The effect of ceramic restoration shade and thickness on the polymerization of light- and dual-cure resin cements

The Influence of Thickness on Light Transmission for Pre- and Fully Crystallized Chairside CAD/CAM Lithium Disilicate Ceramics

AIM

This in vitro study aimed to compare the light-transmission properties of two chairside CAD/CAM lithium disilicate (LD) ceramics (a novel fully crystallized and a traditional pre-crystallized) across varying thicknesses.

MATERIALS AND METHODS

One hundred flat specimens were obtained from precrystallized (e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein) and fully crystallized (LiSi GC Block; GC, Tokyo, Japan) LD at five different thicknesses (0.5, 0.75, 1.0, 1.50 and 2.0 mm). All specimens were polished with a polishing system for lithium disilicate restorations following recommendations from the manufacturer. Light transmission was evaluated with a radiometer. The statistical analysis between e.max CAD and LiSi GC Block was performed using a Mann-Whitney test for each thickness at a significance level of 0.05 (p < 0.05), followed by a Kruskal-Wallis test to compare the light transmission between the thicknesses of e.max CAD and LiSi GC Block.

RESULTS

Light transmittance was significantly affected by ceramic thickness. The 0.5 mm thick specimens exhibited the highest transmittance values compared to all other groups, while a light transmittance of 0.00 was observed in the 2.0 mm thick specimens for both e.max CAD and LiSi GC Block. In the comparison between e.max CAD and LiSi GC Block according to thickness, there was a statistically significant difference exclusively between groups with a thickness of 1.50 mm (p = 0.002).

CONCLUSIONS

Light transmission for pre- and fully crystallized CAD/CAM lithium disilicate ceramics only showed a statistical difference at the thickness of 1.50 mm (p = 0.002). E.max CAD demonstrated acceptable light transmission up to a thickness of 1.5 mm.

CLINICAL SIGNIFICANCE

A thickness of 2 mm for chairside CAD/CAM lithium disilicate ceramics, whether pre-crystallized or fully crystallized, necessitates the use of dual-cure resin luting cement due to reduced light transmission.

Effect of the violet light from polywave light-polymerizing units on two resin cements that use different photoinitiators

STATEMENT OF PROBLEM

Some light-emitting diode polymerization lights have been promoted as multiple peak or polywave lights that use multiple light-emitting diodes to produce both violet and blue light. However, whether the addition of violet light is required to light-activate resin cements that use bis(4-methoxybenzoyl)diethylgermane (Ivocerin) as the photoinitiator is unclear.

PURPOSE

This in vitro study evaluated the effect of violet, blue, or a combination of violet and blue light through ceramic on the degree of conversion of 2 resin cements that use either camphorquinone or Ivocerin as the photoinitiator.

MATERIAL AND METHODS

A Bluephase Style polywave light-emitting diode polymerizing unit delivering 6.4 J/cm2 of violet and blue light was used. This comprised 1.4 J/cm2 of violet (385 to 420 nm) and 5.0 J/cm2 of blue light (420 to 515 nm). The light-emitting diode emitters in a second modified Bluephase Style were connected directly to a power supply so that either just violet (1.4 J/cm2) or just blue (5.0 J/cm2) light was emitted. RelyX Veneer and Variolink Esthetic LC resin cements were either directly light-activated or through 0.5 or 1.5 mm of lithium disilicate ceramic (IPS e.max CAD). The degree of conversion was monitored by using Fourier-transform infrared spectroscopy. Data were subject to a 3-way analysis of variance followed by the Tukey honest significant difference multiple comparison tests (α=.05).

RESULTS

All factors had a significant effect (P<.001). Increasing the ceramic thickness decreased the degree of conversion only for RelyX Veneer cement (P<.001). The effect of the thickness of ceramic was most noticeable when just violet light was delivered to RelyX Veneer. A significant reduction (P<.001) was found in the degree of conversion of RelyX Veneer when just violet light was delivered. Variolink Esthetic LC had significantly higher degree of conversion values than RelyX Veneer, irrespective of the light type used (P<.001).

CONCLUSIONS

A multiple-peak light is not required to photopolymerize a resin cement that uses either camphorquinone or Ivocerin as its photoinitiator. Adding the violet light produced no significant increase in the degree of conversion of the Variolink Esthetic LC cement.

Influence of different curing modes on the bonding effectiveness of self-adhesive resin luting cements in combination with universal adhesives

OBJECTIVES

This study aimed to investigate the immediate dentin bond performance and bond durability of self-adhesive resin luting cements (RLCs) in combination with universal adhesives in different curing modes.

METHODS

Two self-adhesive RLCs were used with universal adhesives as primers. They were also used alone as self-adhesive RLCs. Two multiple-step RLC systems were used as comparison materials. To measure the shear bond strength (SBS) in different curing modes, 12 specimens were prepared for each group. Stainless-steel rods were bonded to bovine dentin, and the bonded specimens were assigned to the baseline group (stored for 24 h) and artificially aged group (thermal cycling [TC], 10,000 cycles). After each storage period, the SBS of the bonded specimens was measured. The Knoop hardness number (KHN) of the cured RLCs was measured with or without primer application in different curing modes at 24 h and after 10,000 TC. The representative RLC/dentin interfaces were observed using scanning electron microscopy (SEM).

RESULTS

Dentin SBS was significantly influenced by the RLC system but not by the curing mode. Self-adhesive RLCs alone showed significantly lower SBS values than self-adhesive RLCs with primer regardless of the curing mode or storage period. The storage period, curing mode, and RLC system significantly influenced the KHN.

SIGNIFICANCE

The use of universal adhesives as a primer may help enhance the immediate dentin bond performance and bond durability of self-adhesive RLCs.

Effect of partially stabilized zirconia thickness on the translucency and microhardness of resin cement

STATEMENT OF PROBLEM

Partially stabilized zirconia has been introduced as a more translucent iteration. However, knowledge of the effect of the thickness of partially stabilized zirconia on the microhardness of resin cement is sparse.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of thickness and material type on the translucency of partially stabilized zirconia and the microhardness of the resin cement polymerized beneath.

MATERIAL AND METHODS

Specimens were prepared from 2 translucent zirconias with different yttrium content (Ceramil Zolid HT+ [HT] and Ceramil Zolid FX [SHT]) and a lithium disilicate glass-ceramic (e.max CAD [EX]) of different thicknesses (0.5, 1, 1.5, and 2 mm) (n=10). Color coordinates were recorded by using a spectrophotometer, and the relative translucency parameter (RTP) was calculated by using the CIEDE2000 formula. The microhardness of the resin cement polymerized under ceramic specimens was measured. Two-way analysis of variance, the Tukey honestly significant difference, and independent samples t tests were used to analyze the data (α=.05).

RESULTS

Material type (P<.001), thickness (P<.001), and their interaction significantly affected the RTP (P=.001) and hardness values (P<.001). Regardless of the thickness, EX had the highest RTP (P≤.027), and the resin cements polymerized under EX showed the highest microhardness (P≤.002). However, the difference between HT and SHT for RTP (P≥.082) and resin cement hardness (P≥.984) was not significant. Specimens of 0.5 mm resulted in higher RTP (P≤.001) and resin cement hardness (P≤.006) than the 1.5- and 2-mm specimens of each ceramic.

CONCLUSIONS

Increasing material thickness reduced the translucency of the partially stabilized zirconia and the hardness of the resin cements polymerized beneath.

Double bond conversion of preheated composite resin beneath lithium disilicate standardized occlusal veneers

The purpose of the study was the investigation of the polymerization of a preheated composite resin beneath lithium disilicate. First, lithium disilicate discs in two shades (HT A2 and HT A4) and three different thicknesses (2, 4, and 6 mm) were bonded on dentine with preheated composite resin that was photo-polymerized for 20 s. The composite resin microhardness, the double bond conversion (DC) and their correlation were estimated. Second, standardized occlusal veneers of two shades and two different thicknesses (4 and 6 mm) were bonded with preheated composite resin and photopolymerized for 60 or 270 s. A microhardness line profiling was performed on the cross-section of each specimen and the correspondence DC was calculated. Shade and thickness of lithium disilicate were found to have a significant impact on micro-hardness and DC of the composite resin. Beneath standardized occlusal veneers DC can reach clinically acceptable level if photopolymerization duration is extended properly.

