Is high-viscosity glass-ionomer-cement a successor to amalgam for treating primary molars?

ObjectivesTo assess and compare the cumulative survival rate of amalgam and atraumatic restorative treatment (ART) restorations in primary molars over 3 years.Methods280 children aged 6–7 years old were enrolled in a cluster randomized controlled clinical trial using a parallel group design covering two treatment groups: conventional restorative treatment with amalgam (CRT) and atraumatic restorative treatment (ART) using a high-viscosity glass-ionomer (HVGIC) Ketac Molar Easymix. Three pedodontists placed 750 restorations (364 amalgam and 386 ART in 126 and 154 children, respectively) which were evaluated at 0.5, 1, 2 and 3 years. The proportional hazard rate regression model with frailty correction, ANOVA and Wald tests, and the Jackknife procedure were applied in analysing the data.ResultsThe cumulative survival rates over 3 years for all, single- and multiple-surface CRT/amalgam restorations (72.6%, 93.4%, 64.7%, respectively) were no different from those of comparable ART/HVGIC restorations (66.8%; 90.1% and 56.4%, respectively) (p = 0.10). Single-surface restorations had higher survival rates than multiple-surface restorations for the both treatment procedures (p < 0.0001). A higher proportion of restorations failed because of mechanical reasons (94.8%) than of secondary caries (5.2%). No difference in reasons for restoration failures between all types of amalgam and ART/HVGIC restorations were observed (p = 0.24).SignificanceThe high-viscosity glass-ionomer used in this study in conjunction with the ART is a viable option for restoring carious dentin lesions in single surfaces in vital primary molars.     

Stability of bonds made to superficial vs. deep dentin,before and after thermocycling

ObjectivesBonding stability of resinous adhesives to dentin is still problematic and may involve regional variations in dentin composition. This study is to evaluate the effect of dentin depth on the stability of resin-dentin bonds under thermocycling challenge.MethodsDentin slabs with two flat surfaces parallel to the tooth axis were obtained from extracted human third molars. The slabs were randomized into eight groups according to the location of dentin [deep dentin (DD) or superficial dentin (SD)], the adhesive treatment (Single Bond 2 or Clearfil S³ Bond), and the storage treatment (thermocycling for 5000 times vs. no). After the adhesive treatment and composite buildup on the dentin slabs, the micro-shear bond strength (μSBS) of each group was detected. The concentrations of cross-linked carboxyterminal telopeptide of type I collagen (ICTP) were also evaluated using an immunoassay to detect the degree of collagen degradation in each group.ResultsDentin depth, adhesive treatment and storage treatment all showed significant effects on both the μSBSs and the ICTP values (P < 0.05). Regardless of the adhesive type, thermocycling decreased the μSBSs and increased the ICTP values (P < 0.05). The DD groups showed significantly lower μSBSs and higher ICTP values than SD groups after thermocycling aging (P < 0.05). The treatment with Single Bond 2 significantly increased the ICTP values (P < 0.05), whereas Clearfil S³ Bond showed no effect on the ICTP values (P > 0.05).SignificanceDeep dentin showed significantly more bond degradation after thermocycling than did superficial dentin.     

Survival of multiple-surface ART restorations using a zinc-reinforced glass-ionomer restorative after 2 years: A randomized triple-blind clinical trial

ObjectiveTo investigate the effectiveness of a new zinc-reinforced glass-ionomer in comparison to a common high-viscous glass-ionomer cement (HVGIC) used in multiple-surface ART-prepared cavities. The hypothesis tested was that the cumulative survival percentage of the new HVGIC is higher than that of the common HVGIC over 2 years.MethodsA randomized triple-blind parallel group clinical trial was used. A total of 218 participants, average age 15.4 years (SD = 0.2), with an occluso-proximal carious lesion in a permanent (pre-) molar were included. Restorations using test (ChemFil Rock) and control (Fuji IX GP) restoratives were placed according to the ART method by four calibrated operators. Restorations were evaluated after one week (baseline), and at 6-, 12-, 18- and 24 months from replicas and coloured photographs according to the ART restoration assessment criteria by two independent evaluators. Restoration survival curves were estimated using the Kaplan–Meier method and difference between dependent and independent variables tested with a Wald (chi-square) test.ResultsThere was a statistically significant difference in cumulative survival percentages between the two types of restorations at 2 years (P = 0.02). A higher percentage of multiple-surface restorations of Fuji IX GP (95.4%) than ChemFil Rock (85.3%) survived. Gender (P = 0.64), operator (P = 0.56) and cavity size (P = 0.81) had no effect on the survival of the type of restoration observed. Type of tooth (P = 0.004) and type of jaw (P = 0.05) showed an effect. Severe wear was the major reason for restoration failure (ChemFil Rock = 7; Fuji IX GP = 1).SignificanceChemFil Rock appears not to be a viable alternative to Fuji IX GP in restoring ART multiple-surface cavities in permanent posterior teeth.     

