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Calheiros-Lobo MJ, Carbas R, da Silva LFM, Pinho T. Impact of in vitro findings on clinical protocols for the adhesion of CAD-CAM blocks: A systematic integrative review and meta-analysis. J Prosthet Dent 2024; 131:1051-1070. [PMID: 36543700 DOI: 10.1016/j.prosdent.2022.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 12/23/2022]
Abstract
STATEMENT OF PROBLEM Computer-aided design and computer-aided manufacturing (CAD-CAM) blocks have evolved rapidly, making it difficult to establish the best clinical protocol for bonding a given block and whether an established protocol is appropriate for a newly introduced product. PURPOSE This integrative systematic review and meta-analysis aimed to clarify whether the clinician can select the most efficient adhesion protocols for CAD-CAM blocks by reading published in vitro studies and implementing them in daily practice. MATERIAL AND METHODS Based on the population, intervention, comparison, and outcome (PICO) strategy, 3 databases were searched for in vitro studies, randomized clinical trials, prospective or retrospective studies, and case reports from January 1, 2015, to July 31, 2021. A meta-analysis analyzed 28 studies to calculate the mean difference between best and worst protocols for each author and block with a random-effects model (α=.05). RESULTS From 508 relevant studies, 37 in vitro studies, 2 clinical studies, and 1 clinical report were selected for data extraction and qualitative analysis. Vita Enamic, IPS e.max CAD, LAVA Ultimate, and Vita Mark II blocks were the most studied, and RelyX Ultimate was the most used luting cement. The meta-analysis confirmed the null hypothesis that the evidence-based efficacy of clinical protocols to bond CAD-CAM blocks is still controversial (P<.05). CONCLUSIONS There are objective standards for individual in vitro tests, but the studies lack standardization. Some tested protocols were more efficient than others. Randomized clinical trials and well-documented clinical situations were almost nonexistent, making direct application of in vitro findings in clinical practice impossible.
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Affiliation(s)
- Maria João Calheiros-Lobo
- Clinical Professor, Department of Conservative Dentistry and Researcher, UNIPRO - Oral Pathology and Rehabilitation Research Unit, IUCS - CESPU, Gandra, Portugal.
| | - Ricardo Carbas
- Postdoctoral Researcher, INEGI - Institute of Science and Innovation in Mechanical and Industrial Engineering, University of Porto, Porto, Portugal
| | - Lucas F M da Silva
- Full Professor, Department of Mechanical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Teresa Pinho
- Full Professor and Researcher, UNIPRO - Oral Pathology and Rehabilitation Research Unit, IUCS - CESPU, Gandra, Portugal
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da Rosa LS, Pilecco RO, Soares PM, Rippe MP, Pereira GKR, Valandro LF, Kleverlaan CJ, Feilzer AJ, Tribst JPM. Repair protocols for indirect monolithic restorations: a literature review. PeerJ 2024; 12:e16942. [PMID: 38406292 PMCID: PMC10893862 DOI: 10.7717/peerj.16942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Despite the advancements in indirect monolithic restorations, technical complications may occur during function. To overcome this issues, intraoral repair using resin composite is a practical and low-cost procedure, being able to increase the restoration's longevity. This review aimed to evaluate the need for repair and suggest a standardized repair protocol to the main indirect restorative materials. For this, studies were surveyed from PubMed with no language or date restriction, to investigate the scientific evidence of indirect monolithic restoration repair with direct resin composite. A classification to guide clinical decisions was made based on the FDI World Dental Federation criteria about defective indirect restorations considering esthetic and functional standards, along with the patient's view, to decide when polishing, repairing or replacing a defective restoration. Based on 38 surveyed studies, different resin composite intraoral repair protocols, that included mechanical and chemical aspects, were defined depending on the substrate considering resin-based, glass-ceramic or zirconia restorations. The presented criteria and protocols were developed to guide the clinician's decision-making process regarding defective indirect monolithic restorations, prolonging longevity and increasing clinical success.
