glazing.

Influence of surface treatment on shear bond strength of orthodontic brackets

INTRODUCTION

The shear bond strength of orthodontic brackets bonded to micro-hybrid and micro-particulate resins under different surface treatment methods was assessed.

METHODS

Two hundred and eighty test samples were divided into 28 groups (n = 10), where 140 specimens were filled with Durafill micro-particulate resin and 140 with Charisma composite. In 140 samples, a coupling agent (silane) was applied. The surface treatment methods were: Phosphoric and hydrofluoric acid etching, sodium bicarbonate and aluminum oxide blasting, stone and burs. A Universal Instron Machine was used to apply an occlusal shear force directly to the resin composite bracket surface at a speed of 0.5 mm/min. The means were compared using analysis of variance and multivariate regression to assess the interaction between composites and surface treatment methods.

RESULTS

Means and standard deviations for the groups were: Sodium bicarbonate jet 11.27 ± 2.78; burs 9.26 ± 3.01; stone 7.95 ± 3.67; aluminum oxide blasting 7.04 ± 3.21; phosphoric acid 5.82 ± 1.90; hydrofluoric acid 4.54 ± 2.87, and without treatment 2.75 ± 1.49. An increase of 1.94 MPa in shear bond strength was seen in Charisma groups. Silane agent application reduced the Charisma shear bond strength by 0.68 Mpa, but increased Durafill means for bicarbonate blasting (0.83), burs (0.98) and stone drilling (0.46).

CONCLUSIONS

The sodium bicarbonate blasting, burs and stone drilling methods produced adequate shear bond strength and may be suitable for clinical use. The Charisma micro hybrid resin composite showed higher shear bond means than Durafill micro particle composite.

Fracture toughness improvements of dental ceramic through use of yttria-stabilized zirconia (YSZ) thin-film coatings

OBJECTIVES

The aim of this study was to evaluate strengthening mechanisms of yttria-stabilized zirconia (YSZ) thin film coatings as a viable method for improving fracture toughness of all-ceramic dental restorations.

METHODS

Bars (2mm×2mm×15mm, n=12) were cut from porcelain (ProCAD, Ivoclar-Vivadent) blocks and wet-polished through 1200-grit using SiC abrasive. A Vickers indenter was used to induce flaws with controlled size and geometry. Depositions were performed via radio frequency magnetron sputtering (5mT, 25°C, 30:1 Ar/O2 gas ratio) with varying powers of substrate bias. Film and flaw properties were characterized by optical microscopy, scanning electron microscopy (SEM), and X-ray diffraction (XRD). Flexural strength was determined by three-point bending. Fracture toughness values were calculated from flaw size and fracture strength.

RESULTS

Data show improvements in fracture strength of up to 57% over unmodified specimens. XRD analysis shows that films deposited with higher substrate bias displayed a high %monoclinic volume fraction (19%) compared to non-biased deposited films (87%), and resulted in increased film stresses and modified YSZ microstructures. SEM analysis shows critical flaw sizes of 67±1μm leading to fracture toughness improvements of 55% over unmodified specimens.

SIGNIFICANCE

Data support surface modification of dental ceramics with YSZ thin film coatings to improve fracture toughness. Increase in construct strength was attributed to increase in compressive film stresses and modified YSZ thin film microstructures. It is believed that this surface modification may lead to significant improvements and overall reliability of all-ceramic dental restorations.

One-bottle silane coupling agent containing 4-META

The effectiveness of commercial and experimental silane coupling agents was evaluated by measuring their shear bond strengths to a ceramic disk. Experimental one-bottle silane coupling agents were prepared using 3-MPTS, 4-META, and resin monomers. The surfaces of two ceramic disks (IPS e-max, Ivoclar Vivadent AG, Schaan, Lichtenstein) were treated by a silane coupling agent to bond them to each other; this bonding was mediated by a commercial flowable resin composite (Clearfil Majesty LV, Kuraray, Tokyo, Japan). A commercial silane coupling agent (Clearfil Porcelain Bond Activator, Kuraray, Tokyo, Japan) modified by adding 4-META exhibited a significantly higher bond strength than the unmodified commercial one-bottle silane coupling agent. Among the tested materials, two experimental one-bottle silane coupling agents composed of 5% 4-META, 45% 3-MPTS, and 50% resin monomers exhibited statistically highest bond strengths.

Shear bond strength of resin cement to an acid etched and a laser irradiated ceramic surface

PURPOSE

To evaluate the effects of hydrofluoric acid etching and Er,Cr:YSGG laser irradiation on the shear bond strength of resin cement to lithium disilicate ceramic.

