Long-term fracture load of all-ceramic crowns : effects of veneering ceramic thickness, application techniques, and cooling protocol

To evaluate, in vitro, the effects of the cooling protocol, application technique, and veneering ceramic thickness on the fracture resistance of ceramic crowns with Y-TZP frameworks. 80 frameworks were made from zirconia by the CAD/CAM technique and divided into 8 groups (n = 10) according to the factors: ?application technique? (stratified-L and pressed -P), ?thickness? (1 mm and 2 mm), and ?cooling protocol? (slow-S and fast-F) of the feldspathic veneering ceramic. After, all crowns were cemented over G10 preparations with resin cement (Panavia F, Kuraray), mechanically cycled (2x106 cycles, 200 N, 3Hz), and subjected to the axial compression resistance test (0.5 mm/min, 10 kN). The data (N) underwent descriptive statistical analysis by 3-way ANOVA and Tukey?s test (5%). Fracture analysis was performed to determine the possible origin of failure. The factors ?cooling protocol? (P=0.0058) and ?application? technique (P=0.0001) influenced the fracture resistance of the crowns. For pressed veneer technique, the P2S (4608.9±464.5). A presented significantly higher results than that P2F(3621.1±523.0)BCD (Tukey?s test). For the stratified technique, this difference was not observed (P>0.05). The thickness of the veneering ceramic was not significant regardless of the cooling protocol and technique (P>0.05). The predominant failure mode was chipping of the ceramic veneer originating in the subsurface. The pressed technique, used with a slow-cooling protocol, leads to the best outcome for the veneering of all-ceramic crowns

Effect of temporary cement removal methods from human dentin on zirconia-dentin adhesion

This study evaluated the effect of temporary cement residue removal methods from human coronary dentin on the bond strength of adhesively-luted zirconia on dentin. Forty non-carious human molars were embedded in acrylic resin and the dentin surfaces were exposed. Temporary acrylic crowns were provisionally cemented with zinc oxide cement without eugenol and stored in distilled water (37 °C/15 days). After crown removal, the excess temporary cement was removed from dentin according to one of the following cleaning methods: (n = 8 per group): (a) air-water rinse (AW), (b) pumice paste (PP), (c) air-abrasion with aluminum oxide particles (Al2O3) (AA), (d) sodium bicarbonate spray (SB) or (e) glycine powder (CP). Forty zirconia cylinders were made and each cylinder was adhesively luted onto each tooth after adhesive resin (Scotch Bond Universal, 3 M ESPE-SBU) application using resin cement (RelyX Ultimate, 3 M ESPE) and photo-polymerized from each surface for 20 s. The bonded specimens were stored in distilled water (37 °C) for 90 days. The bonded interface was loaded under shear (1 mm/min). Data (MPa) were analyzed using 1-way ANOVA and Tukey's test (α = 0.05). Mean bond strength was significantly affected by the cleaning method (p = 0.0289). Cleaning with AA method resulted in significantly higher bond strength than with SB (p  0.05). All cleaning methods were effective in removing temporary resin cement from dentin surfaces. Air-abrasion with aluminum oxide particles was more effective than with sodium bicarbonate spray promoting adhesion between zirconia and dentin

Effect of different surface treatments and multimode adhesive application on the Weibull characteristics, wettability, surface topography and adhesion to CAD/CAM lithium disilicate ceramic

This paper aims to evaluate the effect of different surface treatments on surface topography, wettability, and shear bond strength of resin cement to glass ceramic. Methodology: For SBS test, 32 blocks (7x7x2 mm) of lithium disilicate were obtained and randomly divided into eight groups (four blocks per group) according to each surface treatment (HF 20 s, 60 s, 120 s + silanization/S or Scotch Bond Universal/ SBU) and the Monobond Etch & Prime - MEP application followed or not by SBU. On each treated surface ceramic block, up to four dual-curing resin cement cylinders were prepared and light-cured for 40s (N=120/n=15). The specimens were thermocycled (10,000 cycles, 5-55°C, 30 s) and the SBS test (50KgF, 0.5 mm/min) was performed. Furthermore, failure analysis, wettability, AFM, and SEM were carried out. SBS data (MPa) were analyzed using Student's t-test, two-way ANOVA, Tukey's test (5%) and Weibull's analysis. Results: For HF experimental groups, two-way ANOVA presented the factors “etching time” and “bonding agent” as significant (p<0.05). After silane application, the HF groups presented similar bond strength. SBU application compromised the SBS, except for 120s etching time (HF120sS: 23.39ᵃ±6.48 MPa; HF120sSBU: 18.76ᵃ±8.81MPa). For MEP groups, SBU application did not significantly affect the results (p=0.41). The MEP group presented the highest Weibull modulus (4.08A) and they were statistically different exclusively from the HF20sSBU (0.58B). Conclusion: The HF 20s, 60s, 120 s followed by silane, promoted similar resin-bond strength to ceramic and the SBU application after HF or MEP did not increase the SBS

