Pre-heated dual-cured resin cements: analysis of the degree of conversion and ultimate tensile strength

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.

Effects of sterilization, conditioning, and thermal aging on the retention of zirconia hybrid abutments: A laboratory study

OBJECTIVE

To investigate the effects of sterilization, conditioning method, and thermal aging on the retentive strength of two-piece zirconia abutments.

MATERIALS AND METHODS

In total, 128 stock zirconia abutments were divided into four groups (n = 32) according to the conditioning parameters: (A) air-abrasion using 50 μm alumina particles/1.0 bar, (B) 50 μm/2.0 bar, (C) 100 μm/1.0 bar, and (D) 100 μm/2.0 bar. All abutments were bonded onto titanium bases using DTK adhesive resin and stored in water bath (37°C) for 72 h. Each group was subdivided into two subgroups (n = 16), group 1 was disinfected, whereas group 2 followed disinfection and autoclave sterilization. Half of the specimens of each subgroup (n = 8) was directly subjected to the axial retention test (groups N), while the other half was first subjected to 150 days of thermocycling followed by retention test (groups T). Statistical analysis was performed with three-way ANOVA, additional statistical analysis was performed by using separate one-way ANOVAs followed by the Tukey's post-hoc test for post hoc pairwise comparisons among groups.

RESULTS

The highest median retention strength was recorded for group B2N (1390 N), whereas the lowest strength was recorded for group C1T (688 N). No significant interaction (p ≥ 0.05) was detected between the different variables; conditioning method, sterilization, and the thermal cycling regarding the effect on the resulting retention. However, the sterilization always showed a positive effect. Thermocycling presented an adversely significant effect only in the absence of sterilization (p < 0.05), with the exception of subgroups A. For the sterilized groups, thermocycling had no statistically significant effect on the retention.

CONCLUSION

Steam autoclaving increased the retention of hybrid zirconia abutments. DTK adhesive resin for two-piece zirconia abutments performed well after sterilization and thermocycling.

Effect of Storage Temperature on Selected Strength Parameters of Dual-Cured Composite Cements

Direct restorations are currently the most popular restorations used in dental prosthodontics. Due to the increased requirements for materials used in the fabrication of fixed restorations, there is a need for evaluation of strength parameters of these materials, including dental cements. The present study investigated the change in selected strength parameters of four dual-cured composite cements as a function of storage temperature. The following were investigated: three-point flexural strength (FS), flexural modulus in bending (FM), diametral tensile strength (DTS) and Vickers hardness (HV). Four dual-cured composite cements were tested, i.e., Multilink Automix (Ivoclar Vivadent), seT PP (SDI), MaxCem (Kerr), and Bifix Hybrid Abutment (VOCO). Each of the tested cements was stored for 7 days at one of the selected temperatures: 8 °C, 15 °C, 25 °C, or 35 °C, before the samples were made. Strength properties (DTS, FS) are not strongly dependent on the storage temperature in the range of 8-35 °C. Some statistical differences were observed between the hardness of MaxCem and Multilink Automix storage in various temperatures. FS and FM were lowest for Bifix Hybrid Abutment, MaxCem and Multilink Automix storage at 25 °C, and highest for Bifix Hybrid Abutment, MaxCem, and seT PP stored in 35 °C. The cement with the highest filler content (70% by weight) showed the highest FS and HV.

Operator versus material influence on film thickness using adhesive resin cement or pre‐heated resin composite

OBJECTIVE

There is a growing interest in using pre-heated composites instead of dual-cured cements when luting indirect restorations. This study evaluated the film thickness obtained from two pre-heated composites and two resin cements, by two different operators. The influence of the materials and the level of expertise of the operator were analyzed.

MATERIALS AND METHODS

Forty specimens of human dentin and composite discs were prepared and divided into four groups depending on the luting process. Each group was randomly equally divided to be handled by two operators with different levels of experience. Two of the initial four groups were luted using dual-cured cements and the two remaining groups using light-cured pre-heated composites. Specimen discs were cut after luting, and film thickness was measured using a Digital microscope. Data were analyzed using a 2-way ANOVA with the Holm-Sidak pairwise multiple comparison procedure (p < 0.05).

RESULTS

Mean film thickness ranged from 156.16 ± 4.7 to 33.82 ± 0.7 μm. Significant differences (p < 0.001) were noticed between expert and novice results with pre-heated composites.

CONCLUSION

Within the limits of this study, using pre-heated composites as a luting cement requires a better level of expertise to achieve a clinically acceptable film thickness.

CLINICAL SIGNIFICANCE

Using pre-heated composites as luting agent for indirect restorations requires an experimented skill level to achieve a clinically recommended film thickness.

Retention of zirconia crowns to Ti-base abutments: effect of luting protocol, abutment treatment and autoclave sterilization

PURPOSE

To evaluate the influence of resin cement type, surface pretreatment and autoclave sterilization on the retention of Y-TZP crowns to Ti-base abutments.

