Microleakage of IPS empress 2 inlay restorations luted with self-adhesive resin cements

OBJECTIVE : To assess the microleakage of three self-adhesive and one etch-and-rinse resin cements when luting IPS Empress 2 (Ivoclar Vivadent, Liechtenstein) all-ceramic inlay restorations to the prepared cavities in extracted human molars. METHODS : The cylindrical Class V cavities were prepared on the buccal surfaces of 40 extracted human third molars using diamond burs. The IPS Empress 2 ceramic inlays were placed with Multilink Sprint (Ivoclar Vivadent), RelyX Unicem (3M ESPE, USA), G-Cem (GC, Japan), or Variolink II (Ivoclar Vivadent) as the control group. After storage in distilled water at 37°C for 24 hours, samples were subjected to 1000 thermal cycles between baths of 5°C and 55°C, with a dwell time of 30 seconds. The microleakage scores were examined on the occlusal and gingival margins at 30× magnification after each sample was stained with 0.5% basic fuchsin and sectioned into three parts using a thin diamond blade (Isomet, Buehler, USA) (n=40). The extent of microleakage on both occlusal and gingival margins of the restorations was scored and recorded. The microleakage data were analyzed using Kruskall-Wallis and Mann-Whitney U-tests. RESULTS : Statistically significant differences were observed between the groups in both margins according to the Kruskall-Wallis and Mann-Whitney U-tests (p<0.05). Microleakage scores on the occlusal margins were Variolink II < RelyX Unicem < G-Cem = Multilink Sprint. Microleakage scores on the gingival margins are Variolink II = RelyX Unicem < G-Cem < Multilink Sprint. CONCLUSION : Self-adhesive resin cements displayed higher microleakage scores on the occlusal margins, whereas on the gingival margins RelyX Unicem showed comparable microleakage results with the control samples.     

In vitro evaluation of microleakage of indirect composite inlays cemented with four luting agents

STATEMENT OF PROBLEM: Microleakage around dental restorations is implicated in the occurrence of secondary carious lesions, adverse pulpal response, and reduced restoration longevity. PURPOSE: The aim of this in vitro study was to evaluate the microleakage of indirect resin composite inlays cemented with 4 luting agents. MATERIAL AND METHODS: Standardized Class V inlay preparations overlapping the cemento-enamel junction were prepared on the buccal and lingual surfaces of 40 extracted human mandibular third molars. Eighty postpolymerized, heat-treated resin composite inlays (Targis, 72 specimens, 8 controls) were processed in stone replicas and cemented into the preparations using 4 luting agents (n = 18 + 2 controls for each cement group): a resin composite used with a bonding agent (Variolink II/Excite), a resin composite used with a self-etching primer, but without bonding agent (Panavia F/ED Primer), a modified resin composite used with a bonding agent (Resinomer/One Step), and a resin-modified glass-ionomer cement (Fuji Plus). Thirty-six inlays (n = 9 + 1 control) were subjected to thermal cycling (2000 cycles, 5 degrees C/55 degrees C), whereas the other 36 were not. All the teeth were then immersed in 1% methylene blue dye solution for 48 hours. Microleakage score, margin location (enamel/cementum), thermal cycling history, and preparation location (buccal/lingual) were analyzed using a multivariate model (alpha = .05). Multivariate analysis was performed using a polychotomous logistic regression. RESULTS: The preparation location had no significant effect on dye penetration. The margin location (enamel or cementum) and the thermal cycling had a significant effect on microleakage (odds ratios [ORs] = 17.6 and 8.04, respectively). In comparing the 3 resin-based luting agents (Variolink II, Panavia F, and Resinomer) to Fuji Plus, Panavia F exhibited the lowest significant overall microleakage (OR = 0.09), followed by Variolink II (significant OR equal to 0.43), whereas Resinomer demonstrated the greatest significant overall microleakage (OR = 1.35). CONCLUSION: Within the experimental conditions of this in vitro study, thermal cycling significantly increased microleakage (OR = 8.04). The overall microleakage at the enamel margins was significantly lower than the overall microleakage at the cementum margins for the 4 luting agents tested (OR = 17.6).     