MATERIALS AND METHODS

Fifty-five ceramic blocks (5 mm × 5 mm × 2 mm) were fabricated and embedded in acrylic resin. Their surfaces were finished with 1000-grit silicon carbide paper. The blocks were assigned to five groups: 1) 9.5% hydrofluoric-acid etching for 60 s; 2-4), 1.5-, 2.5-, and 6-W Er,Cr:YSGG laser applications for 60 seconds, respectively; and 5) no treatment (control). One specimen from each group was examined using scanning electron microscopy. Ceramic primer (Rely X ceramic primer) and adhesive (Adper Single Bond) were applied to the ceramic surfaces, followed by resin cement to bond the composite cylinders, and light curing. Bonded specimens were stored in distilled water at 37℃ for 24 hours. Shear bond strengths were determined by a universal testing machine at 1 mm/min crosshead speed. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests (α=0.05).

RESULTS

Adhesion was significantly stronger in Group 2 (3.88 ± 1.94 MPa) and Group 3 (3.65 ± 1.87 MPa) than in Control group (1.95 ± 1.06 MPa), in which bonding values were lowest (P<.01). No significant difference was observed between Group 4 (3.59 ± 1.19 MPa) and Control group. Shear bond strength was highest in Group 1 (8.42 ± 1.86 MPa; P<.01).

CONCLUSION

Er,Cr:YSGG laser irradiation at 1.5 and 2.5 W increased shear bond strengths between ceramic and resin cement compared with untreated ceramic surfaces. Irradiation at 6 W may not be an efficient ceramic surface treatment technique.

Considerations for ceramic inlays in posterior teeth: a review

This review of ceramic inlays in posterior teeth includes a review of the history of ceramic restorations, followed by common indications and contraindications for their use. A discussion on the potential for tooth wear is followed by a review of recommended preparation design considerations, fabrication methods, and material choices. Despite the improved materials available for fabrication of porcelain inlays, fracture remains a primary mode of inlay failure. Therefore, a brief discussion on strengthening methods for ceramics is included. The review concludes with a section on luting considerations, and offers the clinician specific recommendations for luting procedures. In conclusion, inlay success rates and longevity, as reported in the literature, are summarized.

Durability of adhesion between feldspathic ceramic and resin cements: effect of adhesive resin, polymerization mode of resin cement, and aging

PURPOSE

Adhesive cementation is an important step for restorations made of feldspathic ceramic as it increases the strength of such materials. Incorrect selection of the adhesive resin and the resin cement to adhere to the ceramic surface and their durability against aging can affect the adhesion between these materials and the clinical performance. This study evaluated the effect of adhesive resins with different pHs, resin cements with different polymerization modes, and aging on the bond strength to feldspathic ceramic.

MATERIALS AND METHODS

One surface of feldspathic ceramic blocks (VM7) (N = 90) (6.4 × 6.4 × 4.8 mm(3) ) was conditioned with 10% hydrofluoric acid for 20 seconds, washed/dried, and silanized. Three adhesive resins (Scotchbond Multi-Purpose Plus [SBMP], pH: 5.6; Single Bond [SB], pH: 3.4; and Prime&Bond NT [NT], pH: 1.7) were applied on the ceramic surfaces (n = 30 per adhesive). For each adhesive group, three resin cements with different polymerization modes were applied (n = 10 per cement): photo-polymerized (Variolink II base), dual polymerized (Variolink II base + catalyst), and chemically polymerized (C&B). The bonded ceramic blocks were stored in water (37°C) for 24 hours and sectioned to produce beam specimens (cross-sectional bonded area: 1 ± 0.1 mm(2) ). The beams of each block were randomly divided into two conditions: Dry, microtensile test immediately after cutting; TC, test was performed after thermocycling (12,000×, 5°C to 55°C) and water storage at 37°C for 150 days. Considering the three factors of the study (adhesive [3 levels], resin cement [3 levels], aging [2 levels]), 18 groups were studied. The microtensile bond strength data were analyzed using 3-way ANOVA and Tukey's post hoc test (α= 0.05).

RESULTS

Adhesive resin type (p < 0.001) and the resin cement affected the mean bond strength (p= 0.0003) (3-way ANOVA). The NT adhesive associated with the chemically polymerized resin cement in both dry (8.8 ± 6.8 MPa) and aged conditions (6.9 ± 5.9 MPa) presented statistically lower bond strength results, while the SBMP adhesive resin, regardless of the resin cement type, presented the highest results (15.4 to 18.5 and 14.3 to 18.9 MPa) in both dry and aged conditions, respectively (Tukey's test).

