Student Theses, Dissertations and Capstones

Document Type

Thesis

Degree Name

Master of Science (M.S.) in Dentistry

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Dental Medicine

First Advisor

Luana Oliveira-Haas

Publication Date / Copyright Date

2017

Publisher

Nova Southeastern University

Abstract

Brief background and goal/ research question: Ceramic restorations were introduced as indirect restorative materials that combine high esthetics with superior mechanical properties. However, an important requirement for successful function of these restorations is adequate adhesion between the restoration material and tooth structure. The use of CAD/CAM restorations is steadily increasing, proper function and longevity of these restorations depends on good adhesion to the underlying substrate as well as operator technique. Preheated composite has been recommended by some clinicians and investigators for the adhesive luting of porcelain laminate veneers based on its good marginal adaptation and perceived superior mechanical durability when compared to traditional resin luting cements. Marginal adaptation alone is not sufficient to achieve successful cementation. Bond strength and durability, which is actually the most important factor, is yet to be evaluated. 3M™ ESPE™ claims that the “ Scotchbond™ Universal Adhesive is the only adhesive you’ll need. It offers one simple adhesive application technique for both direct and indirect indications and bonds to all surfaces including enamel, dentin, glass ceramic, zirconia, noble and non-precious alloys, and composites – without additional primer.” but there is a lack of in vitro studies specifying why it would be good for using the Scotchbond Universal Adhesive as a primer for the ceramic materials. The results of this study establish new horizons and allow us to determine the efficacy of using the preheated composite as ceramic cementation material and Scotchbond Universal Adhesive as a primer for ceramic E.max material. The present study aims to measure the micro-shear bond strength (SBS) of four deferent composite cement techniques to E.max CAD and to determine the usability of a veneer cementing material. Methods: Lithium disilicate glass ceramic (IPS E.max CAD, Ivoclar- Vivadent Schaan, Liechtenstein) blocks sectioned into microbars approximately 2×2×5 mm3. Extracted bovine teeth without signs of carious lesions were collected under a protocol reviewed and approved by the IRB (institutional review board) at Nova Southeastern University School of Dentistry. Enamel surface of bovine teeth was etched. For three groups E.max CAD microbars were etched with HF acid then Monobond Plus ceramic primer was applied. One group E.max CAD microbars were etched with HF acid then Scotchbond Universal Adhesive was applied. E.max microbars were bonded to enamel surfaces using four different composite cement techniques. Group 1 Preheated FiltekTM Supreme Ultra (universal filling composite, 3M ESPE, St Paul, Minnesota, USA), Group 2 Flowable FiltekTM Supreme Ultra (flowable filling composite, 3M ESPE, St Paul, Minnesota, USA)], Group 3 RelyXTM veneer cement, resin-based luting cement (3M ESPE, St Paul, Minnesota, USA) with Scotchbond Universal Adhesive as ceramic primer according to the manufacturer instructions, and G4 RelyXTM veneer cement, resin-based luting cement (3M ESPE, St Paul, Minnesota, USA) with Monobond Plus as ceramic primer (n=12 per group). Specimens were stored in water (37°C, 4 days), then subjected to shear bond testing. Statistical analysis was performed by using one-way ANOVA and with a Tukey HSD. Results: The shear force recorded on the Universal Testing Machine for each sample was subsequently converted into megapascals (MPa) by the principal investigator, which is a Bond strength (MPa) = Actual Force (N) / Area of the microbars (mm2). The descriptive statistics of these force levels are reported in Table 2. The mean μSBS microshear bond strength values and standard deviations of the four experimental groups are presented in Table 3. One-way ANOVA showed that significant differences in the mean μSBS microshear bond strength values existed among the groups ( p < 0.05). Comparing different cements, G4 RelyX TM Veneer Cement (3M ESPE, St Paul, Minnesota, USA) with Monobond Plus as ceramic primer showed the highest statistically significance with a mean μSBS value of 29.47 MPa, followed by Flowable Filtek TM Supreme Ultra (3M ESPE, St Paul, Minnesota, USA) which ranked second with a mean μSBS value of 26.78 MPa. The third rank was preheated Filtek TM Supreme Ultra (3M ESPE, St Paul, Minnesota, USA) with a mean μSBS value of 18,53 MPa, and the lowest microshear bond strength was RelyX TM Veneer Cement (3M ESPE, St Paul, Minnesota, USA) with Scotchbond Universal Adhesive as ceramic primer achieving a mean μSBS value of 8.80 MPa. Conclusions: Within the limitations of the microshear bond strength method used in this study. Monobond Plus ceramic primer should be used prior to RelyX veneer cement because the results showed the highest μSBS. RelyX veneer cement with Scotchbond Universal Adhesive showed the lowest μSBS. Flowable and Preheated composite could be used as a cement material

Disciplines

Dentistry

Keywords

Cementation, Ceramic, E.max, Porcelain, Resin, Shear bond strength

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