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PubMed2003

Dentin bond strengths of two ceramic inlay systems after cementation with three different techniques and one bonding system.

STATEMENT OF PROBLEM: Cementation of inlay restoration is critical. Because of its high organic content, dentin is a less favorable substrate for bonding than enamel. Therefore it is important to improve dentin adhesion when placing ceramic inlay restorations. PURPOSE: The purpose of this study was to compare the dentin bond strengths of 2 different ceramic inlay systems after cementation with 3 different techniques and 1 bonding system. MATERIAL AND METHODS: One hundred twenty freshly extracted caries- and restoration-free molar teeth used in this study were stored in saline solution at room temperature. Standardized Class I preparations were made in all teeth. Each preparation had a length of 6 mm, a width of 3 mm, a depth of 2 mm, and 6-degree convergence of the walls. Teeth were randomly assigned to 2 groups of 60 each to evaluate the bonding of 2 ceramic systems, Ceramco II (Group I) and IPS Empress 2 (Group II), to dentin. Each of the 2 groups were further divided into 3 cementation technique groups of 20 each (Group I A, B, and C and Group II A, B, and C). Groups I A and B and Groups II A and B used dentin bonding agent (DBA) Clearfil Liner Bond 2V, and resin cement (Panavia F). Groups I C and II C served as control groups and used Panavia F without the dentin-bonding agent. In Groups I A and II A, the DBA was applied immediately after the completion of the preparations (D-DBA). Impressions were then made, and the ceramic inlays were fabricated according to the manufacturers' guidelines. In Groups I B and II B the DBA was applied just before luting the inlay restorations (I-DBA). In Groups I C and II C, no bonding agent was used before the cementation of the inlay restorations (No DBA). Cementation procedures followed a standard protocol. After cementation, specimens were stored in distilled water at 37 degrees C for 24 hours. The teeth were sectioned both mesial-distally and buccal-lingually along their long axis into three 1.2 x 1.2 mm wide |-shaped sections. The specimens were then subjected to microtensile testing at a crosshead speed of 1 mm/min, and the maximum load at fracture (in kilograms) was recorded. Two-way analysis of variance and Tukey honestly significant difference tests were used to evaluate the results (P<.05). Scanning electron microscopy analysis was used to examine the details of the bonding interface. The fractured surfaces were observed with a stereomicroscope at original magnification x22 to identify the mode of fracture. RESULTS: Although no significant difference was found among the 2 ceramic systems with regard to dentin bond strengths (P>.05), the difference between the cementation techniques was found to be significant (P<.001). Comparison among techniques showed that the dentin bond strength in the D-DBA technique had a significantly higher mean (40.27 +/- 8.55 Kg) than the I-DBA (30.20 +/- 6.78 Kg) and No DBA techniques (32.43 +/- 8.58 Kg). As a result of scanning electron microscopy analysis, a distinct and thicker hybrid zone with more, and longer resin tags were found in specimens treated with the D-DBA technique than with the other 2 techniques. Most failures (353 of 360) were adhesive in nature at the bonding resin/dentin interface. Only 7 specimens showed cohesive failure within the bonding resin. CONCLUSION: Within the limitations of this in vitro study, the cementation of the ceramic inlays tested with the D-DBA technique used resulted in higher bond strengths to dentin.

Adhesiveness↗
PubMed2002

Analysis of long-term cemented total hip arthroplasty retrievals.

A detailed biomechanical, histologic, and histomorphometric analysis of autopsy specimens from patients who previously had cemented total hip arthroplasty has helped to elucidate the skeletal response to cemented components. Bone cement has the capacity to provide long-term implant stability. The biologic response to polyethylene wear debris has a more critical effect on destabilization of cemented sockets compared with the femoral side. In contrast, mechanical events tended to predominate the early mode of destabilization of cemented femoral components with debonding at the metal-cement interface and fracture in the cement. Fractures predominate in cement mantles less than 1 mm thick and are associated with mantle defects, debonded interfaces, and sharp corners of the implants. Correlation of the histologic findings at the cement-bone interface with radiolucencies seen on clinical radiographs show that on the acetabular side radiolucencies represent a soft tissue membrane that is the biologic response to polyethylene debris. In contrast, on the femoral side, most radiolucencies were as a result of skeletal remodeling. Femoral adaptive bone remodeling is a diffuse process that occurs over the entire fixation surface. The most profound disuse osteoporosis occurred proximally in the proximal medial quadrant; however, when one takes into account all four quadrants, anterior, posterior, medial, and lateral, the most severe osteoporosis occurred at the midpoint of the stem.

