Biomedical subjects

Matthias Kern

Publications and source records attributed to Matthias Kern.

At least 19 recordsLinked to original sources

PubMed2007

Wear of composite resin veneering materials and enamel in a chewing simulator.

OBJECTIVES: The purpose of this in vitro study was to evaluate the wear of six composite resins for the veneering of crowns compared with the wear of human and bovine enamel, tested in a dual-axis chewing simulator. METHODS: Eight specimens of six different composite resins (Targis I+II, Solidex, BelleglassHP, Estenia, Solidex) and of human and bovine enamel were prepared. Steatite ceramic balls served as antagonistic specimens. Specimens were dynamically loaded in a dual-axis chewing simulator with 49 N up to 1,200,000 loading cycles with additional thermal cycling between 5 and 55 degrees C. After 120,000, 240,000, 480,000, 840,000 and 1,200,000 loading cycles, an impression of the specimens' surface and the antagonistic specimen was taken using a polyvinylsiloxane impression material. The substance loss at the surface was measured with computer-aided laser profilometry. Data were analyzed using ANOVA and the Tukey test. RESULTS: The wear of the ultra fine compact filled composite resins Solidex and BelleglassHP was not statistically significantly different from that of human enamel. The other composite resins and bovine enamel showed a wear statistically significantly higher than human enamel. SIGNIFICANCE: Comparing six composite resins for the veneering of crowns, ultra fine compact filled composite resins BelleGlassHP and Solidex showed a wear not significantly different from the wear of human and bovine enamel.

Animals↗

PubMed2007

Influence of contamination on bonding to zirconia ceramic.

The purpose of this study was to investigate the influences of contaminations and cleaning methods on bonding to dental zirconia ceramic. After saliva immersion and using silicone disclosing agent, airborne-particle abraded ceramic specimens were cleaned with isopropanol (AL), acetone (AC), 37% phosphoric acid (PA), additional airborne-particle abrasion (AA), or only with water rinsing (SS). Airborne-particle abraded specimens without contaminations (CL) were used as control group. For chemical analysis specimens of all groups were examined with X-ray photoelectron spectroscopy (XPS). Plexiglas tubes filled with composite resin were bonded to ceramic specimens using a phosphate-monomer containing composite luting resin. After 3-day water storage, tensile bond strengths (TBS) were tested. XPS analysis of group SS showed the presence of saliva and silicone (Si) contamination on the surface. The ratios of carbon/zirconium and oxygen/zirconium for groups PA and AA were comparable to those ratios obtained for group CL, indicating the removal of the organic saliva contamination. Airborne-particle abrasion and acetone completely removed Si contamination from ceramic surfaces. Isopropanol had little cleaning effect on the two contaminants. TBS (median +/- standard deviation) in MPa of the groups SS (11.6 +/- 3.1), AL (10.0 +/- 2.9), and AC (13.0 +/- 2.8) were statistically lower than those of groups PA (33.6 +/- 5.5), AA (40.1 +/- 3.6), and CL (47.0 +/- 8.1) (p < 0.001), while no differences were found in TBS between groups AA and CL (p > 0.5). Contamination significantly reduced bond strengths to zirconia ceramic. Airborne-particle abrasion was the most effective cleaning method.

Ceramics↗

PubMed2006

Survival rate of endodontically treated teeth with posts after prosthetic restoration.

The purpose of this retrospective clinical study was to evaluate the survival rate of teeth that were endodontically treated and restored with endodontic posts and prosthodontic restorations. A total of 864 teeth in 360 patients were included in the study. Dental records and radiographs of the patients were evaluated and four parameters were documented. The parameters were type of post, type of prosthodontic restoration, observation time, and, in cases of failure, failure mode. Statistical survival analyses were performed according to Kaplan-Meier. The mean observation time was 22.5 +/- 14.9 months. The calculated survival rates of the abutments were statistically significant different for fixed partial dentures (FPDs) and for removable partial dentures (RPDs) with survival rates of 92.7% and 51.0% after 60 months, respectively. Most of the presumed factors influencing the survival rate of endodontically treated abutment teeth only affected the outcome in the RPD group. Teeth restored with post and cores present a high risk for failure when used as abutments for conical-double-crown-retained RPDs.

