Effect of surface treatments on the resin bond to zirconium-based ceramic

Purpose: This study tested the hypothesis that the tribochemical silica coating on ceramic surfaces increases the bond strength of resin cement to a glass-infiltrated zirconium-based ceramic. Materials and Methods: Fifteen blocks of In-Ceram Zirconia from CEREC InLab (5 per group) and 15 composite blocks (Z-250) 5 mm x 5 mm x 4 mm were made. The ceramic surfaces were polished, and the blocks were divided into three groups: (1) airborne abrasion with 110-μm aluminum oxide particles; (2) Rocatec system, tribochemical silica coating; and (3) CoJet system, tribochemical silica coating. The ceramic blocks were cemented to the composite blocks using Panavia F according to the manufacturer's specifications. All samples were stored in 37°C distilled water for 7 days and later sectioned in two axes using a diamond disk under cooling to obtain specimens with a cross-sectional area of approximately 1 mm2 (n = 45). Each specimen was then attached with cyanoacrylate glue to an adapted device for the microtensile test, which was carried out on a universal testing machine. Results: The results were subjected to ANOVA and Tukey's test. Group 2 (23.0 ± 6.7 MPa) and group 3 (26.8 ± 7.4 MPa) showed greater bond strength than group 1 (15.1 ± 5.3 MPa). There was no significant difference between groups 2 and 3. All failures were in the adhesive zone. Conclusion: The hypothesis was confirmed - the tribochemical systems increased the bond strength between Panavia F and In-Ceram Zirconia.

SEM analysis of internal adaptation of adhesive restorations after contamination with saliva

Purpose: This study tested the null hypothesis that different treatments of saliva-contaminated substrate would not affect microgap formation at the dentin walls of bonded restorations. Materials and Methods: Forty freshly extracted human molars received standardized Class V preparations on buccal and lingual surfaces. The specimens were assigned to four experimental groups (n = 20): [G1] no contamination (control group), [G2] saliva contamination (10 s) after etching followed by 5 s air stream; [G3] saliva contamination after etching and rinsed for 10 s; and [G4] re-etching for 10 s after saliva contamination. All specimens were restored with a one-bottle adhesive (Single Bond, 3M ESPE) and microhybrid composite resin (Filtek Z250, 3M ESPE) according to the manufacturer's instructions. The specimens were thermocycled, sectioned through the center of the restoration, and then processed for SEM. Microgaps were measured at the axial wall at 1500X magnification. The data were submitted to Kruskal-Wallis nonparametric statistical analysis at p < 0.05. Results: The data revealed that different groups resulted in a statistically significant difference (p < 0.01) in gap formation. Air drying [G2] and rinsing [G3] the saliva-contaminated dentin resulted in similar microgap values (p > 0.05). However, re-etching the dentin after saliva contamination [G4] increased microgap formation (p < 0.05) when compared with the groups G1 and G2. Although air drying and rinsing produced results comparable to noncontaminated dentin, the presence of microgaps was not completely eliminated. Conclusion: Contaminated saliva did not prevent hybrid layer formation; however, it did reduce the adaptation of the restorative material to bonded surfaces.

Effect of cyclic compressive loading on the bond strength of an adhesive system to dentin after collagen removal

Purpose: The objective of this study was to verify the effect of cyclic compressive loading on the shear bond strength of an adhesive system following collagen removal. Materials and Methods: Sixty bovine teeth were divided into 4 groups based on the adhesive procedure used: groups 1 and 2 - etching with 35% phosphoric acid and application of the Single Bond adhesive system; groups 3 and 4 - after etching, a 10% sodium hypochlorite solution was applied for 1 min before the application of the adhesive. In all the specimens, a Z100 resin cylinder was built up over the bond area. Groups 2 and 4 were submitted to 500,000 cycles with a load of 100 N. Results: The mean values for the shear bond test (MPa) were: group 1: 7.37 ± 1.15; group 2: 5.72 ± 1.66; group 3: 5.95 ± 1.21; group 4: 3.66 ± 1.12. There was no difference between groups 1 and 2 (p > 0.01). Between groups 1 and 3, 2 and 4, and 3 and 4 there was a significant difference (p < 0.01). The majority of the specimens demonstrated an adhesive failure. Conclusion: The application of sodium hypochlorite on dentin decreased the values of shear bond strength, as did the load cycling in the group treated with sodium hypochlorite.

