Short-term in situ/ex vivo study of the anticariogenic potential of a resin-modified glass-ionomer cement associated with adhesive systems

Objective: As resin-modified glass-ionomer cement (RMGIC) is an adhesive material, its association to dentin bonding agents (DBAs) was previously proposed. This study investigated the adjunctive behavior of an RMGIC with etch-and-rinse bonding systems under in situ/ex vivo cariogenic challenge. Method and Materials: Bovine enamel blocks (3 3 2 mm) were randomly assigned to group VP, Vitremer + its own primer (3M ESPE); group VSB, Vitremer + Single Bond (3M ESPE); and group VPB, Vitremer + Prime & Bond 2.1 (Dentsply). Two blocks of each group were randomly placed in an acrylic palatal appliance, so each appliance included six blocks. Volunteers (n = 10) wore these appliances according to given instructions to promote a sucrose challenge eight times/day for 15 days. After this period, the blocks were removed from the devices and cleaned, and demineralization was assessed through longitudinal microhardness analysis (Knoop indenter, 25 g/5 s). Data were submitted to three-way ANOVA and Tukey test (P < .05). Results: No treatment was able to completely avoid demineralization. All materials showed a statistically significant difference in mineral loss when the microhardness on the outer enamel was compared with deeper regions (P < .05). Conclusion: Association of the tested RMGICs with etch-and-rinse DBAs did not seem to be more beneficial against caries than the conventional treatment with RMGIC. (Quintessence Int 2010; 41: e192-e199)

Effect of Conventional and Resin-modified Glass-Ionomer Liner on Dentin Adhesive Interface of Class I Cavity Walls After Thermocycling

Objective: The aim of this in vitro study was to analyze the effect of glass-ionomer cement as a liner on the dentin/resin adhesive interface of lateral walls of occlusal restorations after thermocycling. Materials and Methods: Occlusal cavities were prepared in 60 human molars, divided into six groups: no liner (1 and 4); glass-ionomer cement (GIC, Ketac Molar Easymix, 3M ESPE) (2 and 5); and resin-modified glass-ionomer cement (RMGIC, Vitrebond, 3M ESPE) (3 and 6). Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper Single Bond 2, 3M ESPE) that was mixed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. Specimens of groups 4, 5 and 6 were thermocycled (5 degrees C-55 degrees C) with a dwell time of 30 seconds for 5000 cycles. After this period, teeth were sectioned in approximately 0.8-mm slices. One slice of each tooth was randomly selected for confocal microscopy analysis. The other slices were sectioned into 0.8 nun x 0.8 mm beams, which were submitted to microtensile testing (MPa). Data were analyzed using two-way ANOVA and Tukey test (p < 0.05). Results: There was no detectedstatistical difference on bond strength among groups (alpha < 0.05). Confocal microscopy analysis showed a higher mean gap size in group 4(12.5 mu m) and a higher percentage of marginal gaps in the thermocycled groups. The RNIGIC liner groups showed the lowest percentage of marginal gaps. Conclusions: Lining with RMGIC resulted in less gap formation at the dentin/resin adhesive interface after artificial aging. RMGIC or GIC liners did not alter the microtensile bond strength of adhesive system/resin composite to dentin on the lateral walls of Class I restorations.

Stability of wet versus dry bonding with different solvent-based adhesives

Objective. To evaluate the effects of surface moisture (wet or dry) and storage (24h or 3 months) on the microtensile bond strength (BS) of resin/dentin bonds mediated by two water/ethanol based adhesives Single Bond, 3M-ESPE, (SB) and Opti Bond Solo Plus, Kerr, (OB), and two acetone-based adhesives, One Step, Bisco, (OS) and Prime&Bond NT, Caulk/Dentsply, (PB). Materials and methods. Flat dentin surfaces were polished with 600-grit SiC paper, etched with 35% phosphoric acid for 15 s and rinsed for 20 s. Half the surface was maintained moist and the other half was air-dried for 30 s. Each adhesive was applied simultaneously to both halves, left undisturbed for 30 s and light-cured. Four-mm resin build-ups were constructed incrementally. After storage in water at 37 degrees C for 24h, slabs were produced by transversal sectioning and trimmed to an hourglass shape (0.8 mm 2). Half of the specimens were tested in tension at 0.6 mm/min immediately after trimming and the other half after 3 months of water storage. Data were analyzed by two-way ANOVA and SNK for each material. Results. Both moisture and storage affected BS to dentin, and was material- dependent. Dry, bonding affected mostly the acetone-based adhesives. Larger reductions in bond strength were associated with dry bonding after 3 months of water storage. Significance. Wet bonding resulted in more stable bonds over 3 months of water storage for most of the materials tested. (C) 2007 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