Influence of thickness and degree of opacity of lithium disilicate on the degree of conversion and bond strength of resin cements

The aim of this study was to evaluate the influence of various opacities and thicknesses of lithium disilicate on the degree of conversion (DC) of two resin cements and on their bond strength (BS) to the ceramic. Two hundred and forty ceramic samples of lithium disilicate with high translucency (HT), low translucency (LT), and medium opacity (MO) were obtained from IPS e. max CAD in five different thicknesses. Light-cured and dual-cured resin cements were used for DC (n = 9) and BS (n = 8). Cement samples were light-cured under ceramic samples and analyzed using a Raman confocal spectrometer to determine the DC. For BS, resin cement cylinders were fabricated using ceramic samples which were thsen subjected to a microshear bond strength test. The mean values were provided for statistical analysis. The increase in thickness resulted in a decrease in DC for both cements under all experimental conditions, but only affected the BS of the light-cured cement for the MO ceramic. Comparing the opacities, the most translucent ceramics with particular thicknesses exhibited higher DC values than the less translucent ceramics. The LT and MO ceramics with certain thicknesses exhibited the highest BS values than the HT. The dual-cured cement generally showed highest values in both analyses than the light-cured cement. A thicker and more opaque ceramic material can reduce the DC of the cement. The BS decreases with the increasing thickness of the more-opaque ceramics.

Effect of thickness of CAD/CAM materials on light transmission and resin cement polymerization using a blue light-emitting diode light-curing unit

OBJECTIVE

Evaluate the effect of thickness of high-translucency (HT) CAD/CAM materials on irradiance and beam profile from a blue light-emitting diode light-curing unit (LCU) and on the degree of conversion (DC) and maximum polymerization rate (Rp_max ) of a light-cured resin cement (LCC).

MATERIAL AND METHODS

The direct output from the LCU, the light transmission and irradiance ratio (IR) through one conventional composite and nine HT CAD/CAM materials (0.5, 1.0, 1.5, or 2.0-mm thick; n = 5) were measured with a integrating sphere coupled to a spectrometer. The light beam was assessed with a beam profiler camera. The DC at 600 s and the Rp_max of one LCC was determined using a Fourier transform infrared spectrometer (n = 5). Data were analyzed by ANOVA followed by Tukey's tests, and Dunnett's test was also used for irradiance data (α = 0.05).

RESULTS

A significant decrease in irradiance through all materials occurred as thickness increased. Thin CAD/CAM materials improved light homogeneity, which decreased with the increase in thickness. The DC of the LCC directly exposed to light was the same as when exposed to 45%, 25%, 15%, or 5% IRs. Rp_max decreased with the decrease in IR.

CONCLUSIONS

Although the HT CAD/CAM materials reduced the irradiance from the LCU, minor effects were observed in the LCC's DC.

CLINICAL SIGNIFICANCE

Despite the light attenuation of blue light through different CAD/CAM materials that were up to 2-mm thick, the degree of conversion of one brand of light-cured resin cement was clinically acceptable when the LCU was used for 30 s.

Effect of thickness on the translucency of resin-based composites and glass-ceramics

This study was aimed to evaluate the effect of thickness (1, 2, 3, and 4 mm) on the translucency of resin-based composites (RBCs) and glass-ceramics, and compare the influence of the thickness of those materials on the translucency parameter (TP) value. The materials were divided into two groups, eight RBCs in Group 1 and five glass-ceramics in Group 2 and TP, ΔL*, Δa*, and Δb* were compared. Statistically significant differences were present in the 2, 3, and 4 mm in the TP, in the 2 and 4 mm in ΔL*, and in all thicknesses in Δa* and Δb* betweent the two groups. The TP of RBCs and glass-ceramics decreased as thickness increased, especially from 1 mm to 2 mm. The TP values of the RBCs were more significantly decreased as the thickness of the material increased from 2 mm to 4 mm than those of the glass-ceramics.

Effect of the thickness of CAD-CAM materials on the shear bond strength of light-polymerized resin cement

This study aimed to investigate the effect of the thickness of computer aided design-computer aided manufacturing (CAD-CAM) restorative materials on the bond strength of light-polymerized resin cement. Ninety specimens were prepared from three different CAD-CAM materials (a leucite-based glass-ceramic [Empress CAD], a polymer-infiltrated ceramic network [Vita Enamic], and a zirconia-reinforced lithium silicate glass-ceramic [Vita Suprinity]) in different thicknesses (1, 2, and 3 mm). One surface of each specimen was treated by using a single-step self-etching ceramic primer (Monobond Etch & Prime). Light-polymerized resin cement was bonded to treated surfaces by exposure to a light-emitting diode curing unit from the untreated side of the samples. Shear bond strength (SBS) between the ceramic and the resin cement was measured by using a universal testing machine. The leucite-based glass-ceramic had higher SBS values than the other materials at each thickness. For each material, 1 mm-thick specimens had the highest SBS values. The difference between the SBS values of 2 mm- and 3 mm-thick polymer-infiltrated ceramic network was nonsignificant, whereas the SBS values of 2 mm-thick leucite-based glass-ceramic and the zirconia-reinforced lithium silicate glass-ceramic were significantly higher than those of the corresponding 3 mm-thick specimens. The choice of the material and its thickness may be highly important for clinical success when light-polymerized resin cements are used for cementation.

Intrapulpal temperature changes during the cementation of ceramic veneers

Adhesive cementation of ceramic veneers may increase pulpal temperature (PT) due to the combined effect of heat generated by the curing unit and the exothermic reaction of the luting agent (LA). PT increase may induce pulpal damage. The aim was to determine the PT rise during the luting of ceramic veneers (CV) of different thicknesses with light- or dual-curing (LC, DC) adhesive cements as well as pre-heated restorative resin-based composites (PH-RBC). For this a thermocouple sensor was positioned in the pulp chamber of a prepared maxillary central incisor. LC, DC adhesive cements and PH-RBCs heated to 55 °C were used for the luting of CVs of 0.3, 0.5, 0.7, and 1.0 mm thicknesses. The exothermic reaction of LAs added significantly to the thermal effect of the curing unit. PT change ranged between 8.12 and 14.4 °C with the investigated combinations of LAs and ceramic thicknesses (p ≤ 0.01). The increase was inversely proportional to the increasing CV thicknesses. The highest rise (p ≤ 0.01) was seen with the polymerization of PH-RBCs. Temperature changes were predominantly influenced by the composition of the LA, which was followed by CV thickness.

Effect of Optical Properties of Lithium Disilicate Glass Ceramics and Light-Curing Protocols on the Curing Performance of Resin Cement

This study aimed to investigate the effects of optical properties of lithium disilicate glass ceramics and the light-curing protocols (LCP) on the curing performance of light-cured resin cement. Lithium disilicate glass-ceramics with different optical properties were sectioned to produce ceramic specimens of 0.8 mm thickness. Irradiance through the ceramic specimens was measured by a radiometer. Light transmittance of ceramics was assessed using a UV/Vis spectrophotometer. The light-cured resin cement was injected into a Teflon mold and ceramics with different optical properties were placed on it, cured under different LCPs, and the degree of conversion (DC) and Vickers microhardness of the resin cement were separately measured by Micro-ATR/FTIR spectrometry and the microhardness tester. The shade (p < 0.001) and transparency (p < 0.001) of ceramics affect the irradiance of the light-curing unit. The transparency (p < 0.001) of the ceramic and light-curing protocols (p < 0.001) affect the DC and microhardness of resin cements. When the thickness of the ceramic is 0.8 mm, the light transmittance of the ceramic and the curing performance of the resin cement increase with the increase of the transparency of the ceramic. An appropriate increase in irradiance and exposure time can optimize the curing performance of resin cement. These factors should be taken into account by the clinician when designing the bonding solution for porcelain veneers.