METHODS

Y-TZP crowns were designed and milled to fit Ti-base abutments. Crowns were cemented using either a conventional resin cement (conventional) with a universal adhesive or a self-adhesive resin cement (self-adhesive), both following no surface pretreatment (No) or Ti-base abutment sandblasting (SB) (n=20/group). Half of the cemented samples were subjected to in-office autoclave sterilization. Pullout testing was performed in a universal testing machine at a speed of 1 mm/min until crown displacement. Data were statistically evaluated through a linear mixed model following post hoc comparisons by LSD test.

RESULTS

Pullout data as a function of cement type demonstrated higher retention for conventional relative to self-adhesive cement (p < 0.001). Ti-base sandblasting (SB) favored crown retentiveness over No pretreatment (p < 0.001). Sterilized crowns exhibited higher pullout values than non-sterile (p=0.036). All the two- and three-factor interaction analyses corroborated with the superior adhesive strength of conventional compared to self-adhesive cement (all, p < 0.011), as well as, SB relative to No pretreatment (all, p < 0.024). While autoclave sterilization maximized bond strength when self-adhesive cement (data collapsed over surface pretreatment, p < 0.050) and No pretreatment were evaluated (data collapsed over surface pretreatment, p < 0.013), no significant difference was observed for conventional resin cement (p=0.280) and SB (p=0.878) groups.

CONCLUSIONS

Conventional resin cement and/or Ti-base sandblasting increased Y-TZP crown retentiveness, with no significant influence of autoclave sterilization. Autoclaving increased retentiveness when self-adhesive cement and/or no Ti-base pretreatment were used.

Influence of pre-heating and ceramic thickness on physical properties of luting agents

PURPOSE

The objective of this in vitro study was to evaluate the influence of ceramic thickness and pre-heating of luting agents on their physical properties.

MATERIALS AND METHODS

The materials RelyX Arc, RelyX Ultimate, RelyX Veneer, and Filtek Z350 Flow were handled at different temperatures (23°C or 54°C), inserted into matrix, and photoactivated through ceramic disks (0.75 mm or 1.5 mm). The following tests were performed ( n=8): degree of conversion, Knoop Hardness, cross-link density, water sorption, solubility, and ultimate tensile strength. Data were analyzed using three-way analysis of variance and Tukey's test (α=0.05).

RESULTS

Regarding ceramic thickness, the thinnest ceramic resulted in higher values of Knoop Hardness ( p=0.027). The lowest temperature (23°C) resulted in a higher solubility ( p=0.0257), and water sorption ( p=0.0229) values. There was also statistical difference among the materials: RelyX Arc showed a higher degree of conversion and ultimate tensile strength, followed by RelyX Veneer, RelyX Ultimate, and Filtek Z350 Flow. For Knoop Hardness and cross-link density tests, RelyX Ultimate showed the highest values, followed by RelyX Arc, RelyX Veneer, and Filtek Z350 Flow. For water sorption and solubility, RelyX Veneer showed the highest values, followed by RelyX Arc, RelyX Ultimate, and Filtek Z350 Flow.

CONCLUSION

Pre-heating interfered with water sorption and solubility, whereas ceramic thickness only affected Knoop Hardness; the physical properties of the materials are dependent on their composition.

Correlation between clinical performance and degree of conversion of resin cements: a literature review

Resin-based cements have been frequently employed in clinical practice to lute indirect restorations. However, there are numerous factors that may compromise the clinical performance of those cements. The aim of this literature review is to present and discuss some of the clinical factors that may affect the performance of current resin-based luting systems. Resin cements may have three different curing mechanisms: chemical curing, photo curing or a combination of both. Chemically cured systems are recommended to be used under opaque or thick restorations, due to the reduced access of the light. Photo-cured cements are mainly indicated for translucent veneers, due to the possibility of light transmission through the restoration. Dual-cured are more versatile systems and, theoretically, can be used in either situation, since the presence of both curing mechanisms might guarantee a high degree of conversion (DC) under every condition. However, it has been demonstrated that clinical procedures and characteristics of the materials may have many different implications in the DC of currently available resin cements, affecting their mechanical properties, bond strength to the substrate and the esthetic results of the restoration. Factors such as curing mechanism, choice of adhesive system, indirect restorative material and light-curing device may affect the degree of conversion of the cement and, therefore, have an effect on the clinical performance of resin-based cements. Specific measures are to be taken to ensure a higher DC of the luting system to be used.

Effect of Simulated Tooth Temperature on the Degree of Conversion of Self-adhesive Resin Cements Exposed to Different Curing Conditions

Objectives

This study evaluated the degree of conversion (DC) of two commercial, self-adhesive resin cements (SARCs) using Fourier transform infrared analysis (FTIR) polymerized at simulated prepared tooth surface temperatures and under different curing conditions.

