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PubMed1994

Luting cement-metal surface physicochemical interactions on film thickness.

Low film thickness is critical to the clinical success of cemented castings. This study investigated the effect of luting agent-metal physico-chemical surface interactions on film thicknesses of representative luting agents. Control group luting agents were placed between two glass plates, as described by American Dental Association specifications 8, 61, and 66, and test group luting agents were positioned between glass and metal plates. The materials selected were zinc phosphate cement, polycarboxylate cement, glass ionomer cement, glass ionomer-composite resin hybrid cement and a resinous cement, with a type III gold alloy, a noble metal ceramic alloy, and a base metal ceramic alloy. A two-way analysis of variance and follow-up tests were done. The effects of the type of metal surface, type of cement, and their statistical interaction significantly affected film thickness (p < 0.0001). The type of cement had a greater affect on film thickness than the type of metal. A glass ionomer cement produced lower overall film thicknesses than other cement types, and a noble metal ceramic alloy created lower overall film thicknesses than other types of metal. American Dental Association specifications for cement film thickness did not accurately reflect normal cement use.

American Dental Association↗
PubMed2006

Retention of zirconium oxide ceramic crowns with three types of cement.

STATEMENT OF PROBLEM: Information about the retentive strength of luting agents for zirconium oxide-based crowns is limited. It is unknown if this type of high-strength ceramic restoration requires adhesive cementation to enhance retention. PURPOSE: The purpose of this in vitro study was to determine the ability of selected luting agents to retain a representative zirconium oxide ceramic crown under clinically simulated conditions. MATERIAL AND METHODS: Recently extracted human molars were prepared with a flat occlusal surface, 20-degree taper, and approximately 4-mm axial length. The axial and occlusal surface areas were determined, and specimens were distributed equally by total surface area into 3 cementation groups (n=12). Zirconium oxide ceramic copings (Procera AllZirkon) with an occlusal bar to facilitate removal were fabricated using computer-aided design/computer-assisted manufacturing (CAD/CAM) technology. All copings were airborne-particle abraded with 50-mum Al(2)O(3) and then cleaned in an ultrasonic bath with isopropyl alcohol. Provisional cement was removed from the prepared teeth, followed by a pumice prophy. After trial insertion, the copings were cleaned with phosphoric acid, rinsed, dried, and dehydrated with isopropyl alcohol. They were then cemented with a seating force of 10 kg per tooth, using either a composite resin cement with adhesive agent (Panavia F 2.0 and ED Primer A & B [PAN]), a resin-modified glass ionomer cement (Rely X Luting [RXL]), or a self-adhesive modified composite resin (Rely X Unicem [RXU]). The cemented copings were thermal cycled at 5 degrees C and 55 degrees C for 5000 cycles with a 15 second dwell time, and then removed along the path of insertion using a universal testing machine at 0.5 mm/min. The removal force was recorded, and the stress of dislodgement was calculated using the surface area of each preparation. A 1-way analysis of variance was used to analyze the data (alpha=.05). The nature of failure was also recorded. RESULTS: Mean dislodgement stresses were 5.1, 6.1, and 5.0 MPa for PAN, RXL, and RXU, respectively. The 1-way analysis of variance revealed no differences in mean crown removal stress among the 3 cementation groups. The predominant mode of failure was cement remaining principally on the zirconium oxide copings in 46% of the specimens, followed by cement found on the tooth in 25.7% of the specimens. CONCLUSIONS: Within the limitations of this study, the 3 luting agents, with mean removal stresses ranging from 5.0 to 6.1 MPa were not significantly different. The use of a composite resin cement with a bonding agent did not yield higher coping retention compared to the other 2 cements tested.

Adhesiveness↗
PubMed1989

[Study on fatigue toughness of dental materials. 1. Compressive strength on various luting cements and composite resin cores].