Mechanical performance of encapsulated restorative glass-ionomer cements for use with Atraumatic Restorative Treatment (ART)

The Atraumatic Restorative Treatment (ART) approach was suggested to be a suitable method to treat enamel and dentine carious lesions in patients with disabilities. The use of a restorative glass-ionomer with optimal mechanical properties is, therefore, very important.

Objective:

To test the null-hypotheses that no difference in diametral tensile, compressive and flexural strengths exists between: (1) The EQUIA system and (2) The Chemfil Rock (encapsulated glass-ionomers; test materials) and the Fuji 9 Gold Label and the Ketac Molar Easymix (hand-mixed conventional glass-ionomers; control materials); (3) The EQUIA system and Chemfil Rock.

Material and Methods:

Specimens for testing flexural (n=240) and diametral tensile (n=80) strengths were prepared according to standardized specifications; the compressive strength (n=80) was measured using a tooth-model of a class II ART restoration. ANOVA and Tukey B tests were used to test for significant differences between dependent and independent variables.

Results:

The EQUIA system and Chemfil Rock had significantly higher mean scores for all the three strength variables than the Fuji 9 Gold Label and Ketac Molar Easymix (α=0.05). The EQUIA system had significant higher mean scores for diametral tensile and flexural strengths than the Chemfil Rock (α=0.05).

Conclusion:

The two encapsulated high-viscosity glass-ionomers had significantly higher test values for diametral tensile, flexural and compressive strengths than the commonly used hand-mixed high-viscosity glass-ionomers.     

A preliminary clinical trial using flowable glass-ionomer cement as a liner in proximal-ART restorations: The operator effect

Objectives: This in vivo study was carried out to assess the influence of the operator experience on the survival rate of proximal-ART restorations using a two-layer technique to insert the glass-ionomer cement (GIC). Study Design: Forty five proximal cavities in primary molars were restored in a school setting according to the ART technique. The cavities were restored by two operators with Ketac Molar Easymix, and received a flowable layer of GIC prior to a second GIC layer with a regular consistency. The operators had different clinical experiences with ART (no experience or two years of experience), but both completed a one-week training to perform the restorations and the GIC mixing in this study. Results: After a 12-month follow-up, 74% of the restorations survived; the main reason for failure was bulk fracture or total loss of the restoration.There was no operator influence (log-rank test p=0.2) Conclusion: The results encourage future well designed controlled clinical trials using the two-layer technique for insertion of GIC in proximal-ART restorations, after training the operators. Key words:Atraumatic Restorative Treatment (ART), Glass-ionomer, proximal restorations.     

An evaluation of microleakage of various glass ionomer based restorative materials in deciduous and permanent teeth: An in vitro study

AimTo evaluate the microleakage of recently available glass ionomer based restorative materials (GC Fuji IX GP, GC Fuji VII, and Dyract) and compare their microleakage with the previously existing glass ionomer restorative materials (GC Fuji II LC) in primary and permanent teeth.MethodOne hundred and fifty (75 + 75) non-carious deciduous and permanent teeth were restored with glass ionomer based restorative materials after making class I cavities. Samples were subjected to thermocycling after storing in distilled water for 24 h. Two coats of nail polish were applied 1 mm short of restorative margins and samples sectioned buccolingually after storing in methylene blue dye for 24 h. Microleakage was assessed using stereomicroscope.ResultSignificant differences (P < 0.05) were found when inter group comparisons were done. Except when GC Fuji VII (Group III) was compared with GC Fuji II LC (Group II) and Dyract (Group IV), non-significant differences (P > 0.05) were observed. It was found that there was no statistically significant difference when the means of microleakage of primary teeth were compared with those of permanent teeth.ConclusionsGC Fuji IX GP showed maximum microleakage and GC Fuji VII showed least microleakage.     