Immediate bond performance of resin composite luting systems to saliva-contaminated enamel and dentin in different curing modes

The purpose of this study was to evaluate the immediate shear bond strength of resin composite luting systems to tooth with or without saliva contamination in different curing modes. The Knoop hardness number of the resin composite luting agents was measured. Four combinations of resin composite luting systems were used. The shear bond strength to bovine teeth was measured with and without saliva contamination in different curing modes at different storage periods. The Knoop hardness number of the resin composite luting agents was also evaluated. Significantly lower enamel and dentin shear bond strengths and Knoop hardness number values were observed in all resin composite luting systems at 5 min versus 24 h, regardless of the curing mode or saliva contamination. The influence of the curing mode of the resin composite luting systems on shear bond strengths and Knoop hardness number was dependent on material. For the saliva contamination conditions, only G-CEM ONE EM did not show any significant difference in shear bond strength among the groups with and without saliva contamination, regardless of curing mode, storage period, or tooth substrate. All the resin composite luting systems showed lower shear bond strengths and Knoop hardness number values immediately after setting.

Influence of inhomogeneity of the polymerization light beam on the microhardness of resin cement under a CAD-CAM block

STATEMENT OF PROBLEM

The beam profile of a light polymerization unit shows an inhomogeneous distribution. Therefore, the light passing through indirect restorations may be inhomogeneous and affect the polymerization of the resin cement.

PURPOSE

The purpose of this in vitro study was to investigate the effects of the inhomogeneous distribution of irradiance passing through a computer-aided design and computer-aided manufacturing (CAD-CAM) block on the microhardness of resin cement.

MATERIAL AND METHODS

IPS e.max CAD (A3 LT, A3 HT), Celtra Duo (A3 LT), LAVA Ultimate (A3 LT), and Vita Enamic (A3 T) blocks were tested and cut into 1.0-, 1.5-, 2.0-, and 4.0-mm thicknesses (N=100). The resin cements were Variolink N base (light-polymerized) and RelyX U200 (dual-polymerized). The light transmission, irradiance, and beam profile of each block were measured. For microhardness measurement, 5 points (-4 mm, -2 mm, 0 mm, +2 mm, and +4 mm) that coincided with the distance from the center to the periphery of the tip were marked on the specimen's surface. At each point, microhardness was measured 24 hours after polymerization. Repeated measured 1-way ANOVA with the LSD test was performed to analyze the effect of measuring points on the microhardness (α=.05).

RESULTS

The microhardness of the resin cements decreased with an increase of the CAD-CAM block thickness (P<.05). Resin cements under a 1-mm CAD-CAM block showed relatively uniform microhardness, whereas those under 2-mm and 4-mm blocks showed inhomogeneous microhardness (P<.05).

CONCLUSIONS

Inhomogeneous light transmission from a light polymerization unit through CAD-CAM blocks resulted in the nonuniform microhardness of resin cement.

Degree of conversion and microhardness of resin cements photoactivated through glass ceramic

Background

To assess whether glass-ceramic shade, thickness and translucency affect degree of conversion (DC) and Knoop microhardness (KHN) of resin cements photoactivated using light-emitting diode (LED) or quartz-tungsten-halogen (QTH) units.

Material and Methods

Glass-ceramic blocks were cut (2, 3 and 4mm) and sintered. For DC FT Raman spectroscopy (n=3), film specimens of cements (RelyX ARC, U200, Veneer, C&B) were obtained. For KHN test (n=3), cements were inserted in cylindrical matrix and covered by polyester strip. Specimens were photoactivated (30s) using LED or QTH according to each group: direct photoactivation (DP), interposing ceramic specimens or no photoactivation (NP). Data were analysed by ANOVA and Tukey's test, Kruskal-Wallis and Dunn's tests (p<0.05).

Results

Ceramic features had significant effect on DC of RelyX ARC, U200 and Veneer (p<0.0017). Light source had no effect (p=0.9512). C&B and Veneer had higher DC, followed by dual cements. NP dual cements showed the lowest DC. For KHN, ceramic shade (p=0.1717) and light source (p=0.1421) were not significant, but ceramic translucency, thickness and resin cement were significant (p=0.0001). KHN was higher for U200 followed by ARC, and lowest for Veneer.

Conclusions

DC was affected by ceramic shade, translucency and thickness. KHN was dependent on ceramic translucency and thickness. Higher DC and KHN were achieved for dual-cured cements photoactivated through 2mm-thick low translucent or 3mm-thick high translucent glass-ceramic. Key words:Cementation, composite resin cements, dental curing lights, glass ceramics.

Could light-curing time, post-space region and cyclic fatigue affect the nanomechanical behavior of a dual-curing cement for fiber post luting?

OBJECTIVE

To evaluate the effects of curing time, post-space region and cyclic fatigue on the micromechanical properties of a fiber-post luting cement. The null hypotheses were that (1) curing time, (2) fatigue and (3) post-space region does not affect the nanoindentation modulus and hardness of the dual-curing cement.

MATERIALS AND METHODS

48 premolars were endodontically treated and a class I cavity and 8 mm deep post space was prepared. Fiber posts were luted with a universal, dualized adhesive system and a dual-curing cement following manufacturer's instructions. Specimens were divided into three groups (16 specimens for each group) according to light-curing time (no light-curing, 20 s light-curing and 120 s light-curing), which was performed with a LED lamp at 1000 mW/cm 2. The coronal part of the cavity was restored using a nano-filled resin composite. After 24 h, 8 specimens for each group were randomly extract in order to undergo to fatigue test in wet condition through a chewing simulator, while the other specimens were kept in distilled water as benchmark. All the restored teeth were then sectioned in 1 mm thick slices perpendicularly to the fiber post axis. Specimen slices were classified in coronal and apical to be tested through a nanoindenter. Data were analyzed through Kruskal-Wallis test with a significance level of 1%, in order to evaluate the influence of treatments (i.e., curing time and cyclic loading) on the micromechanical properties of the tested luting cement.

RESULTS

Both fatigue and curing time significantly influenced nanoindentation modulus and hardness of dual-curing cement (p < 0.01). No significant differences were reported for post space region. A significant interaction was found among the analyzed factors (p < 0.01).

SIGNIFICANCE

120 s light-curing time is recommended in order to achieve optimal mechanical proprieties, independently from post space region and cyclic fatigue. As matter of fact, 120 s light-curing allowed to prevent strain hardening induced by the fatigue simulation.

Predictable bonding of adhesive indirect restorations: factors for success

Adhesive indirect restorations are a popular restorative treatment option. This article discusses the many factors that contribute to their successful adhesive cementation, including a review of how to surface treat and manage contaminants across the wide range of indirect materials available.

Critiques the current various adhesive strategies used by resin cements at the tooth tissue interface.

Describes how to prepare the fitting surface of a wide range of restorative materials for adhesive cementation.

Discusses how to mitigate against contaminants during the adhesive cementation process.

Effect of lithium disilicate ceramic thickness, shade and translucency on transmitted irradiance and knoop microhardness of a light cured luting resin cement

This in vitro study evaluates the influence of pressed lithium disilicate thickness, shade and translucency on the transmitted irradiance and the Knoop microhardness (KHN) of a light-cured resin cement at two depths. One hundred and thirty-five ceramic discs of IPS e.max Press (Ivoclar Vivadent) were fabricated and divided into twenty-seven groups (n = 5) according to the association between translucency: HT (hight translucency), LT (low translucency), and MO (medium opacity); shade: BL2, A1 and A3.5; and thickness: 0.5 mm, 1.5 mm, and 2.0 mm. One side of each ceramic disc was finished, polished and glazed. The irradiance (mW/cm²) of a multiwave LED light curing unit (Valo, Ultradent) was evaluated with a potentiometer (Ophir 10ª-V2-SH, Ophir Optronics) without (control group) or with interposition of ceramic samples. The microhardness of Variolink Esthetic LC resin cement (Ivoclar Vivadent) was evaluated after 24 h at two depths (100 μm and 700 μm). Data were submitted to ANOVA followed by Tukey's test (α = 0.05). Irradiance and KHN were significantly influenced by ceramic thickness (p < 0.0001), shade (p < 0.001), translucency (p < 0.0001) and depth (p < 0.0001). Conclusions: the interposition of increasing ceramic thicknesses significantly reduced the irradiance and microhardness of resin cement. Increased depth in the resin cement showed significantly reduced microhardness for all studied groups. Increased ceramic opacity reduced the KHN of the resin cement at both depths for all ceramic thicknesses and shades.