Adult↗

PubMed2006

Resistance to fracture and structural characteristics of different fiber reinforced post systems.

OBJECTIVES: The aim of this study was to investigate the ultrastructure and resistance to fracture of eight different types of fiber post, and to verify the existence of a correlation between structural characteristics and flexural strength. METHODS: Eight types of fiber post were selected for this study. Fiber Kor (Jeneric-Pentron), Para Post Fiber White (Colténe), Luscent Anchor (Dentatus), Twin-Luscent Anchor (Dentatus), Style Post (Metalor), DT White-Post (VDW), DT Light-Post (VDW) and ER Dentin Post (Brasseler). Ten posts of each experimental group were selected for a three-point bending test, and one was processed for SEM evaluation. A universal testing machine loading at an angle of 90 degrees was employed for the three-point bending test. The test was carried out until fracturing of the post. After fracture testing, the posts with the highest and the lowest values of flexural strength of each system were additionally processed for SEM analysis. SEM evaluation was performed using a PC-measurement program to assess the fiber/matrix ratio and fiber dimensions. RESULTS: The fracture load of the tested systems ranged from 60 to 96 N and the flexural strength from 565 to 898 MPa. DT White-Post and DT Light-Post (898 and 842 MPa, respectively) had significantly higher flexural strengths than the other posts. Style Post (565 MPa) showed a significantly lower flexural strength than all other posts. The differences in fiber diameter ranged from 8.2 to 21 microm and for the fiber/matrix ratio from 41 to 76%. Of the various structural characteristics investigated, only the fiber/matrix ratio showed a significant correlation to the flexural strength (r=0.922, p=0.003). SIGNIFICANCE: The FRC-posts investigated displayed significant differences with regard to fracture load and flexural strength. A strong and significant linear correlation between the fiber/matrix ratio and the flexural strength was found.

Composite Resins↗

PubMed2006

Durability of the resin bond strength to zirconia ceramic after using different surface conditioning methods.

OBJECTIVES: The purpose of this in vitro study was the evaluation of the bond strength and its durability of two composite resins to zirconia ceramic after using different surface conditioning methods. METHODS: Plexiglas tubes filled with composite resin were bonded to zirconia ceramic discs (Cercon) which were either in their original state as supplied by the manufacturer only cleaned in isopropanol or were cleaned with an air-powder-water spray with sodium hydrocarbonate solution or were air abraded (50 microm Al(2)O(3)). Groups of 20 specimens each were bonded either with a conventional composite resin (Variolink II) or with a phosphate monomer (MDP)-containing resin (Panavia F) to the ceramic discs. Subgroups of 10 bonded specimens were stored in distilled water (37 degrees C) for either 3 days or for 150 days. Additionally, the 150 days specimens were thermal cycled 37,500 times. Statistical analyses were conducted with the Wilcoxon rank sum test adjusted by Bonferroni-Holm. RESULTS: The initial tensile bond strength (TBS) for Variolink II ranged from 9.0 to 16.6 MPa and were significantly lower (p< or =0.05) than for Panavia F ranging from 18.7 to 45.0 MPa. Air abrasion resulted in significantly higher TBS (p< or =0.01) than the two other surface conditioning methods. After 150 days storage, only the air abraded specimens bonded with Panavia F showed high bond strengths of 39.2 MPa, whereas most other specimens debonded spontaneously or showed very low bond strengths. SIGNIFICANCE: The use of the MDP-containing composite resin Panavia F on air abraded zirconia ceramic can be recommended as promising bonding method.

2-Propanol↗

PubMed2006

Fracture load of composite resin and feldspathic all-ceramic CAD/CAM crowns.

