The bonding effectiveness of five luting resin cements to the IPS Empress 2 all ceramic system.

BACKGROUND: Variolink II is the only resin cement used for bonding IPS (Ivoclar Porcelain System) Empress 2 ceramic restorations. Alternative luting resin cements need to be investigated for their bonding effectiveness with the IPS Empress 2 ceramic. OBJECTIVES: To determine the shear bond strength (SBS) and the effect of thermocycling, on the bonding effectiveness, of five resin cements to IPS Empress 2 ceramic. MATERIALS AND METHODS: The projecting surfaces of one hundred ceramic discs were ground wet on silicone carbide paper. The specimens were divided into 5 groups of 20. The resin cements were bonded to the prepared ceramic surfaces, in the form of a stub. The specimens were stored under distilled water at 37 degrees C in an oven for 24 hours. Ten specimens in each group were thermocycled for 300 cycles between 5 degrees C and 55 degrees C. All the specimens were stressed to failure in an Instron Materials Testing Machine. RESULTS: The results were subjected to a one-way analysis of variance (ANOVA). Statistically similar mean SBS values were grouped using the Bonferroni (Dunn) multiple comparison test. The means for the non-thermocycled group were: 26.21, 19.41, 17.69, 17.43, and 15.76. The means for the thermocycled group were: 22.90, 15.72, 14.34, 13.96 and 13.45. The differences between the means were highly significant (p < 0.0125). CONCLUSIONS: The shear bond strength of Variolink II and Rely XARC to IPS Empress 2 ceramic was effective. Thermocycling had a significant effect on the mean SBS values of Calibra. Thermocycling had no significant effect on the mean SBS values of the other resin cements.     

Bond strength of glass-ceramics on the fluorosed enamel surfaces

OBJECTIVES: Effect of different adhesive luting systems on the shear bond strength of IPS Empress 2 ceramic restorations to fluorosed enamel surface was investigated. METHODS: Forty-eight ceramic discs (2 mm x 3 mm; IPS Empress 2) were fabricated. Twenty-four non-carious extracted human molar teeth with fluorosis and 24 without fluorosis were cleaned with pumice using a plastic brush and then they were divided into two main groups. The IPS Empress 2 ceramic discs were luted to the teeth of four subgroups with two different adhesive luting systems, Variolink 2/Excite DSC (etch-and-rinse) and Clearfil Esthetic Cement/ED Primer II (self-etch), thermocycling was performed 5000 times. Shear bond strengths were tested using Shimadzu Universal Testing Machine until failure. An optical microscope and image analyzer were used at 10x and 1000x magnification to analyze the surfaces for adhesive, cohesive and mixed failure percentages. Data was analyzed with one-way ANOVA and Tukey test at a significance level of p<0.05. RESULTS: Mean shear bond strength data of the groups in MPa were; Variolink 2/Excite DSC on fluorosed enamel: 18.3+/-3.08, Variolink 2/Excite DSC on non-fluorosed enamel: 18.79+/-2.65, Clearfil Esthetic Cement/ED Primer II on fluorosed enamel: 8.43+/-2.45, Clearfil Esthetic Cement/ED Primer II on non-fluorosed enamel: 13.53+/-1.68. Mixed failure was the most prevalent type of failure in moderate fluorosed and non-fluorosed teeth with etch-and-rinse dentin bonding system, and in fluorosed teeth with self-etch dentin bonding system. CONCLUSIONS: The use of an etch-and-rinse adhesive luting procedure produced higher bond strengths of glass-ceramics bonded to fluorosed and non-fluorosed enamel surfaces than the self-etch bonding system.     

三种全瓷基底与其相应饰面瓷的结合性能研究

目的:测试并比较3种全瓷基底材料与其相应饰面瓷的结合强度,为临床选择合适的修复材料提供依据。方法:将成品Lava Frame、Vita In-Ceram Alumina、IPS EmpressⅡ瓷块、StarLoy钴铬合金制成长方体试件,分别在其表面烧结相应的饰面瓷,测试抗剪切强度,激光共聚焦扫描显微镜和扫描电镜观察破坏模式。结果:Lava、Vita、IPS EmpressⅡ、金瓷复合体的抗剪强度值分别为11.40±1.08、9.44±1.23、25.56±1.70、27.02±2.06MPa。IPS EmpressⅡ、金瓷复合体的抗剪切强度显著高于Lava和Vita(P<0.05);IPS EmpressⅡ与金瓷复合体的抗剪切强度差异无统计学意义(P>0.05);Lava与Vita差异无统计学意义(P>0.05)。IPS Em-pressⅡ的破坏模式以基底材料破坏为主,Lava、Vita、金瓷复合体以饰面瓷破坏为主。结论:IPS EmpressⅡ基底与饰面瓷的结合强度最高,与金瓷复合体无差别。     

