Biomedical subjects
Markus B Blatz
Publications and source records attributed to Markus B Blatz.
Resin-ceramic bonding: a review of the literature.
Current ceramic materials offer preferred optical properties for highly esthetic restorations. The inherent brittleness of some ceramic materials, specific treatment modalities, and certain clinical situations require resin bonding of the completed ceramic restoration to the supporting tooth structures for long-term clinical success. This article presents a literature review on the resin bond to dental ceramics. A PubMed database search was conducted for in vitro studies pertaining to the resin bond to ceramic materials. The search was limited to peer-reviewed articles published in English between 1966 and 2001. Although the resin bond to silica-based ceramics is well researched and documented, few in vitro studies on the resin bond to high-strength ceramic materials were identified. Available data suggest that resin bonding to these materials is less predictable and requires substantially different bonding methods than to silica-based ceramics. Further in vitro studies, as well as controlled clinical trials, are needed.
In vitro evaluation of long-term bonding of Procera AllCeram alumina restorations with a modified resin luting agent.
STATEMENT OF PROBLEM: Bonded densely sintered aluminum oxide ceramic restorations such as Procera AllCeram laminates rely on a strong and long-term durable resin bond. Air particle abrasion and a phosphate-modified resin luting agent have the potential to provide such bonds to aluminum oxide ceramics, but their efficacy on the Procera AllCeram intaglio surface is unknown. The inherent microroughness of this surface may influence bond strengths, because micromechanical interlocking is a main contributor for adhesion of resins to ceramic materials. PURPOSE: This study evaluated the bond strength of a phosphate-modified resin luting agent with and without silanization to an air particle-abraded Procera AllCeram intaglio surface compared with a conventional resin-bonding system before and after artificial aging. MATERIAL AND METHODS: Sixty square (10 x 10 x 2 mm) specimens of Procera AllCeram alumina ceramic with the Procera intaglio surface were air particle abraded with aluminum oxide. Composite cylinders (2.9 mm in diameter and 3.0 mm in width) were fabricated with Z-250 composite and bonded to the ceramic specimens with either Panavia 21 TC or Rely X ARC (control) and their corresponding bonding/silane coupling agents. In addition, Panavia was used without silanization as suggested in similar studies. Subgroups of 10 specimens were stored in distilled water for either 3 or 180 days before shear bond strength was tested with a universal testing machine (MPa) until fracture. The 180-day specimens were subjected to thermocycling at 2000 cycles every 30 days (12,000 cycles total). Data were analyzed with 1-way analysis of variance and Tukey's multiple comparison (alpha=.05). Failure modes were examined with a light microscope (original magnification x 25). RESULTS: Differences between short-term and long-term groups were highly significant (P=.000). Bond strength with Rely X ARC and its silane coupling agent (22.75 +/- 4 MPa) decreased significantly (P=.000) after artificial aging (3.32 +/- 3.62 MPa). Panavia 21 after silanization revealed significantly different (P=.003) early (21.42 +/- 4.3 MPa) and late (16.09 +/- 2.37 MPa) bond strengths but achieved the highest bond strength after artificial aging. Bond strengths of Panavia without silanization both early (8.06 +/- 2.1 MPa) and late (6.91 +/- 2.49 MPa) were not significantly different. Failure modes were mainly adhesive at the ceramic surface for all groups. CONCLUSION: Panavia 21 in combination with its corresponding bonding/silane coupling agent can achieve an acceptable resin bond to the air particle-abraded intaglio surface of Procera AllCeram restorations after artificial aging, which had mixed effects on the other investigated groups. The conventional resin luting agent revealed the most dramatic decrease in bond strength.
Long-term resin bond to densely sintered aluminum oxide ceramic.