SEM observation of the bond integrity of fiber-reinforced composite posts cemented into root canals

Objectives. To test the null hypothesis that continuity of resin cement/dentin interfaces is not affected by location along the root canal walls or water storage for 3 months when bonding fiber posts into root canals. Methods. Fiber posts were luted to bovine incisors using four resinous luting systems: Multilink, Variolink II, Enforce Dual and Enforce PV. After cementation, roots were longitudinally sectioned and epoxy resin replicas were prepared for SEM analysis (baseline). The original halves were immersed in solvent, replicated and evaluated. After 3 months water storage and a second solvent immersion, a new set of replicas were made and analyzed. The ratio (%) between the length (mm) of available bonding interface and the actual extension of bonded cement/dentin interface was calculated. Results. Significant lower percent values of bond integrity were found for Multilink (8.25%) and Variolink 11 (10.08%) when compared to Enforce Dual (25.11%) and Enforce PV (27.0%) at baseline analysis. The same trend was observed after immersion in solvent, with no significant changes. However, bond integrity was significantly reduced after 3 months water storage and a second solvent immersion to values below 5% (Multilink = 3.31%, Variolink=1.87%, Enforce Dual=1.20%, and Enforce PV=0.75%). The majority of gaps were depicted at the apical and middle thirds at baseline and after immersion in solvent. After 3 months, gaps were also detected at the cervical third. Significance. Bond integrity at the cement/dentin interface was surprisingly low after cementation of fiber posts to root canals with all resin cements. That was not significantly altered after immersion in solvent, but was further compromised after 3 months water storage. Gaps were mainly seen at middle and apical thirds throughout the experiment and extended to the cervical third after water storage for 3 months. Bond integrity of fiber posts luted to root canals was affected both by location and water storage. (C) 2007 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Mechanical Testing of Indirect Composite Materials Directly Applied on Implant Abutments

Purpose: To test the strength to failure and fracture mode of three indirect composite materials directly applied onto Ti-6Al-4V implant abutments vs cemented standard porcelain-fused-to-metal (PFM) crowns. Materials and Methods: Sixty-four locking taper abutments were randomly allocated to four groups and were cleaned in ethanol in an ultrasonic bath for 5 min. After drying under ambient conditions, the abutments were grit blasted and a custom 4-cusp molar crown mold was utilized to produce identical crowns (n = 16 per group) of Tescera (Bisco), Ceramage (Shofu), and Diamond Crown (DRM) according to the manufacturer`s instructions. The porcelain-fused-to-metal crowns were fabricated by conventional means involving the construction and a wax pattern and casting of a metallic coping followed by sintering of increasing layers of porcelain. All crowns were loaded to failure by an indenter placed at one of the cusp tips at a 1 mm/min rate. Subsequently, fracture analysis was performed by means of stereomicroscopy and scanning electron microscopy. One-way ANOVA at 95% level of significance was utilized for statistical analysis. Results: The single load to failure (+/- SD) results were: Tescera (1130 +/- 239 N), Ceramage (1099 +/- 257 N), Diamond Crown (1155 +/- 284 N), and PFM (1081 +/- 243 N). Stereomicroscopy analysis showed two distinct failure modes, where the loaded cusp failed either with or without abutment/metallic coping exposure. SEM analysis of the fractures showed multiple crack propagation towards the cervical region of the crown below a region of plastic deformation at the indenter contact region. Conclusion: The three indirect composites and PFM systems fractured at loads higher than those typically associated with normal occlusal function. Although each material had a different composition and handling technique, no significant differences were found concerning their single load to fracture resistance among composite systems and PFM.