Effect of provisional restorations on the final bond strengths of porcelain laminate veneers

The purpose of this in vitro study was to evaluate the effect of the different provisional restorations cementation techniques on the final bond strengths of porcelain laminate veneers (PLVs). Thirty-six extracted human central incisors were sectioned 2 mm below the cemento-enamel junction, and crown parts were embedded into self-cure acrylic resin. Standardized PLV preparations were carried out on labial surfaces of the teeth. Then the teeth were randomly divided into three groups of 12 each. In group 1, provisional restorations were cemented with eugenol-free cement. In group 2, prepared teeth surfaces were first coated with a desensitizing agent then provisional restorations were cemented with resin cement. In group 3, provisional restorations were not fabricated to serve as control. After specimens were stored in distilled water for 2 weeks, provisional restorations were removed and final IPS Empress 2 ceramic veneers were bonded with a dual-curing resin. Two microtensile samples from each tooth measuring 1.2 x 1.2 x 5 mm were prepared. These sections were subjected to microtensile testing and failure values were recorded. The data were analysed by one-way anova and Tukey HSD tests. The PLVs, placed on the tooth surface that had received a dentine desensitizer and provisional restorations luted with resin cement (group 2), showed the lowest bond strength in all test groups. But no statistically significant differences were found between the bond strength of PLVs in control group (no provisional restorations) and group 1 (provisional restorations cemented with eugenol-free cement before final cementations). Scanning electron microscopic (SEM) examination of this study also showed that the bonding to enamel surface was better in control group and group 1 than group 2.     

Effect of different bonding agents on shear bond strengths of composite-bonded porcelain to enamel

STATEMENT OF PROBLEM: The use of bonding agents in the luting procedure for porcelain laminate restorations to enamel is not clear. PURPOSE: This study evaluated the shear bond strength differences between an enamel-luting composite and a heat-pressed ceramic with 6 different bonding systems. MATERIAL AND METHODS: Seventy standardized heat-pressed IPS Empress ceramic discs (4-mm diameter, 3-mm height) were prepared. A vertical planar enamel-bonding surface was prepared on the buccal or lingual enamel of 70 freshly extracted sound human molars and premolars. The teeth were oriented to maintain a parallel relationship between the bonding plane and the shear loading axis of a universal testing machine. Tooth specimens were divided into 7 groups (n=10) comprising equal numbers of molars and premolars. The enamel surfaces of specimens in groups 1 through 6 were prepared with 1 of 6 bonding agents (Scotchbond Multi Purpose Plus, Heliobond, PQ1, SE Bond, Prime&Bond NT, and Prompt L-Pop). Finally, the specimens were luted to the ceramic discs with the composite cement (Opal Luting Composite). Ceramic discs in the seventh group (Control) were luted to the etched enamel with the composite cement without using bonding material. Enamel-ceramic specimens were kept in distilled water at room temperature for 30 days after cementation. All specimens were shear loaded axially in a universal testing machine with a crosshead speed of 0.05 mm/min until fracture. Shear bond strength was measured and recorded for each group in MPa. To determine the statistical significance of the differences between the mean shear bond strength values, a 1-way analysis of variance was used (alpha=.05). Post-hoc multiple comparisons were made with Duncan's multiple range analysis. Fractured surfaces of each specimen were also inspected with a stereomicroscope to evaluate failure modes. RESULTS: A 1-way analysis of variance revealed significant differences between the test groups (P=.00). Bond strength values (MPa) from the highest to the lowest were as follows: Prompt L-Pop, 25.46 +/- 5.6; Prime&Bond NT, 18.99 +/- 4.93; Heliobond, 17.28 +/- 4.0; SE Bond, 16.21 +/- 2.6; PQ1, 15.60 +/- 2.8; Scotchbond MPP, 14.82 +/- 2.4; and Control, 10.55 +/- 1.6. Duncan's multiple range post hoc analysis exhibited significant differences between the control group and the adhesive bonding agent groups (P<.05). There were also significant differences between the bonding agent groups (P<.05). Prompt L-Pop showed the highest bond strength values. CONCLUSION: Within the limitations of this study, bonding agents appear to have a strengthening effect on the shear bond strengths of the enamel/composite/porcelain interface of the materials tested. Bonding agents used in this study showed similar bond strength values except for Prompt L-Pop, which demonstrated the highest bond strength values.     