Arthroplasty, Replacement, Hip↗
PubMed1976

Linear dimensional changes during setting of two polycarboxylate cements.

The linear dimensional changes of two polycarboxylate cements have been studied. The measurements were performed on specimens placed on a mercury bath, and were started 3 min after commencing the mix. The specimens were allowed to set at 37 degrees C under various environmental humidity. Specimens from one of the polycarboxylate cements (Durelon), were made using both the universal liquid and the thin liquid meant for cementation. The powder/liquid ratios (P/L) were either 2-5 or 1-5.. Specimens from the second cement (Poly-C), were made using the liquid meant for cementation only with a P/L of 1-5. The dimensional changes of Durelon were dependent on the powder/liquid ratio and the environmental humidity during setting. Under dry conditions this cement showed a maximum contraction of 4-60% after 14 days when a high P/L was used and 6-10% when a low P/L was used. After 1 day under wet conditions no significant differences between cements with high and low P/L were registered, and the mean contraction was 1-10%. The dimensional changes of Poly-C were dependent on the environmental humidity, and after 14 days under dry conditions a maximum contraction of 5-50% was registered and after 1 day under wet conditions a contraction of 0-60%. The contraction of the polycarboxylate cements tested in this study started earlier and were in general more pronounced than that observed for a zinc phosphate cement (Oilo, 1975).

Acrylates↗
PubMed2004

Bonding between resin luting cement and glass infiltrated alumina-reinforced ceramics with silane coupling agent.

The purpose of this study was to evaluate the shear bond strengths of three dual-cured resin luting cements (Linkmax HV, Panavia Fluoro Cement, and RelyX ARC) to glass-infiltrated alumina-reinforced ceramic material and the effect of four silane coupling agents (Clearfil Porcelain Bond, GC Ceramic Primer, Porcelain LinerM, and Tokuso Ceramic Primer) on the bond strength. The two type-shaped of In-Ceram alumina ceramic glass-infiltrated specimens were untreated or treated with one of the four ceramic primers and then cemented together with one of the three dual-cured resin luting cements. Half of the specimens were stored in water at 37 degrees C for 24 h and the other half thermocycled 20,000 times before shear bond strength testing. Surface treatment by all silane coupling agents improved the shear bond strength compared with non-treatment. The specimens treated with Clearfil Porcelain Bond showed significantly greater shear bond strength than any of the other three silane coupling agents regardless of resin luting cements and thermocycling except for the use of Panavia Fluoro Cement at 20,000 thermocycles. When the alumina-reinforced ceramic material was treated with any silane coupling agent except GC Ceramic Primer and cemented with Linkmax HV, no significant differences in bond strength were noted between after water storage and after 20,000 thermocycles. After 20,000 thermocycles, all specimens except for the combined use of Clearfil Porcelain Bond or GC Ceramic Primer and Linkmax HV and GC Ceramic Primer and Panavia Fluoro Cement showed adhesive failures at the ceramic-resin luting cement interface.

Aluminum Oxide↗
PubMed1989

Effect of etching glass-ionomer cements on bond strength to composite resin.

The use of glass-ionomer cement in restorative dentistry has seen a revival because of its capacity for being etched and bonded to composite resin. Past investigators compared an etched cement surface with an unetched surface that was set against a smooth surface. Clinically, however, a glassy smooth surface is not produced when the cement is used as a base. Using Scotchbond bonding resin, we developed this two-part study to evaluate the tensile bond strengths of P-30TM composite resin to several glass-ionomer cements that were (a) unetched but allowed to set in air and (b) etched for 30 s with orthophosphoric acid, and to compare them with the cohesive strength of the respective cement. Using a silver nitrate staining technique, we also evaluated the microleakage of class V cavities restored with SiluxTM composite resin under a base of etched or unetched Ketac Bond cement. Although there were significant differences among three cements between their cohesive strength and the resin bond strength after the two surface treatments (p less than 0.01), the bond to the unetched surface was generally similar to that of the etched surface of the cement. The remaining groups showed no statistical difference. The microleakage was similar in the two groups. SEM micrographs showed a rough topography of the unetched cement that resembled that of the etched surface. This in vitro study suggests that acid-etching a glass-ionomer base for resin-bonding may not be necessary for specific materials. Further clinical evaluation is recommended to validate this observation intra-orally.