Monolithic CAD/CAM Lithium Disilicate Versus Veneered Y-TZP Crowns: Comparison of Failure Modes and Reliability After Fatigue

Purpose: The aim of this research was to evaluate the fatigue behavior and reliability of monolithic computer-aided design/computer-assisted manufacture (CAD/CAM) lithium disilicate and hand-layer-veneered zirconia all-ceramic crowns. Materials and Methods: A CAD-based mandibular molar crown preparation, fabricated using rapid prototyping, served as the master die. Fully anatomically shaped monolithic lithium disilicate crowns (IPS e.max CAD, n = 19) and hand-layer-veneered zirconia-based crowns (IPS e.max ZirCAD/Ceram, n = 21) were designed and milled using a CAD/CAM system. Crowns were cemented on aged dentinlike composite dies with resin cement. Crowns were exposed to mouth-motion fatigue by sliding a WC-indenter (r = 3.18 mm) 0.7 mm lingually down the distobuccal cusp using three different step-stress profiles until failure occurred. Failure was designated as a large chip or fracture through the crown. If no failures occurred at high loads (> 900 N), the test method was changed to staircase r ratio fatigue. Stress level probability curves and reliability were calculated. Results: Hand-layer-veneered zirconia crowns revealed veneer chipping and had a reliability of < 0.01 (0.03 to 0.00, two-sided 90% confidence bounds) for a mission of 100,000 cycles and a 200-N load. None of the fully anatomically shaped CAD/CAM-fabricated monolithic lithium disilicate crowns failed during step-stress mouth-motion fatigue (180,000 cycles, 900 N). CAD/CAM lithium disilicate crowns also survived r ratio fatigue (1,000,000 cycles, 100 to 1,000 N). There appears to be a threshold for damage/bulk fracture for the lithium disilicate ceramic in the range of 1,100 to 1,200 N. Conclusion: Based on present fatigue findings, the application of CAD/CAM lithium disilicate ceramic in a monolithic/fully anatomical configuration resulted in fatigue-resistant crowns, whereas hand-layer-veneered zirconia crowns revealed a high susceptibility to mouth-motion cyclic loading with early veneer failures. Int J Prosthodont 2010; 23: 434-442.

Push-out Bond Strength of Fiber Posts Luted with Unfilled Resin Cement

Purpose: The study evaluates the behavior of different adhesive systems and resin cements in fiber post placement, with the intent to clarify the possible role of unfilled resin as a luting material for fiber posts. Materials and Methods: Two luting agents (Dual-Link and Unfilled Resin) for cementing fiber posts into root canals were applied either with All-Bond 2 or One-Step Plus, or without an adhesive system, and challenged with the push-out test. Slices of roots restored with posts were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under SEM. Results: Push-out strength was significantly influenced by the luting agent (p < 0.05), but not by the bonding strategy (p > 0.05). The best results were obtained in combination with Unfilled Resin with One-Step Plus. Dual-Link groups failed mainly cohesively within the cement, while Unfilled Resin demonstrated more adhesive fracture at the post interface. Conclusion: The results of this study support the hypothesis that adhesive unfilled resin application is essential for achieving high bond strength to radicular dentin.

Reliability of Metalloceramic and Zirconia-based Ceramic Crowns

Despite the increasing utilization of all-ceramic crown systems, their mechanical performance relative to that of metal ceramic restorations (MCR) has yet to be determined. This investigation tested the hypothesis that MCR present higher reliability over two Y-TZP all-ceramic crown systems under mouth-motion fatigue conditions. A CAD-based tooth preparation with the average dimensions of a mandibular first molar was used as a master die to fabricate all restorations. One 0.5-mm Pd-Ag and two Y-TZP system cores were veneered with 1.5 mm porcelain. Crowns were cemented onto aged (60 days in water) composite (Z100, 3M/ESPE) reproductions of the die. Mouth-motion fatigue was performed, and use level probability Weibull curves were determined. Failure modes of all systems included chipping or fracture of the porcelain veneer initiating at the indentation site. Fatigue was an acceleration factor for all-ceramic systems, but not for the MCR system. The latter presented significantly higher reliability under mouth-motion cyclic mechanical testing.