Influence of dentin pretreatment with 2.5% titanium tetrafluoride on inhibiting caries at the tooth-restoration interface in situ

ObjectiveInvestigate the effects of dentin pretreatment with 2.5% titanium tetrafluoride (TiF₄) aqueous solution followed by two-step self-etching (CLE/Clearfil SE Bond) and one-step self-etching adhesive systems (SBU/Single Bond Universal) on carious lesion inhibition at the tooth-restoration interface using an in situ model.DesignSixty-four cavities at the enamel-dentin junction of dental fragments were randomly distributed according to groups (n = 16): 1) TiF₄ + CLE; 2) TiF₄ + SBU; 3) CLE; 4) SBU. Cavities were restored using resin composite, and placed in intraoral palatal devices used by 16 volunteers for 21 days, to induce caries formation in situ. The fragments were then ground-flat to perform Knoop microhardness tests. Nine indentations were performed on each enamel and dentin substrate, subjacent to the restoration. Analysis of variance and Tukey’s test were applied.ResultsEnamel: groups receiving TiF₄ dentin pretreatment (regardless of adhesive system and tooth-restoration interface distance) presented higher hardness means at a depth of 25 μm from the outer tooth surface (p < 0.0001). Dentin: groups receiving CLE presented higher means when applying TiF₄ pretreatment, whereas groups restored with SBU presented higher means without pretreatment (p = 0.0003).ConclusionsDentin pretreatment with TiF₄ inhibited demineralization of the enamel interface in situ, regardless of the adhesive, and TiF₄ pretreatment followed by CLE application showed higher potential for inhibiting dentin demineralization at the interface.     

Effects of layering techniques on the micro-tensile bond strength to dentin in resin composite restorations

ObjectivesThe purpose of this work was to investigate the effects of layering techniques in resin composite restorations on the micro-tensile bond strength to the dentin of the occlusal cavity.MethodsHuman premolars were extracted and randomly divided into four groups. The occlusal enamel was then removed to expose a flat superficial dentin surface. Cavities 3.5 mm long and 3.5 mm wide were prepared to a depth 3 mm below the dentin surface. The adhesive Single Bond was applied according to the manufacturer's instructions. The teeth were then restored with Z100 resin composite as follows: Group 1 was restored in horizontal increments (three layers). Groups 2 and 3 were restored in different oblique increments (three layers). Group 4 was restored in oblique increments (four layers). After 24 h storage at 37 °C in water, all the teeth were sectioned to obtain bar-shaped specimens with a bonded surface area of approximately 0.9 mm × 0.9 mm. Dentin micro-tensile bond strength was measured at a crosshead speed of 0.5 mm/min. The results obtained were statistically analyzed using one-way ANOVA and SNK test at a significance level of P = 0.05. All fractures were then observed under a scanning electron microscope (SEM).ResultsThe results showed that there is a significant difference between the strength of the micro-tensile bonds to the dentin of occlusal cavities depending on which of the four layering restorative techniques was used (P < 0.01). SEM observation showed that failure patterns were most evidently interfacial cohesive failure.SignificanceLayering techniques in resin composite restorations affected the micro-tensile bond strength between the resin composite and the dentin. But the outcomes related to only Single Bond, as the same using other adhesives might have different outcomes.     

Can a soda-lime glass be used to demonstrate how patterns of strength dependence are influenced by pre-cementation and resin-cementation variables?

ObjectivesTo determine how the variability in biaxial flexure strength of a soda-lime glass analogue for a PLV and DBC material was influenced by precementation operative variables and following resin-cement coating.MethodsThe flexural modulus of a transparent soda-lime glass was determined by longitudinally sectioning into rectangular bar-shaped specimens and the flexural moduli of three resin-based materials (Venus Flow, Rely-X Veneer and Clearfil Majesty Posterior) was also determined. Disc shaped soda-lime glass specimens (n = 240) were divided into ten groups and were alumina particle air abraded, hydrofluoric (HF) acid-etched and resin-cement coated prior to biaxial flexure strength testing. Sample sets were profilometrically evaluated to determine the surface texture. One-way analyses of variance (ANOVA) and post hoc all paired Tukey tests were performed at a significance level of P < 0.05. The mean biaxial flexure strengths were plotted against resin-coating thickness and a regression analysis enabled estimation of the ‘actual’ magnitude of strengthening.ResultsThe mean three-point flexural modulus of the soda-lime glass was 40.0 (1.0) GPa and the Venus Flow, Rely-X Veneer and Clearfil Majesty Posterior were 3.0 (0.2) GPa, 6.0 (0.2) GPa and 14.8 (1.6) GPa, respectively. At a theoretical ‘zero’ resin-coating thickness an increase in biaxial flexure strength of 20.1% (63.2 MPa), 30.8% (68.8 MPa) and 36.3% (71.7 MPa), respectively was evident compared with the control (52.6 (5.5) MPa).ConclusionsDisc-shaped specimens cut from round stock facilitated rapid fabrication of discs with uniform surface condition and demonstrated strength dependence was influenced by precementation parameters and resin-cementation variables.     

