Adhesion of conventional and simplified resin-based luting cements to superficial and deep dentin

This study evaluated the bond strengths of conventional (chemically and dual-polymerized) and simplified resin-based luting cements with their corresponding adhesives to superficial dentin (SD) and deep dentin (DD). Recently extracted third molars (N = 70, n = 10 per group) were obtained and prepared for testing procedures. After using their corresponding etchants, primers, and/or adhesive systems, the conventional and simplified cements (Variolink II [group A, conventional], Bifix QM [group B, conventional], Panavia F2.0 [group C, conventional], Multilink Automix [group D, simplified], Superbond C&B [group E, conventional], Clearfil Esthetic Cement [group F, simplified], Ketac-Fil [group G, conventional]) were adhered incrementally onto the dentin surfaces using polyethylene molds (inner diameter 3.5mm, height 5mm) and polymerized accordingly. Resin-modified glass-ionomer cement (RMGIC) acted as the control material. Shear bond strengths (1mm/min) were determined after 500 times of thermocycling. Kruskal-Wallis and Mann-Whitney tests were used to analyze the data (α = 0.05). Bond strength (MPa) results were significantly affected by the cement types and their corresponding adhesive systems (p ≤ 0.05). The shear bond strengths (MPa ± SD) for groups A-G were 14.6 ± 3.8, 18.9 ± 3.9, 5.5 ± 4.5, 3.1 ± 3.6, 1.1 ± 2.5, 15.5 ± 2.6, 7 ± 4.3 and 7.1 ± 5.8, 15.1 ± 7.8, 8.4 ± 7.3, 7.5 ± 7.3, 4.9 ± 5.1, 12.5 ± 2.1, 6 ± 2.6 for SD and DD, respectively. The level of dentin depth did not decrease the bond strength significantly (p > 0.05) for all cements, except for Variolink II (p < 0.05). On the SD, bond strength of resin cements with "etch-and-rinse” adhesive systems (Variolink II, Bifix QM, Super-Bond C&B) showed similar results being higher than those of the simplified ones. Simplified cements and RMGIC as control material showed inferior adhesion to superficial and deep dentin compared to conventional resin cements teste

Zirconia: More and More Translucent

Purpose of Review Yttria-stabilized zirconium dioxide, 3 mol% Y-TZP (zirconia, 3Y-TZP) was introduced as a prosthetic material to provide metal-free, tooth-colored, and durable material option for the patients. However, its optical properties are not ideal. This review describes the different strategies to increase translucency of zirconia material and summarizes the current knowledge of translucent zirconia for fixed prosthodontic applications. Recent Findings One of the most common ways of increasing the translucency of zirconia is to add the cubic phase by increasing Y2O3 content. Y2O3 4Y mol% and Y2O3 5Y mol% partially stabilized zirconia materials seem to have better optical properties compared to 3Y-TZP materials but with less favorable mechanical properties. Summary Despite the attempts to develop a translucent zirconia material, its optical properties are still far from those of natural tooth structures. Possible solution for achieving more translucent and durable zirconia material could be utilizing nanocrystalline zirconia. The production of nanocrystalline zirconia is yet very technique-sensitive, and the sintering process needs to be well controlled. Additional research in this field is needed before recommendation for clinical use. In the future, the challenge will be in achieving balance between improved translucency without sacrificing from mechanical properties. This would apply not only for subtractive but also additively manufactured zirconia ceramics

Randomized Trial of Feasibility and Preliminary Effectiveness of PerioTabs® on Periodontal Diseases

This double-blinded and split-mouth design, randomized feasibility study aimed to assess the efficacy of prophylactic and therapeutic use of a new age NitrAdineTM-based brushing solution (PerioTabs®) on the clinical parameters before and after periodontal therapy. Four subjects were randomly assigned to two treatment groups according to periodontal infection: PerioTabs® and placebo. At the first appointment, a split-mouth scaling was performed in all participants. All oral care instructions concerning the use of effervescent tablets were explained to the participants in detail. The morning after the tablets were finished, a full-mouth scaling was completed in all participants. All parameters were recorded at 0, 11, and 40 days. According to the results, both the therapeutic and prophylactic interventions showed similar impacts on the gingival index and probing depth compared to the placebo in all patients. The bleeding on probing was further reduced at the PerioTabs® group at baseline until day 40 compared to the placebo in the gingivitis patients with both interventions; at both 11 and 40 days in the periodontitis patients receiving the therapeutic intervention; and at baseline to day 40 in the periodontitis group receiving the prophylactic intervention. While the preliminary results of this new-age brushing solution appear to be a promising approach for a future therapy of periodontal diseases, further research on a larger sample size is needed to draw firm conclusions

Effect of clinical and laboratory contamination media on the adhesion of luting cement to direct and indirect resin composite materials