Composite filling removal with erbium:yttrium-aluminum-garnet laser: morphological analyses

Considering the increase in esthetic restorative materials and need for improvement in unsatisfactory restoration substitution with minimal inadvertent removal of healthy tissues, this study assessed the efficacy of erbium:yttrium-aluminum-garnet (Er:YAG) laser for composite resin removal and the influence of pulse repetition rate on the morphological analyses of the cavity by scanning electron microscope. Composite resin fillings were placed in cavities (1.0 mm deep) prepared in bovine teeth, and the 75 specimens were randomly assigned to five groups according to the technique used for composite filling removal (high-speed diamond bur, group I, as a control, and Er:YAG laser, 250 mJ output energy and 80 J/cm(2) energy density, using different pulse repetition rates: group II, 2 Hz; group III, 4 Hz; group IV, 6 Hz; group V, 10 Hz). After the removal, the specimens were split in the middle, and we analyzed the surrounding and deep walls to check for the presence of restorative material. The estimation was qualitative. The surfaces were examined with a scanning electron microscope. The results revealed that the experimental groups presented bigger amounts of remaining restorative material. The scanning electron microscopy (SEM) analyses showed irregularities of the resultant cavities of the experimental groups that increased proportionally with increase in repetition rate.

Bond Strength of Fiber Posts to Weakened Roots After Resin Restoration With Different Light-Curing Times

Introduction: This study evaluated the bond strength of translucent fiber posts to experimentally weakened radicular dentin restored with composite resin and polymerized with different light-exposure time. Methods: Roots of 60 maxillary incisors were used. Twenty-four hours after obturation, the filling materials of root canals were removed to a depth of 12 mm, and 4 groups were randomly formed. In 3 groups, root dentin was flared to produce a space between fiber post and canal walls. In the control group, the roots were not experimentally weakened. The flared roots were bulk restored with composite resin, which was light-activated through the translucent post for 40, 80, or 120 seconds. Posts were cemented, and after 24 hours, all roots were sectioned transversely in the coronal, middle, and apical regions, producing 1-mm-thick slices. Push-out test was performed, and failure modes were observed. Results The quantitative analysis showed significant statistical difference only among groups (P <.001). Comparing the weakened/restored groups, composite light-exposure time did not influence the results. Overall, adhesive failures occurred more frequently than other types of failures. Cohesive failures occurred only in the weakened/restored roots. Conclusions Intracanal root restoration with composite resin and translucent fiber posts provided similar or higher bond strength to dentin than the control group, regardless of the light-exposure time used for polymerization. (J Endod 2009;35:1034-1039)

Influence of Filling Materials on the Bonding Interface of Thin-walled Roots Reinforced with Resin and Quartz Fiber Posts

Introduction: A common complication during the restoration of severely destroyed teeth is the loss of coronal root dentine. The aim of this study was to evaluate the influence of different sealers on the bonding interface of weakened roots reinforced with resin and fiber posts. Methods: Sixty extracted maxillary canines were used. The crowns were removed, and the thickness of root dentine was reduced in the experimental (n = 40) and positive control (n = 10) groups. The specimens of experimental group were assigned to four subgroups (n = 10) according to the filling material: gutta-percha + Grossmann`s sealer, gutta-percha + AH Plus (Dentsply De Trey Gmbh, Konstanz, Germany), gutta-percha + Epiphany (Pentron Clinical Technologies, Wallingford, CT), and Resilon (Resilon Research LLC, Madison, CT) + Epiphany. In the negative control group (n = 10), canals were not filled. After post space preparation, the roots were restored with composite resin light-activated through a translucent fiber post. After 24 hours, specimens were transversally sectioned into 1-mm-thick slices. Push-out test and scanning electron microscopic (SEM) analyses of different regions were performed. Data from push-out test were analyzed by using Tukey post hoc multiple comparison tests. The percentage of failure type was calculated. Data from SEM analysis were compared by Friedman and Kruskal-Wallis tests (alpha = 0.05). Results: The mean bond strength was significantly higher in the negative control group as compared with the other groups (P < .05). In all groups, the most frequent type of failure was adhesive. Overall, apical and middle regions presented a lower density of resin tags than the coronal region (P < .05). Conclusions: The push-out bond strength was not affected by sealer or region. The canal region affected significantly the resin tag morphology and density at the bonding interface. (J Endod 2011;37:531-537)