Marginal leakage of two newer glass-ionomer-based sealant materials assessed using micro-CT

Objectives

To test newer glass-ionomer-based materials as sealant materials. One glass-ionomer sealant was light-cured to obtain an early setting reaction. The null-hypothesis tested was: there is no difference in marginal leakage of sealants produced with high-viscosity glass-ionomer, with and without energy supplied, and that of glass-carbomer, in comparison with resin composite sealants in vitro.

Methods

Materials used were Clinpro^®, Ketac Molar Easymix^® and Glass-Carbomer^®. Sealants were placed in the occlusal surface of 89 molar teeth, thermocycled for 5000 cycles and evaluated using micro-CT for silver nitrate penetration depth at the enamel–sealant interface by two trained evaluators. Data were analysed, using ANOVA and Scheffe's test.

Results

Glass-carbomer sealants showed one or more ‘fracture lines’ in the material and at the enamel–material interface, filled with a kind of transparent, but not black coloured, material. High-viscosity glass-ionomer sealants with and without energy supplied had statistically significantly lower mean marginal leakage scores than sealants produced by composite resin (p < 0.01). No marginal leakage was found in the high-viscosity glass-ionomer group without energy supplied.

Conclusions

The high-viscosity glass-ionomer (Ketac Molar Easymix^®) sealants had lower marginal leakage than resin composite sealants, and should be tested in vivo. Glass-carbomer sealants were non-interpretable.     

Microhardness of resin composite materials light-cured through fiber reinforced composite

ObjectivesTo compare polymerization efficiency of resin composite basing materials when light-cured through resin composite and fiber reinforced composite (FRC) by testing microhardness.MethodsSimulated indirect restorations were prepared by application of resin composite (Clearfil AP-X) or FRC (EverStick) to nylon rings with 1.5 mm thickness and 8 mm diameter, followed by light-curing. Resin composite basing material (Clearfil Majesty Flow or Clearfil AP-X) was applied to identical rings and light-cured through the simulated indirect restorations with exposure times of 20, 40, or 60 s. Light-curing though a ring without resin material (=no indirect restoration) served as control. For each combination of basing material and indirect restoration 10 specimens were prepared for each exposure time. Top and bottom surface Vickers microhardness numbers (VHNs) of basing materials were recorded after 24 h.ResultsAfter 60 s exposure time, VHNs with indirect FRC were not different from control VHNs, while VHNs with indirect resin composite were significantly lower (p < 0.001). Linear regression analysis revealed that resin composite basing material used had the greatest effect on top and bottom VHNs (p < 0.001). The presence of an indirect restoration resulted in decreased VHNs (p < 0.001), with resin composite resulting in lower VHNs when compared to FRC. Moreover, a longer exposure time resulted in increased VHNs (p < 0.001).SignificanceResults suggest that polymerization of resin composite basing materials is more effective when light-curing through an FRC than through a resin composite indirect restoration. Prolonging of exposure time, however, is necessary when compared to light-curing without presence of indirect restoration material.     

Shear Bond Strength of Conventional Glass Ionomer Cements Bound to Mineral Trioxide Aggregate

IntroductionThis study measured the shear bond strength of conventional glass ionomer cements (GICs; Ketac Molar Easymix and Fuji IX) bonded to white mineral trioxide aggregate (WMTA) that had been allowed to set for 2 different time intervals.MethodsForty-eight WMTA specimens were prepared; half were stored for 45 minutes, and the remaining 24 specimens were stored for 72 hours at 37 °C and 100% humidity. Then each group was divided into 2 subgroups of 12 specimens, and each GIC was layered on each of the 2 WMTA preparations. The GIC-WMTA shear bond strengths were measured and were compared by using one-way analysis of variance.ResultsThe shear bond strengths with the 45-minute and 72-hour WMTAs were 8.85 and 9.16 MPa, respectively, for Ketac Molar Easymix and 9.34 and 9.96 MPa, respectively, for Fuji IX. The GIC-WMTA bond strength was not different between GIC applications to WMTA that had set for 45 minutes versus 72 hours (P >.05).ConclusionsGICs might be used over MTA after the MTA has set for 45 minutes to allow single-visit procedures.     