This study evaluated the effect of contamination media on the adhesion of resin cement to resin composites. Specimens of direct (DRC) (Quadrant Photo Posterior) and indirect resin composite (IRC) (Gradia) (N = 300, n = 15 per group) were prepared. Except the control group (C), the specimens of DRC and IRC were contaminated with one of the following media: (a) saliva (S), (b) silicon (SI), (c) dental stone (D), and (d) isolation medium (I). While one half was only rinsed with water, the other half was silica coated (30 μm SiO2, Siljet). All specimens were silanized (Monobond Plus) and coated with adhesive resin (Heliobond). Resin cement (Variolink II) was bonded to the substrates and photo-polymerized for 40 s. After thermocycling (x5.000, 5–55 °C), composite–cement interface was loaded under shear in a Universal Testing Machine (1 mm/min). Data (MPa) were analyzed using Univariate analysis, Tukey’s and Dunnett-T3 tests. Both contamination media (p = 0.000) and surface conditioning (p = 0.005) significantly affected adhesion to DRC and IRC. No significant difference was found between the DRC and IRC (without: p = 0.098; with: p = 0.084). Significantly lower results were obtained after SI (DRC: 0.66 ± 0.6; IRC: 0.8 ± 1.3) followed by I contamination (DRC: 2.1 ± 2.6; IRC: 0.8 ± 1.3) (p < 0.05). Regardless of contamination medium, surface conditioning significantly increased the results for both DRC (15.1 ± 6.1–23.6 ± 3.7) and IRC (20.3 ± 5.4–25.1 ± 3.6) (p < 0.05). Weibull distribution increased after surface conditioning for both DRC (without: 1.33–3.27; with: 2.55–9.34) and IRC (without: 1.07–3.75; with: 3.7–7.73). Predominantly adhesive (132 out of 150) failures were observed when surfaces were not conditione

Additive Manufacturing Technologies Used for Processing Polymers: Current Status and Potential Application in Prosthetic Dentistry

There are 7 categories of additive manufacturing (AM) technologies, and a wide variety of materials can be used to build a CAD 3D object. The present article reviews the main AM processes for polymers for dental applications: stereolithography (SLA), digital light processing (DLP), material jetting (MJ), and material extrusion (ME). The manufacturing process, accuracy, and precision of these methods will be reviewed, as well as their prosthodontic applications

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

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

Early bond strength of two resin cements to Y-TZP ceramic using MPS or MPS/4-META silanes

For cementation of yttrium-stabilized tetragonal zirconium polycrystal (Y-TZP) ceramic frameworks, protocols of surface-conditioning methods and available cements vary, resulting in confusion among clinicians regarding selection and effects of different conditioning methods on cement adhesion. This study evaluated the effect of two silanes (3-trimethoxysilylpropylmethacrylate (MPS) and 3-trimethoxysilylpropylmethacrylate/4-methacryloyloxyethyl trimellitate anhydride methyl methacrylate (MPS/4-META) on the adhesion of two resin-based cements (SuperBond and Panavia F 2.0) to Y-TZP ceramic and compared several protocols with those indicated by the manufacturer of each of these cements. Disks of Y-TZP ceramic (LAVA, 3M ESPE) (n = 60) were divided into six experimental groups (n = 10 per group) and treated as follows: (1) silica coating (SC) + MPS silane + SuperBond; (2) SC + MPS/4-META + silane + SuperBond); (3) SC + MPS silane + Panavia F 2.0); (4) SC + MPS/4-META silane + Panavia F 2.0); (5) no conditioning + MPS/4-META silane + Super-Bond (SuperBond instructions); and (6) 50-μm Al2O3 conditioning + Panavia F 2.0 (Panavia F 2.0 instructions). The specimens were subjected to shear-bond testing after water storage at 37°C for 3 months in the dark. Data were analyzed by analysis of variance and Tukey's HSD (α = 0.05). After silica coating, the mean bond strength of SuperBond cement was not significantly different between MPS and MPS/4-META silanes (20.2 ± 3.7 and 20.9 ± 1.6 MPa, respectively), but the mean bond strength of Panavia F 2.0 was significantly higher with MPS silane (24.4 ± 5.3 MPa) than with MPS/4-META (12.3 ± 1.4 MPa) (P < 0.001). The SuperBond manufacturer's instructions alone resulted in significantly higher bond strength (9.7 ± 3.1 MPa) than the Panavia F 2.0 manufacturer's instruction (0 MPa) (P < 0.001). When silica coating and silanization were used, both SuperBond and Panavia F 2.0 cements demonstrated higher bond strengths they did when the manufacturers' instructions were followed. With SuperBond, use of MPS or MPS/4-META silane resulted in no significant difference when the ceramic surface was silica coated, but with Panavia F 2.0, use of MPS silane resulted in a significantly higher bond strength than use of MPS/4-META. Use of chairside silica coating and silanization to condition the zirconia surface improved adhesion compared with the manufacturers' cementation protocols for SuperBond and Panavia F 2.0 resin cement