Acid Etching, Dental↗
PubMed2000

Relative influence of composition and viscosity of acrylic bone cement on its apparent fracture toughness.

The composition and viscosity of an acrylic bone cement have both been identified in the literature as being parameters that affect the mechanical properties of the material and, by extension, the in vivo longevity of cemented arthroplasties. The objective of the present study was to determine the relative influence of these parameters on a key cement mechanical property; namely, its fracture toughness. Two sets of cements were selected purposefully to allow the study objective to be achieved. Thus, one set comprised two cements with very similar compositions but very different viscosities (Cemex RX, a medium-viscosity brand, and Cemex Isoplastic, a high-viscosity brand) while the other set comprised two cements with similar viscosities but with many differences in composition (Cemex Isoplastic and CMW 1). Values of the fracture toughness (as determined using chevron-notched short rod specimens) [K(ISR)] obtained for Cemex RX and Cemex Isoplastic were 1.83 +/- 0.12 and 1.85 +/- 0.12 MPa square root(m), respectively, with the difference not being statistically significant. The K(ISR) values obtained for Cemex Isoplastic and CMW 1 were 1.85 +/- 0.12 and 1.64 +/- 0.18 MPa square root(m), respectively, with the difference being statistically significant. Thus, the influence of cement composition on its K(ISR) is more marked relative to the influence of cement viscosity. Explanations of this finding are offered, together with comments on the implications of the results for the in vivo longevity of cemented arthroplasties.

Acrylic Resins↗
PubMed2003

Evaluation of the effects of implant materials and designs on thermal necrosis of bone in cemented hip arthroplasty.

The exothermic polymerization of bone cement may induce thermal necrosis of bone in cemented hip arthroplasty. A finite element formulation was developed to predict the evolution of the temperature with time in the cemented hip replacement system. The developed method is capable of taking into account both the chemical reaction that generates heat during bone cement polymerization (through a kinetic model) and the physical process of heat conduction (with an energy balance equation). The possibility of thermal necrosis of bone was then evaluated based on the temperature history in the bone and an appropriate damage criterion. Specifically, we evaluate the role of implant materials and designs on the thermal response of the system. Results indicated that the peak temperature at the bone/cement interface with a metal prosthesis was lower than that with a polymer or a composite prosthesis in hip replacement systems. Necrosis of bone was predicted to occur with a polymer or a composite prosthesis while no necrosis was predicted with a metal prosthesis in the simulated conditions. When reinforcing osteoporotic hips with injected bone cement in the cancellous core of the femur, the volume of bone cement implanted is increased which may increase the risk of thermal necrosis of bone. We evaluate whether this risk can be decreased through the use of an insulator to contain the bone cement. No thermal necrosis of bone was predicted with a 3 mm thick polyurethane insulator while more damage is predicted for the use of bone cement without the insulator. This method provides a numerical tool for the quantitative simulation of the thermal behavior of bone-cement-prosthesis designs and for examining and refining new designs computationally.

Animals↗
PubMed2005

Influence of provisional cements on ultimate bond strength of indirect composite restorations to dentin.

