An in vitro study to compare the influence of different all-ceramic systems on the polymerization of dual-cure resin cement

The Toothbrushing Effects on Surface Properties and Color Stability of CAD/CAM and Pressable Ceramic Fixed Restorations-An In Vitro Study

Pressable ceramic restorations have been introduced and investigated, and found comparable to CAD/CAM ceramic in terms of mechanical properties; however, the effect of toothbrushing on the pressable ceramic has not been thoroughly investigated. The objective of the current study was to assess the effect of artificial toothbrushing simulation on the surface roughness, microhardness, and color stability of different ceramic materials. Three lithium disilicate-based ceramics (IPS Emax CAD [EC], IPS Emax Press [EP]; (Ivoclar Vivadent AG), and LiSi Press [LP] (GC Corp, Tokyo, Japan)) were examined. For each ceramic material, eight bar-shaped specimens were prepared and subjected to 10,000 brushing cycles. Surface roughness, microhardness, and color stability (∆E) were measured before and after brushing. Scanning electron microscopy (SEM) was used for surface profile analysis. The results were analyzed using one-way ANOVA, Tukey's post hoc test, and paired sample t-test α = 0.05. The findings revealed a non-significant decrease in the surface roughness of EC, EP, and LP groups (p > 0.05), and both LP and EP have the lowest surface roughness values (0.64 ± 0.13, 0.64 ± 0.08 µm) after brushing, respectively. Toothbrushing showed a decrease in the microhardness of the three groups: EC and LP, p < 0.001; EP, p = 0.012). EP showed the lowest hardness value after brushing (862.45 ± 273.83). No significant changes (∆E) were observed in all groups (p > 0.05); however, the EC group was found to be considerably affected by color changes, in comparison to the EC and LP groups. Toothbrushing had no effect on surface roughness and color stability of all tested materials, but it decreased the microhardness. Material type, surface treatments, and glazing of ceramic materials contributed to the surface changes in the ceramic materials, necessitating further investigations in terms of the toothbrushing effect with different glazing as variables.

A Scoping Review on the Polymerization of Resin-Matrix Cements Used in Restorative Dentistry

In dentistry, clinicians mainly use dual-cured or light-cured resin-matrix cements to achieve a proper polymerization of the organic matrix leading to enhanced physical properties of the cement. However, several parameters can affect the polymerization of resin-matrix cements. The main aim of the present study was to perform a scoping review on the degree of conversion (DC) of the organic matrix, the polymerization, and the light transmittance of different resin-matrix cements used in dentistry. A search was performed on PubMed using a combination of the following key terms: degree of conversion, resin cements, light transmittance, polymerization, light curing, and thickness. Articles in the English language published up to November 2022 were selected. The selected studies' results demonstrated that restorative structures with a thickness higher than 1.5 mm decrease the light irradiance towards the resin-matrix cement. A decrease in light transmission provides a low energy absorption through the resin cement leading to a low DC percentage. On the other hand, the highest DC percentages, ranging between 55 and 75%, have been reported for dual-cured resin-matrix cements, although the polymerization mode and exposure time also influence the DC of monomers. Thus, the polymerization of resin-matrix cements can be optimized taking into account different parameters of light-curing, such as adequate light distance, irradiance, exposure time, equipment, and wavelength. Then, optimum physical properties are achieved that provide a long-term clinical performance of the cemented restorative materials.

Influences of Different CAD/CAM Ceramic Compositions and Thicknesses on the Mechanical Properties of Ceramic Restorations: An In Vitro Study