BACKGROUND: Densely sintered aluminium oxide ceramic is a popular material for ceramic copings and all-ceramic restorations. A strong, predictable, and long-term durable resin bond is key for long-term clinical success of bonded alumina-based restorations. PURPOSE: The purpose of this study was to measure and compare in vitro shear bond strengths of three resin cements with and without their corresponding silane coupling/bonding agent to air particle- abraded densely sintered aluminum oxide ceramic after long-term water storage and thermocycling. MATERIALS AND METHODS: Composite resin cylinders were bonded to air particle-abraded samples of densely sintered aluminum oxide ceramic with Noribond DC (Noritake Dental Supply, Inc., Aichi, Japan), Panavia 21 EX (Kuraray, Osaka, Japan), and Variolink II (Ivoclar Vivadent, Schaan, Liechtenstein), which were used with and without their corresponding silane coupling and bonding agents (n = 15). All specimens (N = 90) were stored for 180 days in water and subjected to repeated thermocycling for a total of 12,000 cycles before shear bond strength was tested. Data were analyzed with the Kruskal-Wallis test and the Wilcoxon two-sample rank sum test at the 5% level of significance. RESULTS: Most groups had no or only minimal bond strength to densely sintered alumina after simulated aging. Panavia had the highest bond strength without silane/bonding agent application. Noribond with its silane/bonding agent revealed the highest overall bond strength, which was significantly greater than that of either Variolink or Panavia after silanization. CONCLUSIONS: Resin cements revealed significantly different bond strengths, and the use of silane coupling and bonding agents had various effects on the resin bond to pure densely sintered alumina. CLINICAL SIGNIFICANCE: Selection of the proper cement/bonding system is fundamental to clinical long-term success of bonded alumina-based restorations. Noribond with its bonding agent and ceramic primer seem to fulfill these requirements under clinically relevant testing conditions.
Influence of silanization on early bond strength to sandblasted densely sintered alumina.
OBJECTIVE: The increased popularity of alumina-based restorations has resulted in an interest in proper adhesive techniques to assure a strong and predictable bond to these restorations. This study investigated the early bond strength of three different resin-cement systems to densely sintered alumina (aluminum-oxide ceramic) with and without the use of their corresponding silane coupling agent (silanization). METHOD AND MATERIALS: Ninety samples of densely sintered high-purity aluminum-oxide ceramic were randomly divided into three groups. Composite cylinders were bonded to the ceramic samples with three resin-cement/bonding-agent systems: Noribond DC (NOR), Panavia 21 EX (PAN), and Variolink II (VAR). Each resin-cement/bonding-agent system was used with and without their corresponding silane (SIL) coupling agent (n = 15). After fabrication, the specimens were stored in distilled water for 3 days at room temperature, and shear bond strength was tested. RESULTS: Application of the silane-coupling agent on sandblasted densely sintered alumina did not significantly influence bond strengths with PAN. Silanization significantly improved shear bond strengths with NOR and VAR. NOR-SIL and VAR-SIL revealed the statistically highest values, with NOR-SIL showing the highest mean bond strength of all groups. CONCLUSIONS: Silanization of sandblasted densely sintered alumina had mixed effects on the applied resin cements: It had no effect on the performance of the phosphate-modified resin cement PAN, but significantly improved shear bond strength of the Bis-GMA composite resin cements VAR and NOR. NOR-SIL revealed the highest overall mean bond strength.
Cementation of aluminum-oxide ceramic restorations.
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Impression techniques and their relation to material properties.
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Bonding to cast-metal and porcelain-fused-to-metal restorations.
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Long-term clinical success of all-ceramic posterior restorations.
Modern all-ceramic systems offer a highly esthetic, biocompatible, and functional alternative to traditional restorative materials. Such systems allow for a wide range of indications, from inlays to multiple-unit fixed partial dentures, and are increasingly used in posterior regions of the mouth. Many of these systems have been introduced to the market only recently. However, new materials and techniques should be followed up and their clinical performance proven for at least 5 years before they become routine modalities of treatment. This article reviews the current literature and scientific data on the long-term success of all-ceramic restorations in the posterior region and compares and discusses alternative treatment options.
Cementation of porcelain restorations.
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The effect of silica coating on the resin bond to the intaglio surface of Procera AllCeram restorations.