Shear bond strength vs interfacial fracture toughness — Adherence to CAD/CAM blocks

ObjectiveTo compare shear bond strength (SBS) and interfacial fracture toughness (IK_IC) results when assessing the effect of surface roughness and thermocycling on the adherence of a resin composite luting agent (RCLA) to a CAD/CAM resin composite block (RCB).MethodsTetric CAD HT along with the recommended bonding system, Adhese Universal and Variolink Esthetic LC, were used. Surface roughness was achieved with 600/320/60 grit SiC papers. Samples were stored 24 h in 37 °C water or thermocycled 10000× (5 °C–55 °C) prior to testing. Results were analyzed by univariate ANOVA and Scheffé modified t-tests (α = 0.05). Fractured specimens were viewed with a stereo microscope and selected specimens with a scanning electron microscope.ResultsSBS results showed a significant difference between the 60 grit group and the other groups, both after 24 h and thermocycling. A large number of SBS samples showed cohesive fracture or subsurface damage in RCB. Thermocycling led to a significant decrease in SBS in all groups. IK_IC results showed no significant differences due to surface preparation after 24 h storage in 37 °C. After thermocycling, there was a significant difference between the 60 and the 600 grit groups. All K_IC samples fractured adhesively at the RCB surface. K_IC of the RCLA was significantly higher than IK_IC of all groups.SignificanceThe results endorse the use of fracture mechanics methodology for the assessment and characterization of adherence, while identifying difficulties in its implementation. The results suggest also that adherence to CAD/CAM RCB may be limited by the strength of the resin composite block — adhesive interface.     

Influence of surface treatments and resin cement selection on bonding to densely-sintered zirconium-oxide ceramic

ObjectivesTo evaluate the effect of surface conditioning on the microtensile bond strength of zirconium-oxide ceramic to dual-cured resin cements.MethodsEighteen cylinder-shaped zirconium-oxide ceramic blocks (Cercon^® Zirconia, Dentsply) were treated as follows: (1) Sandblasting with 125 μm aluminum-oxide (Al₂O₃) particles; (2) tribochemical silica coating using 50 μm Al₂O₃ particles modified by silica; (3) no treatment. Each ceramic cylinder was duplicated in composite resin (Tetric Evo Ceram, Ivoclar-Vivadent) using a silicon mold. Composite cylinders were bonded to conditioned ceramics using: (1) Calibra (Densply Caulk); (2) Clearfil Esthetic Cement (Kuraray); (3) Rely × Unicem (3 M ESPE). After 24 h bonded specimens were cut into microtensile sticks that were loaded in tension until failure. Data were analyzed using two-way ANOVA and Student–Newman–Keuls test for multiple comparisons (p < 0.05). Failure mode was recorded and the interfacial morphology of debonded specimens was observed using a scanning electron microscope (SEM). Surface topography and ceramic average surface roughness were analyzed under an atomic force microscope (AFM).ResultsSignificant changes in zirconia surface roughness occurred after sandblasting (p < 0.001). Bond strength of Clearfil cement to zirconia was significantly higher than that of Rely × Unicem and Calibra, regardless of the surface treatment (p < 0.001). When using Calibra, premature failures occurred in non-treated and silica coated zirconia surfaces.SignificanceThe phosphate monomer-containing luting system (Clearfil Esthetic Cement) is recommended to bond zirconia ceramics and surface treatments are not necessary.     