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Affiliation(s)
| | | | | | | | | | | | - Cornelis Johannes Kleverlaan
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - Albert J. Feilzer
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - João Paulo Mendes Tribst
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
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Turunç-Oğuzman R, Şişmanoğlu S. Influence of surface treatments and adhesive protocols on repair bond strength of glass-matrix and resin-matrix CAD/CAM ceramics. J ESTHET RESTOR DENT 2023; 35:1322-1331. [PMID: 37680089 DOI: 10.1111/jerd.13131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To specify the effects of self-etching ceramic primer, Monobond Etch and Prime (MEP), and universal adhesive (UA) on repair bond strength between CAD/CAM blocks and resin composite. MATERIALS AND METHODS Vita Mark II (VM), IPS e.max CAD (EMAX), Shofu Block HC (SHC), and Tetric CAD (TET) blocks were sliced and thermocycled. They were divided into four groups according to surface treatments (n = 24): control, sandblasting (AL), hydrofluoric acid etching (HF), and MEP application. SEM analysis assessed surface topography. Subdivided, specimens followed distinct adhesive protocols (n = 12): control (silane + adhesive [SA] or adhesive [A] only for MEP group) and UA. Microshear bond strength (μSBS) was measured following resin composite repair. Data were analyzed using two-way ANOVA and Tukey tests (p < 0.05). RESULTS The μSBS of CAD/CAM blocks was significantly influenced by surface treatment type and adhesive protocol. The highest μSBS values for each block, considering surface treatment + adhesive protocol, were VM, HF + SA, or HF + UA; EMAX, MEP + A; and SHC and TET, AL + SA, or AL + UA. CONCLUSIONS Except for EMAX, it was not the adhesive protocol that made the significant difference in bond strength for each CAD/CAM block, but the surface treatment. MEP + UA application on glass ceramics lowered μSBS values significantly, so it is not recommended in clinical conditions. CLINICAL SIGNIFICANCE Repair is an essential therapeutic option, particularly in esthetic restorations, to swiftly repair the impaired esthetics caused by fracture. Repair protocol is dependent on the restorative material, and to have a reliable repair bond strength, the following surface treatment and adhesive protocol combinations are recommended for each CAD/CAM block: VM, HF + SA, or HF + UA; EMAX, MEP + A; and SHC and TET, AL + SA, or AL + UA.
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Affiliation(s)
- Rana Turunç-Oğuzman
- Department of Prosthodontics, Faculty of Dentistry, Altınbaş University, Istanbul, Turkey
| | - Soner Şişmanoğlu
- Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Uğur M, Kavut İ, Tanrıkut ÖO, Cengiz Ö. Effect of ceramic primers with different chemical contents on the shear bond strength of CAD/CAM ceramics with resin cement after thermal ageing. BMC Oral Health 2023; 23:210. [PMID: 37041493 PMCID: PMC10091622 DOI: 10.1186/s12903-023-02909-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/24/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND This study evaluated the effect of ceramic primers containing 10-methacryloyloxydecyl phosphate (10-MDP) and γ-methacryloxypropyl trimethoxysilane (γ-MPTS) agents on the shear bond strength (SBS) of CAD/CAM ceramics with different chemical structures and resin cement. METHODS A total of 640 CAD/CAM ceramic specimens were obtained from Vita Mark II (VM), IPS E.max CAD (EM), Vita Suprinity (VS) and Vita Enamic (VE). The specimens were divided into two groups: etched with hydrofluoric acid (HF) and unetched. Each group was treated with a different ceramic primer (Clearfil Ceramic Primer Plus, G-Multi Primer and Monobond S), except for an untreated group (n = 10). After ceramic primers and resin cement were applied to each ceramic surface, half of the specimens were thermally aged at 10,000 cycles, 5-55 ± 1 °C, with a dwell time of 30 s. The SBS was tested with a universal testing machine at a 0.5 mm/min crosshead speed. Data were analysed by using statistical software (SPSS 20). Normal data distribution was checked with the Shapiro‒Wilk test. Three-way ANOVA was used to analyse the difference between the numeric data of the HF etched and thermally aged groups. A post hoc Tukey test was applied in the paired comparison of significant difference. The statistical significance level was accepted as p < 0.05. RESULTS The highest SBS values were obtained in the HF etched G-Multi primer applied nonaged EM group (28.3 ± 2.62 MPa), while the lowest values were obtained in the nonetched and thermally aged EM group that received no treatment (2.86 ± 0.04 Mpa). The SBS significantly increased in all specimens on which the ceramic primer was applied (p < 0.001). Thermal ageing had a significant negative effect on the SBS values in all groups (p < 0.001). CONCLUSION The positive combined effects of the 10-MDP and γ-MPTS agents resulted in a significant increase in the bonding strength of the resin cement to the CAD/CAM ceramics. In addition, the increase in the amount of inorganic filler provided a favourable effect on durable adhesion.