STATEMENT OF PROBLEM: Various machinable materials are currently used with computer-aided design/computer-assisted manufacturing (CAD/CAM) technologies for the chairside fabrication of restorations. However, properties of these new machinable materials, such as fracture load, wear, marginal deterioration, and color stability, should be investigated in vitro under replicated clinical conditions prior to time-consuming clinical studies. PURPOSE: This study investigated the effect of cyclic loading fatigue and different luting agents under wet conditions on the fracture load of CAD/CAM machined composite resin and all-ceramic crowns. MATERIALS AND METHODS: Ninety-six intact human maxillary premolars were prepared for composite resin and all-ceramic crowns with the following preparation criteria: 6-degree axial taper, 1.5-mm shoulder finish line placed 0.5 mm occlusal to the cemento-enamel junction, 1.5-mm axial reduction, 2-mm occlusal reduction, and 5-mm occluso-gingival height. Sixteen unprepared premolars served as controls. Forty-eight all-ceramic crowns (Vita Mark II) and 48 millable composite resin crowns (MZ100 Block) were fabricated using a CAD/CAM system (Cerec 3). Three luting agents-RelyX ARC (RX), GC Fuji CEM (FC), and zinc phosphate cement (ZP)-were used for cementation (n = 16). After 1-week storage in water, half of the specimens (n=8) in each subgroup were cyclically loaded and thermal cycled under wet conditions for 600,000 masticatory cycles and 3500 thermal cycles (58 degrees C/4 degrees C; dwell time, 60 seconds) in a masticatory simulator; the other half (n = 8) were fractured without cyclic loading. All specimens were loaded in a universal testing machine with a compressive load (N) applied along the long axis of the specimen at a crosshead speed of 1 mm/min until fracture. Fracture loads (N) were recorded for each specimen. Three-way analysis of variance was used to detect the effects of the experimental factors (crown material, luting agent, and loading conditions) on the fracture load. The comparison with the unprepared natural teeth as controls was done by means of t tests (alpha=.05). RESULTS: Analysis of variance revealed a statistically significant influence of the luting agent and the cyclic loading (P < .001), whereas the crown material had no significant influence. Cyclic loading fatigue significantly decreased the mean fracture load of test groups independent of the 3 luting agents used: MZ100/ZP, 827.1 to 552.5 N; MZ100/FC, 914.7 to 706.2 N; MZ100/RX, 955.9 to 724.4 N; Vita/ZP, 772.3 to 571.5 N; Vita/FC, 923.6 to 721.1 N; and Vita/RX, 929.1 to 752.7 N. However, there was no significant difference in the mean fracture load of control specimens before and after cyclic loading (1140.1 N and 1066.2 N, respectively). Adhesive luting agents RelyX ARC and GC Fuji CEM increased fracture load significantly compared to zinc phosphate cement. CONCLUSIONS: Cyclic loading fatigue significantly reduced the fracture loads of composite resin and all-ceramic crowns, whereas adhesive cementation significantly increased the fracture loads.

Analysis of Variance↗

PubMed2006

Effect of surface treatment on retention of glass-fiber endodontic posts.

STATEMENT OF PROBLEM: The effects of surface treatment on the retention of prefabricated fiber-reinforced epoxy resin posts are not well understood because most studies measure retention shortly after cementation, without artificial aging. PURPOSE: The purpose of this study was to evaluate the effect of surface treatment on the retention of glass-fiber endodontic posts luted with resin cement and subjected to artificial aging. MATERIAL AND METHODS: Thirty-two single-rooted teeth were selected, the coronal aspect of each tooth was removed, and the remaining root received endodontic therapy. Specimens were then divided into 4 groups (n = 8). Post spaces were prepared to a depth of 10 mm by using ISO 90 rotary instruments. The tapered posts received 1 of 4 surface treatments: cleaning with alcohol (Alc), cleaning with alcohol and conditioning with ED-Primer material (Alc-ED), airborne-particle abrasion (Air), or airborne-particle abrasion and conditioning with ED-Primer material (Air-ED). All posts were luted with a composite resin luting agent (Panavia F) after conditioning the canal dentin with autopolymerizing dentin primer (ED-Primer) and without acid etching of the canal dentin. After cementation, the specimens were stored in water at 37 degrees C for 30 days and subjected to simulated aging conditions consisting of 7500 thermal cycles (5 degrees C/55 degrees C) and 300,000 mechanical loading cycles with 30 N. Retention (N) of the posts was measured with a universal testing machine with a crosshead speed of 2 mm/min. The data were analyzed using 1-way ANOVA and the Tukey HSD test (alpha = .05). The dislodged posts were also examined microscopically at x8 and x20 magnification to evaluate the mode of failure. RESULTS: The mean retentive values (N) and SDs of the test groups were as follows: Alc, 375.9 +/- 85.0; Alc-ED, 421.2 +/- 46.8; Air, 534.8 +/- 65.8; and Air-ED, 555.8 +/- 86.9. Airborne-particle-abraded posts had significantly higher retention compared with nonabraded posts (P < .001). Treating the post's surface with ED-Primer material prior to cementation had no significant effect on retention. The failure mode was purely adhesive at the resin cement-post interface for all nonabraded posts. A mixed failure mode, adhesive at the resin cement-dentin interface, at the resin cement-post interface, and cohesive in the resin cement, was observed for airborne-particle-abraded posts. CONCLUSION: Treating the surface of the posts with ED-Primer material before cementation with Panavia F cement produced no significant improvement in the retention of the posts. Airborne-particle abrasion of the surface of the post significantly improved the retention.