Effect of types of luting agent on push-out bond strength of zirconium oxide posts

ObjectiveThe aim of this study was to investigate the effect of different luting agents on the bond strength of zirconium oxide posts in root canals after artificial ageing.Material and methodsThirty single-rooted extracted teeth were collected. Post spaces were prepared. Custom milled zirconium oxide posts (Cercon, Degudent) were fabricated. Specimens were divided into 3 groups (n = 10), according to the luting agents used: group RA, conventional resin luting agent (RelyX ARC); group RU, self-adhesive resin luting agent (RelyX Unicem); and group Z, zinc phosphate luting agent (DeTrey). Specimens were subjected to thermocycling and water storage at 37 °C. Specimens were horizontally sectioned into three sections and subjected to a push-out test with 0.5 mm/min crosshead speed. The failure mode was assessed by scanning electron microscopy. Data were analysed by using 2-way ANOVA.ResultsThe following bond strength values were obtained: group RA – 8.89 MPa, group RU – 10.30 MPa and group Z – 9.31 MPa. There was no significant difference in bond strength among the groups (P = 0.500). Adhesive failure mode at the cement/post bonded interface was seen in 100%, 66.67% and 83.3% of examined sections in groups RA, RU and Z, respectively. There was no significant difference in bond strength among different root regions (P = 0.367).ConclusionThe type of luting agent had no significant effect on the push-out bond strength of zirconium oxide posts after artificial ageing.Clinical significanceConventional luting agents, such as zinc phosphate cement, seem to provide comparable retention to resin luting agents for cementing custom milled zirconium oxide posts.     

Effect of cleaning protocol on silica deposition and silica-mediated bonding to Y-TZP

ObjectivesTo evaluate the effect of cleaning methods on the deposition of silica on yttria-stabilized zirconium dioxide (Y-TZP) surface and on the silane-silica mediated bond strength between Y-TZP and resin cement.MethodsY-TZP slabs were air-abraded with 30 μm silica-coated alumina particles and distributed in three groups: no cleaning, cleaning with a stream of oil-free air/water spray for 5 s and cleaning with an ultrasonic bath in water for 10 min. The distribution of Si on the Y-TZP surfaces was recorded using energy dispersive spectroscopy (EDS). After the treatment was applied, Y-TZP slabs (n = 20) received a primer application and resin cement cylinders were built on the surface. After storage (24 h) in water storage or 3 months plus thermocycling; n = 10), microshear bond strength test (μSBS) was performed. X- ray Photoelectron Spectroscopy (XPS) characterized the chemical bonds between the silica layer and the silane-containing primer. Data were analyzed using ANOVA and Tukey test, as well as Weibull analysis (α = 0.05).ResultsCleaning method had a significant effect on the amount of Si deposited on zirconia surface (p < 0.001) and, consequently, on bond strength (p < 0.001). Storage/aging also had a significant effect on bond strength (p < 0.001). Low values of Weibull moduli for bond strength were observed for all groups after aging. XPS showed silane-silica chemical interaction for all groups.SignificanceThe silica deposited by tribochemical coating to Y-TZP was removed by the cleaning methods evaluated, compromising bond strength. Stability of the bonding is also a concern when no cleaning method is applied.     

Strength of tunnel-restored teeth with different materials and marginal ridge height

ObjectiveThe aim of the study was to investigate the strength of the marginal ridge of tunnel preparations with different marginal ridge heights, using different restorative materials.Materials and methods120 sound premolars were randomly divided into three groups of standardized tunnel preparations with a remaining marginal ridge height of 1.5 mm, 2.5 mm and 3.5 mm, respectively. In each tunnel group, 10 teeth were filled with all four newly developed adhesive materials that had not previously been used in tunnel preparation: Ketac Aplicap, Fuji IX, Fuji II LC and Beautifil Flow F02. The control group comprised 10 sound teeth. All teeth were subjected to incremental dynamic force testing. Remaining marginal ridge height and restoration material were the independent variables. The mean maximum energy (MEI) score was the dependent variable. Data were analyzed, using one- and two-way analysis of variance. Scheffe's test and Student's t-test were used for comparison between groups.ResultsBoth restorative material (P < 0.0001) and remaining marginal ridge height (P < 0.0001) had a statistically significant effect on the mean MEI score of tunnel-prepared teeth. At the 2.5 mm of remaining marginal ridge height, no statistically significant difference in mean MEI score existed between Beautifil Flow F02-filled tunnel-prepared teeth and sound teeth.SignificancePremolars tunnel-restored with Beautifil Flow F02 at 2.5 mm distance from the marginal ridge were as strong as sound teeth.     