Materials and Methods

RelyX U100 (U100, 3M ESPE) and Maxcem Elite (MX, Kerr Corporation) were mixed at 25°C and applied to the surface of a horizontal attenuated total reflectance (ATR) unit, which was near room temperature (RT, control) (25°C) or heated to simulate prepared tooth surface temperatures (28°C and 32°C) and then attached to an infrared spectrometer. The products were polymerized using one of three conditions: direct light exposure through a glass slide (DLE), exposure through a 1.5-mm thick ceramic disc overlay (CO) (A2 shade, IPS e.max, Ivoclar Vivadent), or self-curing (SC). FTIR spectra were recorded for 12 minutes (1 spectrum/s, 16 scans/spectrum, resolution 4 cm−1) immediately after application to the ATR. The DC was calculated using standard techniques of observing changes in aliphatic-to-aromatic peak ratios before and 12 minutes after curing, as well as during each 1-second interval. DC data (n=7) were analyzed by two-way analysis of variance and Tukey's post-hoc test (p=0.05).

Results

Both simulated tooth temperatures significantly increased DC in all groups of MX and in the CO and SC groups of U100 compared with the RT control. For MX, the self-cure groups exposed to tooth temperatures showed DC values similar to those of the CO groups. For U100, the CO groups showed higher DC values than SC groups regardless of temperature. Time-based conversion profiles ranged according to product, temperature, and curing mode.

Conclusions

Causing SARCs to polymerize at simulated tooth temperatures increases DC of SARCs compared with room-temperature curing values, mainly in the SC mode.

The role of spacer carbon chain in acidic functional monomers on the physicochemical properties of self-etch dental adhesives

OBJECTIVES

To evaluate the effects of acidic functional monomers with different hydrophilicity and spacer carbon chain length on the degree of conversion (DC), wettability (contact angle), water sorption (WS) and ultimate tensile strength (UTS) of experimental one-step self-etch adhesives (1-SEAs).

METHODS

A series of standard resin blends was prepared with each formulation containing 15mol% of each acidic monomer. The structural variations of the acidic monomers were MEP (spacer chain with 2 carbons), MDP (10-carbons), MDDP (12-carbons), MTEP (more hydrophilic polyether spacer) and CAP-P (intermediate hydrophilicity ester spacer). Dumbbell-shaped and disc specimens were prepared and tested for UTS and WS, respectively. DC was assessed by FTIR, while the wettability of each 1-SEA was evaluated on glass slides and flat dentine surfaces. Results were analysed with one-way ANOVA and Tukey's test (p<0.05).

RESULTS

The outcomes showed lower UTS for CAP-P, control blend and MEP than MTEP, MDDP and MDP (p<0.05). The degree of conversion was statistically similar for all resins (p=0.122). On dentine, the wettability was higher (lower contact angle) with the most hydrophilic monomer MTEP. Higher WS was attained using MTEP. Different lengths of the spacer chains did not result in different wettability and WS (p>0.05).

CONCLUSION

At similar molar percentage, different acidic functional monomers induced similar degree of conversion and different UTS when included in a 1-SEA. However, the inclusion of highly hydrophilic monomer may increase the wettability on dentine and the WS.

Influence of the interposition of ceramic spacers on the degree of conversion and the hardness of resin cements

This study evaluated: I) the effect of photo-activation through ceramics on the degree of conversion (DC) and on the Knoop hardness (KHN) of light- and dual-cured resin cements; and II) two different protocols for obtaining the spectra of uncured materials, to determine the DC of a dual-cured resin cement. Thin films of cements were photo-activated through ceramics [feldspathic porcelain (FP); lithium disilicate glass-ceramics of low translucency (e.max-LT), medium opacity (e.max-MO) and high translucency (e.max-HT); glass-infiltrated alumina composite (IC) and polycrystalline zirconia (ZR)] with thicknesses of 1.5 and 2.0 mm. DC was analyzed by Fourier transform infrared (FTIR) spectroscopy. Two protocols were used to obtain the spectra of the uncured materials: I) base and catalyst pastes were mixed, and II) thin films of base and catalyst pastes were obtained separately, and an average was obtained. KHN assessment was performed with cylindrical specimens. The results were analyzed by ANOVA and Tukey's test (α= 0.05). The light-cured cement showed higher DC (61.9%) than the dual-cured cement (55.7%). The DC varied as follows: FP (65.4%), e.max-HT (65.1%), e.max-LT (61.8%), e.max-MO (60.9%), ZR (54.8%), and IC (44.9%). The light-cured cement showed lower KHN (22.0) than the dual-cured (25.6) cement. The cements cured under 1.5 mm spacers showed higher KHN (26.2) than when polymerized under 2.0 mm ceramics (21.3). Regarding the two protocols, there were significant differences only in three groups. Thus, both methods can be considered appropriate. The physical and mechanical properties of resin cements may be affected by the thickness and microstructure of the ceramic material interposed during photo-activation.