In this study, we investigated compressive strength of various luting cements and composite resin cores in both dry and wet condition, and then influences of repeating load on compressive strength in wet condition of distilled water at 37 degrees C. As frequency of repeating load increased, compressive strength of all materials decreased. It means that the repeated load cycling test used in this study is adequate for evaluating durability of various dental materials. The results were as follows: 1. In the condition of no loading in both dry and wet condition, resin cement indicated the highest compressive strength of all cements examined and was followed by glass ionomer cement, zinc phosphate cement and polycarboxylate cement. Glass ionomer cement was notably influenced in wet condition. 2. After 10,000 cycles of loading in wet condition, resin cement indicated the highest compressive strength again and was followed by glass ionomer cement, polycarboxylate cement and zinc phosphate cement. In particular, compressive strength of zinc phosphate cement decreased remarkably. 3. In the condition of no loading, visible light-cured composite resin core was superior to chemical one. Visible light one was notably influenced in wet condition. 4. After 10,000 cycles of loading, visible light-cured composite resin core was superior to chemical one.

Composite Resins↗
PubMed1987

Comparison of the mechanical properties of Simplex P, Zimmer Regular, and LVC bone cements.

The mechanical properties of the three cement preparations most widely used in the United States were compared by conducting tensile and fatigue tests on Simplex P, LVC, and Zimmer Regular bone cements. Specimens of all three cement preparations were prepared for mechanical testing with and without centrifugation of the cement immediately after mixing. Although the results of the tensile testing revealed a few specific instances of significant differences in the tensile properties of the three cement preparations, there was no consistent evidence that one cement was superior in tension to the others. However, the fatigue properties of Simplex P were consistently and significantly superior to the fatigue properties of both LVC and Zimmer Regular bone cements. Centrifugation of the cement immediately after mixing significantly improved both the tensile and fatigue properties of all three bone cements. However, the fatigue strength of centrifuged Simplex P was substantially and significantly superior to the fatigue strength of the centrifuged LVC and Zimmer Regular bone cements. Since in total joint replacements bone cement is subjected to cyclic loading, these data suggest that centrifuged Simplex P is a preferable bone cement to LVC and to Zimmer Regular cement with or without centrifugation.

Biomechanical Phenomena↗
PubMed1995

Pullout strength of fixation screws from polymethylmethacrylate bone cement.

Polymethylmethacrylate bone cement is often used to fill voids and increase the strength of osteoporotic and pathological bone. However, it is unclear as to which method of cement augmentation provides optimal screw fixation. This study was conducted to determine which of the current cement augmentation techniques provides the strongest construct when used in association with orthopaedic fixation screws. Pullout strength was determined for screws placed in sawbones with no cement, soft cement, doughy cement and hard cement after drilling and tapping. All cement-screw constructs were significantly stronger than the no cement group. Screws placed in doughy cement had a significantly higher pullout force than those placed in hard cement. Pullout strength of screws placed in soft cement was intermediate between the other cement techniques but not significantly different from either group.

Biocompatible Materials↗
PubMed1993

In vitro and in vivo studies of pressurization of femoral cement in total hip arthroplasty.

Improvements in cementing techniques in the absence of pressurization of the cement have led to major increases in the long-term success rate of fixation of the femoral components of cemented total hip arthroplasty (THA). The strength of the cement-bone interface is strongly related to cement intrusion into the bone. The depth of cement intrusion, in turn, is correlated with the cement-intrusion pressure. Thus, adding cement pressurization to those current techniques that have already been validated may further increase the long-term durability of fixation of the femoral component of cemented THA. To assess cement pressurization in the proximal femur for THA, the authors compared in vitro the efficacy of three existing pressurization systems (the Johnson and Johnson system [New Brunswick, NJ], the Miller system [Zimmer, Warsaw, IN], and the Zimmer system [Zimmer]) in cadaver femurs using pressure transducers and evaluated their ease and optimization for clinical use. The authors then selected one (the Zimmer system) for use in studies in vivo to quantify the actual pressures achieved in the medullary canal in vivo under surgical conditions using pressure transducers placed throughout the femoral cortex. Each of the three commercially available femoral cement pressurization systems has its own advantages and disadvantages. All three systems were shown to produce average peak cement-intrusion pressures in vitro of over 21 N/cm2 (30 psi) throughout the cement mantle including, importantly, in the proximal portion of the femur.(ABSTRACT TRUNCATED AT 250 WORDS)

Cementation↗
PubMed2005

Nano-mechanics of bone and bioactive bone cement interfaces in a load-bearing model.