The aim of this study was to assess the influences of different CAD/CAM ceramic compositions and thicknesses on the surface roughness and hardness of ceramic restorations. Four different ceramics were used in the current study: lithium disilicate (LD), leucite reinforced (LE), advanced lithium disilicate (ALD), and zirconia-reinforced lithium silicate (ZLS). Each group included 30 specimens subdivided into three different ceramic thicknesses (0.5, 1 and 1.5 mm thicknesses). The microhardness was measured for all the specimens using a microhardness testing machine, while the surface roughness was measured using a non-contact optical profilometer at three intervals (before toothbrushing and after toothbrushing, with and without toothpaste). Three-way and two-way ANOVA were used to determine the factors influencing the surface roughness and microhardness. There was a significant difference in the surface roughness between the studied groups for all the thicknesses. The findings showed that ALD had the lowest surface roughness, while ZLS showed the highest surface roughness. Moreover, ALD, followed by ZLS, had the highest hardness, while LD and LE had the lowest hardness values. Regarding the thicknesses, both the 0.5 and 1 mm ceramic thicknesses showed a significantly lower surface roughness than the 1.5 mm thickness, while the 1.5 mm thickness showed a significantly higher microhardness than the 0.5 mm thickness. The surface roughness and hardness were significantly affected by the ceramic composition and type of filler. It is recommended to use 1.5 mm-thick ceramic materials for the fabrication of definitive full-coverage ceramic restorations, while veneers require 0.5 mm-thick materials. ALD is a promising CAD/CAM material that can be used for the fabrication of restorations with a proper strength in both anterior and posterior regions.

Degree of conversion of resin-cements (light-cured/dual-cured) under different thicknesses of vitreous ceramics: systematic review

PURPOSE

This systematic review synthesized and analyzed the scientific evidence on the degree of conversion (DC) obtained by Fourier-transform infrared spectroscopy (FTIR) of light-cured and dual-cured resinous cements, photopolymerized under different thicknesses of vitreous ceramics.

STUDY SELECTION

The study protocol of this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017069319). A comprehensive search (PubMed/MEDLINE, Scopus, EMBASE, and LILACS) was performed for papers including an in vitro design and indexed from January 2007 to December 2020 according to the study purposes. A quality appraisal (specific instrument) and descriptive analysis of the articles that met the inclusion criteria were conducted.

RESULTS

Nine included studies were analyzed. Two of them used feldspathic ceramics, six used lithium disilicate, and one used both (comparing different types and opacities of ceramics). Three studies found a higher DC in dual cements, while one did not find any significant differences, and five studies found a higher DC in light-cured resin cements. Light-cured cements showed a better DC in relation to dual-cured cements in vitreous ceramic restorations with thicknesses up to 2 mm.

CONCLUSION

According to the findings, the use of good photoactivation is the most relevant variable to achieve an adequate DC in light-cured and dual-cured resin cements. The use of vitreous ceramic restorations with a thickness of less than 2 mm (light-curing cements) shows a better DC. Standardized in vitro studies are required to generate accurate scientific evidence.

Impact of Immediate and Delayed Photo-activation of Self-adhesive Resin Cements on Bonding Efficacy and Water Uptake Under Simulated Pulpal Pressure

This study investigated the effect of immediate versus delayed photo-activation on the bonding performance and water uptake of self-adhesive (SA) resin cements under simulated pulpal pressure (SPP). The occlusal dentin surface was exposed in 66 extracted third molars. Resin composite cylinders were cemented to dentin under SPP, with either RelyX Unicem 2 (RU) (3M Oral Care, St Paul, MN, USA) or Maxcem Elite (MC) (Kerr, Orange, CA, USA). Each cement group was equally divided into three groups (n=8 each) according to the time elapsed between placement and photo-activation: immediate activation (IM), 30-second delayed activation (D30), or 120-second delayed activation (D120). Shear bond strength (SBS) was measured, and the type of failure was determined using a stereomicroscope. Three additional samples from each experimental subgroup were used for confocal laser scanning microscopy (CLSM) analysis. A fluorescent dye solution was added to the pulpal fluid reservoir, then a CLSM was used to detect the dye distribution within the tooth-restoration interface. Two-way analysis of variance (ANOVA) and the Tukey post-hoc test were used to analyze the SBS results (α=0.05). D30 resulted in a significantly higher mean SBS in the two cement groups than IM and D120 (p<0.05). RU showed significantly higher SBS values than MC regardless of the time of light activation (p<0.05). RU showed less dye uptake confined to the cement-dentin interface compared to the MC groups, which showed dye uptake throughout the entire thickness of the cement layer and gap formation at the interface, especially in the D120 group. The 30-second photo-activation delay group significantly improved the bond strength of SA cements. Delaying the photo-activation to 120 seconds increased pulpal fluid uptake by SA cements and compromised the integrity of the bonded interfaces.

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.