Minimum Radiant Exposure and Irradiance for Triggering Adequate Polymerization of a Photo-Polymerized Resin Cement

This study aimed to establish the minimum radiant exposure and irradiance to trigger an adequate polymerization of a photo-polymerized resin cement. In total, 220 disc-shaped specimens (diameter of 10 mm and thickness of 0.1 mm) were fabricated using a photo-polymerized resin cement (Variolink N-transparent, Ivoclar Vivadent). To investigate the minimum radiant exposure, the specimens were polymerized with radiant exposures of 1, 2, 3, 4, 5, 6, and 18 J/cm² (n = 20). During polymerization, the irradiance was maintained at 200 mW/cm². To investigate the minimum irradiance, the specimens were polymerized with irradiances of 50, 100, 150, and 200 mW/cm² (n = 20). During polymerization, the radiant exposure was maintained at the previously determined minimum radiant exposure. The Vickers microhardness (HV) and degree of conversion (DC) of the carbon double bond of the specimens were measured to determine the degree of polymerization of the specimens. The results were analyzed using one-way analysis of variance (ANOVA) and Tukey’s test (p < 0.05). In the investigation of the minimum radiant exposure, the HV and DC of the specimens polymerized with a radiant exposure from 1 to 5 J/cm² were significantly lower than those with 18 J/cm² (all p < 0.05). However, no significant difference in HV and DC was found between the specimens polymerized with 6 J/cm² and 18 J/cm² (p > 0.05). In the investigation of the minimum irradiance, the specimens polymerized with an irradiance of 50 mW/cm² had significantly lower HV and DC than the specimens polymerized with an irradiance of 200 mW/cm² (p < 0.05). However, no significant difference in the HV and DC was found among the specimens cured with irradiances of 100, 150, and 200 mW/cm² (p > 0.05). In conclusion, the minimum radiant exposure and irradiance to trigger an adequate polymerization of the light-cured resin cement were 6 J/cm² and 100 mW/cm², respectively.

Effect of LED Light-Curing Spectral Emission Profile on Light-Cured Resin Cement Degree of Conversion

CLINICAL RELEVANCE

The use of multipeak LED light-curing guarantees efficiency on light activation of Ivocerin-containing light-cured resin cement.

SUMMARY

Evaluation of microhardness and water sorption/solubility of dual-cure resin cement through monolithic zirconia in different shades

Aim:

The objective is to evaluate the effect of shades of monolithic zirconia on the microhardness and sorption/solubility of the underlying two dual-cured resin types of cement.

Materials and Methods:

Eighty samples of two dual-cured resin cement discs were polymerized under 60 monolithic zirconia discs in three shades and directly activated resin discs of cement were used as the control group (n = 10). After 24 h storage at 37°C in an incubator, Vickers microhardness and the sorption and solubility were measured.

Statistical Analysis Used:

Two-way ANOVA , one-way ANOVA, Independent t-test, Tukey's honestly significant difference, and Tamhane's T2 tests.

Results:

The mean microhardness of the Variolink N resin cements were significantly higher than Panavia SA ones (P < 0.001). Furthermore, Variolink N cements exhibited lower sorption/solubility than Panavia SA resin cements (both P < 0.05). The ceramic shade had a significant influence on the microhardness of both cements (P < 0.001) but had no significant effect on the sorption/solubility of resin cements (P > 0.05).

Conclusion:

Interposition of monolithic zirconia decreases the microhardness of resin cement especially Panavia SA. In Variolink N, by increasing the chroma saturation of ceramics, the microhardness decreased, however in Panavia SA, it was altered by the shades, but not in a specific pattern. For both cements, there were no statistical differences between the sorption/solubility of samples photo-cured under different shades. There was a reverse correlation between microhardness and water sorption/solubility of both cements.

Influence of toothbrush abrasion and surface treatments on the color and translucency of resin infiltrated hybrid ceramics

PURPOSE

The study compared the color change, lightness, and translucency of hybrid resin ceramics exposed to toothbrush abrasion and surface treatment.

MATERIALS AND METHODS

Four hybrid ceramics [Lava Ultimate (LU), Vita Enamic (EN), Shofu HC (SH), and Crystal Ultra (CU)] were compared with a glass-ceramic (Vita Mark II) control. One hundred and twenty specimen blocks were prepared using a precision saw machine. Specimens in each material were divided into four subgroups based on the surface treatment (polishing or staining) and a storage medium (water or citric acid). Simulated tooth brushing with a mixture of 100 RDA (radioactive abrasives) with 0.3 ml distilled water was used for 3650 cycles (7300 strokes) for each specimen. Measurements for the color change, lightness, and translucency were measured after toothbrushing using a spectrophotometer. Statistical analysis compared outcomes using paired t-test, ANOVA, and Tukey post hoc test.

RESULTS

The maximum color change was identified in SH (stained acid) [1.44 (0.40)], whereas the lowest was identified in EN (polished water) [0.66 (0.16)] material. The maximum and minimum loss of surface translucency was observed in SH (polished water) [12.3 (0.52)] and EN (stained acid) [6.5 (0.55)] specimens, respectively. Lastly, loss of lightness was the highest in VM (polished acid) [69 (0.95)], whereas the lowest was observed in CU (stained water) [56.7 (0.86)].

CONCLUSION

The comparison presented a significant effect of toothbrush abrasion on translucency and lightness of the hybrid resin ceramics. Color change was not significantly influenced irrespective of the storage medium employed. Surface staining demonstrated the preservation and stability of color and optical properties under the influence of toothbrush abrasion and chemical trauma.

Influence of feldspar ceramic thickness on the properties of resin cements and restorative set

This in vitro study evaluated the influence of feldspathic ceramic thickness on the properties of light- and dual-cured resin cements. For each cement (RelyX Veneer, Allcem Veneer, RelyX Ultimate, and Allcem Dual), three ceramic specimens were prepared, with seven thicknesses for each (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, and 3.5 mm). The degree of conversion, Vickers microhardness, irradiance power, color variation (ΔE₀₀ ), and translucency parameters were assessed. Microhardness and irradiance power were analyzed using analysis of variance (ANOVA) with post hoc Tukey's test, while ΔE₀₀ , translucency parameters, and degree of conversion were analyzed using ANOVA of ranks with post hoc Duncan's Multiple Range Test. The relationship between each of the dependent variables (degree of conversion, ΔE₀₀ , and translucency parameter tests) and the specimen thickness was described using linear regression for each of the four resin cements. The significance level for all analyses was set at 5%. RelyX Ultimate yielded the lowest degree of conversion values among all resin cements. Allcem Veneer produced the lowest microhardness values, without statistical differences between thicknesses, of up to 1 mm. Allcem Dual produced the highest ΔE₀₀ and translucency parameter values. Feldspathic ceramic thickness influenced the mechanical properties of resin cements and optical aspects of the restorative set.

Comparing endocrown restorations on permanent molars and premolars: a systematic review and meta-analysis

Objectives The objective of this systematic review was to evaluate the success of endocrown restorations on molars in comparison with endocrown restorations on premolars.Registration number The methodology for this review is registered with the PROSPERO database (CRD42019149543).Data sources Medline, Embase, Dentistry & Oral Sciences Source and Cochrane CENTRAL were searched through January 2020, supplemented with hand searching of additional relevant journals.Data selection and data extraction Two independent reviewers screened studies against predefined inclusion criteria and extracted data.Data analysis Narrative analysis was carried out and random-effects meta-analysis was performed where possible.Results Out of the selected eight studies, reported success rate of endocrown restoration in molars varied from 72.73% to 99.57% and in premolars ranged from 68.75% to 100%, with a follow-up range of 3-19 years. The pooled odds ratio and 95% confidence intervals for failure rates in molars compared to premolars in four studies selected for meta-analysis were 1.096 (95% CI: 0.280, 4.292).Conclusions These findings showed similar success rates and no difference in the rate of endocrown failures between molars and premolars, thus suggesting that premolars may be considered suitable candidates for endocrowns. However, the findings should be interpreted with caution due to methodological limitations of the included studies. Further better quality and specifically designed controlled trials directly comparing the clinical performance of endocrowns on molars and premolars are required.