Influence of testing parameters on the load-bearing capacity of prosthetic materials used for fixed dental prosthesis: A systematic review and meta-analysis

The aim of this study was to systematically review the literature to assess static fracture strength tests applied for FDPs and analyze the impact of periodontal ligament (PDL) simulation on the fracture strength. Original scientific papers published in MEDLINE (PubMed) database between 01/01/1981 and 01/06/2010 were included in this systematic review. Data were analyzed considering the test method (static loading), material type (metal-ceramic-MC, oxide all-ceramic-AC, fiber reinforced composite resin-FRC, composite resin-C), PDL (without or with) and restoration type (single crowns, 3-unit, 4-unit, inlay-retained and cantilever FDPs). The selection process resulted in the 72 studies. In total, 377 subgroups revealed results from static load-bearing capacity of different materials. Fourteen metal-ceramic, 190 AC, 121 FRC, 45 C resin groups were identified as subgroups. Slightly decreased results were observed with the presence of PDL for single crowns (without PDL=1117±215 N; with PDL=876±69 N), 3-unit FDPs (without PDL=791±116 N; with PDL=675±91 N) made of AC, 3-unit FDP (without PDL=1244±270 N; with PDL=930±76 N) and inlay-retained FDP (without PDL=848±104 N; with PDL=820±91 N) made of FRC and 4-unit FDPs (without PDL=548±26 N; with PDL=393±67 N) made of C. Overall, for single crowns, fracture strength of FRC was higher than that of AC and MC; for 3-unit FDPs FRC=C>AC=MC; for 4-unit FDPs AC>FRC>C and for inlay-retained FDPs, FRC=AC. An inclination for decreased static fracture strength could be observed with the simulation of PDL but due to insufficient data this could not be generalized for all materials used for FDPs

Effect of primer-cement systems with different functional phosphate monomers on the adhesion of zirconia to dentin

PURPOSE The objective of this study was to evaluate the effect of primer-cement systems with different functional phosphate monomers on the adhesion of zirconia to dentin with and without aging protocols. MATERIALS AND METHODS Bovine teeth (N = 180) were embedded in acrylic resin after sectioning their roots with with their coronal parts exposed. The buccal surface of each tooth was polished with silicon carbide papers (#200, 400, 600) until dentin exposure. Sintered zirconia cylinders (N = 180) (Ø: 3.4 mm; height: 4 mm) (Vita In-Ceram 2000) were prepared and distributed into 18 groups (n = 10 per group) considering the following factors: "Cementation System" (Panavia F - PAN; RelyX Ultimate - ULT, Multilink N - MULT) and "aging" (water storage in distilled water at 37 °C for 24 h (control, C); 30 days (30D); 6 months (6 M) and thermocycling for 5000 (5TC), 10,000 (10TC) and 20,000 (20TC) thermal cycles (5-55 °C; dwell time: 30 s)". Zirconia and dentin cementation surfaces were conditioned according to the recommendations of the manufacturers of each resin cement. The cylinders were adhesively cemented to the dentin surfaces and the specimens were submitted to the aging protocols. After aging, the specimens were subjected to shear bond strength test (SBS) (1 mm/min) in a Universal Testing Machine and failure types were analyzed. The data (MPa) were statistically using Kruskal-Wallis followed by the Dunn test (α = 5%). The degree of conversion (DC) rates of the cementing systems were also measured. RESULTS While without aging (24 h) no significant difference was found between the cement systems (p > 0.05), after 30D (4.3-5.4), the highest decrease in all groups were observed after 5TC (1.5-2.3) (p < 0.05). Overall, MULT and ULT presented significantly higher results than that of PAN (p < 0.05). Pre-test failures during TC were more frequent in the PAN group. Complete adhesive failures at the cement/dentin interface were more frequent for MULT (30-80%) and PAN (10-70%) and for ULT (20-90%) at the cement/ceramic interface. DC of the tested cements did not show significant difference. CONCLUSION Adhesion performance of the primer-cement systems with different functional phosphate monomers on zirconia-dentin complex varied as a function of aging strategies with MULT and ULT delivering higher bond strength values. When failure types considered, none of the cement systems performed well on both ceramic and dentin

Can the Application of Multi-Mode Adhesive be a Substitute to Silicatized/Silanized Y-TZP Ceramics?