Quantitative analysis of potentially toxic metals in alginates for dental use

Alginate is one the materials most employed in practice to make dental impressions. Substances like zinc, cadmium and lead silicate, which are included in several alginate brands with the aim of improving their physical, chemical and mechanical properties, are a source of serious concern as regards their toxicity. The most serious chronic effect of oral exposure to cadmium is renal toxicity. Assimilation of lead has deleterious effects on the gastrointestinal tract, hematopoietic system, cardiovascular system, central and peripheral nervous systems, kidneys, immune system, and reproductive system. Chronic oral exposures to zinc have resulted in hypochromic and microcyte anemia in some individuals. The aim of the present study was to measure the cadmium, lead and zinc contents of seven brands of alginate for dental use on sale in Brazil. The samples were weighed and placed in the Teflon cups of a closed-system microwave oven. Aqua regia (4mL concentrated HCI:HNO3, 3:1 v/v) and hydrofluoric acid (2mL concentrated HF) were added to the samples, which were then subjected to heating. The samples were then cooled to room temperature and diluted to 25 mL in deionized water in a volumetric glass flask. The samples were diluted in duplicate and analyzed against a reagent blank. The analyses were performed in an atomic absorption flame spectrophotometer. Neither lead nor cadmium was detected. Zinc contents ranged from 0.001% to 1.36% by weight. The alginates exhibited low contents of the metals under study and gave no cause for concern regarding toxicity; even so, it is advisable to monitor potentially toxic materials continually and to analyze their plasmatic levels in the professionals working with them.

Fatigue resistance of the bond of a glass-infiltrated alumina ceramic to human dentin

Purpose: To evaluate the fatigue resistance of the bond between dentin and glass-infiltrated alumina ceramic, using different luting protocols. Materials and Methods: The null hypothesis is that the fatigue resistance varies with the luting strategy. Forty blocks of In-Ceram Alumina were prepared, and one surface of each block was abraded with 110-μm aluminum oxide particles. Then, the blocks were luted to flat dentin surfaces of 40 human third molars, using 4 different luting strategies (luting system [LS]/ceramic surface conditioning [CSC]) (n=10): (G1) [LS] RelyX-Unicem/[CSC] airborne abrasion with 110-μm Al2O3 particles; (G2) [LS] One-Step + Duo-Link (bis-GMA-based resin)/[CSC] etching with 4% hydrofluoric acid + silane agent; (G3) [LS] ED-Primer + Panavia F (MDP-based resin)/[CSC] Al2O 3; (G4) [LS] Scotchbond1+RelyX-ARC (bis-GMA-based resin)/[CSC] chairside tribochemical silica coating (air abrasion with 30-μm SiO x particles + silane). After 24 h of water storage at 37°C, the specimens were subjected to 106 fatigue cycles in shear with a sinusoidal load (0 to 21 N, 8 Hz frequency, 37°C water). A fatigue survivor score was given, considering the number of the fatigue cycles until fracture. The failure modes of failed specimens were observed in a SEM. Results: G3 (score = 5.9, 1 failure) and G4 (score = 6, no failures) were statistically similar (p = 0.33) and had significantly higher fatigue resistance than G1 (score = 3.9, 5 failures) and G2 (score = 3.7, 6 failures) (p < 0.03). SEM analysis of fractured specimens of G1 and G2 showed that almost all the failures were between ceramic and cement. Conclusion: The MDP-based resin cement + sandblasting with Al2O3 particles (G3) and bis-GMA-based resin cement + tribochemical silica coating (G4), both using the respective dentin bonding systems, were the best luting protocols for the alumina ceramic. The null hypothesis was confirmed.