Effect of photo-polymerization mode on the degree of conversion of resin cement under different ceramic materials

BACKGROUND

This study evaluated the effect of different polymerization modes and duration on the degree of conversion (DC) of resin cement under different types of ceramics.

METHODS

Ceramic materials were divided into 3 groups (N.=60): group 1, Cerasmart; group 2, Vita Enamic; and group 3, Vita Mark II. Each group was then divided into three subgroups (N.=20) according to the polymerization mode (A: low-intensity; B: high-intensity; and C: soft-start). Subgroups were then divided into two further groups according to the polymerization time (I: 10 s; and II: 20 s). DC of light-cured resin cement beneath different kinds of ceramics was tested using FTIR spectroscopy. Results were compared to a control group cured without overlying ceramic.

RESULTS

While the type of ceramic and mode of polymerization showed a significant effect on the DC of resin cement, polymerization duration did not. Vita Mark II group showed the highest DC of resin cement followed by Vita Enamic and Cerasmart. High- and low-intensity polymerization modes did not show significant difference, but both showed significantly lower DC when compared to soft start mode.

CONCLUSIONS

Type of ceramic and polymerization mode showed a direct effect on the DC of resin cement.

The effect of thickness and translucency of polymer-infiltrated ceramic-network material on degree of conversion of resin cements

PURPOSE

The aim of the present study was to determine the degree of conversion of light- and dual-cured resin cements used in the cementation of all-ceramic restorations under different thicknesses of translucent (T) and high-translucent (HT) polymer-infiltrated ceramic-network (PICN) material.

MATERIALS AND METHODS

T and HT PICN blocks were prepared at 0.5, 1.0, 1.5, and 2.0 mm thicknesses (n=80). Resin cement samples were prepared with a diameter of 6 mm and a thickness of 100 µm. Light-cured resin cement was polymerized for 30 seconds, and dual-cure resin cement was polymerized for 20 seconds (n=180). Fourier transform infrared spectroscopy (FTIR) was used for degree of conversion measurements. The obtained data were analyzed with ANOVA and Tukey HSD, and independent t-test.

RESULTS

As a result of FTIR analysis, the degree of conversion of the light-cured resin cement prepared under 1.5- and 2.0-mm-thick T and HT ceramics was found to be lower than that of the control group. Regarding the degree of conversion of the dual-cured resin cement group, there was no significant difference from the control group.

CONCLUSION

Within the limitation of present study, it can be concluded that using of dual cure resin cement can be suggested for cementation of PICN material, especially for thicknesses of 1.5 mm and above.

Cement opacity and color as influencing factors on the final shade of metal-free ceramic restorations

OBJECTIVE

To investigate the influence of opacity and color of luting cements on the final shade of metal-free restorations.

MATERIALS AND METHODS

Five resin cement colors in combination with four different thicknesses of CAD/CAM ceramic materials were tested, and a composite substrate was used as dentin color reference (n = 3). Specimen color was measured with a spectrophotometer equipped with an integrating sphere before and after cementation (CIELAB). Cement and ceramic color and opacity (TP) were assessed by measuring the tested ceramic thickness as a 1-mm thick disk for each of the cement shades. The differences in color were evaluated (ΔE₀₀ ). Data were statistically analyzed by a Two-Way ANOVA followed by the Tukey Test for post-hoc comparison (P < .05) and multiple comparison Pearson's test (P < .05); the acceptability and perceptibility threshold were evaluated.

RESULTS

Statistically significant influence was found for factors ceramic thickness and cement shade (P < .001). Perceptible and unacceptable color changes were induced on the final restoration by resin cements (ranging from ΔE₀₀  = 0.69 ± 0.54 to ΔE₀₀  = 5.53 ± 0.46), the correlation between factors became strong (r²  > 0.6) in case of mismatch between color and translucency of cement and ceramic. Only the clear shade in combination with the thickest ceramic, resulted in an imperceptible color change (ΔE₀₀  = 0.69 ± 0.54).

CONCLUSIONS

The final shade of ceramic restorations can be influenced by resin cements; the magnitude of influence is related to the cement optical properties.

CLINICAL SIGNIFICANCE

In order to influence the final shade of a ceramic restoration, a cement more opaque than the restorative material should be used. Conversely, in the case of a fitting shade of the restoration, a cement more translucent than the restoration should be used to avoid undesired changes.

The effect of curing mode of a high-power LED unit on bond strengths of dualcure resin cements to dentin and CAD/CAM resin blocks

The purpose of this study was to investigate the effects of curing mode with a high-power LED curing unit (VALO) in terms of microtensile bond strength (μTBS) to dentin and microhardness of two dual-cure resin cements. Panavia V5 (V5) and Rely X Ultimate (RXU) were polymerized using one of three curing modes with VALO or self-cure mode to bond a CAD/CAM resin block to a flat dentin surface. Specimens were sectioned and subjected to μTBS test. Vickers hardness values of V5 and RXU were also measured. Two-way ANOVA indicated curing mode and resin cement affected μTBS. For self-cure mode, V5 had significantly higher μTBS than RXU (p<0.05). Higher irradiance did not always provide higher μTBS of dual-cure resin cement to dentin. One-way ANOVA indicated the curing modes affected microhardness of each cement. As for microhardness of RXU, there were significant differences between selfcure mode and light cure modes (p<0.05).

Influence of the composition and shades of ceramics on light transmission and degree of conversion of dual-cured resin cements

Objective

Since the transmittance of ceramics can influence the degree of conversion (DC) of resin cements, ceramics composition and shade should be considered in the selection of resin cement. This in vitro study aimed to evaluate the effect of the transmittance of different composition, opacities and shades of ceramics on the degree of conversion of two dual-cured resin cements.

Methodology

Sixty discs were prepared from low translucency (LT) and medium opacity (MO) lithium disilicate ceramic, and zirconia ceramic (Z). Each group was subdivided into 5 subgroups (n=4) in shades A2, A3.5, B2, C2 and D3. The transmittance measurement was performed in a spectrophotometer. The Variolink II and Rely X U200 resin cements were photoactivated by LED (1400 mW/cm2) for 40 s through the ceramic discs and without the discs (control group). The DC was measured with infrared FTIR spectroscopy, immediately after light activation. Data were analyzed with Kruskall-Wallis and one-way ANOVA, following post-hoc comparisons by Tukey test and Pearson’s correlation test (P<0.05).

Results

LT ceramic exhibited higher transmittance values compared to MO and Z ceramics. LTA2 and LTB2 showed statistically higher transmittance values compared to MOA2, MOA3.5 and ZA3.5. For Variolink II, the ceramic interposition did not influence the DC, since there were no statistical differences between groups with ceramic interposition and the control group. For Rely X U200 cement, the interposition of some ceramics types/shades (LTA3.5, MOA2, MOA3.5 and ZA3.5) significantly decreased the DC values compared to control group. A positive correlation was found between the ceramic transmittance and DC values of both tested cements. Conclusions. The transmittance and DC values of the cements were influenced by composition and shades of the ceramics. The higher the transmittance of ceramics, the higher the DC values for both cements.

Evaluation of the light transmission of chairside polymer infiltrated hybrid ceramics in different shades and thicknesses

BACKGROUND:

This in vitro study aimed to evaluate the amount of polymerizing light passing through hybrid ceramic specimens in different shades and thicknesses.

METHODS:

Rectangular-shaped feldspathic ceramic computer aided design and computer aided manufacturing (CAD-CAM) blocks and translucent and high translucent polymer infiltrated hybrid ceramic CAD-CAM blocks in four different shades (1M1, 1M2, 2M2, and 3M2) were sectioned in four different thicknesses (0.8, 1.5, 2, and 3 mm), and a total of 48 groups ( n = 10) were obtained. Feldspathic ceramic specimens served as the control group. The light transmission of each ceramic specimen was measured three times by using a light-emitting diode and a radiometer. Data were statistically analyzed by using univariate analysis of variance (ANOVA) followed by one-way ANOVA, Tukey honest significant difference, and Tamhane T2 tests (α = 0.05).