Effect of an antibacterial adhesive on the bond strength of three different luting resin composites

OBJECTIVES: Effect of a dentin adhesive system containing antibacterial monomer-MDPB (Clearfil Protect Bond) on the shear bond strength of all-ceramic-IPS Empress 2 restorations luted with three different dual-polymerizing systems (Variolink 2, RelyX ARC and Panavia F 2.0) to dentin was investigated. METHODS: One hundred and eight all-ceramic discs (2 x 3mm; IPS Empress 2) were fabricated and ultrasonically cleaned. The buccal surfaces of 108 non-carious extracted human premolars were flattened to expose dentin and subsequently polished with 600-grit wet silicon carbide paper. Three dual-polymerizing luting systems had test groups and control groups consisting of 18 samples each. For the test groups Clearfil Protect Bond was applied to the exposed dentin surfaces. Control groups received the original bonding procedures of each adhesive system. After the all-ceramic samples were luted to the teeth, thermocycling was performed 5000 times. Shear bond strengths were tested using Shimadzu Universal Testing Machine until failure. Analysis of fractured dentin surfaces were performed using Optical Microscope at x10 and x1000 magnifications and the images were analyzed with Image Analyzer. Data was analyzed with one-way ANOVA and Bonferroni test at a significance level of p<0.05. RESULTS: Mean shear bond strength data of the groups in MPa were; Variolink: 20.45+/-4.75, Variolink+Clearfil Protect Bond:29.32+/-2.37, RelyX ARC:18.82+/-3.19, RelyX ARC+Clearfil Protect Bond:25.58+/-4.05, Panavia F 2.0:17.11+/-2.98, Panavia F 2.0+Clearfil Protect Bond:24.40+/-7.46. Application of the antibacterial adhesive increased the shear bond strengths of all three dual-polymerizing systems to dentin (p=0.00). The surface analysis showed that most of the specimens showed the adhesive failure mode between the dentin and the composite luting agent interface. CONCLUSION: The antibacterial adhesive system Clearfil Protect Bond can be safely used to prevent the potential risk of complications resulting from bacterial activity regardless of affecting the bond strength of IPS Empress 2 restorations luted with the dual-polimerizing systems used in this study.     

Influence of ceramic thickness and polymerization mode of a resin luting agent on early bond strength and durability with a lithium disilicate-based ceramic system

STATEMENT OF PROBLEM: Attenuation of polymerization light energy by translucent all-ceramic materials may result in insufficient polymerization of underlying resin luting agents and inadequate early bond strength and durability. There is little information regarding the selection of an appropriate polymerization mode for cementing translucent all-ceramic restorations. PURPOSE: The purpose of this study was to evaluate the influence of ceramic thickness and polymerization mode on the early bond strength and bond durability of a lithium disilicate-based ceramic system. MATERIAL AND METHODS: The occlusal surfaces of 120 extracted, intact, human third molars were sectioned to expose a flattened area of dentin. The surface was etched with 32% phosphoric acid, and a single-step adhesive (One-Step) was applied to the etched dentin surfaces. Ceramic specimens (Empress 2), 6 mm in diameter and 1 mm, 1.5 mm, or 2 mm thick (n=40 per group), were fabricated using fluoropolymer resin matrixes. Each specimen was ground flat. Following hydrofluoric acid etching and silane treatment, ceramic discs of each thickness were further divided into 2 groups (n=20 per group) and bonded to the dentin surfaces with a dual-polymerized resin luting agent (Illusion), either with a catalyst (dual polymerization) or without a catalyst (light polymerization). A shear bond test was performed after 10 minutes (n=10) or after 24 hours following 1000 thermal cycles between 5 degrees C and 55 degrees C and a dwell time of 30 seconds (n=10). Debonded dentin surfaces were examined with SEM. The data were analyzed with 3-way analysis of variance (ANOVA) (alpha=.05). RESULTS: The shear bond strengths ranged between 13.2 +/- 4.1 MPa and 15.9 +/- 2.0 MPa. Three-way ANOVA revealed that ceramic thickness, polymerization mode, storage time, or combinations of these parameters did not influence shear bond strength. The location of failure for all specimens was adhesive, between the dentin surface and bonding agent. CONCLUSION: Both light polymerization and dual polymerization provided similar early shear bond strengths for the lithium disilicate-based ceramic system (Empress 2). The bond strength was not dependent on the thickness of the ceramic material tested. Durability of the bond was similar for both of the polymerization modes.     