Mechanical properties of new self-adhesive resin-based cement

PurposeThe aim of this study was to compare the bonding strength, flexural strength, elastic modulus, water absorption and the expansion after water storage of new self-adhesive resin cements to commercially available dental cements.MethodsTwo types (hand-mix and auto-mix) of new self-adhesive resin cements (SAC-H and SAC-A, Kuraray Medical), one conventional resin cement (Panavia F2.0), three self-adhesive resin cements (Relyx Unicem, Maxcem and G-Cem), and two resin-modified glass-ionomer cements (Fuji Luting S and Vitremer) were used. Shear bond strengths, flexural strengths and elastic moduli (ISO 4049), water absorption (ISO 4049), and the expansion rate after water storage were investigated.ResultsBoth SAC-H and SAC-A provided adhesion to enamel and dentin, and had the same bond strength to gold alloy and zirconia as conventional resin cements. SAC-H and SAC-A had greater flexural strengths (86.4–93.5 MPa) than commercial self-adhesive resin cements or glass-ionomer cements. The elastic moduli of self-adhesive and glass-ionomer cements were 5.2–7.4 GPa and 2.3–3.4 GPa, respectively. The water absorption of SAC-H and SAC-A (26.3–27.7 μg/mm³) were significantly lower than commercial self-adhesive resin cements. SAC-H and SAC-A showed significantly lower expansion rates (0.17–0.26%) than commercial self-adhesive cements and glass-ionomer cements after 4 weeks water storage.ConclusionsIt is suggested that the new self-adhesive resin cements exhibited a favorable bonding capability and mechanical properties.     

A comparison of stress relaxation in temporary and permanent luting cements

PurposeThe stress relaxation and compressive strength of resin, resin-modified glass ionomer, glass ionomer, polycarboxylate, and zinc oxide eugenol cements were measured to determine the characteristics of these materials after setting.MethodsA total of 19 luting cements including 12 permanent cements and 7 temporary cements were used. Cylindrical cement specimens (10 mm long and 6 mm in diameter) were obtained by chemical setting or light curing. The specimens were stored for 24–36 h in water at 37 °C and were then used for the stress relaxation and compression tests. The stress relaxation test was carried out using three constant cross-head speeds of 5, 50, and 100 mm/min. Upon reaching the preset dislocation of 0.5 mm, the cross-head movement was stopped, and the load was recorded for 60 s. Fractional stress loss at 1 s was calculated from the relaxation curves. The compressive strength and modulus were measured at a cross-head speed of 1 mm/min. Data were analyzed with the Kruskal–Wallis test and Holm's test.ResultsA zinc oxide eugenol cement [TempBOND NX] exhibited the largest fractional stress loss. A resin cement [ResiCem] showed the largest compressive strength, while a glass ionomer cement [HY-BOND GLASIONOMER CX] showed the largest compressive modulus among all tested cements (p < 0.05).ConclusionThe fractional stress loss could not be classified by the cement type. Two implant cements [Multilink Implant and IP Temp Cement] showed similar properties with permanent resin cements and temporary glass ionomer cements, respectively. Careful consideration of the choice of cement is necessary.     

Vertical and horizontal polymerization shrinkage in composite restorations

ObjectivePolymerization shrinkage developed in vertical and horizontal directions after light activation of light-curing composite restorative materials. The purpose of this study was to examine the effects of vertical and horizontal polymerization shrinkage on: (a) dimensional changes of resin composites in tooth cavities; (b) shear bond strengths to enamel and dentin; and (c) marginal gap width in a non-reacting Teflon mold.MethodsVertical and horizontal polymerization shrinkage in tooth cavities were measured immediately (3 min) after light activation. With the same time lapse, shear bond strengths to enamel and dentin and marginal gap widths in Teflon mold were also measured.ResultsThere was a significant correlation between vertical and horizontal polymerization shrinkage (r = 0.647, p = 0.043) in the tooth cavity. Composite materials which produced small vertical shrinkage also produced smaller horizontal shrinkage. Composite materials which produced small vertical shrinkage in the tooth cavity exhibited greater shear bond strengths to both enamel (r = −0.697, p = 0.025) and dentin (r = −0.752, p = 0.012). Composite materials which produced smaller horizontal shrinkage produced smaller marginal gap widths in the Teflon mold (r = 0.829, p = 0.003). No relationships were observed between horizontal shrinkage in the tooth cavity and shear bond strengths to both enamel and dentin (p > 0.05).SignificanceDuring the early stage of setting (<3 min) in tooth cavities, the vertical shrinkage of light-activated composite restorative materials was correlated with horizontal shrinkage.