Mechanical properties of luting cements after water storage

This study determined the effect of water storage on flexural strength (FS) and compressive strength (CS) of 12 luting cements from different material classes. In addition, the influence of the curing method on the mechanical properties was investigated. The materials examined were two zinc phosphate cements (Harvard cement and Fleck's zinc cement), two glass ionomer cements (Fuji I and Ketac-Cem), three resin-modified glass ionomer cements (Fuji Plus, Fuji Cem and RelyX Luting), four resin cements (RelyX ARC, Panavia F, Variolink II and Compolute) and one self-adhesive universal resin cement (RelyX Unicem). The samples were prepared and tested according to ISO specifications. Specimens for FS and CS were loaded to fracture at a constant crosshead speed of 1 mm/minute. The mechanical properties were measured after the materials were stored in distilled water at a temperature of 37.0 +/- 1.0 degrees C for 24 hours and 150 days after mixing. In a one-way ANOVA, multiple mean value comparisons using Duncan's multiple comparison tests were performed. Resin cements had the highest flexural and compressive strengths, followed by self-adhesive universal resin cement. These materials were statistically stronger than resin-modified glass ionomer cements, glass ionomer cements and zinc phosphate cements.     

Human pulp response to resin cements used to bond inlay restorations.

OBJECTIVE: The aim of this study was to evaluate the pulp response following cementation of inlays using two different resin cements. METHODS: Deep Class V cavities were prepared on the buccal surface of 34 sound human premolars. Impressions were taken and inlays were prepared which were cemented with the following luting materials-Group 1: Rely X Unicem (3M ESPE); Group 2: Variolink II (Ivoclar Vivadent). In Group 3 (control), after lining the cavity floor with Dycal (Dentsply Caulk) the inlays were cemented with Rely X Unicem. Four additional teeth were used as an intact control group. For Variolink II, the adhesive system Excite was used as part of the cementation procedure. After 7 or 60 days, the teeth were extracted and processed for histological assessment. RESULTS: At 7 days, Rely X Unicem and Variolink II system triggered in two samples a mild and moderate inflammatory response, respectively. At 60 days, the pulpal response decreased for both groups. A discrete persistent inflammatory response occurred in Group 2 in which displacement of resin components across the dentin tubules was observed. In the control group, normal histological characteristics were observed. The inflammatory response and tissue disorganization were related to the remaining dentin thickness between the cavity floor and the pulp tissue. SIGNIFICANCE: Techniques for inlay cementation using distinct luting cements may cause specific pulpal damage. Variolink II associated with the adhesive system Excite cause more aggressive effects to the pulp-dentin complex than Rely X Unicem cement when both are used to cement inlay restorations.     

The shear bond strength between luting cements and zirconia ceramics after two pre-treatments

This study evaluated the shear-bond strength of 11 luting cements from different material classes to manufactured pre-treated zirconia ceramics (Lava: 97% ZrO2, stabilized with 3% Y2O3). In addition, the influence of the curing method on shear-bond strength was investigated. The cements examined were one zinc-phosphate cement (Fleck's zinc cement), two standard glass-ionomer cements (Fuji I, Ketac-Cem), three resin-modified glass-ionomer cements (Fuji Plus, Fuji Cem, RelyX Luting), four standard resin cements (RelyX ARC, Panavia F, Variolink II, Compolute) and one self-adhesive universal resin cement (RelyX Unicem). The ceramic surface was sand-blasted with 100-microm alumina or tribochemically coated with silica. After bonding procedure, one group was tested after 30 minutes (Time I), the other group was stored in distilled water at 37 degrees C for 14 days and subsequently thermocycled 1000 times (Time II). Statistical analysis was performed by multifactorial ANOVA models with interactions. For multiple pairwise comparisons, the Tukey method was used. After sandblasting, the highest shear-bond strength was obtained for the self-adhesive universal resin cement at 9.7 MPa (Time I) and 12.7 MPa (Time II), respectively. When using the Rocatec system, the highest values were found for one of the resin cements at 15.0 MPa (Time I) and for the self-adhesive universal resin cement at 19.9 MPa (Time II).     