Many bioactive bone cements were developed for total hip replacement and found to bond with bone directly. However, the mechanical properties at the bone/bone cement interface under load bearing are not fully understood. In this study, a bioactive bone cement, which consists of strontium-containing hydroxyapatite (Sr-HA) powder and bisphenol-alpha-glycidyl dimethacrylate (Bis-GMA)-based resin, was evaluated in rabbit hip replacement for 6 months, and the mechanical properties of interfaces of cancellous bone/Sr-HA cement and cortical bone/Sr-HA cement were investigated by nanoindentation. The results showed that Young's modulus (17.6+/-4.2 GPa) and hardness (987.6+/-329.2 MPa) at interface between cancellous bone and Sr-HA cement were significantly higher than those at the cancellous bone (12.7+/-1.7 GPa; 632.7+/-108.4 MPa) and Sr-HA cement (5.2+/-0.5 GPa; 265.5+/-39.2 MPa); whereas Young's modulus (6.3+/-2.8 GPa) and hardness (417.4+/-164.5 MPa) at interface between cortical bone and Sr-HA cement were significantly lower than those at cortical bone (12.9+/-2.2 GPa; 887.9+/-162.0 MPa), but significantly higher than Sr-HA cement (3.6+/-0.3 GPa; 239.1+/-30.4 MPa). The results of the mechanical properties of the interfaces were supported by the histological observation and chemical composition. Osseointegration of Sr-HA cement with cancellous bone was observed. An apatite layer with high content of calcium and phosphorus was found between cancellous bone and Sr-HA cement. However, no such apatite layer was observed at the interface between cortical bone and Sr-HA cement. And the contents of calcium and phosphorus of the interface were lower than those of cortical bone. The mechanical properties indicated that these two interfaces were diffused interfaces, and cancellous bone or cortical bone was grown into Sr-HA cement 6 months after the implantation.

Animals↗
PubMed2005

Characterization of Portland cement for use as a dental restorative material.

OBJECTIVES: The aim of this study was to evaluate the suitability of fast-setting cement formulations based on Portland cement as dental core build-up materials using two different methods of testing compressive strength and evaluation of setting times. METHODS: Four fast-setting cements based on Portland cement and their four respective densified with small particle (DSP) mortars were tested for setting time, constitution of cement by EDAX, and compressive strength using International and British Standards. Ordinary Portland cement (OPC) was used as a control. RESULTS: All the fast-setting cements had a similar elemental composition to OPC and the setting times were less than 7 min. The compressive strength of OPC was different between the two methods (P<0.001). All the fast-setting cements tested showed no difference in compressive strength regardless of the method of testing at 1 and 7 days (P>0.05), but the cylinders showed a lower compressive strength at 28 days (P<0.05). The OPC DSP mortar showed poorer compressive strength than OPC (P<0.01) at all times for cube testing but not for cylinder testing, where no difference was observed. The fast-setting DSP mortars had a lower compressive strength at 1 day (P<0.005) with both methods. At later times, there was no difference between the cements and DSP mortars for the cubes. SIGNIFICANCE: The pure fast-setting cements set in <7 min and were not susceptible to changes in the compressive strength testing procedure at 1 and 7 days but at 28 days all the fast-setting cements had a significantly higher strength with the test using cubes (P<0.05). A reduction in strength was observed at 28 days in cylinder testing. Most of the cements tested did not show encouraging strengths, however, one of the prototype cements tested could be a prospective dental restorative material.

Aluminum Oxide↗
PubMed2006

Load-fatigue performance of gold crowns luted with resin cements.