Air Abrasion, Dental↗

PubMed2006

A new design for all-ceramic inlay-retained fixed partial dentures: a report of 2 cases.

In a previous clinical study, all-ceramic resin-bonded 3-unit inlay-retained fixed partial dentures (IRFPDs) had a significantly worse outcome in the posterior region than did crown-retained 3-unit FPDs made from the same material. Debonding or fractures were causes of failure. To improve the clinical outcome of IRFPDs, a new framework design was developed: (1) The inlay retainers were made out of CAD/CAM-manufactured zirconia ceramic to improve fracture resistance, and additional veneering of the inlays was omitted. (2) The inlay retainers were completed with a shallow occlusal inlay (1-mm minimum thickness) and an oral retainer wing (0.6-mm minimum thickness). The wings were designed to reduce stress on the inlay retainer caused by torsion forces when the FPD is loaded nonaxially and to increase the enamel adhesive surface area. The pontic was circumferentially veneered with feldspathic porcelain. The clinical and laboratory procedures of this new treatment modality are described, and 2 exemplary clinical cases are presented. This new preparation and framework design might improve the clinical outcome of all-ceramic resin-bonded IRFPDs. However, adequate evidence of long-term safety and efficacy is required before this new design can be recommended for general clinical practice.

Adult↗

PubMed2006

Fracture strength of teeth restored with all-ceramic posts and cores.

OBJECTIVE: The purpose of this in vitro investigation was to evaluate the fracture strength of endodontically treated teeth restored with different all-ceramic posts and cores. METHOD AND MATERIALS: Seventy-two endodontically treated human maxillary central incisors were divided into 3 groups with 24 teeth each and restored with 1 of the following methods: prefabricated zirconia ceramic posts and resin composite buildups; zirconia ceramic posts and copy-milled alumina ceramic cores (2-piece technique), or copy-milled all-ceramic posts and cores made from a zirconia-reinforced glass-infiltrated alumina ceramic (1-piece technique). Each group was divided into 3 subgroups of 8 samples each, consisting of teeth that did not receive crown restorations and were stored for 60 days, teeth restored with all-ceramic crowns and stored for 60 days, and teeth restored with all-ceramic crowns and subjected to 1.2 million loading cycles with 30 N in a chewing simulator. RESULTS: The mean fracture strengths ranged from 205 to 522 N. Prefabricated zirconia posts and resin composite buildups showed a statistically significantly lower fracture strength after chewing simulation than teeth restored with prefabricated zirconia posts and alumina ceramic cores. CONCLUSION: All-ceramic posts and cores made with the 2-piece technique showed promising fracture strengths under the tested conditions.

Acrylic Resins↗

PubMed2005

Micro-tensile bond strength of three luting resins to human regional dentin.