RESULTS:

Translucent polymer infiltrated hybrid ceramic specimens exhibited significantly ( p < 0.001) lower light transmission values than high translucent polymer infiltrated hybrid ceramic and feldspathic ceramic specimens, whereas feldspathic ceramic specimens exhibited significantly ( p < 0.001) higher light transmission than translucent and high translucent polymer infiltrated hybrid ceramic specimens. The amount of light transmission significantly ( p < 0.05) decreased when the shade value decreased and the thickness increased.

CONCLUSIONS:

Polymer infiltrated hybrid ceramic specimens showed lower light transmission values than feldspathic ceramic specimens, and the amount of light transmission was affected by the ceramic shade and thickness.

Light transmittance of CAD/CAM ceramics with different shades and thicknesses and microhardness of the underlying light-cured resin cement

Objectives

The aim of this in vitro study was to evaluate the effects of the thickness and shade of 3 types of computer-aided design/computer-aided manufacturing (CAD/CAM) materials.

Materials and Methods

A total of 120 specimens of 2 shades (A1 and A3) and 2 thicknesses (1 and 2 mm) were fabricated using VITA Mark II (VM; VITA Zahnfabrik), IPS e.max CAD (IE; IvoclarVivadent), and VITA Suprinity (VS; VITA Zahnfabrik) (n = 10 per subgroup). The amount of light transmission through the ceramic specimens was measured by a radiometer (Optilux, Kerr). Light-cured resin cement samples (Choice 2, Bisco) were fabricated in a Teflon mold and activated through the various ceramics with different shades and thicknesses using an LED unit (Bluephase, IvoclarVivadent). In the control group, the resin cement sample was directly light-cured without any ceramic. Vickers microhardness indentations were made on the resin surfaces (KoopaPazhoohesh) after 24 hours of dark storage in a 37°C incubator. Data were analyzed using analysis of variance followed by the Tukey post hoc test (α = 0.05).

Results

Ceramic thickness and shade had significant effects on light transmission and the microhardness of all specimens (p < 0.05). The mean values of light transmittance and microhardness of the resin cement in the VM group were significantly higher than those observed in the IE and VS groups. The lowest microhardness was observed in the VS group, due to the lowest level of light transmission (p < 0.05).

Conclusion

Greater thickness and darker shades of the 3 types of CAD/CAM ceramics significantly decreased the microhardness of the underlying resin cement.

Effect of Ceramic Interposition and Post-activation Times on Knoop Hardness of Different Shades of Resin Cement

The aim of this study was to evaluate Knoop hardness of different shades of a resin cement light-cured directly or through ceramic discs, measured 15 min or 24 h after light exposure, and at different depths. Specimens of a commercial resin cement (Variolink Veneer) in seven shades, were fabricated in an elastomeric mold, covered with a mylar strip, a 0.7 mm thick ceramic disc (IPS e.max Press) was placed and the cement was light-activated for 20 s using a blue LED (Radii-Cal). The cured resin cement specimens were transversely wet-flattened to their middle portion and microhardness (Knoop) values were recorded at 15 min after light exposure and after deionized water storage at 37 ºC for 24 h. Five indentations were made in the cross-sectional area at 100 and 700 μm depths from the top surface. Ten specimens were made for each test conditions. Data were submitted to ANOVA split-plot design (shade, post-cure time, mode of activation and depth), followed by Tukey post hoc test (α=0.05). Significant differences for shade (p<0.0001), mode of activation (p<0.001), post-cure time (p<0.0001) and depth (p<0.0001) were detected. No significant interactions (p>0.05) were found, except for shade x post-cure time (p<0.0045) and mode of activation x post-cure time (p<0.0003). Resin cement shade has a significant effect on Knoop hardness. Indirect activation through a ceramic material reduced significantly Knoop hardness. Hardness Knoop significantly increased after 24 h in all cements shades compared to values obtained after 15 min. Resin cement depth significantly reduced Knoop hardness.

Effect of heat treatment on cytotoxicity of self-adhesive resin cements: Cell viability analysis

Objective

The aim of the study was to assess, in vitro, the influence on cytotoxicity of heat treatment applied before photopolymerization, while mixing three self-adhesive resin cements, in an NIH/3T3 fibroblast cell culture, based on cell viability measures.

Methods

Samples were divided into three groups: (1) no heat treatment while mixing (control), (2) 37°C, and (3) 60°C heat treatment while mixing. Cements were light-cured immediately after mixing and immersed in Dulbecco's Modified Eagle Media for the extraction of possibly uncured products after 24 h and 7 days. Cultures contained 0.5 mL of NIH/3T3 fibroblasts per well at a concentration of 0.4 × 10⁵ cells/mL and specific extracts for each sample.

Statistical Analysis Used

Data were statistically analyzed with ANOVA and post hoc Student-Newman-Keuls (significance of 5%).

Results

Cement cytotoxicity increased with time, as shown by the higher values observed at 7 days. There was a slight difference in intragroup cytotoxicity levels between 24 h and 7 days. Heat treatment at 60°C was associated with a major decrease in cytotoxicity levels in all three groups, both at 24 h and at 7 days, with no differences among the cements.

Conclusions

Heat treatment at 60°C should be considered as a strategy to reduce cytotoxicity of self-adhesive resin cements, as evidenced by the results observed at 24 h and 7 days of analysis.

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.

Influence of polymerization time on properties of dual-curing cements in combination with high translucency monolithic zirconia

PURPOSE

The aim of this in vitro study was to assess conversion degree (DC), micro-hardness (MH) and bond strength of two dual-curing resin cements employed under translucent monolithic zirconia irradiated with different time protocols.

METHODS

84 square shaped samples of 1mm thickness were prepared from high translucency zirconia blocks and divided into two groups (n=24) according to the cement employed: (1) Rely-X Ultimate; (2) Panavia SA. Each group was further divided into 3 subgroups (n=8) according to the irradiation time: (a) no light; (b) 20s; (c) 120s. Light curing was performed 60s after the sample was placed on the diamond support of a FT-IR spectrophotometer with a high power multiLED lamp. Final DC% were calculated after 10min. After 24h, Vickers Test on the cement layer was performed. The same protocol was used to lute composite cylinders in order to evaluate microshear bond-strength test. ANOVA and Bonferroni tests were performed to find differences between MH and bond-strength to zirconia, while for DC% the Scheirer-Ray-Hare two-way test was used.

RESULTS

The two cements reached higher DC% in subgroup (b) and (c). As concern MH, statistics showed an increase in curing time was able to improve MH significantly. Bond-strength was not affected by irradiation time only for Panavia SA.

CONCLUSIONS

The first null hypothesis has to be rejected since DC% and MH of the dual-cements tested were influenced by the curing time. The second null hypothesis is partially rejected since the bond strength was influenced by the curing time only for Rely-X Ultimate.

Influence of glass-based dental ceramic type and thickness with identical shade on the light transmittance and the degree of conversion of resin cement

The purpose of this study was to assess the influence of the types and thicknesses of glass ceramic plates on light transmittance and compare the degrees of conversion (DC) of resin cement under the ceramic materials. Three ceramic plates with thicknesses of 0.5, 1.0, 2.0, and 4.0 mm were fabricated from each of five commercial ceramic blocks in shade A2: high-translucency and low-translucency IPS Empress CAD (Emp_HT and Emp_LT); high-translucency and low-translucency IPS e.max CAD (Emx_HT and Emx_LT); and Vita Mark II (Vita). The translucency parameter was obtained using a colorimeter. The light transmittance rate was measured using a photodetector attached to an optical power meter. The DC of a resin cement (Variolink N) underneath the ceramic plates was examined by Fourier transform infrared spectroscopy. The translucency parameter, light transmittance rate, and DC showed significant differences by ceramic type and thickness (P < 0.05). The Emp_HT specimens showed the highest light transmission and DCs, and the Emx_LT showed the least light transmission and the lowest DCs. The high-translucency Empress showed significantly higher DCs than the low-translucency types (P < 0.05), but there was no significant difference in e.max (P > 0.05). Both type and thickness of the glass ceramics significantly influenced the light transmittance and DC of the light-cured resin cement beneath the ceramic of the same shade.