A study of the physical and chemical properties of four resin composite luting cements

PURPOSE: This study evaluated the surface microhardness and flexural and compressive strengths of five luting cements and compared the degree of conversion of dual and autopolymerized forms of four resin-based luting cements. MATERIALS AND METHODS: Four resin composite luting cements-Panavia F, Variolink 2, RelyX Unicem Applicap, and RelyX ARC-and a polycarboxylate cement (Durelon, control group) were used in three-point bending, compression, and Vickers hardness tests following water storage for 1 week. Resin composite cements were additionally investigated with both dual and autopolymerization techniques under Fourier transformed infrared spectroscopy. Differences were analyzed using one-way ANOVA. RESULTS: The highest flexural strengths were obtained with Variolink 2 (90 MPa, SD 22), whereas the lowest were observed with Durelon (28 MPa, SD 4). RelyX Unicem showed the highest hardness values (44 HV, SD 5), whereas Variolink 2 gave the lowest (32 HV, SD 6). The highest compressive strengths were obtained with RelyX Unicem (145 MPa, SD 32), whereas the lowest were observed with Durelon (41 MPa, SD 17). For both dual and autopolymerized groups, RelyX ARC showed the highest degrees of conversion (81% and 61%, respectively) and RelyX Unicem had the lowest (56% and 26%, respectively). CONCLUSION: Resin composite luting cements of similar chemical characterizations differed in their physical properties, and polymerization method influenced their degree of conversion.     

Microleakage along Glassix glass fibre posts cemented with three different materials assessed using a fluid transport system

AIM: To evaluate the microleakage along Glassix fibre posts cemented with three different materials. METHODOLOGY: The root canals of maxillary central incisor teeth were filled and restored with Glassix posts (Harald Nordin sa, Chailly/Montreux, Switzerland) cemented with either a zinc-phosphate Harvard cement (Richter & Hoffmann, Harvard Dental GmbH, Berlin, Germany), Fuji PLUS cement (GC Corporation, Tokyo, Japan) or Variolink II cement (Vivadent, Schaan, Lichtenstein) in three groups of 15 canals each. Twenty unrestored canals served as a control group, 10 filled with gutta-percha and sealer (negative control group), the remaining 10 with gutta-percha only (positive control group). Coronal microleakage was evaluated using a fluid transport system. The movement of an air bubble in a capillary glass tube connected to the apex of the experimental root section was measured over 5-min periods. Measurements were performed four times for each specimen and the mean values recorded. ANOVA and Duncan's test were performed. RESULTS: The positive control group had the highest values of microleakage. Amongst experimental groups, the highest values of microleakage occurred in the group with the posts cemented with Harvard cement, followed by Fuji PLUS and Variolink II cements. Groups with Fuji PLUS, Variolink II and the negative control group had significantly (P < 0.00001) less microleakage compared with the Harvard cement group and the positive control group. CONCLUSION: Canals with Glassix posts cemented with Variolink II and Fuji PLUS cement had the least leakage when assessed using a fluid transport system.     

Dentin bonding of cements. The bonding of cements with dentin in combination with various indirect restorative materials

The number of both luting agents and restorative materials available on the market has rapidly increased. This study compared various types of luting agents when used to bond different indirect, laboratory restorative materials to dentin. Cylinders were produced of six restorative materials (gold alloy, titanium, feldspathic porcelain, leucite-glass ceramic, zirconia, and an indirect resin composite). Following relevant pretreatment, the end surface of the cylinders were luted to ground, human dentin with eight different luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37 °C for one week, the shear bond strength of the specimens was measured and the fracture mode was examined stereo-microscopically. Restorative material and luting agent both had a significant effect on bond strength and there was a significant interaction between the two variables. The zinc phosphate cement and the glass ionomer cements resulted in the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements.     

Bond strength of fiber posts after the application of erbium:yttrium-aluminum-garnet laser treatment and gaseous ozone to the root canal

The aim of the present study was to investigate the effects of antibacterial agents (erbium:yttrium-aluminum-garnet [Er:YAG] laser or gaseous ozone) intended to disinfect root canals on bond strengths of fiber posts compared with canals that were finally irrigated using chlorhexidine (CHX). One hundred forty-four human anterior teeth were divided into three groups (n = 48); root canal instrumentation was performed, and antimicrobial pretreatment was conducted as follows: control group: CHX, group 2: Er:YAG laser, and group 3: gaseous ozone. In all groups, fiber posts were inserted using Panavia F 2.0 (Kuraray, Osaka, Japan), Variolink II (Ivoclar Vivadent, Schaan, Liechtenstein), RelyX Unicem (3M Espe; Seefeld, Germany), or Ketac Cem (3M Espe) (n = 12 each). Push-out bond strengths to root canal dentin were affected by the type of luting agent but not by the antimicrobial pretreatment regimen. However, significant interactions between the luting agent and pretreatment could be observed, and adhesion of the self-adhesive resin cement RelyX Unicem was significantly reduced after using gaseous ozone.     