OBJECTIVES: To evaluate the micro-tensile bonding strength (muTBS) of three luting resins to human regional dentin. METHODS: Dentin disks from non-carious third molars were prepared from different regions (s, superficial dentin; d, deep dentin; c, cervical dentin), and divided into groups based on anatomical locations and luting resins (Super-Bond C&B: SB; Panavia F 2.0: PF; RelyX Unicem: RU): SB-s, SB-d, SB-c; PF-s, PF-d, PF-c; RU-s, RU-d, RU-c. Luting resins were used according to the manufacturers' instructions, to bond 1-mm-diameter PMMA or composite rods to the exposed dentin specimens under a load of 7.5 N, in the self-curing mode. After storage for 1 or 3 days, muTBS was tested at a cross-head speed of 1mm/min. Data were analyzed with ANOVA and Fisher's PLSD test. The bonding interface and fractography analyses were performed with SEM and TEM. RESULTS: ANOVA results showed that muTBS to superficial dentin was significantly higher than to deep or cervical dentin for all three luting resins. SB-s and PF-s, with the highest muTBS, failed primarily cohesively in luting resin. muTBS of SB-d and SB-c were significantly higher than those of PF and RU. RU, with the lowest regional muTBS, failed mostly within demineralized dentin. SEM and TEM showed that adhesive failures in SB and PF occurred at the top of the hybrid layer (HL), but no obvious HL was observed in RU. SIGNIFICANCE: Luting resins with different chemical formulations and applications yield significantly different bond strengths to different regions in human dentin.

Adolescent↗

PubMed2005

Effect of structural change of collagen fibrils on the durability of dentin bonding.

This study investigates the effect of structural changes of collagen fibrils on the bonding durability of a total etch luting resin (Super-Bond C&B) and a self-etching luting resin (Panavia F 2.0) to dentin. An atomic force microscope (AFM) was used to observe structural changes of intact dentin collagen fibrils after acidic conditionings of two bonding systems. After 90 d water storage and 15,000 thermal cycles (TC) as artificial aging, micro-tensile bond strength (microTBS) was utilized to evaluate the bonding durability of the two bonding systems to dentin. microTBS after 1 d or 90 d water storage without TC were separately measured in control groups. A cross-banding periodicity of about 67 nm along collagen fibrils was seen on demineralized intertubular dentin surfaces in AFM images. For both luting resins, thermal cycling decreased (p < 0.05) microTBS of 1 d and 90 d, compared to controls. Scanning electron microscope and transmission electron microscopic examinations revealed that the top and bottom of hybrid layer (HL) were weak links in the bonding interface over time. The results suggest that the top of HL contains disorganized collagen fibrils from the smear layer which degrade over time. AFM results indicate that the demineralized intact collagen fibrils beneath the smear layer were not denatured during acidic conditioning. However, these collagen fibrils may be structurally unstable due to poor infiltration by resin or loss of resin protection within the HL over time, reducing the long-term microTBS. This process was accelerated by thermal fatigue cycling.

Adhesiveness↗

PubMed2005

Comparison of titanium dowel retention using four different luting agents.

STATEMENT OF PROBLEM: Luting material, surface properties, and loading conditions affect the retention of prefabricated dowels to varying degrees. PURPOSE: The purpose of this study was to evaluate the effect of roughening of the dentinal walls and artificial aging on the retention of prefabricated tapered titanium dowels, using 4 different luting materials. MATERIAL AND METHODS: One-hundred twenty-eight single-rooted teeth were selected, the coronal aspect of each tooth was removed, and the remaining root received endodontic therapy. All specimens were divided into 4 groups (n=32). Dowel spaces were prepared to a depth of 10 mm using ISO 90 rotary cutting instruments. Tapered titanium dowels were luted with the following luting materials: zinc-phosphate cement (Harvard cement), glass-ionomer cement (Ketac Cem EasyMix), resin composite luting agent (Panavia 21) with autopolymerizing dentin primer (ED-Primer), or a self-adhesive composite luting agent (RelyX Unicem). Both composite luting agents were used without acid etching of the canal dentin. Each luting agent was used under 2 conditions: in 1 subgroup (n=16) the dentinal walls were not roughened, and in the other subgroup (n=16), walls were roughened with a diamond rotary cutting instrument. Eight specimens from each subgroup were stored in water at 37 degrees C for 3 days; the other 8 specimens were stored for 150 days and subjected to simulated aging conditions using 37,500 thermal cycles (5 degrees C/55 degrees C) and 300,000 mechanical loading cycles with 30 N. Dowel retention (N) was measured using a universal testing machine with a crosshead speed of 2 mm/min. Data were analyzed using 2- and 3-way ANOVAs and the Tukey HSD test (alpha=.05). RESULTS: The dislodged dowels were examined microscopically to evaluate mode of failure. The nonroughened dentinal walls showed no significant differences between the different luting agents. Roughening the dentinal walls increased the retention significantly for all groups. This increase was significantly higher for the resin composite groups (P=.0001). Storage for 150 days with thermal cycling and mechanical loading caused a significant decrease in dowel retention (P=.001). The failure mode was purely adhesive at the luting material-dentin interface for all dowels cemented in nonroughened root canals. A mixed failure mode, adhesive at the luting material-dentin interface and cohesive in the luting material, was observed for dowels cemented in roughened root canals. CONCLUSION: Roughening the dentinal walls and the use of resin luting cements provided statistically significant increases in dowel retention values.