This study evaluated the effectiveness of a multi-mode adhesive (SBU-Scotch Bond Universal/3M) as a substitute for silica coating and silane application on the bonding of zirconia ceramics to resin cement. One-hundred and twenty sintered zirconia ceramic blocks (5 x 5 x 5 mm) were obtained, finished by grounding with silicon carbide paper (#600, #800, #1000 and #1200) and randomly divided into 12 groups (n=10) in accordance with the factors "surface treatment" (ScSi - silicatization + silanization; ScSBU - silicatization + SBU; SBU - SBU without photoactivation and SBUp - SBU photoactivated) and "ceramic" (Lava / 3M ESPE, Ceramill Zirconia / Amann Girrbach and Zirkonzahn / Zirkonzahn). Dual resin cement cylinders (RelyX Ultimate/3M ESPE) were subsequently produced in the center of each block using a silicon matrix (Ø=2 mm, h=5 mm) and photoactivated for 40 s (1200 mW/cm2). The samples were stored for 30 days in distilled water (37ºC) and submitted to shear bond strength test (1 mm/min, 100 KgF). Data (MPa) were analyzed under ANOVA (2 levels) and Tukey test (5%). Complementary analyzes were also performed. ANOVA revealed that only the factor "surface treatment" was significant (p=0.0001). The ScSi treatment (14.28A) promoted statistically higher bond strength values than the other ScSBU (9.03B), SBU (8.47B) and SBUp (7.82B), which were similar to each other (Tukey). Failure analysis revealed that 100% of the failures were mixed. The silica coating followed by the silanization promoted higher bond strength values of resin cement and ceramic, regardless of the zirconia ceramic or SBU

Effect of different surface treatments and multimode adhesive application on the Weibull characteristics, wettability, surface topography and adhesion to CAD/CAM lithium disilicate ceramic

METHODOLOGY This paper aims to evaluate the effect of different surface treatments on surface topography, wettability, and shear bond strength of resin cement to glass ceramic. For SBS test, 32 blocks (7x7x2 mm) of lithium disilicate were obtained and randomly divided into eight groups (four blocks per group) according to each surface treatment (HF 20 s, 60 s, 120 s + silanization/S or Scotch Bond Universal/ SBU) and the Monobond Etch & Prime - MEP application followed or not by SBU. On each treated surface ceramic block, up to four dual-curing resin cement cylinders were prepared and light-cured for 40s (N=120/n=15). The specimens were thermocycled (10,000 cycles, 5-55°C, 30 s) and the SBS test (50KgF, 0.5 mm/min) was performed. Furthermore, failure analysis, wettability, AFM, and SEM were carried out. SBS data (MPa) were analyzed using Student's t-test, two-way ANOVA, Tukey's test (5%) and Weibull's analysis. RESULTS For HF experimental groups, two-way ANOVA presented the factors "etching time" and "bonding agent" as significant (p<0.05). After silane application, the HF groups presented similar bond strength. SBU application compromised the SBS, except for 120s etching time (HF120sS: 23.39ᵃ±6.48 MPa; HF120sSBU: 18.76ᵃ±8.81MPa). For MEP groups, SBU application did not significantly affect the results (p=0.41). The MEP group presented the highest Weibull modulus (4.08A) and they were statistically different exclusively from the HF20sSBU (0.58B). CONCLUSION The HF 20s, 60s, 120 s followed by silane, promoted similar resin-bond strength to ceramic and the SBU application after HF or MEP did not increase the SBS