Marginal integrity of partial ceramic crowns within dentin with different luting techniques and materials

This in vitro study evaluated the marginal integrity of partial ceramic crowns (PCCs) luted with or without a resin-coating and compared the results with the marginal sealing of a recently introduced self-adhesive universal resin cement. PCC preparations were performed on 84 extracted human molars, with proximal margins placed 1 mm below the cemento-enamel junction. The PCCs were fabricated from Vita Mark II ceramic (Vita) using the Cerec-3 Unit (Sirona). The prepared teeth were assigned to three groups: (1) conventional luting technique (n=36), (2) resin-coating luting technique (n=36) or (3) recently introduced self-adhesive universal resin cement (n=12). Within these three groups, the following materials were applied: (1) Excite/Variolink II (EVC), ED-Primer/Panavia-F2.0 (PAC), Syntac Classic/ Variolink II (SYC); (2) Excite/Variolink II with Excite/Tetric Flow resin-coating (EVR), ED-Primer/Panavia-F2.0 with Clearfil SE-Bond/ Protect-Liner F resin-coating (PAR), Excite/ Variolink II with Syntac Classic/Tetric Flow resin-coating (SYR); (3) RelyX Unicem (REX). After thermocycling and mechanical loading (TC: 5000 cycles at 5 degrees C/55 degrees C; 30 seconds/cycle; ML:500000 cycles at 72.5 N, 1.6 Hz), microleakage was assessed by evaluating silver staining (%) on multiple tooth sections. Ceramic/composite-, resin-coating/composite- (where applicable) and dentin/composite-interfaces were evaluated separately. The data were statistically analyzed with the Mann-Whitney-U-test and the Error Rates Method. In Groups 1 and 2, the evaluation of microleakage at dentin showed better marginal integrity when the resin-coating technique was applied (EVR, PAR, SYR: 18-53%) than within the conventional luting technique group (EVC, PAC, SYC: 58-67%). However, the lowest microleakage values were found for RelyX Unicem (REX: 15%). In conclusion, resin-coating may improve the marginal sealing within dentin, depending on the materials used. Luting with a self-adhesive universal resin cement showed the best marginal sealing of all groups.     

Bonding of restorative materials to dentin with various luting agents

The aim was to compare eight types of luting agents when used to bond six indirect, laboratory restorative materials to dentin. Cylinders of the six restorative materials (Esteticor Avenir [gold alloy], Tritan [titanium], NobelRondo [feldspathic porcelain], Finesse All-Ceramic [leucite-glass ceramic], Lava [zirconia], and Sinfony [resin composite]) were ground and air-abraded. Cylinders of feldspathic porcelain and glass ceramic were additionally etched with hydrofluoric acid and were silane-treated. The cylinders were luted to ground human dentin with eight luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], and RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37°C for one week, the shear bond strength of the specimens (n=8/group) was measured, and the fracture mode was stereomicroscopically examined. Bond strength data were analyzed with two-factorial analysis of variance (ANOVA) followed by Newman-Keuls' Multiple Range Test (α=0.05). Both the restorative material and the luting agent had a significant effect on bond strength, and significant interaction was noted between the two variables. Zinc phosphate cement and glass ionomer cements produced the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements. Generally, the fracture mode varied markedly with the restorative material. The luting agents had a bigger influence on bond strength between restorative materials and dentin than was seen with the restorative material.     

The marginal quality of luted ceramic inserts in bovine teeth and ceramic inlays in extracted molars after occlusal loading