STATEMENT OF PROBLEM: Resin cements have gained popularity over the past few years because of their improved physical properties. There is a need to test these cements under fatigue loading, as there is growing recognition that fatigue testing is more clinically relevant than traditional monotonic static tests. PURPOSE: This study investigated the load-fatigue performance of complete gold crowns cemented with 4 types of resin cement. MATERIAL AND METHODS: Four resin cements (C & B Opaque [CBO], Calibra Esthetic [CE], RelyX Unicem [RU], and Panavia F [PF]) and a control, zinc phosphate cement (HY-Bond [HBZPC]) were tested. Fifty human maxillary premolars were prepared to an occluso-cervical dimension of 4 mm and a convergence angle of 20 degrees. Complete gold crowns were cast (Strator 3) and cemented with 1 of the 5 cements (n=10). A fatigue load of 73.5 N was applied at an angle of 135 degrees to the long axis of each tooth-crown specimen. Preliminary failure was defined as the propagation of a crack in or around the crown luting cement layer. The number of cycles to preliminary failure and the cement failure location were determined. Significant differences in cycles to preliminary failure were assessed by the nonparametric Kruskal-Wallis test, with follow-up Mann-Whitney tests (alpha=.05). RESULTS: Group CE had the highest rank of cycles to preliminary failure, while HBZPC had the lowest cycles to preliminary failure. Group CE had a significantly higher failure cycle count compared to PF (P=.016), RU (P=.001), and HBZPC (P<.001), but was not significantly different from CBO (P=.112). There was no significant difference in the failure cycle count between RU and HBZPC (P=.070). CONCLUSION: Not all tested resin cements had a superior fatigue life when compared with zinc phosphate cement. Of the 4 resin cement groups, Groups CE, CBO, and PF were significantly superior to HBZPC.

Crowns↗
PubMed2004

Methyl-methacrylate bone cement surface does not promote platelet aggregation or plasma coagulation in vitro.

Leakage of viscous bone cement into venous blood possibly resulting in pulmonary embolism may occur during percutaneous vertebroplasty. Our aim was to study if bone cement surface or cement liquid component could induce platelet aggregation or plasma coagulation in vitro. Two types of commonly used methyl-methacrylate bone cement, Palacos (Heraeus Kulzer, Germany) and Vertebroplastic (DePuy, Acro Med, England), were smeared on thin glass slides that were inserted over the bottom of cuvettes immediately or after 24 h, and platelet aggregation was recorded over 10 min. Bone cement liquid component, containing methyl-methacrylate monomer and N,N-dimethyl-p-toluidine, was tested in 2% and 4% final concentration. Partial thromboplastin time (PTT) was determined by the hook method in the presence of bone cement-smeared glass slides or 6% bone cement liquid. Both types of bone cement, either fresh or aged, did not promote platelet aggregation, whereas collagen-coated glass slides induced substantial platelet aggregation (65 +/- 37%). On the other hand, bone cement liquids reduced platelet aggregation induced by collagen solution to an average of less than 15% (p < 0.01). Bone cement, fresh or aged, had no effect on PTT, but bone cement liquids significantly prolonged PTT: median and 1st-3rd interquartile range 149 (96-171) s for Vertebroplastic and 132 (99-194) s for Palacos, p = 0.03 for both comparisons with normal pool plasma without additives that had PTT of 69 (62-71) s. We conclude that the surface of fresh or aged bone cement is not thrombogenic in vitro. The bone cement liquid inhibits platelet aggregation and plasma clotting in relatively high concentrations that cannot be expected in vivo.

Blood Coagulation↗
PubMed2003

Soft-tissue response to injectable calcium phosphate cements.

In this study, the soft tissue reaction to two newly developed injectable calcium phosphate bone cements (cement D and W) was evaluated after implantation in the back of goats. For one of the cements (cement D) the tissue reaction was also investigated after varying the concentration of accelerator Na(2)HPO(4) in the cement liquid (resulting in cement D1 and D2). Eight healthy mature female Saanen goats were used. The cement was applied 10min after mixing while it was still moldable and plastic. The material was given a standardized cylindrical shape. Thirty-two implants of each cement formulation were inserted and left in place for 1, 2, 4, and 8weeks. At the end of the study, eight specimens of each material and healing period were available for further analysis. Two specimens were used for X-ray diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) and six specimens were used for light microscopical evaluation. XRD and FTIR showed that the cements did set as microcrystalline carbonate apatite with the disappearance of monetite from the cements during implantation. Histological analysis showed that after 8weeks of implantation around all materials a thin soft-tissue capsule was formed (thickness ranging from 5 to 15 cell layers) with almost complete absence of inflammatory cells. Only in some specimens a slightly higher inflammatory reaction was observed. This was due to cement surface defects and a zone of dispersed particles near the cement-soft tissue interface. There was almost no resorption of the material after 8 weeks of implantation. In a few 4 and 8weeks samples, small areas of calcification were found in the fibrous capsule surrounding the implants. On the basis of our observations, we conclude that the tested cements were biocompatible and can be used next to soft tissue.