Effect of Surface Acid Etching on the Biaxial Flexural Strength of Two Hot-Pressed Glass Ceramics

Purpose: The purpose of this study was to assess the effect of surface acid etching on the biaxial flexural strength of two hot-pressed glass ceramics reinforced by leucite or lithium disilicate crystals.
Materials and Methods: Forty glass ceramic disks (14-mm diameter, 2-mm thick) consisting of 20 leucite-based ceramic disks (IPS Empress®) and 20 lithia disilicate-based ceramic (IPS Empress 2®) were produced by hot-pressing technique. All specimens were polished and then cleaned ultrasonically in distilled water. Ten specimens of each ceramic group were then etched with 9% hydrofluoric (HF) acid gel for 2 minutes and cleaned ultrasonically again. The biaxial flexural strength was measured by the piston-on-three-ball test in a universal testing machine. Data based on ten specimens in each group were analyzed by two-way ANOVA  (α= 0.05)  . Microstructure of ceramic surfaces before and after acid etching was also examined by a scanning electron microscope.
Results: The mean biaxial flexural strength values for each group tested were (in MPa): nonetched IPS Empress = 118.6 ± 25.5; etched IPS Empress = 102.9 ± 15.4; nonetched IPS Empress 2 = 283.0 ± 48.5; and etched IPS Empress 2 = 250.6 ± 34.6. The results showed that the etching process reduced the biaxial flexural strengths significantly for both ceramic types ( p = 0.025). No significant interaction between the ceramic type and etching process was found ( p = 0.407).
Conclusion: From the results, it was concluded that surface HF acid etching could have a weakening effect on hot-pressed leucite or lithia disilicate-based glass ceramic systems.     

Effect of ceramic surface treatment on the shear bond strengths of two resin luting agents to all-ceramic materials

The purpose of this study was to evaluate the bond strengths of some resin luting cements of two different all ceramic materials (In-Ceram, IPS-Empress). Composite cylinders 3.2 x 2 mm were prepared on the ceramic surfaces for a shear test. Four ceramic surface treatments were performed. (i). As received, (ii). grinding with diamond bur, (iii). sandblasting with 50 microm alumina grit and (iv). HF acid treatment and sandblasting with 50 microm alumina grit. Ceramic specimens were treated with one of the four methods and then cemented together with each of the two luting agents. The tested luting cements were Panavia F and Clearfil Se Bond (CSeB). The CSeB demonstrated the highest bond strength (59.95 MPa) regardless of the ceramic blocks. The average of load to fracture the In-Ceram blocks luted with Panavia F cement was 25.89 MPa. The mean shear bond strength of IPS Empress blocks luted with Panavia F cement was 10.31 MPa. Grinding the surface with a diamond bur for In-Ceram blocks luted with Panavia-F was 30.93 MPa and with CSeB was 77.04 MPa. For IPS-Empress blocks these values decreased to 12.39 MPa for Panavia-F and 30.84 MPa for CSeB. Acid etching of the surfaces with HF acid demonstrated a weak tendency to improve bond strength (In-Ceram-->Panavia-F= 14.59 MPa and CSeB=59.32 Mpa; IPS-Empress--> Panavia-F=5.85 MPa and CSeB= 23.33 MPa).     

Intra‐oral adhesive systems for ceramic repairs: a comparison

The aim of this investigation was to compare the bond strength of restorative composite resin to dental ceramic conditioned with primers and adhesives of various commercial repair kits. Three intra‐oral ceramic repair systems—Silistor (Heraeus Kulzer), Cimara (Voco), Ceramic Repair (Vivadent)—were used on all‐ceramic (IPS Empress 2, Ivoclar‐Vivadent) substrate. Shear bond strength of restorative composite resin to substrate was tested after thermocycling and without thermocycling (n=10). Substrate surfaces of the specimen after loading were examined microscopically (SEM). The highest bond strengths in both water‐stored (7.0±5.7 MPa) and thermocycled conditions (2.5±1.8 MPa) were obtained with the Vivadent repair system, while the lowest values were observed with the Cimara system (0.6±1.4 MPa and 0.0±0.0 MPa, respectively). Shear bond strengths appeared to be significantly affected by thermocycling (ANOVA, P<0.05). It is concluded that there are significant differences in the bond strengths of resin composites and ceramic substrate. The roughened surface does not necessarily provide a better bond strength; the bond strength of composite decreases with storage in water and after thermocycling. Bond strength values were generally low for all of the tested materials.     

The influence of internal surface treatments on tensile bond strength for two ceramic systems