Analysis of Variance↗

PubMed2005

Assessment of dental appearance following changes in incisor proportions.

This study aimed to evaluate the assessment of attractiveness of standardized changes in incisor proportions. Two original photographs, showing the maxillary anterior teeth in the frame of a smile, were computer-manipulated. From the so-produced symmetrical 'golden standard' images, two sets were constructed. Each set contained one golden standard image and seven images with different standardized changes concerning (i) width-to-length ratios of the central incisors (60-96%) and (ii) tooth-to-tooth proportions between the widths of lateral and central incisors (43-87%). The judges, consisting of three groups of individuals (24 dentists, 24 medical students, and 179 patients), ranked each photo set for attractiveness on a visual analogue scale. The width-to-length ratios were assessed as most attractive within a range of 75-85% (medical students, patients) or 75-80% (dentists), respectively. The tooth-to-tooth proportions showed the best results concerning attractive appearance within a range of 50-74% (medical students, patients) or 56-68% (dentists), respectively. No significant differences between the participant groups were found except for some extreme variations. It was concluded that a most attractive 'golden range' could be identified for both the width-to-length ratios and the tooth-to-tooth proportions of the maxillary incisors.

Adolescent↗

PubMed2005

Clinical long-term survival of two-retainer and single-retainer all-ceramic resin-bonded fixed partial dentures.

OBJECTIVES: All-ceramic resin-bonded fixed partial dentures (RBFPDs) were introduced as a conservative treatment approach 15 years ago. The purpose of this prospective study was to evaluate the long-term clinical survival of RBFPDs made with a conventional two-retainer design or a cantilever single-retainer design. METHOD AND MATERIALS: A total of 37 anterior RBFPDs were made from the glass-infiltrated alumina ceramic In-Ceram. Sixteen RBFPDs with a conventional two-retainer design were inserted in 14 patients, and 21 RBFPDs with a cantilever single-retainer design were inserted in 16 patients. Panavia or Panavia 21 were used as luting agents either after silica-coating and silanation or after air-abrasion only. Patients were recalled every year for a clinical examination to evaluate the restorations with regard to function and possible failures. The mean observation time in the two-retainer group was 75.8 months, and in the single-retainer group it was 51.7 months. RESULTS: No restoration debonded. In the two-retainer group, one restoration was lost because it fractured after 3 months at both connectors and one restoration was removed alio loco accidentally. Also in this group, four RBFPDs fractured within 15 months after insertion at one connector, but the pontic remained in situ as a cantilever RBFPD for several years. In the single-retainer group, only one FPD fractured and was lost 48 months after insertion. The 5-year survival rate was 73.9% in the two-retainer group and 92.3% in the single-retainer group. When unilateral fracture of a FPD was taken as criterion for failure, the five-year survival rate decreased to 67.3% in the two-retainer group. CONCLUSIONS: Cantilever all-ceramic resin-bonded fixed partial dentures made from high-strength oxide ceramics present a promising treatment alternative to two-retainer RBFPDs in the anterior region.