PURPOSE: The aim of this study was to evaluate the effect of provisional cements on the adhesion of resin bonded indirect restorations and determine the best method for avoiding adverse effects. MATERIALS AND METHODS: Forty-five bovine incisors were selected, and the enamel removed with a 600-grit SiC abrasive disk to expose superficial dentin. Provisional restorations of acrylic resin were cemented with three different provisional cements: calcium hydroxide cement, Dycal (HC); cement containing zinc oxide-eugenol, Provy (ZOE); zinc oxide eugenol-free cement, TempBond NE (ZNE). The specimens were stored at 100% humidity, 37 degrees C. Then provisional restorations were removed with: (1) hand scaler for 10 s; (2) pumice-water slurry for 10 s; (3) aluminum oxide sandblasting for 10 s. The indirect restorations were subsequently cemented with Single Bond and Rely-X ARC. The teeth were sectioned, 4 slices per tooth (n = 16), and each slice trimmed with a diamond bur to obtain an adhesion area of 1 mm2. The microtensile bond strength test was performed with a universal testing machine (Instron-4411) at a crosshead speed of 0.5 mm/min. The results were analyzed with ANOVA, followed by Tukey's test (p < 0.05). RESULTS: ANOVA showed significant differences in the interaction between provisional cement and dentin cleaning method; in general, aluminum oxide sandblasting provided the highest values of bond strength and calcium hydroxide the lowest. CONCLUSION: The type of provisional cement and its method of removal can affect the adhesion of resin-bonded indirect restorations.

Acrylic Resins↗
PubMed2005

SEM evaluation of the cement layer thickness after luting two different posts.

PURPOSE: To verify with SEM the cement layer thickness and uniformity of resin-relined translucent fiber posts (anatomic posts) and standard translucent fiber posts. MATERIALS AND METHODS: On 20 extracted maxillary anterior teeth, the roots were endodontically treated and prepared for the insertion of a fiber post. Translucent fiber posts (DT) were luted with a dual-curing resin cement (Duo-Link) in 10 specimens (group 1) after the canal walls had been treated with the One-Step bonding system. In the other 10 specimens (group 2), experimental anatomic posts (Anatomic Post'n Core) were tested. To these posts, a layer of light-curing resin is added to allow for a pre-cementation relining of the post, aimed at improving its fit into the endodontic space. For luting, the same adhesive-resin cement combination of group 1 was used. All the roots were sectioned and prepared for SEM observations. At the 1-mm, 4.5-mm, and 8-mm level of each root, cement thickness was measured, and the presence of gaps or voids within the luting material or at its interfaces was evaluated. A statistical analysis was performed to test the significance of differences in the cement layer thickness around the two types of post and at different levels of the same type of post. RESULTS: In the presence of anatomic posts, the cement layer was significantly thinner and more uniform at the coronal and middle level of the root. In both groups, voids and bubbles were detected within the luting material, within the abutment material, and between fiber post and cement. Gaps were also visible between post and relining material. CONCLUSIONS: The resin cement thickness was significantly lower in the anatomic post group than in the control group (standardized posts), except at the apical third of the canal, where there was no statistically significant difference. A good adaptation of anatomic posts was evident in all of the specimens.

Analysis of Variance↗
PubMedDate not supplied

Caries protection after orthodontic band cementation with glass ionomer.

This study evaluated the resistance of the enamel to an artificial caries challenge after removing orthodontic bands cemented with a glass ionomer cement (GIC). Ten extracted caries-free molars were cleaned with a slurry of pumice and randomly divided into 2 groups of 5 teeth each: Group 1: Cementation with GIC (Fuji) and Group 2: Cementation with a zinc phosphate cement (Mizzy). Both cements were handled according to manufacturer's instructions. Before cementing the bands, an area of S x S mm was masked with adhesive tape on the lingual surfaces of all teeth. The orthodontic bands were cemented over this adhesive tape. After band cementation, the occlusal and gingival margins of the band were delineated with a bur on the tooth surface. The teeth were thermocycled (200 cycles, 5-55 degrees C, 30-second dwell time) and stored in distilled water for 24 hours. Then, the bands and adhesive tape were removed and the teeth again stored in distilled water for a week, changing the water daily. The teeth were then varnished with the exception of a 5 x 5 mm window (including previously exposed and covered areas) on the buccal and lingual surfaces. All teeth were then placed in an acidified gel (pH 4.5) for 5 weeks to produce artificial caries. At least three sections from the exposed and covered areas were made from the buccal and lingual challenged areas. Sections were ground to approximately 100 microns. Polarized microscopy and image analysis were used to analyze the results.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Caries↗
PubMed1996

Low force cementation.