STATEMENT OF THE PROBLEM: The ceramic composition and surface microstructure of all-ceramic restorations are important components of an effective bonding substrate. Hydrofluoric acid and sandblasting are well-known procedures for surface treatment; however, surface treatment for high alumina-containing and lithium disilicate ceramics have not been fully investigated. PURPOSE: This in vitro study evaluated the tensile bond strength of resin cement to two types of ceramic systems with different surface treatments. METHODS AND MATERIALS: Thirty specimens of each ceramic system were made according to the manufacturer's instructions and embedded in polyester resin. Specimens of In-Ceram Alumina [I] and IPS Empress 2 [E] were distributed to three groups with differing surface treatments (n = 10): sandblasting with 50 microm aluminum oxide (APA); sandblasting with 110 microm aluminum oxide modified with silica particles (ROCATEC System-RS); a combination of sandblasting with APA and 10% hydrofluoric acid etching (HA) for two minutes on In-Ceram and for 20 seconds for IPS Empress 2. After the respective surface treatments, all the specimens were silanated, and Rely-X resin cement was injected onto the ceramic surface and light polymerized. The specimens were stored in distilled water at 37 degrees C for 24 hours and thermally cycled 1,100 times (5 degrees C/55 degrees C). The tensile bond strength test was performed in a universal testing machine at a 0.5 mm/minute crosshead speed. RESULTS: The mean bond strength values (MPa) for IPS Empress 2 were 12.01 +/- 5.93 (EAPA), 10.34 +/- 1.77 (ERS) and 14.49 +/- 3.04 (EHA). The mean bond strength values for In-Ceram Alumina were 9.87 +/- 2.40 (IAPA) and 20.40 +/- 6.27 (IRS). All In-Ceram specimens treated with 10% hydrofluoric acid failed during thermal cycling. CONCLUSION: The Rocatec system was the most effective surface treatment for In-Ceram Alumina ceramics; whereas, the combination of aluminum oxide sandblasting and hydrofluoric acid etching for 20 seconds worked more effectively for Empress 2 ceramics.     

Fracture Resistances of Cast Metal and Ceramic Dowel and Core Restorations: A Pilot Study

PURPOSE: The purpose of this study was to compare fracture strengths of teeth restored with cast metal and ceramic dowel and cores supporting all-ceramic crowns. MATERIALS AND METHODS: Eighteen recently extracted teeth were randomly divided into 3 equal groups. Metal dowel and cores (MDC) were fabricated for 1 group using a base metal alloy, and served as the control. The other groups received In-Ceram Spinell (ICS) and IPS Empress 2 (IPS) dowel and cores. IPS Empress 1 crowns were fabricated for all samples. Each tooth was subjected to a shear force at a crosshead speed of 2 mm/min on a universal testing machine until failure occurred. RESULTS: The mean fracture strengths and standard deviations of MDC, ICS, and IPS restorations were 1101 N (361), 832 N (288), and 1137 N (367), respectively. The differences between groups were insignificant (p < 0.05). Fractures of the all-ceramic crowns were observed in the MDC group, whereas the failure of ceramic dowel and core restorations was associated with root fracture at the cervical region. CONCLUSIONS: Due to improved mechanical properties, In-Ceram Spinell and IPS Empress 2 ceramic dowel and cores may be candidates for the restoration of endodontically treated anterior teeth.     

Effect of etching and airborne particle abrasion on the microstructure of different dental ceramics

STATEMENT OF PROBLEM: The ceramic composition and microstructure surface of all-ceramic restorations are important components of an effective bonding substrate. Both hydrofluoric acid etching and airborne aluminum oxide particle abrasion produce irregular surfaces necessary for micromechanical bonding. Although surface treatments of feldspathic and leucite porcelains have been studied previously, the high alumina-containing and lithium disilicate ceramics have not been fully investigated. PURPOSE: The purpose of this study was to assess the surface topography of 6 different ceramics after treatment with either hydrofluoric acid etching or airborne aluminum oxide particle abrasion. MATERIAL AND METHODS: Five copings each of IPS Empress, IPS Empress 2 (0.8 mm thick), Cergogold (0.7 mm thick), In-Ceram Alumina, In-Ceram Zirconia, and Procera (0.8 mm thick) were fabricated following the manufacturer's instructions. Each coping was longitudinally sectioned into 4 equal parts by a diamond disk. The resulting sections were then randomly divided into 3 groups depending on subsequent surface treatments: Group 1, specimens without additional surface treatments, as received from the laboratory (control); Group 2, specimens treated by use of airborne particle abrasion with 50-microm aluminum oxide; and Group 3, specimens treated with 10% hydrofluoric acid etching (20 seconds for IPS Empress 2; 60 seconds for IPS Empress and Cergogold; and 2 minutes for In-Ceram Alumina, In-Ceram Zirconia, and Procera). RESULTS: Airborne particle abrasion changed the morphologic surface of IPS Empress, IPS Empress 2, and Cergogold ceramics. The surface topography of these ceramics exhibited shallow irregularities not evident in the control group. For Procera, the 50-microm aluminum oxide airborne particle abrasion produced a flattened surface. Airborne particle abrasion of In-Ceram Alumina and In-Ceram Zirconia did not change the morphologic characteristics and the same shallows pits found in the control group remained. For IPS Empress 2, 10% hydrofluoric acid etching produced elongated crystals scattered with shallow irregularities. For IPS Empress and Cergogold, the morphologic characteristic was honeycomb-like on the ceramic surface. The surface treatment of In-Ceram Alumina, In-Ceram Zirconia, and Procera did not change their superficial structure. CONCLUSION: Hydrofluoric acid etching and airborne particle abrasion with 50-microm aluminum oxide increased the irregularities on the surface of IPS Empress, IPS Empress 2, and Cergogold ceramics. Similar treatment of In-Ceram Alumina, In-Ceram Zirconia, and Procera did not change their morphologic microstructure.     