PURPOSE: To compare the marginal adaptation of adhesively luted ceramic inserts in standardized cylindrical cavities of bovine dentin and enamel with the marginal adaptation of adhesively luted ceramic inlays in extracted molars after mechanical loading, and to calculate the minimum sample size required to differentiate between material groups based on the findings of this investigation. MATERIALS AND METHODS: Ceramic inserts of similar dimension were luted in standardized cylindrical cavities of bovine dentin and enamel (n = 6, O = 4 mm) with seven different adhesive/resin cement systems (Syntac/Variolink, Prime & Bond NT/Variolink, Excite DSC/Variolink, AdheSE/Variolink, Excite DSC/Multilink, Multilink Primer/ Multilink, RelyX Unicem). The same materials were used to lute ceramic inlays (Empress II) in three-surface cavities of extracted human molars (n = 6 per group). All specimens were submitted to 2000 cycles of thermocycling. In addition, restored teeth were submitted to cyclic loading (640,000 cycles, 50 N) in a chewing simulator. Replicas after stressing were analyzed with SEM, and the percentage of continuous margin of the inserts and the inlays was calculated, differentiating the proximal part of the inlay into cervical dentin/enamel and axio-proximal enamel. The mean percentage values per material group of the insert and inlay groups were ranked using relative ranks. Sample size estimation was done for pooled standard deviations comparing between two and seven materials and assuming 20% or 10% of the mean of continuous margin to be statistically significant. RESULTS: The Spearman correlation coefficient between the variables "insert dentin" and "inlay cervical dentin" was 0.71 (p = 0.07), between "insert enamel" and "inlay axio-proximal enamel" 0.07 (p = 0.9). The variability of the test results was large for both the insert and inlay variables, especially at the resin-dentin interface. No statistically significant difference between the materials could be found for the insert method when ANOVA and Bonferroni post-hoc tests were applied (p > 0.05), while the inlays luted with Prime & Bond NT/Variolink showed significantly less continuous margin at the cervical dentin than all other groups with the exception of RelyX Unicem. At least 16 (63) inlays and 14 (57) inserts had to be used per group for differences of 20% (10%) of the mean of continuous margin. CONCLUSION: To evaluate luting agents with regard to their ability to reduce marginal discrepancies, the inlay model is inadequate due to high sample numbers which make the test time-consuming and expensive; furthermore its clinical relevance is uncertain. Alternatively, the insert method may be a suitable screening method for dentinal margins, although its clinical relevance is also unknown.     

Four-year clinical evaluation of a self-adhesive luting agent for ceramic inlays

Objectives

The aim of this randomized controlled clinical trial was to evaluate the 4-year clinical performance of a self-adhesive resin cement, RelyX Unicem (3M ESPE), used for cementation of ceramic inlays. In addition, the influence of selectively acid-etching enamel prior to luting on the clinical performance of the restorations was assessed.

Methods

Sixty-two IPS Empress 2 inlays/onlays were placed in 31 patients by two experienced clinicians. The restorations were luted with RelyX Unicem with (=experimental group: E) or without (=control group: NE) prior enamel etching with phosphoric acid. At baseline, 6 months, and 1, 2, and 4 years after placement, the restorations were assessed by two calibrated investigators using modified USPHS criteria. Ten selected samples of each group were investigated under SEM regarding morphological changes at the cement–inlay interface.

Results

The recall rate at 4 years was 97 %. Two restorations (1 E, 1 NE) were lost, and one (E) had to be replaced due to inlay and tooth fracture resulting in a survival rate of 95 %. No significant differences between the experimental and control group were noticed regarding all criteria (McNemar, p?<?0.05). An obvious deterioration in marginal integrity was observed after 4 years as only 5 % (E?=?7 %; NE?=?3 %) of the restorations exhibited an excellent marginal adaptation. In 90 % of the restorations small, still clinically acceptable marginal deficiencies were observed. SEM of the luting gap showed an increased wear of the RelyX Unicem cement over the 4-year period.

Conclusions

The self-adhesive luting cement RelyX Unicem can be recommended for bonding of ceramic inlays/onlays. Additional selective enamel etching does not improve the clinical performance of the restorations within the 4-year period.

Clinical relevance

The self-adhesive resin composite RelyX Unicem showed acceptable clinical performance after 4 years of clinical service.     

Microleakage of various cementing agents for full cast crowns.