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Affiliation(s)
- Mehmet Uğur
- Department of Prosthodontics, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey
| | - İdris Kavut
- Department of Prosthodontics, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey.
| | - Özgür Ozan Tanrıkut
- Department of Prosthodontics, Faculty of Dentistry, Mersin University, Mersin, Turkey
| | - Önder Cengiz
- Gungoren Oral and Dental Health Center, Istanbul, Turkey
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Effect of Anti-COVID-19 Mouthwashes on Shear Bond Strength of Resin-Matrix Ceramics Repaired with Resin Composite Using Universal Adhesive: An In Vitro Study. J Funct Biomater 2023; 14:jfb14030158. [PMID: 36976082 PMCID: PMC10052296 DOI: 10.3390/jfb14030158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Using anti-COVID-19 mouthwashes has become necessary to reduce acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmissions. Resin-matrix ceramic (RMCs) materials that are exposed to mouthwashes may affect the bonding of repaired materials. This research was performed to assess the effects of anti-COVID-19 mouthwashes on the shear bond strengths (SBS) of RMCs repaired with resin composites. A total of 189 rectangular specimens of two different RMCs (Vita Enamic (VE) and Shofu Block HC (ShB)) were thermocycled and randomly divided into nine subgroups according to different mouthwashes (distilled water (DW), 0.2% povidone–iodine (PVP-I), and 1.5% hydrogen peroxide (HP)) and surface treatment protocols (no surface treatment, hydrofluoric acid etching (HF), and sandblasting (SB)). A repair protocol for RMCs was performed (using universal adhesives and resin composites), and the specimens were assessed using an SBS test. The failure mode was examined using a stereomicroscope. The SBS data were evaluated using a three-way ANOVA and a Tukey post hoc test. The SBS were significantly affected by the RMCs, mouthwashes, and surface treatment protocols. Both surface treatment protocols (HF and SB) for both RMCs, whether immersed in anti-COVID-19 mouthwash or not, improved the SBS. For the VE immersed in HP and PVP-I, the HF surface treatment had the highest SBS. For the ShB immersed in HP and PVP-I, the SB surface treatment had the highest SBS.
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Jung SN, Rüttermann S. Influence of mechanical and chemical pre-treatments on the repair of a hybrid ceramic. Dent Mater 2022; 38:1140-1148. [PMID: 35672161 DOI: 10.1016/j.dental.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 05/06/2022] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study aimed to investigate the influence of the respective mechanical and chemical pre-treatments on the composite repair of a CAD/CAM hybrid ceramic using a microtensile bond strength test (μTBS). METHODS 15 CAD/CAM Blocks of Vita Enamic (VE) were randomly sectioned into three mechanical pre-treatments: (1.) Diamond bur (D), (2.) Airborne abrasion (A), (3.) Tribochemical silica coating (T) and subsequently five chemical pre-treatments: (1.) Clearfil SE Bond Bond (B; negative control), (2.) ESPE Sil (S), (3.) Clearfil Ceramic Primer Plus (CPP), (4.) Clearfil Repair (CR) and (5.) Scotchbond Universal (SCB). Per block, n = 20 specimens were sawn. Half of the specimens were randomly selected and subjected to an immediate bond strength test, while the other half was subjected to artificial aging for 6 months 180 days at 37 °C and subsequent thermocycling of 5000 cycles. A μTBS was performed and data (MPa) were compared in one-way and two-way ANOVA and Tukey's HSD. Paired-t-test was used for artificial aging (α = 0.05). Debonded specimens were analyzed of for failure modes with a stereomicroscope (SEM). RESULTS The results of one-way ANOVA for the fifteen fastening procedures after aging indicated significant differences according to SCB-A and CPP-T. Two-way ANOVA after aging observed inferior bond strength for SCB. No differences were observed for mechanical pre-treatments. Artificial aging showed a significant reduction in bond strength on most of the fastening procedures. SIGNIFICANCE SCB showed the lowest bond strength values besides B, S, CPP, and CR. MDP and silane are both suitable for the repair of VE.
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Affiliation(s)
- Sascha Niklas Jung
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt D-60598, Germany
| | - Stefan Rüttermann
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt D-60598, Germany.