Animals↗
PubMed1998

Formation of hydroxyapatite in new calcium phosphate cements.

Tetracalcium phosphate (TTCP) has been shown previously to be an essential component of self-setting calcium phosphate cements that form hydroxyapatite (HA) as the only end-product. We report herein on a new self-setting calcium phosphate cement that does not contain TTCP. These cements consist of dicalcium phosphate anhydrous (DCPA), dicalcium phosphate dihydrate (DCPD), alpha-tricalcium phosphate, or amorphous calcium phosphate and, as an additional source of calcium, calcium hydroxide or calcium carbonate. These cements require the use of a phosphate (0.2 moll(-1) or higher) solution or a high pH solution as the cement liquid. The cements harden in relatively short time (5-30 min) and form HA as the dominant end-product in 24 h. The diametral tensile strengths of the 24-h samples are in the range of 0.2 to 7.5 MPa. Results from X-ray diffraction studies suggest that the cement setting is caused by rapid HA formation induced by the high phosphate concentration of the cement liquid. Because DCPA and DCPD are highly soluble at pH values above 12.7, which is the pK3 of phosphoric acid, high phosphate concentration in the slurry solution was also attainable by using a highly alkaline solution as the cement liquid. The physicochemical properties of these cements are comparable to those of TTCP-containing cements, and the new cements may be expected to have in vivo characteristics similar to those of TTCP-containing cements as well.

Biocompatible Materials↗
PubMed1998

Performance of adhesive bone cement containing hydroxyapatite particles.

A new acrylic bone cement which can adhere to both bone and prostheses was developed based on a methyl methacrylate (MMA) monomer containing 4-methacryloyloxyethyl trimellitate anhydride (4-META) as adhesion promoting agent. Moreover, hydroxyapatite (HA) particles were introduced into the 4-META cement as a bone compatible filler. The mechanical strengths of an acrylic bone cement without 4-META decreased drastically with an increase in the percentage of HA particles in the cement. However, the mechanical strengths of the HA-containing 4-META cement did not change in the same way as that of the 4-META cement without HA due to adhesion between the cement HA particles and matrix. The HA particles did not affect the adhesion of the 4-META cement to bone and metals. Implantation of the 4-META cement and the HA-containing 4-META cement in animals demonstrated that these cements did not disturb bone ingrowth and the new bone was able to contact the cement directly. The 4-META cements, with and without HA particles, could adhere to bone in vivo.

Biocompatible Materials↗
PubMed1997

Gentamicin-loaded hydraulic calcium phosphate bone cement as antibiotic delivery system.

A hydraulic calcium phosphate cement made of beta-tricalcium phosphate [beta-Ca3(PO4)2], monocalcium phosphate monohydrate [Ca(H2PO4)2-H2O], and water was used as a delivery system for the antibiotic gentamicin sulfate (GS). GS, added as powder or as aqueous solution, was very beneficial to the physicochemical properties of the cement. The setting time increased from 2 to 4.5 min with 3% (w/w) GS and then slowly decreased to 3.75 min with 16% (w/w) GS. The tensile strength increased from 0.4 to 1.6 MPa with 16% (w/w) GS. These effects were attributed to the presence of sulfate ions in GS. The release of GS from the cement was measured in a pH 7.4 phosphate-buffered saline solution at 37 degrees C by USP paddle method. Factors such as cement porosity, GS content and presence of sulfate ions or polymeric additives were investigated. The amount of GS released was roughly proportional to the square root of time up to approximately 50% release. Afterwards, the release rate markedly slowed down to zero. In all but two cement formulations, the total dose of GS was released within 7 days, indicating that no irreversible binding occurred between the cement paste and the antibiotic. When small amounts of hydroxypropylcellulose or poly(acrylic acid) were added to the cement, the maximum fraction released was a few percent lower than the total GS dose, suggesting some binding between the polymer and GS. The GS release rate was strongly influenced by the presence of sulfate ions in the cement paste and by the cement porosity. The higher the sulfate ion content of the cement paste, the lowe the GS release rate. This influence was attributed to the finer cement micro-structure induced by the presence of sulfate ions. Furthermore, when the initial cement porosity was increased from 38 to 69%, the release rate almost tripled (0.16 to 0.45 h-1/2). Finally, the biological activity of GS in the cement was maintained, as measured by assaying the release medium.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Optimizing the bone cement-implant interface by hydrolysis-resistant conditioning of the metal surface].