Marginal Gap,Internal Fit,and Fracture Load of Leucite‐Reinforced Ceramic Inlays Fabricated by CEREC inLab and Hot‐Pressed Techniques

Purpose: This in vitro study was designed to evaluate and compare the marginal gap, internal fit, and fracture load of resin‐bonded, leucite‐reinforced glass ceramic mesio‐occlusal‐distal (MOD) inlays fabricated by computer‐aided design/manufacturing (CAD/CAM) or hot pressing. Materials and Methods: Fifty caries‐free extracted human molars were prepared for standardized MOD inlays. Impressions of each specimen were made and poured using type IV dental stone. Dies were randomly divided into two equal groups. Twenty‐five ceramic inlays were fabricated by the hot‐pressed technique using IPS Empress leucite‐reinforced glass ceramics, and the other 25 ceramic inlays were produced by CAD/CAM technology using ProCAD leucite‐reinforced ceramic blocks and CEREC inLab facilities. Inlays were bonded to the teeth using a dual‐cured resin cement. The specimens were stored in distilled water at 37°C for 24 hours and then thermocycled for 5000 cycles. The marginal gap measurements were taken with a stereomicroscope. Specimens in each group of inlay systems were randomly divided into two subgroups of 10 and 15 specimens each. Ten specimens in each subgroup were sectioned mesiodistally for evaluation of the internal fit. The fracture load of specimens in the second subgroup (n = 15) of the two inlay systems was determined under compressive load in a universal testing machine. Data were analyzed using Student's t‐test at a significance level of p < 0.05. Results: The mean marginal and internal gap size in both IPS Empress and ProCAD inlays were less than 100 μm; however, the marginal gap for the IPS Empress restorations was significantly higher than that of ProCAD restorations (p < 0.05). There was no significant difference in the mean internal fit or the fracture load between the two glass ceramic inlays (p > 0.05). Conclusions: The leucite‐reinforced glass ceramic inlay restorations fabricated by CEREC inLab (CAD/CAM) and the hot‐pressed technique provided clinically acceptable marginal and internal fit with comparable fracture loads after luting.     

Effect of Veneering Techniques on Color and Translucency of Y‐TZP

Purpose: This study compared the color parameters and total luminous transmittance of disc specimens by different veneering techniques in order to examine the effect of veneering technique on esthetics of yttria‐stabilized tetragonal zirconia polycrystalline (Y‐TZP) all‐ceramic restorations. Materials and Methods: Thirty disc specimens (10‐mm diameter, 0.50 ± 0.01 mm thick) were fabricated of IPS e.max ZirCAD core material, and ZL1 IPS e.max ZirLiner (0.10‐mm thick) was layered. The specimens were randomly divided into three groups (n = 10/group). Group ZP (fully anatomical technique) was veneered 0.60 mm by heat‐pressing IPS e.max ZirPress fluorapatite glass‐ceramic ingots; Group ZC (traditional layering technique) was veneered 0.60 mm by condensing and sintering IPS e.max Ceram low‐fusing nano‐fluorapatite veneering porcelain; Group ZPC (cutback technique) was veneered by partially pressed ingots and subsequently layered 0.30 mm with veneering porcelain. Color parameters (L*, a*, b*) and total luminous transmittance (τ) of zirconia core discs and core and veneer specimens were measured with ShadeEye NCC dental colorimeter and spectrophotometer, respectively. Color saturation (C*ab) and color difference (ΔE) were calculated using color difference formula. One‐way analysis of variance (ANOVA) combined with a Tukey multiple‐range test were used to analyze the data (α= 0.05). Results: As to ZP, ZPC, and ZC groups, the value of a* increased (?1.35 ± 0.07, ?0.64 ± 0.06, ?0.36 ± 0.05, respectively) (p < 0.05); b* decreased (27.01 ± 0.07, 25.48 ± 0.11, 23.28 ± 0.25, respectively) (p < 0.05); and C*ab decreased (27.04 ± 0.08, 25.49 ± 0.11, 23.28 ± 0.25, respectively) (p < 0.05). L* value and total luminous transmittance were highest in ZP group (87.53 ± 0.48, 1.64 ± 0.03, respectively), and lowest in ZPC group (82.14 ± 0.18, 1.47 ± 0.01, respectively) (p < 0.05). Conclusions: Y‐TZP all‐ceramic restoration veneered by fully anatomical technique was the most transparent and lightest, while restorations veneered by cutback technique were the least translucent and the darkest.     