OBJECTIVES: This study investigated the influence of a silica-coating method on the resin bond of two different resin composite cements to the intaglio surface of Procera AllCeram densely sintered, high-purity, alumina ceramic restorations after long-term storage and thermocycling. METHOD AND MATERIALS: Densely sintered alumina ceramic specimens were fabricated with the intaglio surface of the Procera AlICeram coping and randomly divided into five adhesive groups (100 total specimens). Resin composite cylinders were bonded either to the untreated or to the tribochemical silica/silane-coated ceramic surface with either a conventional Bis-GMA resin cement or a resin composite containing an adhesive phosphate monomer (Panavia 21) in combination with their corresponding bonding/silane coupling agents. Panavia was also used without silanization to the untreated ceramic surface (control). Subgroups of 10 specimens were stored in distilled water for either 3 (baseline) or 180 days prior to shear bond strength testing. The 180-day samples were subjected to repeated thermocycling for a total of 12,000 cycles. Data were analyzed with one-way analysis of variance and Tukey's multiple comparison. RESULTS: Silica coating significantly increased overall bond strength to Procera AllCeram. RelyX ARC and silica coating revealed the highest bond strength at baseline. Long-term storage and thermocycling significantly decreased overall bond strength. Two groups revealed the significantly highest bond strength values after artificial aging: Panavia 21 with its silane/bonding agent to the original ceramic surface and Panavia 21 to the silica-coated ceramic surface. CONCLUSION: The use of a resin composite containing an adhesive phosphate monomer either in combination with a silane coupling/bonding agent or after tribochemical silica/silane coating revealed the highest long-term shear bond strength to the intaglio surface of Procera AllCeram restorations.
Cementation of zirconium-oxide ceramic restorations.
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Principles and mechanisms of peri-implant soft tissue healing.
The long-term clinical and esthetic success of implant-supported restorations is determined by osseointegration and optimal remodeling of peri-implant soft tissues. Complications of soft-tissue management are often caused by fibrotic regeneration of oral mucosa after multiple surgical procedures. Knowledge of the proliferative processes in wound healing is necessary to attain adequate soft-tissue conditions. Successful reconstruction of peri-implant soft tissues is feasible even in fibrotic conditions when appropriate surgical techniques are selected. The pleiotropic proliferative cytokine TGF-beta is involved in the regulation of all phases of wound healing and tissue remodeling. The isoform TGF-beta1 is a cytokine associated with the development of fibrotic tissue. Overexpression of TGF-beta1 causes scarring and fibrosis, and results in limited clinical success of intraoral soft-tissue management. Experimental therapeutic approaches with neutralizing antibodies to block TGF-beta1 resulted in less scarring and a reduction of fibrosis. Further molecular biologic research of cell-matrix-cytokine interactions in wound healing will provide highly specific antifibrotic therapeutic approaches in the future.
In vitro wear of different material combinations of intracoronal precision attachments.
PURPOSE: This study examined the retentive forces of intracoronal precision attachments after wear cycling. MATERIALS AND METHODS: Three material combinations of an intracoronal cylindric T-attachment were tested. A total of 10,000 separating and joining movements were performed, and retentive forces were measured. RESULTS: Components made of gold alloy performed significantly better (P = .002) than other materials. The average proportional loss of retention was 90% for titanium and 47% for gold alloy components. CONCLUSION: Cyclic loading of metal precision attachment components results in loss of retention, which can be fully compensated by reactivating internal screws in the patrices. Machined, high-noble gold alloys show less wear than other materials.
A conservative approach for the management of a crown-root fracture.
Subgingival crown-root fractures are major complications that jeopardize tooth survival and require the clinician to adopt a multidisciplinary approach combining different dental specialties to effectively treat the teeth and ensure long-term survival. Fragment reattachment is a conservative therapeutic option for uncomplicated crown-root fractures. However, biologic width involvement must be carefully evaluated and addressed. This article describes a case of restoration of a crown-root fracture by means of periodontal surgical exposure of the fracture, crown and root recontouring, and fragment reattachment.