Effects of tissucol™ and epsilon aminocaproic acid in the healing process following dental extraction in dehydrated rats

A histological study was conducted of the alveolar bone healing process following tooth extraction of dehydrated rats after the implantation of fibrin adhesive (TISSUCOL™) associated to previous irrigation of the wound with a 5% epsilon aminocaproic acid solution (EACA). Seventy two rats were used, divided into three groups receiving different treatments after the surgical procedure. In group I, the gingival mucosa was sutured after extraction of the right upper incisor. In groups II and III, chronic dehydration was produced by water deprivation for 9 days (3 days in the preoperative period and 6 days in the postoperative period). In the animals of Group II, after tooth extraction, the gingival mucosa was sutured in the same way as performed in group I. In group III, after extraction, the dental socket was irrigated with 5% EACA, followed by implantation of the fibrin adhesive (TISSUCOL™). The mucosa was sutured in the same way as performed in the other groups. At 3, 7, 15 and 21 postoperative days, the animals were sacrificed in number of 6 for each group. Specimens containing the dental socket were removed and fixed in 10% formalin and decalcified in an equal part formic acid and sodium citrate solution. After routine processing, the specimens were embedded in paraffin for microtomy. We obtained 6 μm semi-serial slices that were stained with hematoxylin and eosin for histological evaluation. The results showed that the water deprivation in the pre- and postoperative periods caused a delay in the alveolar bone healing process. The use of the fibrin adhesive (TISSUCOL™) produced an improvement in the fibrinolytic picture caused by dehydration.

The effect of temperature on self-etching adhesive penetration.

The purpose of this study was to investigate the penetration of an aggressive self-etching adhesive system at refrigerated and room temperatures into ground and unground enamel surfaces. Thirty extracted human teeth were used to measure adhesive penetration into enamel by light microscopy analysis (x400). The unground enamel surfaces were cleaned with pumice and water using a rotary dental brush. For each specimen, part of the unground enamel was manually ground and part was kept intact. A self-etch adhesive was evaluated for its ability to penetrate ground and unground enamel surfaces at room temperature (25 degrees C), at 30 minutes after removal from the refrigerator, and immediately after removal from the refrigerator (6 degrees C). Data were analyzed using variance and the Tukey test, which revealed significant differences in length of penetration of this material when applied on ground and unground enamel surfaces and between the different temperatures used (P > .05). The self-etching system used in this study had significantly lower penetration into unground enamel and at 6 degrees C (P < .05). No statistical difference was found between the interactions of these factors. It was concluded that the self-etching system produced the best penetration into ground enamel surface at room temperature (25 degrees C) and at 30 minutes after removing the specimens from the refrigerator.

Shear bond strength fatigue limit of rest seats made with dental restoratives

Purpose: This study compared the shear bond strength (SBS) to enamel of rest seats made with a glass-ionomer cement (Fuji IX GP Fast), a resin-modified glass-ionomer cement (Fuji II LC), and a composite resin (Z100 MP) under monotonic and cyclic loading. Materials and Methods: Rest seats were built up onto the lingual surfaces of 80 intact human mandibular incisors. Specimens (n=10) were stored in distilled water at 37°C for 30 days and subjected to shear forces in a universal testing machine (0.5 mm/min) until fracture. The SBS values were calculated (MPa) using the bonding area (9.62 mm2) delimited by adhesive tags. A staircase approach was used to determine the SBS fatigue limit of each material. Specimens were submitted to either 10,000 cycles (5 Hz) or until specimen fracture. A minimum of 15 specimens was tested for each material. Scanning electron microscopy was used to examine the mode of failure. Data were statistically analyzed with one-way ANOVA and Tukey HSD tests (α = 0.05). Results: Z100 MP yielded higher (p < 0.05) SBS (12.25 MPa) than Fuji IX GP Fast (7.21 MPa). No differences were found between Fuji II LC (10.29 MPa) and the other two materials (p > 0.05). Fuji II LC (6.54 MPa) and Z100 MP (6.26 MPa) had a similar SBS limit. Fuji IX GP Fast promoted the lowest (p < 0.05) SBS fatigue limit (2.33 MPa). All samples showed cohesive failure patterns. Conclusion: Fatigue testing can provide a better means of estimating the performance of rest seats made with dental restoratives.