Study on the potential inhibition of root dentine wear adjacent to fluoride-containing restorations

The purpose of this in vitro study was to determine whether the vicinity of root dentine that had been restored with fluoride-releasing materials was at reduced risk for erosive/abrasive wear compared to root dentine restored with a non-fluoride-containing material. According to a randomized complete block design, standardized cavities prepared on the surface of 150 bovine root dentine slabs were restored with glass-ionomer cement, resin-modified glass ionomer, polyacid-modified resin composite, fluoride-containing or conventional composite. Specimens were coated with two layers of an acid-resistant nail varnish exposing half of the dentine surface and half of the restoration. Subsequently, specimens were either eroded in an acidic drink or left uneroded, then exposed to artificial saliva and abraded in a toothbrushing machine. Wear depth in the vicinity of restorations was quantified by a stylus profilometer, based on the nonabraded areas surrounding the erosion/abrasion region. Two-way ANOVA did not demonstrate significant interaction between restoratives and eroded-uneroded dentine (p = 0.5549) nor significant difference among restorative materials (p = 0.8639). Tukey`s test ascertained that the wear depth was higher for eroded than for uneroded groups. Fluoride-releasing materials seemed to negligibly inhibit wear in the vicinity of restored root dentine subjected to erosive/abrasive challenges.

Microtensile Bond Strength of Glass Fiber Posts Cemented with Self-adhesive and Self-etching Resin Cements

Purpose: To evaluate the bond strength of glass fiber posts to intraradicular dentin when cemented with self-etching and self-adhesive resin cements. Materials and Methods: Forty-eight single-rooted human teeth were decoronated, endodontically treated, post-space prepared and divided into 8 groups (n = 6). The glass fiber posts used were: Exacto (EA) (Angelus) and everStick (ES) (StichTeck), which were cemented with two self-adhesive resin cements: BisCem (BIS) (Bisco) and Rely-X Unicem (UNI) (3M/ESPE), and two self-etching resin cements: Esthetic Cementing System NAC100 (NAC) (Kuraray) and Panavia-F (PAN) (Kuraray). Specimens were thermocycled between 5 degrees C and 55 degrees C for 1000 cycles and stored in water at 37 degrees C for 1 month. Four 1-mm-thick (in cross section) rods were obtained from the cervical region of the roots. Specimens were then subjected to microtensile testing in a special machine (BISCO; Schaumburg, IL, USA) at a crosshead speed of 0.5 mm/min. Microtensile bond strength (mu TBS) data were analyzed with two-way ANOVA and Tukey`s tests. Results: Means (and SD) of mu TBS (MPa) were: EA/PAN: 10.3 (4.1), EA/NAC: 14 (5.1) EA/BIS: 16.4 (4.8), EA/UNI: 19.8 (5.1), ES/PAN: 25.9 (6.1), ES/NAC: 29.1 (7), ES/BIS: 28.9 (6), ES/UNI: 30.5 (6.6). ANOVA indicated significant differences among the groups (p < 0.001). Mean mu TBS values obtained with ES post were significantly higher than those obtained with EA (p < 0.001). For EA, Tukey`s test indicated that higher mu TBS means were obtained with the self-adhesive resin cements (BIS and UNI), which were statistically significantly different (p < 0.05) from values obtained with the self-etching resin cements (PAN and NAC). Different cements had no significant effects on the bond strength values of ES post (p > 0.05). mu TBS values obtained with ES post were significantly higher than those obtained with EA post irrespective of the resin cement used. Conclusion: everStick posts resulted in the highest mean mu TBS values with all cements. Self-adhesive cements performed well in terms of bond strength.