Aluminum Oxide↗

PubMed2004

Durability of the resin bond strength to the alumina ceramic Procera.

OBJECTIVES: The purpose of this in vitro study was to evaluate the tensile bond strength of adhesive bonding systems to the densely sintered alumina ceramic Procera, and its durability. METHODS: Plexiglas tubes filled with composite resin were bonded to Procera ceramic discs (99% Al2O3), which were either in their original state as supplied by the manufacturer or which were sandblasted for surface conditioning. Groups of 20 specimens were bonded in an alignment apparatus using 10 bonding methods. Subgroups of 10 bonded specimens were tested for tensile strength following storage in distilled water at 37 degrees C either for 3 days or for 150 days. In addition, the 150 days specimens were thermal cycled 37,500 times. The statistical analyses were conducted with the Kruskal-Wallis test followed by multiple pair-wise comparison of groups using the Wilcoxon rank sum test. RESULTS: Not sandblasted groups showed relatively poor initial bond strengths independent from bonding resins. During 150 days storage time all specimens in the not sandblasted groups debonded spontaneously. Moderate to relatively high initial bond strengths between 18 and 39 MPa were achieved to sandblasted specimens by using the PMMA luting resin Superbond C & B or the composite resin Variolink II or by silica coating and silanation in combination with Variolink II. However, in these groups after 150 days storage time the bond strength decreased significantly. The phosphate monomer containing composite resin Panavia 21 showed the highest bond strength to sandblasted Procera ceramic which did not decrease significantly over storage time. In addition, the bond strengths of sandblasted groups bonded with Variolink II after priming the ceramic with Alloy Primer or the silane Monobond S were relatively high and did also not decrease significantly after 150 days storage time. SIGNIFICANCE: Using ten bonding systems, a stable resin bond to Procera ceramic could be achieved after sandblasting and by using Panavia 21 or by using Variolink II after priming the ceramic with Alloy Primer or Monobond S.

Boron Compounds↗

PubMed2004

Fracture strength of all-ceramic crowns luted using two bonding methods.

STATEMENT OF THE PROBLEM: Excellent esthetic quality is one of the major advantages of all-ceramic restorations; however, catastrophic fracture of such restorations is still a disadvantage. Ceramic bonding systems using ceramic primers without the use of hydrofluoric acid have been introduced, but data about the efficiency of these systems are lacking. PURPOSE: This study investigated the influence of 2 bonding procedures on the fracture resistance of low-fusing ceramic and computer aided design-computer aided manufacturing (CAD-CAM) all-ceramic crowns. MATERIAL AND METHODS: Forty-two standardized all-ceramic crowns were fabricated on human maxillary premolars. Seven unprepared maxillary premolars were used as control. Three all-ceramic crown systems were used: 1 low-fusing ceramic (Duceram) and 2 machineable ceramics (Vita Mark II and ProCAD) using the Cerec 3 CAD-CAM system. The intaglio surfaces of fabricated crowns (n=7) were subjected to 2 different conditioning techniques: etching, using 4.9% hydrofluoric acid followed by application of Mirage ABC silane, or cleaning, using 65% phosphoric acid and application of primer (Porcelain Liner-M). The crowns were luted to the teeth using Superbond C&B luting agent. After 24 hours storage in water, specimens were loaded in a universal testing machine with the compressive load applied along the long axis of the specimen at a crosshead speed 1 mm/min until fracture. Fracture loads (N) were recorded. One-way analysis of variance (ANOVA) and the Tukey HSD test (alpha=.05) were used for statistical analysis of the data. RESULTS: The mean fracture load of control specimens (738.3+/-195.3 N) was not significantly different from that of the 2 CAD-CAM crowns (667.7+/-72.3 N, 715.9+/-105.2 N). However, fracture load of natural teeth and the 2 CAD-CAM crowns was significantly higher than the fracture load of the low-fusing ceramic crowns treated with HF acid and silane (465.5+/-101.1 N) and, when cleaned, using phosphoric acid and an application of primer (447.5+/-63.4 N) (P<.05). There was no significant difference in the mean fracture load of each ceramic material when bonded using the 2 different procedures, either treated with HF acid and silane or cleaned using phosphoric acid and application of primer (P>.05). CONCLUSION: The application of a primer (Procelain Liner-M) was an effective method for treating the intaglio surface of all-ceramic crowns before cementation.