OBJECTIVES: The marginal adaptation of full coverage restorations is adversely affected by the introduction of luting agents of various minimum film thicknesses during the cementation process. The increase in the marginal opening may have long-term detrimental effects on the health of both pulpal and periodontal tissues. The purpose of this study was to determine the effects of varying seating forces (2.5, 12.5, 25 N), venting, and cement types on post-cementation marginal elevation in cast crowns. MATERIALS: A standardized cement space of 40 microns was provided between a machined gold crown and a stainless steel die. An occlusal vent was placed that could be opened or closed. The post-cementation crown elevation was measured, following the use of two commercially available capsulated dental cements (Phosphacap, and Ketac-cem Applicap). RESULTS: The results indicate that only the combination of Ketac-Cem Applicap and crown venting produced post-cementation crown elevation of less than 20 microns when 12.5 N seating force was used. Higher forces (25 N) and venting were required for comparable seating when using Phosphacap (19 microns). CONCLUSIONS: The amount of force required to allow maximum seating of cast crowns appears to be cement specific, and is reduced by effective venting procedures.

Cementation↗
PubMed1996

Clinical comparison of postoperative sensitivity for a glass ionomer and a zinc phosphate luting cement.

In 60 patients, 120 partial and full-coverage restorations were cemented on vital abutment teeth with either a glass ionomer or a zinc phosphate luting cement. A split-mouth design and a patient blind data acquisition protocol were used. During an average observation period of 17.3 months there were no differences between the two types of luting cements in regard to subjective and clinical parameters. A high incidence of postoperative hypersensitivity, which is often said to accompany the use of glass ionomer luting cements, was not observed. With the cementation method used in this study, the glass ionomer cement Ketac-Cem Maxicap was an acceptable alternative to conventional zinc phosphate cement. Capsule systems make the clinical handling of glass ionomer luting cements safe and easy and should be used routinely in dental practice.

Adult↗
PubMed1998

Microscopic and energy dipersive x-ray analysis of surface adaptation of dental cements to dental ceramic surfaces.

STATEMENT OF PROBLEM: Clinical failure rates reported for acid etched/resin-bonded ceramic restorations are significantly lower than those reported for restorations luted with traditional cements. This improved clinical performance may be associated with greater adaptation of the resin cements to the ceramic surfaces. PURPOSE: The objective of this study was to determine whether the use of resin cements accompanied by acid etching results in improved adaptation when compared with the use of zinc phosphate or glass ionomer cements. RESULTS: The results of this experiment indicate that superior adaptation of cement to ceramic is produced by acid etching and luting with resin cement. In addition, the results lead to the hypothesis that the high clinical failure rates reported for zinc phosphate or glass ionomer luted restorations are due either to incomplete adaptation or to failure within the cement. CONCLUSION: The findings indicate that the use of resin cements accompanied by acid etching of the ceramic surface is the preferred technique for clinical placement of all-ceramic restorations.

Acid Etching, Dental↗
PubMed1996

Evaluation of a dentin barrier test by cyctotoxicity testing of various dental cements.

In this study, cell reaction after exposure to several dental cements was determined using a dentin barrier test device. The reaction of mouse fibroblasts grown on the "pulpal" side of a bovine dentin disk was determined after exposure to dental cements applied on the "cavity" side of the disk. For pretreatment, dentin disks (500-micrometer-thick) were etched on one side and either sterilized by autoclaving or disinfected with ethanol. It was found for both pretreatment groups that zinc phosphate cement was less toxic than the conventional glass ionomer cements. A light-cured glass ionomer cement and zinc oxide-eugenol were the most toxic materials tested. Disinfecting the dentin slices instead of autoclaving reduced the toxicity of the phosphate cement and the glass ionomer cements tendentiously. Because the strong cytotoxic reaction evoked by zinc oxide-eugenol and by the glass ionomer cements is in contrast to in vivo findings, further improvements of the dentin barrier test device will be necessary.

Animals↗
PubMed2003

A hybrid zinc-calcium-silicate polyalkenoate bone cement.