Influence of brush type as a carrier of adhesive solutions and paper points as an adhesive-excess remover on the resin bond to root dentin

Purpose: To evaluate the influence of the brush type as a earner of priming adhesive solutions and the use of paper points as a remover of the excess of these solutions on the push-out bond strength of resin cement to bovine root dentin. The null hypotheses were that brush type and the use of paper points do not affect the bond strength. Materials and Methods: The canals of 80 single-root bovine roots (16 mm in length) were prepared at 12 mm using the preparation drill (FRC Postec Plus, Ivoclar). Half of each root was embedded in acrylic resin and the specimens were divided into 8 groups, considering the factors brush type (4 levels) and paper point (2 levels) (n = 10): Gr 1: small microbrush (Cavi-Tip, SDI); Gr 2: Microbrush (Dentsply); Gr 3: Endobrush (Bisco); Gr 4: conventional brush (Bisco); Gr 5: Cavi-Tip (SDI) + paper points; Gr 6: Microbrush (Dentsply) + paper points; Gr 7: Endobrush (Bisco) + paper points; Gr 8: conventional brush (Bisco) + paper points. The root dentin was treated with a multistep total-etch adhesive system (All Bond 2). The adhesive system was applied using each microbrush, with and without using paper points. One fiber post was molded with addition silicon and 80 posts were made of resin cement (Duolink), The resin posts were luted (Duolink resin cement), and the specimens were stored for 24 h in water at 37°C. Each specimen was cut into 4 disk-shaped samples (1.8 mm in thickness), which were submitted to the push-out test. Results: The brush type (p < 0.0001) (small microbrush > microbrush = endobrush = conventional brush) and the use of paper points (p = 0.0001) (with > without) influenced the bond strength significantly (two-way ANOVA). The null hypotheses were rejected. Conclusion: The smallest brush (Cavi-Tip) and the use of paper points significantly improved the resin bond to bovine root dentin.

Length of resin tags in pit-and-fissure sealants: all-in-one self-etching adhesive vs phosphoric acid etching.

PURPOSE: To investigate the penetration (tags) of adhesive materials into enamel etched with phosphoric acid or treated with a self-etching adhesive, before application of a pit-and-fissure sealant. MATERIALS AND METHODS: The sample comprised six study groups with six specimens each. Before pit-and-fissure sealing with the materials Clinpro SealantTM (Groups I and II), Vitro Seal ALPHA (Groups III and IV) and Fuji II LC (Groups V and VI), the teeth in Groups I, III, and V were etched with 35% phosphoric acid for 30 seconds. Teeth in Groups II, IV, and VI received application of the self-etching adhesive Adper Prompt L-Pop. The treated teeth were sectioned buccolingually, ground to 100-microm thickness, decalcified, and analyzed by conventional light microscopy at 400x magnification. RESULTS: The teeth etched with phosphoric acid exhibited significantly greater penetration than specimens treated with self-etching adhesive. CLINICAL SIGNIFICANCE: When compared with enamel treated with a self-etching adhesive, the penetration (tags) of adhesive materials into enamel was greater when applied on enamel etched with phosphoric acid.

Adhesive cementation of zirconia posts to root dentin: Evaluation of the mechanical cycling effect

This study evaluated the effect of mechanical cycling on the bond strength of zirconia posts to root dentin. Thirty single-rooted human teeth were transversally sectioned to a length of 16 mm. The canal preparation was performed with zirconia post system drills (CosmoPost, Ivoclar) to a depth of 12 mm. For post cementation, the canals were treated with total-etch, 3-steps All-Bond 2 (Bisco), and the posts were cemented with Duolink dual resin cement (Bisco). Three groups were formed (n = 10): G1 - control, no mechanical cycling; G2 - 20,000 mechanical cycles; G3 - 2,000,000 mechanical cycles. A 1.6-mm-thick punch induced loads of 50 N, at a 45° angle to the long axis of the specimens and at a frequency of 8 Hz directly on the posts. To evaluate the bond strengths, the specimens were sectioned perpendicular to the long axis of the teeth, generating 2-mm-thick slices, approximately (5 sections per teeth), which were subjected to the push-out test in a universal testing machine at a 1 mm/min crosshead speed. The push-out bond strength was affected by the mechanical cycling (1-way ANOVA, p = .0001). The results of the control group (7.7 ± 1.3 MPa) were statistically higher than those of G2 (3.9 ± 2.2 MPa) and G3 (3.3 ± 2.3 MPa). It was concluded that the mechanical cycling damaged the bond strength of zirconia posts to root dentin.