Acid Etching, Dental↗

PubMed2004

Influence of cyclic loading and luting agents on the fracture load of two all-ceramic crown systems.

STATEMENT OF PROBLEM: Inherent mechanical properties, fabrication techniques, luting agents, and intraoral conditions are primary factors attributing to longevity of all-ceramic crowns. Before doing time-consuming and costly clinical studies, preclinical in vitro studies should be conducted to evaluate the durability of these crowns. Purpose This study investigated the influence of different luting agents and cyclic loading under wet conditions on the fracture load of CAD-CAM and pressable all-ceramic crowns. MATERIAL AND METHODS: Ninety-six human premolars were prepared for all-ceramic crowns with the following preparation criteria: 6-degree axial taper, 1.5-mm shoulder finish line placed 0.5 mm occlusal to the CEJ, 2-mm occlusal reduction, and occluso-gingival height of 5 mm. Sixteen unprepared premolars served as controls. Forty-eight crowns were laboratory fabricated from a lithium disilicate glass-ceramic (IPS-Empress 2), while 48 CAD-CAM crowns were directly fabricated using a leucite-reinforced glass-ceramic (ProCAD) and the Cerec 3 CAD-CAM system. Three luting agents (Panavia F, Superbond C&B and ProTec CEM) were used for cementation (n = 16). After 1 week storage in water, half of the specimens of each subgroup (n = 8) were cyclically loaded and thermal cycled under wet conditions for 600,000 masticatory cycles and 3500 thermal cycles (58 degrees C/4 degrees C; dwell time 60 seconds) in a masticatory simulator. All specimens were loaded in a universal testing machine with the compressive load (N) applied along the long axis of the specimen at a crosshead speed of 1 mm/min until fracture. Fracture load was recorded for each specimen. The Kruskal-Wallis test was used first to detect overall significance, followed by Mann-Whitney U tests to identify which pairs of groups had significant differences (P =.05). RESULTS: Cyclic loading significantly decreased the median fracture load of ProCAD crowns luted using Superbond from 987.2 to 786.0 N (P =.014) and those luted using ProTec CEM from 914.4 to 630.7 N (P =.007). Also, the median fracture load of Empress 2 crowns luted using ProTec CEM decreased significantly from 977.3 to 622.9 N (P =.013). However, cyclic loading did not decrease the median fracture load of crowns luted using Panavia F, Empress 2 (P =.431) and ProCAD (P =.128). With the same loading conditions and luting agents, there were no significant differences in the fracture loads of ProCAD and Empress 2 crowns (P >.05). CONCLUSIONS: Cyclic loading reduced the fracture load of ProCAD crowns luted with Superbond C&B and ProTec CEM and of Empress 2 crowns luted with ProTec CEM.

Bicuspid↗

PubMed2004

Inability to relate tooth forms to face shape and gender.

This study aimed to examine whether there exists a gender-dependent correlation between the inverted face shape and that of the upper central incisor as the literature often suggests. Standardized portraits and anterior tooth photographs of 204 dental students were made. Standardized enlargements of facial outlines and of the upper right incisor outlines were traced. They were classified into three different shapes: tapered, ovoid and square-shaped. Ten dentists determined twice - with an intervening interval of 3 wk - the gender of the students on the basis of the anterior tooth photographs. Tooth and face shapes could be classified as tapered (25% and 27%, respectively), ovoid (39% and 41%, respectively) or square-shaped (36% and 32%, respectively). A significant correlation could be shown between face shape and gender, but not between tooth shape and gender. The dentists were correct about the gender of the subjects in 47 to 59% of all cases. The reproducibility of their judgments varied between 54% and 77%. The theory that the tooth shape should correspond to the inverted facial shape could therefore not be confirmed. In addition it could be shown that the participants were not capable of determining a subject's gender from intraoral photographs alone.

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