PURPOSE: The hydrolytic degradation of the implant-cement interface has to be seen as the main reason for aseptic loosening of cemented total hip replacements. Therefore, a new method of conditioning the metallic surface was developed in order to achieve a hydrolytic-resistant bound stability between the implant and bone cement. Preliminary experimental data on test bodies are presented here. METHOD: The metallic surface of 6 pairs of cylindrical test bodies each (CoCr-alloy, circular testing surface with O 6 mm) were conditioned by the method of silicoating/silanisation to gain a covalent coupling with the applied bone cement. In order to examine the initial stability and the hydrolytic resistance of the metal-cement compound, these pairs of surface-conditioned test bodies (SCT) as well as a reference series of surface-unconditioned test bodies (SUT) were immersed for 0, 30, 90, 150 days (d) in moisture environment (physiological saline solution, 37 degrees C) after coupling with bone cement. The adhesive strength of the test bodies-(bone cement-compounds) were determined by tensile tests on an universal testing machine (Typ Z030, Zwick, Ulm) with gimbal suspension. RESULTS: At time 0 d (that was without immersion of the test bodies) the mean maximum tensile bond strength of the SCT-cement-compounds was 39.5 MPa (SD +/- 4.7 MPa) and that of the SUT-cement-compounds 37.1 MPa (SD +/- 7.3 MPa) (p = 0.575). After immersion the tensile bond strength of the SUT-cement-compounds significantly decreased to an average of 13.5 MPa (SD +/- 2.7 MPa) (30 d), 10 MPa (SD +/- 1.7 MPa) (90 d) and 12.3 MPa (SD +/- 1.4 MPa) (150 d) (p < 0.01). In contrast, the SCT-cement-compounds showed a nearly unchanged high mechanical stability with tensile bond strength values of 37.0 MPa (SD +/- 4.9 MPa) after 30 d, 36.1 MPa (SD +/- 5.0 MPa) after 90 d und 30.2 MPa (SD +/- 4.7 MPa) after 150 d (p > 0.01). CONCLUSIONS: With reservation as to further in vitro and in vivo investigations the increased hydrolytic stability of the metal-cement-bound of surface-conditioned CoCr-alloy test bodies promises an improvement of the long-term stability of cement total joint replacements.

Arthroplasty, Replacement, Hip↗
PubMedDate not supplied

[Status of cementation technique in total hip endoprostheses in Germany].

AIM: The correlation between improved cementing techniques and improved long-term results after total hip arthroplasty (THA) is well documented. The purpose of this study was to assess the use of modern cementing techniques in Germany. METHODS: A detailed questionaire regarding cement and bone preparation, cementing techniques on actabulum and femur, and implants used was sent to 584 German orthopaedic and trauma hospitals, as well as to visiting surgeons with an interest in THA. In total, 333 questionaires were available for evaluation and statistical analysis. RESULTS: In this survey, Palacos bone cement is used in 84%, low viscosity cement in 9%. Cement chilling is performed in 58%. Mixing is done by hand without vacuum mixing systems in 53%, the mixing time is standardised in 66%. For the femur 83% and for the acetabulum 74% preserve cancellous bone, 13% use pulsed lavage. Cement application is done via cement gun in 97%, in 41% in a retrograde manner and in 18% without drainage of the intramedullary canal. A cement pressurising technique is used in 63% for the femur and in 57% for the acetabulum. A cement mantle of less than 2 mm is attempted in 41%. More than 50 different stem design are implanted with the Müller straight stem being used most often, followed by anatomic designs. Almost 50% of hips are used with a 28 mm head, and almost 50% are implanted with a 32 mm head. Half the heads are ceramic, half are metal. CONCLUSIONS: The results from this survey document, that overall only slightly more than 10% of hips are implanted using second/third generation (modern) cementing techniques with application of pulsed lavage. This has implications on the number of arthroplasties that may require revision. From the data available the current status of cementing technique in Germany cannot be judged satisfactory.