Influence of acid etching and universal adhesives on the bond strength to dentin

The purpose of this study was to evaluate the influence of the application mode of three universal adhesive systems on interfacial physical properties of indirect composite restorations adhesively cemented to dentin cavities. Seventy-eight bovine lower incisors were selected and a slice of dentin (thickness: 2 mm) between the buccal surface and pulp chamber was obtained for each tooth. Conical cavities were made on this surface. The internal walls of the cavities were then coated with a hydrophilic gel, filled with composite resin and photopolymerized. The dentin/cone sets were divided into 6 groups (n=10) according to type of universal adhesive (TETRI: Tetric N Bond, FUT: Futura Bond U, SBU: Single Bond Universal) and acid etching on dentin (A: with acid etching; WA: without acid etching). The acid etching and the adhesive systems were applied to the surface of the dentin. All composite resin cones were sandblasted (Al2O3, 20 s) and silanized. After surface treatment, the cones were cemented (RelyX Ultimate) into the dentin cavity and photopolymerized. After thermocycling (10,000 cycles), samples were submitted to marginal adaptation analysis (using caries detector dye), push-out test (0.5 mm/min), and failure mode analysis. Additional samples were prepared for nanoleakage analysis (SEM). The data (MPa) were analyzed by two-way ANOVA and Tukey's post-test (5%). The groups in which the dentin was acid etched showed significantly lower bond strength values in the push-out test (p<0.01). Dentin acid etching significantly reduced the bond strength between universal adhesive systems and dentin in indirect restorative procedures

Hydrofluoric acid concentration, time and use of phosphoric acid on the bond strength of feldspathic ceramics

The objective of this study was to evaluate the influence of hydrofluoric acid (HF) concentration, etching time, and application of phosphoric acid (PA) followed by neutralization with sodium bicarbonate on the bond strength between a feldspar ceramic and resin cement. Thus, 80 blocks (10 x 12 x 2 mm) of glass ceramic (VM-Vita Mark II-Vita Zahnfabrik) were made and randomly assigned to eight groups (n = 10) according to the factors: HF concentration (5 and 10%), etching time (60 and 120 s), and use of phosphoric acid (PA) (with and without). According to the experimental group, 37% PA (Condac, FGM) was applied after HF etching for 60s. Afterwards, samples were immersed in sodium bicarbonate for 1 min then in an ultrasonic bath in distilled water (5 min) for cleaning. After surface bonding treatment, cylinders (O = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block. The samples were then stored in water (37C) for 90 days and submitted to the shear bond test (50 KgF, 1 mm/min). Failure analysis was performed by stereomicroscope and scanning electron microscopy. Data (MPa) were analyzed with 3-way ANOVA and Tukey's test. Only the factor "HF concentration" was significant (p = 0.02). Most failures were of cohesive in ceramic (40%) and mixed types (42.5%). The 10% HF resulted in higher shear bond strength value than the 5% HF. Surface cleaning with phosphoric acid followed by sodium bicarbonate and HF time (60 or 120 seconds) did not influence the resin bond strength to feldspar ceramic

Effect of hydrofluoric acid concentration and etching time on resin-bond strength to different glass ceramics

The objective of this study was to evaluate the effect of the hydrofluoridric acid (HF) concentration and time of acid conditioning on bond strength of three glass ceramics to a resin cement. Thus, fifty blocks (10 mm x 5 mm x 2 mm) of each ceramic (LDCAD: IPS e. max CAD; LCAD: IPS Empress CAD and LDHP: IPS e. max Press) were made and embedded in acrylic resin. The surfaces were polished with sandpaper (#600, 800, 1000, and 1200 grits) and blocks were randomly divided into 15 groups (n = 10) according to the following factors: Concentration of HF (10% and 5%), conditioning time (20 s and 60 s) and ceramic (LDCAD, LDHP, and L). After conditioning, silane (Prosil / FGM) was applied and after 2 min, cylinders (O = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block using a Teflon strip as matrix and light cured for 40 s (1,200 mW/cm2). Then, the samples were thermocycled (10,000 cycles, 5/55°C, 30s) and submitted to the shear bond test (50 KgF, 0.5 mm/min). The data (MPa) were analyzed with 3-way ANOVA and Tukey's test (5%). Failure analysis was performed using a stereomicroscope (20x) and a scanning electron microscope (SEM). ANOVA revealed that the "concentration" factor (p = 0.01) and the interaction "acid concentration X ceramic" (p = 0.009) had a significant effect, however, the "ceramic" (p = 0.897) and "conditioning time" (p = 0.260) factors did not influence the results. The LDHP10%60s (10.98 MPa)aA group presented significantly higher bond strength than LDHP10%20s (6.57 MPa)bA, LCAD5%20s (6,90 ±3,5)aB and LDHP5%60s (5.66 ± 2,9MPa)aA groups (Tukey). Failure analysis revealed that 100% of specimens had mixed failure. In conclusion, etching with 5% HF for 20 seconds is recommended for lithium disilicate and leucite-reinforced CAD/CAM ceramics. However, for pressed lithium disilicate ceramic, 10% HF for 60 s showed significantly higher bond strength to resin cement