OBJECTIVES: To evaluate microleakage and marginal gaps in full cast crown restorations bonded with six different types of cementing agents. METHODS: Sixty non-carious human premolars and molars were prepared in a standardized manner for full cast crown restorations. The mesial and distal margins were located in dentin, while the vestibular and palatal/lingual margins were located in enamel. Crowns were made from a high-gold alloy using a standardized technique. The specimens were randomized to six groups of cementing agents: one zinc-phosphate cement (Harvard cement), one conventional glass-ionomer cement (Fuji I), one resin-modified glass-ionomer cement (Fuji Plus), two standard resin cements (RelyX ARC, Panavia F), and one self-adhesive universal resin cement (RelyX Unicem). After 4 weeks of storage in distilled water at 37 degrees C, the specimens were subjected to 5000 thermocycles ranging from 5 to 55 degrees C. Then, they were placed in a silver nitrate solution, embedded in resin blocks, and vertically cut in buccolingual and mesiodistal direction. Subsequently, the objects were evaluated for microleakage and marginal gap using a high-resolution digital microscope camera. RESULTS: A number of inter-group differences were statistically significant. RelyX Unicem showed the smallest degree of microleakage both in enamel and in dentin. Panavia F und RelyX Unicem were associated with significantly larger marginal gaps than all other cementing agents. No association was observed between microleakage and marginal gap other than a weak direct correlation when using Harvard cement on enamel. SIGNIFICANCE: The cementing agents investigated revealed different sealing abilities. These differences were not associated with specific types of materials.     

The clinical performance of CAD/CAM-generated composite inlays

BACKGROUND: The authors conducted a study to evaluate the longitudinal clinical performance of a resin-based composite (Paradigm, 3M ESPE, St. Paul, Minn.) for computer-aided design/computer-aided manufacturing (CAD/CAM)-generated adhesive inlays. METHODS: The researchers used a CAD/CAM unit (CEREC 2, Sirona Dental Systems, Bensheim Germany) to fabricate 40 porcelain (Vita Mark II, Vita Zahnfabrik, Bad S?ckingen, Germany) and 40 resin-based composite (Paradigm, 3M ESPE) inlays. Both restorative materials were cemented with a total-etch technique using Single Bond dental adhesive (3M ESPE) and a dual-cured resin cement (RelyX ARC Adhesive Resin Cement, 3M ESPE). Two examiners evaluated the inlays using modified U.S. Public Health Service (PHS) criteria at six months, one year, two years and three years. RESULTS: No sensitivity was reported for either material at any recall period. There was no significant difference between the two materials relative to margin adaptation at three years. Margin adaptation initially was very good for both materials, with an increase in margin detection due to apparent wear of the resin-based composite luting agent. There was a significant difference in color match between the two materials at three years, with 91.4 percent of the resin-based composite inlays and 58.8 percent of the porcelain inlays rated Alfa. CONCLUSIONS AND CLINICAL IMPLICATIONS: The resin-based composite inlays had a significantly better color match at three years than did the porcelain inlays. Resin-based composite CAD/CAM inlays performed as well as porcelain CAD/CAM inlays after three years of clinical service.     

Bond strength of a new universal self-adhesive resin luting cement to dentin and enamel

The objective of this study was to assess the bonding performance of a new universal self-adhesive cement RelyX Unicem (RXU) to dentin and enamel compared to four currently used luting systems, using a shear bond strength test with and without thermocycling. Median bond strengths were determined after 24 h storage, and after thermocycling (6,000 cycles, 5–55°C) for RXU and compared to Syntac/Variolink II (SynC/V) as a standard for luting conventional ceramics, ED-Primer II/Panavia F2.0 (EDII/PF2), Prime&Bond NT/Dyract Cem Plus (PBNT/DyCP), and a glass ionomer cement, Ketac Cem (KetC), as a standard for luting high-strength ceramic and metal-based restorations. Data (n=10 per group) were statistically analyzed using the Mann–Whitney–Wilcoxon test at the 0.05 level of significance. The bond strength (MPa) of RXU to dentin (10.8) was not statistically different from those of SynC/V (15.1), EDII/PF2 (10.5) or PBNT/DyCP (10.1), and statistically higher than KetC (4.1). The bond strength of RXU to enamel (14.5) was significantly lower than those of SynC/V (32.8), EDII/PF2 (23.6), and PBNT/DyCP (17.8), but higher than KetC (6.1). After thermocycling, the bond strength of RXU to enamel significantly decreased, but was still significantly higher than that of KetC. RelyX Unicem may be considered an alternative to Ketac Cem for high-strength ceramic or metal-based restorations, and may be used for luting conventional ceramic crowns with little or no enamel left.     