Arthroplasty, Replacement, Hip↗
PubMedDate not supplied

[Initial stability of an implanted cement-canal prosthesis. Results in experimental studies on human cadaver femurs].

Upon implantation of a cement-canal prosthesis in the proximal femur in total hip replacement, the bone cement is injected through the prosthesis via a system of drill holes. A second system of drill holes is used in this endoprosthesis to drain the distal femoral space as well as the cavities within the cement layer which form when the cement is being injected. Since the cement pressure is sustained until the cement has cured, substantial penetration of the cement into the cancellous bone can be achieved by using low intra-medullary cement pressures. Using cadaveric human femurs, the initial stability in the trabecular intertrochanteric region was determined in pull-out experiments for three different curing cement pressures (0.5 bar, 1.0 bar and 1.5 bar). The results were compared to corresponding controls in which a conventional cementation technique was used. With respect to the contact area of the bone/bone-cement interface, the initial stability increased by the factor 2.8 (cement-curing pressure 0.5 bar), 3.7 (cement-curing pressure 1.0 bar) and 2.9 (cement-curing pressure 1.5 bar) compared to the control group.

Arthroplasty↗
PubMed2002

Shear bond strength of resin cements to both ceramic and dentin.

STATEMENT OF PROBLEM: All ceramic restorations benefit from resin cement bonding to the tooth. However, the literature is unclear on which cement, ceramic conditioning treatment, and dentin bonding agent produce the highest and longest-lasting bond strength. PURPOSE: This in vitro study evaluated immediate and 6-month shear bond strengths between a feldspathic ceramic and 4 different resin cements with the use of 6 different surface-conditioning treatments. Shear bond strengths between the 4 resin cements and dentin also were measured. MATERIAL AND METHODS: Four hundred eighty discs (10 mm in diameter and 4 mm thick) of Ceramco II porcelain were randomly divided into 6 main groups (n = 80). The ceramic specimens received 6 different surface conditioning treatments before the application of resin cement. These surface treatments were sanding with 600-grit silicon carbide paper, microetching with aluminum oxide, sanding followed by silane application, microetching followed by silane application, hydrofluoric acid-etching, and hydrofluoric acid-etching followed by silane application. Each group then was subdivided into 4 subgroups (n = 20) for the application of 1 of 4 cements: Nexus, Panavia 21, RelyX ARC, and Calibra. All cemented specimens were tested under shear loading until fracture on a universal testing machine; the load at fracture was reported in MPa as the bond strength. Bond strengths were determined at 24 hours and after 6 months of specimen storage in a saline solution. For dentin-resin cement shear bond strength testing, dentin specimens were treated with dentin bonding agents, and a thin layer of resin cement was applied according to the manufacturer's directions. Prodigy composite was bonded to the cement. Shear bond strengths were determined as above and reported in MPa at fracture. Data were analyzed with 3-way analysis of variance (P<.01). RESULTS: Hydrofluoric acid-etching followed by silane application produced bond strengths (15.0 +/- 7.4 to 21.8 +/- 5.8 MPa) in the highest statistical group with all 4 cements at both 24 hours and 6 months (P<.01). Sanding with 600-grit silicon carbide paper and microetching with aluminum oxide produced the lowest bond strengths (0.0 to 4.0 +/- 3.5 MPa). At 24 hours and 6 months, there were no significant differences among the 4 cements when hydrofluoric acid-etching was followed by silane application. Both auto- and light-polymerized dentin bonding agents bonded better to dentin than dual-polymerized bonding agents. CONCLUSION: Within the limitations of this study, hydrofluoric acid-etching followed by silane application produced the best bonds at 24 hours and 6 months with all 4 cements. Auto- and light-polymerized adhesives were associated with higher bond strengths to dentin than dual-polymerized adhesives.

Acid Etching, Dental↗