How well a dental filling or crown performs depends not only on the strength of ceramic material used but also on its thickness and type. Sun-Young Kim of Seoul National University and colleagues investigated how the thickness and type of glass-based ceramic affected how well it transmitted light and thus how well resin cement underneath it hardened. Orthodontists use a special ‘curing’ light to harden resin cement and create a strong bond between the ceramic material and the underlying mouth tissue. They shined light on different types of ceramic plates of similar shade but varying thickness and found that both their ability to transmit light and how well the resin cement underneath them hardened varied significantly. They conclude that orthodontists should not only choose ceramics for dental treatments based on their inherent strength, but should also consider how well they transmit light.

Influence of curing protocol and ceramic composition on the degree of conversion of resin cement

OBJECTIVE

Due to increasing of aesthetic demand, ceramic crowns are widely used in different situations. However, to obtain long-term prognosis of restorations, a good conversion of resin cement is necessary. To evaluate the degree of conversion (DC) of one light-cure and two dual-cure resin cements under a simulated clinical cementation of ceramic crowns.

MATERIAL AND METHODS

Prepared teeth were randomly split according to the ceramic's material, resin cement and curing protocol. The crowns were cemented as per manufacturer's directions and photoactivated either from occlusal suface only for 60 s; or from the buccal, occlusal and lingual surfaces, with an exposure time of 20 s on each aspect. After cementation, the specimens were stored in deionized water at 37°C for 7 days. Specimens were transversally sectioned from occlusal to cervical surfaces and the DC was determined along the cement line with three measurements taken and averaged from the buccal, lingual and approximal aspects using micro-Raman spectroscopy (Alpha 300R/WITec®). Data were analyzed by 3-way ANOVA and Tukey test at =5%.

RESULTS

Statistical analysis showed significant differences among cements, curing protocols and ceramic type (p<0.001). The curing protocol 3x20 resulted in higher DC for all tested conditions; lower DC was observed for Zr ceramic crowns; Duolink resin cement culminated in higher DC regardless ceramic composition and curing protocol.

CONCLUSION

The DC of resin cement layers was dependent on the curing protocol and type of ceramic.

Spectrophotometric analysis of clinical factors related to the color of ceramic restorations: A pilot study

STATEMENT OF PROBLEM

Shade matching natural teeth with ceramic restorations is still an esthetic, clinical challenge.

PURPOSE

The purpose of this prospective clinical study was to evaluate the influence of color-related factors on the color variation of ceramic restorations based on spectrophotometric analysis.

MATERIAL AND METHODS

Color records were obtained from 11 participants who received 38 lithium disilicate restorations. CIELab color coordinates were measured with a spectrophotometer on the ceramic restoration, tooth (baseline), prepared tooth, and luted ceramics. Color variation (ΔE₀₀) was calculated for each variable (luting agent and restoration type, tooth substrate shade, ceramic thickness, and translucency parameters) measured at baseline on the prepared tooth and after cementation of the restorations. Confidence intervals (CI) for the means (95% CI) were calculated, and the ΔE₀₀ values and CIELab individual color coordinates were compared for each pair of variable by using the Student t test or Welch test (α=.05).

RESULTS

Greater color variation values were observed between measurements obtained on the prepared tooth and luted restoration. The lower ΔE₀₀ values were observed over darker tooth substrate measured at baseline and after luting (P=.007).

CONCLUSIONS

The 3 conditions evaluated presented clinically visible color differences, highlighting the importance of clinical evaluations on the visual color acceptability limits for restorations, which are usually defined in laboratory studies. The lithium disilicate ceramic showed lower masking ability over darker tooth substrate, whereas the coordinates L*, a*, and b* were cementation-dependent.

Effect of ceramic type, thickness, and time of irradiation on degree of polymerization of dual - cure resin cement

Aim:

The aim of the study is to evaluate the effect of ceramic type, thickness, and time of irradiation on degree of polymerization of dual-cure resin cement.

Materials and Methods:

Dual-cure resin cement (SoloCem) was used to prepare disk-shaped samples (0.5 mm thick × 5 mm diameter). Study group samples (n = 5) were light-cured for 40, 60, and 80 s through all ceramic leucite-reinforced (Cergo Kiss), lithium disilicate-reinforced (IPS e.max), and monolithic zirconia-reinforced (Ziecon) of three thicknesses (2, 3, and 4 mm). Negative control group samples were cured through metal disks and positive control samples were cured without the presence of ceramic. The degree of conversion (DC) was evaluated by Fourier transform infrared spectrometer. The recorded data were subjected to one-way analysis of variance, followed by post hoc analysis (Tukey HSD).

Results and Conclusion:

Greatest light transmission and DC were seen through Cergo Kiss, followed by IPS e.max Press and Ziecon, with insignificant difference between the latter two. The attenuation of light irradiance increased with increasing thickness of ceramic disks, with statistically significant values between 3 and 4 mm. Increasing time of irradiation to cure dual-cure resin cement did not always result in greater degree of polymerization.

Light transmittance and surface roughness of a feldspathic ceramic CAD-CAM material as a function of different surface treatments

BACKGROUND

The aim of the present study was to determine the effect of different surface treatments on light transmission of aesthetic feldspathic ceramics used in CAD-CAM chairside restorations.

METHODS

Forty eight feldspatic ceramic test specimens were prepared from prefabricated CAD-CAM blocks by using a slow speed diamond saw. Test specimens were prepared and divided into 4 groups (n = 12). In the control group, no surface treatments were applied on the feldspathic ceramic surfaces. In the hydrofluoric acid group, the bonding surfaces of feldspathic ceramics were etched with 9.5 % hydrofluoric acid. In the sandblasting group the feldspathic ceramic surfaces were air-abraded with 30-μm alumium oxide (Al2O3) particles and Er:YAG laser was used to irradiate the ceramic surfaces. The incident light power given by the LED device and the transmitted light power through each ceramic sample was registered using a digital LED radiometer device. Each polymerization light had a light guide with 8-mm-diameter tips. Light transmission of feldspathic ceramic samples was determined by placing it on the radiometer and irradiating the specimen for 10 s at the highest setting for each light polymerization. All specimens were coated with gold using a sputter coater and examined under a field emission scanning electron microscope. Surface roughness measurement each group were evaluated with 3D optical surface and tactile profilometers.

RESULTS

One-way ANOVA test results revealed that both surface conditioning method significantly affect the light transmittance (F:412.437; p < 0.001) and the surface roughness values (F:16.386; p < 0.001). Al2O3 and Er-YAG laser application reduced the light transmission significantly (p < 0.05).

CONCLUSIONS

The laser and Al2O3 applications reduced the light transmission of 1.5 mm thickness feldspathic ceramic material below the value of 400 mW/cm(2) which is critical limit for safe polymerization.

Additional chemical polymerization of dual resin cements: reality or a goal to be achieved?

Abstract Introduction This study serves as a warning to dentists and researchers that dual-cured resin cements may not polymerize completely under some prosthetic crowns. Objective The aim of this study was to analyse the polymerization degree of dual-cured resin cements under prosthetic barrier, by microhardness test. Material and method Three cements (Bistite II, RelyX ARC and Variolink II) were light-cured through different barriers, placed between the cement and the light source: G1: without barrier; G2: composite resin (Cesead); G3: Inceram alumina; G4: IPS Empress; G5: Inceram zirconia; G6: tooth fragment. Photopolymerization was carried out using a halogen light unit (650 mW/cm2); microhardness was evaluated using the Microhardness Tester FM 700, under a load of 50gf with a dwell time of 15s, at two evaluation times (30min and 24h). Result The results were submitted to ANOVA and Tukey tests (5%). Both Inceram alumina and Inceram zirconia ceramic barriers hindered polymerization. Bistite, followed by RelyX and Variolink, exhibited the highest microhardness values (p<0.05). As the highest values were obtained without a barrier, it was determined that the barrier, followed by the tooth, influenced microhardness. Both Empress and Cesead had the smallest microhardness values but with no statistically significant difference between them. Conclusion The barrier negatively affected the microhardness of dual-cured resin cements; evaluation time did not affect microhardness values for most of the conditions tested. There is a limited effect of the chemical activator on the polymerization of some dual-cured cements, and their performance is product specific.