CONCLUSION

Application of a low-pH adhesive resin onto a hydrofluoric acid etched and silanized feldspathic ceramic surface in combination with chemically polymerized resin cement did not deliver favorable results. The use of adhesive resin with high pH could be clinically advised for the photo-, dual-, and chemically polymerized resin cements tested.

Evaluation of shear bond strength of zirconia bonded to dentin after various surface treatments of zirconia

Establishing a reliable bond of resin cement to zirconia based materials has been a major limitation against zirconia restoration.

PURPOSE OF STUDY

This study evaluated the shear bond strength of zirconia bonded to dentin specimens using a self etch dual cure resin cement after various surface treatments of zirconia. Twenty zirconia rods (3 × 2.5 mm) were prepared from zirconia blocks and assigned into 5 groups for the following surface treatments. (1) Group I: Control (C) no treatment (2) Group II: airborne-particle abrasion (APA), (3) Group III: hydrofluoric acid etching (HF), (4) Group IV: hydrofluoric acid etching followed by silanation (HF/S), and (5) Group V: application of zirconia primer (Z). Dentin Specimens were prepared from extracted molars stored in 0.5% chloramine-T. Zirconia rods were bonded to dentin using resin cement (Multilink Speed), then light polymerized. The specimens tested for failure were tested using the notched shear bond test method in a universal loading apparatus. One way ANOVA followed by Tukey HSD for cell means were used to analyze the data (=0.05). The highest values were obtained with group V (Z) (8.66 MPa) followed by group II (APA) (6.71 MPa), and group IV (HF/S) (4.41 MPa). The least values were obtained for group III (HF) (3.88 MPa) with no significant difference (P value 0.53) between group III (HF) (3.88 MPa) and group I (C) (3.70 MPa). Among the surface treatments employed in this study zirconia primer application is a practical procedure to improved bond strength of zirconia to resin cement followed by Airborne Particle Abrasion with 50 μm Al2O3 particles.

Bond strength of composite resin to glass ceramic after saliva contamination

OBJECTIVES

Purpose of this study was to investigate the effect of cleaning methods of glass ceramic specimens contaminated with saliva on tensile bond strength (TBS) to composite resin. Additionally, effect of water storage on bond strength was evaluated.

MATERIALS AND METHODS

Glass ceramic discs (IPS Empress, Ivoclar-Vivadent, FL) distributed among five groups (n = 28) were etched with hydrofluoric acid, silanized, contaminated with human saliva, and in group W rinsed with water, group WS additionally silanized, group E rinsed with water and cleaned with ethanol, and group ES additionally silanized. Group C served as a control without contamination. Plastic screws were bonded to the glass ceramic discs using Variolink II (Ivoclar-Vivadent). TBS was measured after 24 h and after 150 days of storage. Failure modes were examined. ANOVA was applied to explore group effect on TBS. Pair-wise comparisons were calculated.

RESULTS

The mean TBS [in megapascals] were for W 46 ± 14, WS 55 ± 8, E 48 ± 11, ES 52 ± 10, and C 50 ± 8 after 24 h, and W 39 ± 11, WS 53 ± 9, E 48 ± 8, ES 48 ± 11, and C 50 ± 8 after 150 days. After 150 days specimens of group W showed significantly lower TBS compared to group C (p = 0.05). Additional silanization in group WS led to a significant increase of TBS compared to specimens of group W (p = 0.003). Adhesive fractures were observed only in specimens without second application of silane.

CONCLUSIONS

The cleaning of the contaminated glass ceramic surface by rinsing only did not result in a durable bond.

CLINICAL RELEVANCE

Pre-silanized glass ceramic restorations need to be rinsed and treated with a fresh layer of silane after saliva contamination.

Possible hazardous effects of hydrofluoric acid and recommendations for treatment approach: a review

Hydrofluoric acid (HF) is commonly used for conditioning the glass ceramics either prior to cementation or for intraoral repair in prosthetic and restorative dentistry. The present study offers a review of chemical properties of HF used, highlight the possible hazardous effects of this agent, and to recommend the treatment approach for potential risks. Available published information documented in PubMed, Medline, and Picarta literature databases was reviewed. Additional information was derived from scientific reports, medical and chemical textbooks, handbooks, product information, manufacturers' instructions, Internet web sites of the HF manufacturers. No report was found on the incidence of the hazardous effects of HF in dentistry. Reports from other fields presented incidences of acute and chronic symptoms in exposure to HF. While acute symptoms include skin or nail burns, chronic ones involve systemic toxicity, eye injuries, inhalation and ingestion-related symptoms that can be even fatal. HF can be harmful and particularly aggressive to soft tissues, but symptoms may not be apparent immediately after exposure. The hazardous effects are not based on the pH value, but on the toxicity of HF. Potential hazards of HF known from other applications than dentistry should be considered also in dental applications. Especially the clinicians, who often deal with adhesive cementation or repair of glass ceramics, should take necessary precautions for possible hazards of HF.