Bond strength of composite resin to glass ceramic after saliva contamination

Objectives

Purpose of this study was to investigate the effect of cleaning methods of glass ceramic specimens contaminated with saliva on tensile bond strength (TBS) to composite resin. Additionally, effect of water storage on bond strength was evaluated.

Materials and methods

Glass ceramic discs (IPS Empress, Ivoclar-Vivadent, FL) distributed among five groups (n?=?28) were etched with hydrofluoric acid, silanized, contaminated with human saliva, and in group W rinsed with water, group WS additionally silanized, group E rinsed with water and cleaned with ethanol, and group ES additionally silanized. Group C served as a control without contamination. Plastic screws were bonded to the glass ceramic discs using Variolink II (Ivoclar-Vivadent). TBS was measured after 24 h and after 150 days of storage. Failure modes were examined. ANOVA was applied to explore group effect on TBS. Pair-wise comparisons were calculated.

Results

The mean TBS [in megapascals] were for W 46?±?14, WS 55?±?8, E 48?±?11, ES 52?±?10, and C 50?±?8 after 24 h, and W 39?±?11, WS 53?±?9, E 48?±?8, ES 48?±?11, and C 50?±?8 after 150 days. After 150 days specimens of group W showed significantly lower TBS compared to group C (p?=?0.05). Additional silanization in group WS led to a significant increase of TBS compared to specimens of group W (p?=?0.003). Adhesive fractures were observed only in specimens without second application of silane.

Conclusions

The cleaning of the contaminated glass ceramic surface by rinsing only did not result in a durable bond.

Clinical relevance

Pre-silanized glass ceramic restorations need to be rinsed and treated with a fresh layer of silane after saliva contamination.     

Fatigue resistance of ultrathin CAD/CAM ceramic and nanoceramic composite occlusal veneers

ObjectiveThe fracture resistance of different ultrathin occlusal computer-aided design/computer-aided manufacturing (CAD/CAM) veneers was investigated under cyclic mechanical loading to restore combined enamel-dentin defects.MethodsEighty-four molars were reduced occlusally until extensive dentin exposure occurred with a remaining enamel ring. Twenty-four molars were ground flat for examination of highly standardized specimens, of which 8 were treated with uniformly flat 0.3 mm IPS Empress CAD and 0.3 and 0.5 mm IPS e.max CAD restorations. Sixty-four molars were anatomically prepared until dentin exposure and were restored using occlusal veneers with fissure/cusp thicknesses of 0.3/0.5 mm from 3 different dental CAD/CAM materials: IPS Empress CAD, IPS e.max CAD and Lava Ultimate CAD/CAM. Teeth were etched with 37% phosphoric acid, and occlusal veneers were bonded using an adhesive luting system (Syntac Primer, Adhesive, Heliobond and Variolink II). Specimens were placed under cyclic mechanical loading in a chewing simulator (1 million cycles at 50 N) and were examined for cracks after each cyclic loading sequence. The anatomical 0.3/0.5 mm IPS e.max CAD specimens experienced an additional 1 million cycles at 100 N. Kaplan–Meier survival curves and log-rank tests were used for data analysis.ResultsAll highly standardized and 0.3/0.5 mm IPS e.max CAD specimens tolerated cyclic loading. One anatomical Lava Ultimate CAD/CAM and 10 IPS Empress CAD specimens showed cracks.SignificanceUltrathin occlusal veneers of lithium disilicate ceramic and nanoceramic composite showed remarkably high fracture strength under cyclic mechanical loading. These veneers might be a tooth substance preserving option for restoring combined dentin–enamel defects.     

Repair strength of etched vs silica-coated metal-ceramic and all-ceramic restorations

The purpose of this in vitro study was to examine shear bond strengths of composite resin to metal-exposed porcelain-fused-to-metal (PFM) and all-ceramic restorations after silica coating or etching with 5% hydrofluoric acid (HF). Specimens were fabricated for each of the following groups: two all-ceramic materials [a feldspathic porcelain (Vita Mark II) and a leucite-reinforced glass-ceramic (IPS Empress)], and one noble metal-ceramic (Orplid Keramik I alloy; Vita VMK 68 N felspathic veneer ceramic). These groups were repaired with resin composites after different pretreatment methods. In one metal-ceramic subgroup the surface exhibited a 50% metal and 50% ceramic exposure. In the silica-coating groups, the specimen surfaces were air abraded with silica acid-modified Al2O3 (CoJet Sand) and treated corresponding to the porcelain repair with resin composite. For control groups, the surfaces were etched with 5% HF for 60 seconds and treated in the same way as the silica-coated groups. After 24 hours of storage (distilled water, 37 degrees C) and an additional 24 hours of thermocycling (1150 x 5 degrees C/55 degrees C) the specimens were debonded using a shear bond strength test (n = 15). In all groups the silica coat repair achieved equal or significantly higher bond strengths than did the etching technique (p < 0.05, Mann-Whitney U test). In the metal-exposed group, the mean bond strength increased from 7.3 MPa to 16.3 MPa following the silica-coat repair. Results indicated that silica coating represents a suitable treatment for the intraoral repair of the materials tested in the present study.     