A novel bone cement composed of sintered zinc-calcium-silicate phosphate and hybrid polyalkenoates has been developed. Synthesis and formulation of glass fillers, monomers and polymers as well as formulation of the cement were described. The effects of sintering, polymer content, glass powder/polymer liquid (P/L) ratio and comonomer on compressive strength (CS) and curing time (CT) were investigated. The effects of P/L ratio and comonomers on shrinkage as well as exotherm were also studied. Results show that the experimental cement was 61% higher in CS, 10% lower in diametral tensile strength, 35% lower in flexural strength, 62% less in exotherm, and 68% less in shrinkage, compared to conventional polymethylmethacrylate cement. With increasing polymer content and P/L ratio in the cement formulation CS of the cement increased but CT decreased. Curing time, shrinkage and exotherm of the cement decreased with increasing P/L ratio. It appears that this novel cement may be a potential candidate for orthopedic restoration if its biological performance is good and formulation is optimized.

Biocompatible Materials↗
PubMed2002

A comparison of in vitro enamel demineralization potential of 3 orthodontic cements.

The objective of this in vitro study was to compare resistance to enamel demineralization after banding with 3 orthodontic cements. The 3 orthodontic cement groups and the nonbanded control group were evaluated for cariopreventive potential. One hundred twenty extracted human molars were selected for banding, embedded in resin blocks, and randomly assigned to the following 4 groups: zinc phosphate cement, zinc polycarboxylate cement, resin-modified glass ionomer (RMGI), and nonbanded control. Orthodontic bands were placed and cemented; specimens were stored in artificial saliva at 37 degrees C for 30 days, thermocycled for 24 hours, and then debanded with a customized band-removal device attached to a universal testing machine. The cement was hand removed, and 2 coats of nail varnish were applied to the teeth, leaving a 2 x 2-mm window exposed on the buccal surface of the mesiobuccal cusp. The teeth were stored in lactic acid-gelatin solution for 4 weeks at 37 degrees C to develop simulated white spot decalcification in the window. The teeth were subjected to dye (10% methylene blue) for 24 hours and then sectioned through the window. The depth of dye penetration was determined and used as a measure of the cariopreventive effect of the banding cement. Data were analyzed with a 1-way ANOVA and a Tukey test for the multiple comparisons. Dye penetration occurred as follows: the zinc phosphate and control groups were about the same; there was less dye penetration with the zinc polycarboxylate, and the least with the resin-modified glass ionomer. The 2 fluoride-releasing cements (zinc polycarboxylate and RMGI) demonstrated less demineralization than the zinc phosphate in vitro and might provide greater protection from demineralization around a band periphery in clinical settings.

Analysis of Variance↗
PubMed1997

In vitro enamel demineralization and the marginal gap of simulated cast restorations with three different cements.

PURPOSE: This study investigated 1) the relationship between marginal gap sizes and enamel demineralization, and 2) the influence of three cements on this enamel demineralization. MATERIALS AND METHODS: Horizontal sections of 60 noncarious, freshly extracted human third molars were randomly assigned to one of four groups. Simulated cast restorations were attached to the specimens with 1) zinc phosphate cement, 2) glass ionomer cement, 3) composite resin cement, or 4) no cement (control). The tooth/restoration gaps were controlled at 51, 102, and 204 microns. The specimens were incubated for 16 weeks in buffered lactic acid gelatin to induce demineralization. Photomicrographs were obtained from sections of each sample using a polarized light microscope. Three evaluators measured wall and primary enamel lesion depths allowing for the determination of a demineralization ratio (DR). Data were analyzed by repeated-measures ANOVA (alpha = 0.05). RESULTS: The between-evaluator effects were not significant. All evaluators agreed that DR was significantly related to cement (p = .0001) but not to marginal gap size. The resin cement had the smallest DR (0.7 +/- 0.3), and the control group had the greatest (4.4 +/- 2.0). CONCLUSIONS: The presence of any one of the three investigated cements resulted in decreased demineralization. The amount of demineralization was unaffected by marginal gap size.

Analysis of Variance↗
PubMed1979

The hydration of dental cements.

A study was made of the hydration of dental cements, water being classified as "non-evaporable" and "evaporable". The ratio of these two types of water was found to vary greatly among different cement types, being lesser in zinc oxide and ionic polymer cements and greater in ion-leachable glass and phosphoric acid cements. The cement with the least "non-evaporable" water, i.e., showing least hydration (the zinc polycarboxylate cement), had the lowest strength and modulus and the greatest deformation at failure. A linear relationship was found to exist between strength and the degree of hydration of dental cements. All the cements were found to become more highly hydrated and stronger as they aged.

Absorption↗