Cone-beam computed tomography analysis of the apical third of curved roots after mechanical preparation with different automated systems

The present study evaluated by cone-beam computed tomography (CBCT) the apical canal transportation and centralizing ability of different automated systems after root canal preparation. The mesiobuccal canals of maxillary first molars (n=10 per group) were prepared with: GI - reciprocating system with K-Flexofile; GII - reciprocating system with NiTiFlex files; GIII - rotary system with K3 instruments; GIV - rotary system with RaCe instruments. CBCT scans were taken before and after biomechanical preparation up to a #40.02 diameter. Canal transportation was determined by measuring the smallest distance between the inner canal walls and the mesial and distal sides of the root. The centralization ability corresponded to the difference between the measurements from transportation evaluation, using the linear voxel to voxel method of analysis. The mean transportation was 0.06 ± 0.14 mm, with a tendency to deviate to the mesial side of the root (n=22), with no statistically significant difference among the groups (p=0.4153). The mean centralization index was 0.15 ± 0.65 also without statistically significant difference among the groups (p=0.0881). It may be concluded that apical canal transportation and centralization ability were not influenced by the type of mechanical movement and instruments used.

Correlation of the hybrid layer thickness and resin tags length with the bond strength of a self-etching adhesive system.

The objective of this study was to measure the thickness of the hybrid layer (HLT), length of resin tags (RTL) and bond strength (BS) in the same teeth, using a self-etching adhesive system Adper Prompt L Pop to intact dentin and to analyze the correlation between HLTand RTL and their BS. Ten human molars were used for the restorative procedures and each restored tooth was sectioned in mesio-distal direction. One section was submitted to light microscopy analysis of HLT and RTL (400x). Another section was prepared and submitted to the microtensile bond test (0.5 mm/min). The fractured surfaces were analyzed using scanning electron microscopy to determine the failure pattern. Correlation between HLT and RTL with the BS data was analyzed by linear regression. The mean values of HLT, RTL and BS were 3.36 microm, 12.97 microm and 14.10 MPa, respectively. No significant relationship between BS and HLT (R2= 0.011, p>0.05) and between BS and RTL (R2= 0.038) was observed. The results suggested that there was no significant correlation between the HLT and RTL with the BS of the self-etching adhesive to dentin.

A comparison of the film thickness of two adhesive luting agents and the effect of thermocycling on their microTBs to feldspathic ceramic.

The aim of the present study was to evaluate the effect of thermocycling (TC) on the microtensile bond strength (microTBS) of two luting agents to feldspathic ceramic and to measure their film thickness (FT). For the microTBS test, sixteen blocks (6.4 x 6.4 x 4.8 mm) were fabricated using a feldspathic ceramic, etched with 10% hydrofluoric acid, rinsed and treated with the silane agent. The ceramic blocks were divided into two groups (n= 8): Gr1: dual-cured resin cement and Gr2: flowable resin. The luting agents were applied on the treated surfaces. Microsticks (1 +/-0. 1mm2) were prepared and stored under two conditions: dry, specimens immediately submitted to the microTBS test, and TC (6,000 cycles; 5 degrees C-55 degrees C). The microTBS was evaluated using a universal testing machine (1 mm/min). The microTBS data (MPa) were submitted to two-way ANOVA and Tukey' test (5%). For the FT test (ISO 4049), 0.05 ml of each luting agent (n=8) was pressed between two Mylar-covered glass plates (150 N) for 180 seconds and light polymerized. FT was measured using a digital paquimeter (Model 727-2001). The data (mm) were submitted to one-way ANOVA. The luting cement did not influence the microTBS results (p= 0.4467). Higher microtensile bond values were found after TC (20.5 +/- 8.6 MPa) compared to the dry condition (13.9 +/- 4. 7MPa), for both luting agents. The luting agents presented similar film thicknesses: Gr1- 0.052 +/- 0.016 mm; Gr2-0.041 +/- 0.003 mm. The luting agents presented similar film thickness and microTBS values, in dry and TC conditions and TC increased the bond strength regardless of the luting agent.