Microhardness of dual-polymerizing resin cements and foundation composite resins for luting fiber-reinforced posts

Statement of problem The optimal luting material for fiber-reinforced posts to ensure the longevity of foundation restorations remains undetermined. Purpose The purpose of this study was to evaluate the suitability of 3 dual-polymerizing resin cements and 2 dual-polymerizing foundation composite resins for luting fiber-reinforced posts by assessing their Knoop hardness number. Material and methods Five specimens of dual-polymerizing resin cements (SA Cement Automix, G-Cem LincAce, and Panavia F2.0) and 5 specimens of dual-polymerizing foundation composite resins (Clearfil DC Core Plus and Unifil Core EM) were polymerized from the top by irradiation for 40 seconds. Knoop hardness numbers were measured at depths of 0.5, 2.0, 4.0, 6.0, 8.0, and 10.0 mm at 0.5 hours and 7 days after irradiation. Data were statistically analyzed by repeated measures ANOVA, 1-way ANOVA, and the Tukey compromise post hoc test (α=.05). Results At both times after irradiation, the 5 resins materials showed the highest Knoop hardness numbers at the 0.5-mm depth. At 7 days after irradiation, the Knoop hardness numbers of the resin materials did not differ significantly between the 8.0-mm and 10.0-mm depths (P>.05). For all materials, the Knoop hardness numbers at 7 days after irradiation were significantly higher than those at 0.5 hours after irradiation at all depths (P<.05). At 7 days after irradiation, the Knoop hardness numbers of the 5 resin materials were found to decrease in the following order: DC Core Plus, Unifil Core EM, Panavia F2.0, SA Cement Automix, and G-Cem LincAce (P<.05). Conclusions The Knoop hardness number depends on the depth of the cavity, the length of time after irradiation, and the material brand. Although the Knoop hardness numbers of the 2 dual-polymerizing foundation composite resins were higher than those of the 3 dual-polymerizing resin cements, notable differences were seen among the 5 materials at all depths and at both times after irradiation

Challenges to the clinical placement and evaluation of adhesively-bonded, cervical composite restorations

Objectives. The incidence of non-carious cervical lesions (NCCLs) has been increasing. The clinical performance of resin composites in NCCLS was previously unsatisfactory due to their non-retentive forms and margins lying on dentin. In order to address this problem, a lot of effort has been put into developing new dentin adhesives and restorative techniques. This article discusses these challenges and the criteria used for evaluating clinical performance as they relate to clinical studies, especially long-term clinical trials. Polymerization contraction, thermal changes and occlusal forces generate debonding stresses at adhesive interfaces. Methods. In laboratory studies, we have investigated how these stresses can be relieved by various restorative techniques and how bond strength and durability can be enhanced. Lesion forms, restorative techniques, adhesives (adhesive strategies, bond strengths, bond durability, and the relationship between enamel and dentin bond strengths) were found to have a complex relationship with microleakage. With regard to some restorative techniques, only several short-term clinical studies were available. Results. Although in laboratory tests marginal sealing improved with a low-viscosity resin liner, an enamel bevel or prior enamel etching with phosphoric acid, clinical studies failed to detect significant effects associated with these techniques. Long-term clinical trials demonstrated that adhesive bonds continuously degraded in various ways, regardless of the adhesion strategy used. Significance. Early loss of restoration may no longer be the main clinical problem when reliable adhesives are properly used. Marginal discoloration increased over time and may become a more prominent reason for repair or replacement. Reliable and standardized criteria for the clinical evaluation of marginal discoloration should be established as soon as possible and they should be based on evidence and a policy of minimal intervention