Degree of conversion of a resin cement light-cured through ceramic veneers of different thicknesses and types

During the cementation of ceramic veneers the polymerization of resin cements may be jeopardized if the ceramics attenuate the irradiance of the light-curing device. The aim of this study was to evaluate the effect of different types and thicknesses of ceramic veneers on the degree of conversion of a light-cured resin-based cement (RelyX Veneer). The cement was light-cured after interposing ceramic veneers [IPS InLine, IPS Empress Esthetic, IPS e.max LT (low translucency) and IPS e.max HT (high translucency) - Ivoclar Vivadent] of four thicknesses (0.5 mm, 1.0 mm, 1.5 mm and 2.0 mm). As control, the cement was light-cured without interposition of ceramics. The degree of conversion was evaluated by FTIR spectroscopy (n=5). Data were analyzed with one-way ANOVA and Tukey's test (α=0.05). Significant differences were observed among groups (p<0.001). The degree of conversion was similar to the control for all light-cured groups with interposition of ceramics of 0.5 mm and 1.0 mm (p>0.05). Among 1.5-mm-thick veneers, IPS e.max LT was the only one that showed different results from the control (p<0.05). At the thickness of 2.0 mm, only the IPS e.max LT and HT veneers were able to produce cements with degrees of conversion similar to the control (p>0.05). The degree of conversion of the evaluated light-cured resin cement depends on the thickness and type of ceramics employed when veneers thicker than 1.5 mm are cemented.

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.

LED and Halogen Light Transmission through a CAD/CAM Lithium Disilicate Glass-Ceramic

The effect of thickness, shade and translucency of CAD/CAM lithium disilicate glass-ceramic on light transmission of light-emitting diode (LED) and quartz-tungsten-halogen units (QTH) were evaluated. Ceramic IPS e.max CAD shades A1, A2, A3, A3.5, high (HT) and low (LT) translucency were cut (1, 2, 3, 4 and 5 mm). Light sources emission spectra were determined. Light intensity incident and transmitted through each ceramic sample was measured to determine light transmission percentage (TP). Statistical analysis used a linear regression model. There was significant interaction between light source and ceramic translucency (p=0.008) and strong negative correlation (R=-0.845, p<0.001) between ceramic thickness and TP. Increasing one unit in thickness led to 3.17 reduction in TP. There was no significant difference in TP (p=0.124) between shades A1 (ß1=0) and A2 (ß1=-0.45) but significant reduction occurred for A3 (ß1=-0.83) and A3.5 (ß1=-2.18). The interaction QTH/HT provided higher TP (ß1=0) than LED/HT (ß1=-2.92), QTH/LT (ß1=-3.75) and LED/LT (ß1=-5.58). Light transmission was more effective using halogen source and high-translucency ceramics, decreased as the ceramic thickness increased and was higher for the lighter shades, A1 and A2. From the regression model (R2=0.85), an equation was obtained to estimate TP value using each variable ß1 found. A maximum TP of 25% for QTH and 20% for LED was found, suggesting that ceramic light attenuation could compromise light cured and dual cure resin cements polymerization.

Efeito da intensidade de fontes de luz e barreiras de cerâmica na microdureza de cimento resinoso dual

<title>Resumo</title><sec><title>Introdução</title><p>O cimento resinoso dual é o principal material para cimentação de cerâmicas. Contudo, fatores, como fonte de luz, podem influenciar no desempenho do cimento.</p></sec><sec><title>Objetivo</title><p>Avaliar a influência de duas fontes de luz de diferentes intensidades sobre a microdureza de um cimento resinoso quando fotoativado sob diferentes cerâmicas.</p></sec><sec><title>Material e método</title><p>Foram fotoativados 40 espécimes de cimento resinoso dual (10 mm × 1,0 mm) por meio de duas fontes de luz LED, com intensidades de 1.000 mW/cm² e 800 mW/cm² durante 40 segundos, sob cerâmicas (15 mm × 2 mm) à base de zircônia, espinélio MgAl₂O₄ e dissilicato de lítio. No grupo controle, foi utilizada uma placa de vidro de mesma dimensão. As amostras tiveram a superfície regularizada com lixa d`água (600 e 1200). Após armazenagem a seco no escuro (24 h), foram realizadas as medidas de microdureza Vickers (HMV Shimadzu - 50g/10 segundos). Os dados foram submetidos à Anova fatorial e ao teste de Tukey com nível de significância de 5%.</p></sec><sec><title>Resultado</title><p>O cimento polimerizado apresentou valor médio de microdureza e desvio padrão para o grupo controle de 43,9±1,5 e 43,4±1,3, para as intensidades de 1.000 mW/cm² e 800 mW/cm², respectivamente. O menor valor de microdureza do cimento foi observado para a cerâmica à base de espinélio MgAl₂O₄, polimerizado a 800 mW/cm², com valor de 34,3±3,3.</p></sec><sec><title>Conclusão</title><p>O tipo de cerâmica e a intensidade da fonte de luz influenciam na microdureza do cimento. A intensidade de 1.000 mW/cm² sobre as cerâmicas à base de zircônia e espinélio MgAl₂O₄ resultaram na melhor combinação de valores de dureza do cimento.</p></sec>

Indirect Restoration Thickness and Time after Light-Activation Effects on Degree of Conversion of Resin Cement

<p>This study evaluated the effects of indirect restorative materials, curing conditions and time on the degree of conversion (DC) of a dual-cured resin cement using infrared spectroscopy. The resin cement (RelyX Unicem 2, 3M ESPE) was applied to the diamond surface of a horizontal attenuated-total-reflectance unit and activated using one of following conditions: self-cure, direct light exposure, light exposure through indirect restorative materials (resin nano-ceramic: Lava Ultimate, 3M ESPE or feldspathic ceramic: Vita Blocks Mark II, Vita Zahnfabrik). Four thicknesses (0.5, 1.0, 1.5 or 2.0 mm) of each indirect material were analyzed, and the light-activation was performed using a blue LED light. Data (n=5) were analyzed by three-way ANOVA, Tukey's post hoc and Dunnett's tests (α=5%). No significant differences in DC were observed between indirect materials of similar thickness. All groups exhibited higher DC after 10 min than after 5 min. At both times points, the self-cure group exhibited significantly lower DC than all the light exposure groups. Only when the overlying indirect restoration had a thickness of 2 mm did DC decrease significantly. The presence of a thick, indirect restoration can decrease the DC of resin cement. DC after 10 min was higher than after 5 min. The self-cure mode yielded lower DC than the light-activating one.</p>

Effects of Temperature and Aging on Working/Setting Time of Dual-cured Resin Cements

OBJECTIVES

To evaluate the effects of aging and temperature on working time (WT) and setting time (ST) of several dual-cured resin cements.

METHODS

WT and ST were determined with a thermo-controlled stage oscillating rheometer. New cement kits were used for the study. Cements were mixed according to instructions and dispensed on the oscillating stage that was preset at 22°C or 37°C. Rheologic charts were generated from the beginning of mixing until no further oscillation was detected. After initial measurements, cement kits were aged at 37°C for 12 weeks, and WT/ST was determined again at both temperatures. Five samples were read for each material and condition. Data were analyzed with repeated measures analysis of variance and a Tukey test at α=5% for each individual material.

RESULTS

The WT and ST of all cements were significantly affected by temperature and aging (p<0.05). In general, higher temperature accelerated WT/ST, but aging effects were material dependent. Some materials presented reduced WT/ST, whereas others showed increased WT/ST, regardless of the temperature.

CONCLUSIONS

The WT and ST were significantly affected by temperature variation and aging condition. Although temperature changes appeared to affect all materials similarly, aging effects were material dependent.