Effect of antioxidant treatment on the shear bond strength of composite resin to bleached enamel

INTRODUCTION

This study examined the antioxidant treatment on the shear bond strength of composite resin to enamel after bleaching with two different bleaching systems.

MATERIALS AND METHODS

Seventy flat enamel surfaces were prepared from freshly extracted human molars using a low speed diamond saw. Then the specimens were divided into seven random groups (n = 10) to apply different procedures; namely, bleaching with White Smile and bonding with composite resin (G1), bleaching with White Smile, treatment with ascorbic acid and bonding with composite resin (G2), bleaching with White Smile, immersing in artificial saliva for 2 weeks and bonding with composite resin (G3), bleaching with Opalesence and bonding with composite resin (G4), bleaching with Opalesence, treatment with ascorbic acid and bonding with composite resin (G5) and bleaching with Opalesence, immersing in artificial saliva for 2 weeks and bonding with composite resin (G6). Another group was used as a control group. Shear bond test was performed on all specimens and data were analyzed using one way ANOVA and Bonferroni's test (p < 0.05).

RESULTS

Bond strengths of bleached specimens were significantly lower than those of non-bleached specimens. No statistical difference was found in bond strength between the bleached and non-bleached groups when the antioxidant treatment was carried out.

CONCLUSION

Ten per cent ascorbic acid treatment was found to be an effective method to reverse the compromised bond strength.

Surface characterization of Ti and Y-TZP following non-thermal plasma exposure

Novel non-thermal plasma (NTP) technology has the potential to address the bonding issues of Y-TZP and Ti surfaces. This study aims to chemically characterize and evaluate the surface energy (SE) of Y-TZP and Ti surfaces after NTP application. Y-TZP and Ti discs were treated with a hand-held NTP device followed by SE evaluation. Spectra of Y-TZP 3d and Ti 2p regions, survey scans, and quantification of the elements were performed via X-ray photoelectron Spectroscopy (XPS) prior and after NTP. Separate Y-TZP and Ti discs were NTP treated for contact angle readings using (10-methacryloyloxydecyl dihydrogenphosphate) MDP primer. Significant augmentation of SE values was observed in all NTP treated groups. XPS detected a large increase in the O element fraction on both Y-TZP and Ti surfaces. Reduction of contact angle reading was obtained when the MDP primer was placed on NTP treated Y-TZP. Ti surface showed high SE before and after NTP application on Ti surfaces. NTP decreased C and increased O on both surfaces independently of application protocol. Wettability of MDP primer on Y-TZP was significantly increased after NTP. The high polarity obtained on Y-TZP and Ti surfaces after NTP applications appear promising to enhance bonds.

Effect of etchant variability on shear bond strength of all ceramic restorations - an in vitro study

The present study was carried out to evaluate the effect of pre-luting surface treatments by 3 different etchant used at 3 different etching periods and their effect on shear bond strength of IPS Empress 2 luted to tooth by dual cure resin cement. Fifty samples of ceramic were divided into four groups as group I control group: No surface treatment, group II: Etched with Hydrofluoric (HF) acid (4.9%), group III: Etched with Ammonium bifluoride acid (9.4%) and group IV: Etched with Phosphoric acid (37%). Group II, III and IV were further divided into 3 Subgroups; namely A, B and C according to the etching periods (20, 60 and 120 s) respectively. The shear bond strength was determined by using a Universal testing Machine. The morphological changes of the surface treated ceramic samples prior to luting to tooth and mode of the fracture failure after shear bond test were observed by using a Scanning Electron Microscope. The mean shear bond strength was highest when IPS Empress 2 ceramic samples were surface treated using 4.9% Hydrofluoric acid gel and 9.4% Ammonium bifluoride acid for 120 s. The least mean shear bond strength was noticed in case of control group, where no surface treatment was done and samples treated by 37% Phosphoric acid. Thus it could be concluded, that Ammonium bifluoride could be an appropriate alternative to be used instead of HF acid. 120 s etching showed highest bond strength values for HF acid (4.9%) and Ammonium bifluoride (9.4%).