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Lührs A, Brachmann C, Jacker‐Guhr S. Dentin contamination during repair procedures: A threat to universal adhesives? Clin Exp Dent Res 2022. [PMCID: PMC9209802 DOI: 10.1002/cre2.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective This study examined the influence of surface contamination during repair procedures with hydrofluoric acid, silane, or ammonium polyfluoride on the bond strength of universal adhesives to dentin using different etching modes before and after thermocycling. Materials and Methods Dentin surfaces of human molars were contaminated in different ways (silane, hydrofluoric acid, ammonium polyfluoride, and no pretreatment as control) followed by application of a universal adhesive (etch & rinse or self‐etch mode). After a composite build‐up was placed onto each tooth, sticks for the microtensile bond strength (MTBS) test were sectioned. Half of the sticks were tested after water storage for 24 h, the other half after thermocycling (15,000 cycles, 5/55°C). The MTBS data were analyzed statistically by using the Kolmogorov–Smirnov test, one‐way analysis of variance, and Tukey HSD test (p < 0.05). The fracture patterns of all specimens were evaluated and analyzed using a χ2 test. Results Dentin contamination with a multifunctional silane does not influence microtensile bond strength irrespective of aging. Contamination with hydrofluoric acid or an ammonium polyfluoride primer leads to a significantly lower bond strength after aging, irrespective of the etch mode. Conclusion Dentin contamination with hydrofluoric acid or ammonium polyfluorides during repair procedures should be avoided, as they appear to decrease the bond strength of universal adhesives.
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Affiliation(s)
- Anne‐Katrin Lührs
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry Hannover Medical School Hannover Germany
| | - Cosima Brachmann
- Department of Prosthetic Dentistry and Biomedical Materials Research Hannover Medical School Hannover Germany
| | - Silke Jacker‐Guhr
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry Hannover Medical School Hannover Germany
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OĞUZ Eİ, ÇİÇEKCİ G. Influence of different repair protocols and artificial aging on bond strength of composite to a CAD/CAM polymer-infiltrated ceramic. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.802118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sismanoglu S, Yildirim-Bilmez Z, Erten-Taysi A, Ercal P. Influence of different surface treatments and universal adhesives on the repair of CAD-CAM composite resins: An in vitro study. J Prosthet Dent 2020; 124:238.e1-238.e9. [PMID: 32376031 DOI: 10.1016/j.prosdent.2020.02.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM The repairability of computer-aided design and computer-aided manufacturing (CAD-CAM) composite resins might be adversely affected by the high degree of matrix polymerization that occurs during their manufacturing process. However, information on their repairability is lacking. PURPOSE The purpose of this in vitro study was to evaluate the microtensile bond strength of CAD-CAM composite resins subjected to simulated repair procedures by using varying surface treatments and universal adhesives. MATERIAL AND METHODS Four different CAD-CAM blocks (Brilliant Crios, Lava Ultimate, Shofu Block HC, and Vita Enamic) were thermocycled (5000 times, 5/55 °C) and divided into 4 groups according to the surface treatment: control, 9% hydrofluoric acid etching, aluminum oxide airborne-particle abrasion, and tribochemical silica airborne-particle abrasion. After surface treatments, the surface roughness was measured with a nanoindenter and further examined with scanning electron microscopy. After the application of 3 different universal adhesives (Clearfil Universal Bond, Prime&Bond Universal, and Single Bond Universal), the specimens were subjected to a simulated repair process with composite resin. Bonded specimens were cut into 1 mm2 beams, and microtensile bond strength values were determined until failure at a crosshead speed of 0.5 mm/min. The bond strength data were analyzed with 3-way analysis of variance, and surface roughness data were analyzed with 2-way analysis of variance tests. Pairwise analyses were performed with the Tukey test (α=.05). RESULTS All surface treatments effectively improved repair microtensile bond strength values compared with the control (P<.05). Aluminum oxide airborne-particle abrasion had similar mean bond strength values compared with tribochemical silica airborne-particle abrasion (P>.05). Among the CAD-CAM blocks treated with hydrofluoric acid etching, Vita Enamic had the highest mean bond strength values. The highest mean microtensile bond strength repair values with the highest cohesive failure rates were found with the silane-containing universal adhesive (Single Bond Universal). CONCLUSIONS Surface treatment with aluminum oxide airborne-particle abrasion and tribochemical silica airborne-particle abrasion produced successful repair results for aged resin nanoceramics, whereas hydrofluoric acid etching can be used for aged hybrid ceramic repair. Silane-containing universal adhesive reported increased bond strength. Application of universal adhesive after surface treatment is recommended to increase repair strength.
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Affiliation(s)
- Soner Sismanoglu
- Assistant Professor, Department of Restorative Dentistry, School of Dentistry, University of Altinbas, Istanbul, Turkey.
| | - Zuhal Yildirim-Bilmez
- Assistant Professor, Department of Restorative Dentistry, School of Dentistry, University of Hatay Mustafa Kemal, Hatay, Turkey
| | - Aysegul Erten-Taysi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Altinbas, Istanbul, Turkey
| | - Pınar Ercal
- Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Altinbas, Istanbul, Turkey
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