三种粘结剂粘结嵌体的微渗漏对比研究

目的：评价复合树脂嵌体及纯钛嵌体采用3种不同粘结剂的微渗漏情况。方法：选择72颗健康上颌前磨牙,随机分为6个实验组,每组12颗。按嵌体备洞要求制备Ⅱ类洞。前三组制作纯钛嵌体,分别用玻璃离子、树脂改良型玻璃离子和树脂粘结剂粘结固位。后三组制作复合树脂嵌体,分别用玻璃离子、树脂改良型玻璃离子和树脂粘结剂粘结固位。结果：同一种材料嵌体用不同粘结剂处理,其微渗漏程度差异有显著性（P〈0.05）;在相同粘结处理不同种嵌体的组间比较,其微渗漏差异P〉0.05。结论：树脂改良型玻璃离子粘结剂与树脂粘结剂抗微渗漏性能优于玻璃离子粘结剂。     

4种粘接剂粘接氧化铝渗透陶瓷基底冠的边缘微渗漏研究

目的 研究不同粘接剂对氧化铝渗透陶瓷基底冠微渗漏的影响。方法 选择40个离体磨牙,常规制作氧化铝渗透陶瓷基底冠,随机分为玻璃离子、树脂加强型玻璃离子、树脂粘接剂和自粘接树脂组。在进行微渗漏实验前对样本进行冷热循环。采用染料渗入法测定冠边缘微渗漏情况,进行统计分析。结果 4种粘接剂粘接氧化铝渗透陶瓷基底冠的边缘微渗漏不同,差异有统计学意义(P<0.05),65%的基底冠发生了微渗漏。结论 树脂粘接剂边缘微渗漏少,是粘接氧化铝渗透陶瓷基底冠的理想材料。     

Chairside vs. labside ceramic inlays: Effect of temporary restoration and adhesive luting on enamel cracks and marginal integrity

Objectives

To assess the influence of different temporary restorations and luting techniques of labside and chairside ceramic inlays on enamel defects and marginal integrity.

Methods

120 extracted human third molars received MOD preparations with one proximal box each limited in either enamel or dentin. 64 Cerec 2 inlays and 56 IPS Empress I inlays were randomly assigned to the following groups (fabrication mode: chairside (CS) = no temporary restoration (TR), labside (LS) = TR with Luxatemp (L) inserted with TempBond NE, or Systemp.inlay (SI) without temporary cement), luting technique: SV = Syntac/Variolink II, RX = RelyX Unicem: A: Cerec inlays were luted with (1) CS/SV. (2) CS/SV/Heliobond separately light-cured. (3) CS/RX. (4) LS/L/SV. (5) LS/L/RX. (6) LS/SI/SV. (7) LS/SI/RX. (8) LS/SI/RX with selective enamel etching. B: Empress. (9) L/SV. (10) L/SV/Heliobond separately light-cured. (11) L/RX. (12) SI/SV. (13) SI/SV, Heliobond separately lightcured. (14) SI/RX. (15) SI/RX after selective enamel etching. Before and after thermomechanical loading (TML: loading time of TR 1000 × 50 N + 25 thermocycles (TC) between +5 °C and +55 °C; clinical simulation: 100,000 × 50 N + 2500 TC) luting gaps, enamel cracks, and marginal adaptation to enamel and dentin were determined under an SEM microscope (200×) using replicas.

Results

Loading time of temporary restorations negatively affected enamel integrity and enamel chipping (p < 0.05). Luxatemp resulted in less enamel cracks than Systemp.inlay (p < 0.05). Syntac/Variolink achieved better marginal enamel quality than RelyX Unicem in all groups (p < 0.05). Marginal quality in dentin revealed no differences when no temporary cement was used (p > 0.05). Temporary cement negatively affected dentin margins when RelyX Unicem was used (p < 0.05).

Significance

Chairside-fabricated Cerec inlays reduce the risk of enamel cracks and marginal enamel chipping due to omitted temporary restorations. Syntac/Variolink revealed a significantly better performance than RelyX Unicem.     

Erosion of luting cements exposed to acidic buffer solutions

The aim of this study was to evaluate acidic erosion of 7 luting cements. Erosion was evaluated via immersion in 0.1 M aqueous sodium lactate/lactic acid buffer (pH = 2.74 and 4.0, respectively). The rank order of cement loss was as follows: Phosphate Cement > Fuji I hand-mixed = Fuji I encapsulated > Ketac Cem > Calibra = Fuji Plus = Variolink Ultra. Cement type, pH, and time had statistically significant effects. Water-based cements exhibited more erosion compared to resin-based cements, and the latter underwent hygroscopic expansion caused by water sorption.