To Evaluate the Effect of Various Surface Treatments on the Shear Bond Strength of Three Different Intraoral Ceramic Repair Systems: An In Vitro Study

Fractures of metal-ceramic restoration pose an esthetic and functional dilemma both for patient and the dentist. Intraoral repair systems eliminate the remake and removal of restoration. Many intraoral repair materials and surface treatments are available to repair intraorally fractured metal-ceramic restoration. Bond strength data of various materials and specific technique used for repair are necessary for predicting the success of a given repair system. This study evaluated the shear bond strength of three different intraoral repair systems for metal-ceramic restorations applied on exposed metal and porcelain surface. One hundred and twenty metal discs (20 mm in diameter × 0.7 mm thick) were fabricated with nickel–chromium alloy (Mealloy, Dentsply, USA). Feldspathic porcelain (Duceram, Degudent, Germany) were applied over one test surface of the discs in the thickness of 1.8 mm followed by conventional firing. The defect, which simulates clinical failures were created in 1/4th area of the metal-ceramic discs. The metal-ceramic discs samples were divided into ceramic substrate (Group I, n = 60) and metal substrate (Group II, n = 60), according to the defect location. Then, samples of ceramic substrate (Group I) and metal substrate (Group II) were subdivided into A, B according to the surface treatments (A; roughening with diamond bur and B; abraded with 50 μ Al₂O₃) and repaired with one of the intraoral repair systems tested (a. Ceramic repair system, Ivoclar Vivadent; b. Clearfil repair system, Kurary, c; Porcelain repair system, 3 M ESPE). All the repaired samples were stored in distilled water at 37 °C for 24 h. After thermocycling at 6–60° C, all the samples were stored at 37 °C for additional 7 days. Shear bond strength of all the samples were calculated by using Universal testing machine. The mean shear bond strength values for the group I (A/B) were as follows: Ceramic repair system (9.47 ± 1.41/14.03 ± 2.54 MPa), Clearfil repair system (14.03 ± 2.32/14.64 ± 2.28 MPa), and Porcelain repair system (14.41 ± 3.96/14.86 ± 3.10 MPa). The mean shear bond strength values for the group II (A/B) were as follows: Ceramic repair system (9.42 ± 1.44/18.61 ± 2.60 MPa), Clearfil repair system (14.44 ± 3.23/14.98 ± 2.73 MPa), and Porcelain repair system (11.86 ± 2.24/13.24 ± 2.72 MPa). Air abrasion with 50 μm aluminum oxide particles is the preferred surface treatment. Porcelain repair system showed the highest shear bond with air abrasion for ceramic substrate and for metal substrate Ceramic repair system showed the highest bond strength with air abrasion as a surface treatment. This study suggest that the three repair systems tested are adequate for intraoral chairside repair of metal-ceramic restoration when air abrasion is used for surface treatment of the substrate (Ceramic repair system, Ivoclar Vivadent, Germany; Clearfil repair system, Kurary, Japan; Porcelain repair system, 3M ESPE, Germany).     

粘接剂与基牙颜色对三种CAD/CAM全瓷贴面颜色的影响

目的 评价全瓷修复体材料、基牙颜色及粘接剂对CAD/CAM椅旁系统修复体色泽的影响.方法 选择三种CAD/CAM椅旁全瓷修复材料：IPS Empress CAD、IPS E.max CAD和Cerec Blocs.每种材料各制备出厚度为（0.8±0.02）mm的试样18片,随机分为3组,以聚四氟乙烯为模板,制作15mm×13mm×2mm的3种颜色的基牙树脂试件,分别采用2种颜色（Transparent与Bleach）的粘接剂粘接瓷片与基牙树脂,每组3片,静压2min,光照20s,使用台式分光亮度仪测量三种全瓷材料的透光度,比较粘接前后修复体的L＊、a＊、b＊值,并计算粘接前后的色差△E.结果 不管基牙颜色或瓷片种类如何,透明色粘接剂组粘接前后的色差△E皆显著大于漂白色粘接剂组.Cerec Blocs组粘接前后的色差最大,E.max组的色差最小,而Empress则介于两者之间.结论 三种全瓷材料中,Empress的透光度最佳,Cerec Blocs陶瓷材料更易受基牙颜色与粘接剂的影响.透明色粘接剂对基牙树脂与瓷贴面复合体的颜色影响大于漂白色粘接剂.