Evaluation of the Abrasiveness of Dentifrices for Complete Dentures

Purpose: This study analyzed the surface roughness and weight loss in Plex Glass specimens caused by dentifrices, one conventional (Sorriso) and three specific for dentures. Materials and Methods: Specimens (n = 6) of Plex Glass were divided into 5 groups including: negative control (water); positive control 1 (Sorriso) and 2 (Corega Brite); Experimental 1 (containing Chloramine T, antimicrobial agent); and Experimental 2 (containing Zonyl, detergent). Brushing was performed in a toothbrushing machine (Pepsodent) with a soft brush and a suspension of toothpaste and distilled water for 300 minutes, representing 6 years of brushing. Weight was measured initially and after the trial period; roughness was measured after the trial period only. The results of roughness and weight loss were analyzed using ANOVA and Tukey tests at 5%. Results: The negative control (2.82 +/- 4.41 mg) showed the lowest weight loss. Experimental 1 (13.62 +/- 4.29 mg) and Experimental 2 (15.4 +/- 5.80 mg) were equal statistically, and Sorriso (23.22 +/- 7.23 mg) and Corega (28.83 +/- 6.34 mg) produced the greatest weight loss. Concerning roughness, the negative control group (0.03 +/- 0.01 mu m) showed the lowest value. No significant differences were found between Corega (13.43 +/- 1.65 mu m), Experimental 1 (12.28 +/- 0.85 mu m), and Experimental 2 (10.68 +/- 2.56 mu m). The Sorriso toothpaste produced the greatest amount of surface roughness (19.15 +/- 2.36 mu m). Conclusion: Of the tested dentifrices, the experimental preparations proved to be the least abrasive and resulted in the lowest weight loss after brushing of the acrylic. Based on these findings, the use of these experimental dentifrices is advocated. Further evaluation based on the ability of these preparations to remove biofilms is required.

Physical Properties of an Acrylic Resin after Incorporation of an Antimicrobial Monomer

Purpose: This study evaluated the effect of the incorporation of the antimicrobial monomer methacryloyloxyundecylpyridinium bromide (MUPB) on the hardness, roughness, flexural strength, and color stability of a denture base material. Materials and Methods: Ninety-six disk-shaped (14-mm diameter x 4-mm thick) and 30 rectangular (65 x 10 x 3.3 mm(3)) heat-polymerized acrylic resin specimens were divided into three groups according to the concentration of MUPB (w/w): (A) 0%, (B) 0.3%, (C) 0.6%. Hardness was assessed by a hardness tester equipped with a Vickers diamond penetrator. Flexural strength and surface roughness were tested on a universal testing machine and a surface roughness tester, respectively. Color alterations (Delta E) were measured by a portable spectrophotometer after 12 and 36 days of immersion in water, coffee, or wine. Variables were analyzed by ANOVA/Tukey HSD test (alpha = 0.05). Results: The following mean results (+/-SD) were obtained for hardness (A: 15.6 +/- 0.6, B: 14.6 +/- 1.7, C: 14.8 +/- 0.8 VHN; ANOVA: p = 0.061), flexural strength (A: 111 +/- 17, B: 105 +/- 12, C: 88 +/- 12 MPa; ANOVA: p = 0.008), and roughness (A: 0.20 +/- 0.11, B: 0.20 +/- 0.11, C: 0.24 +/- 0.08 mu m; ANOVA: p = 0.829). Color changes of immersed specimens were significantly influenced by solutions and time (A: 9.1 +/- 3.1, B: 14.8 +/- 7.5, C: 13.3 +/- 6.1 Delta E; ANOVA: p < 0.05). Conclusions: The incorporation of MUPB affects the mechanical properties of a denture base acrylic resin; however, the only significant change was observed for flexural strength and may not be critical. Color changes were slightly higher when resin containing MUPB was immersed in wine for a prolonged time; however, the difference has debatable clinical relevance.