PURPOSE: The aim of this study was to evaluate the microshear bond strength (µSBS) of four computer-aided design/computer-aided manufacturing (CAD/CAM) blocks repaired with composite resin using three different surface treatment protocols.MATERIALS AND METHODS: Four different CAD/CAM blocks were used in this study: (1) flexible hybrid ceramic (FHC), (2) resin nanoceramic (RNC), (c) polymer infiltrated ceramic network (PICN) and (4) feldspar ceramic (FC). All groups were further divided into four subgroups according to surface treatment: control, hydrofluoric acid etching (HF), air-borne particle abrasion with aluminum oxide (AlO), and tribochemical silica coating (TSC). After surface treatments, silane was applied to half of the specimens. Then, a silane-containing universal adhesive was applied, and specimens were repaired with a composite, Next, μSBS test was performed. Additional specimens were examined with a contact profilometer and scanning electron microscopy. The data were analyzed with ANOVA and Tukey tests.RESULTS: The findings revealed that silane application yielded higher µSBS values (P<.05). All surface treatments were showed a significant increase in µSBS values compared to the control (P<.05). For FHC and RNC, the most influential treatments were AlO and TSC (P<.05).CONCLUSION: Surface treatment is mandatory when the silane is not preferred, but the best bond strength values were obtained with the combination of surface treatment and silane application. HF provides improved bond strength when the ceramic content of material increases, whereas AlO and TSC gives improved bond strength when the composite content of material increases.
Adhesives ; Aluminum Oxide ; Ceramics ; Clinical Protocols ; Dental Bonding ; Dental Restoration Repair ; Hydrofluoric Acid ; Microscopy, Electron, Scanning ; Polymers ; Shear Strength ; Silicon Dioxide

Increasing demands for esthetic dental treatment, zirconia, which has high mechanical and esthetic properties, had been applied more and more in clinics. Therefore, assessment of biocompatibility of zirconia is necessary. In this article, a review of in vivo studies of zirconia compatibility was performed. In vivo studies showed zirconia had great biocompatibility both on soft and hard tissue. Studies with various animals and patients reported high biocompatibility of zirconia. In terms of bone synthesis and bone adhesion, zirconia showed similar biocompatible properties to titanium. On the other hand, zirconia could be used as implant. For using as an implant, various methods of Hydroxyapatite (HA) coating had been suggested. Since HA coating on titanium implant showed some problems such as low bonding strength and degeneration of HA, HA-zirconia composite, HA-coated zirconia, and HA-zirconia functionally graded material (FGM) or intermediate layer of alumina had been proposed. These methods showed higher bonding strength and biocompatibility.
Aluminum Oxide ; Animals ; Durapatite ; Hand ; Humans ; Titanium

PURPOSE: The aim of this study was to compare the effect of different finishing and polishing techniques on water absorption, water solubility, and microhardness of ceramic or glass-polymer based computer-aided design and computer-aided manufacturing (CAD/CAM) materials following thermocycling. MATERIALS AND METHODS: 150 disc-shaped specimens were prepared from three different hybrid materials and divided into five subgroups according to the applied surface polishing techniques. All specimens were subjected up to #4000 grit SiC paper grinding. No additional polishing has been done to the control group (Group I). Other polishing procedures were as follows: Group II: two-stage diamond impregnated polishing discs; Group III: yellow colored rubber based silicone discs; Group IV: diamond polishing paste; and Group V: Aluminum oxide polishing discs. Subsequently, 5000-cycles of thermocycling were applied. The analyses were conducted after 24 hours, 7 days, and 30 days of water immersion. Water absorption and water solubility results were analyzed by two-way ANOVA and Tukey post-hoc tests. Besides, microhardness data were compared by Kruskal-Wallis and Mann-Whitney U tests (P<.05). RESULTS: Surface polishing procedures had significant effects on water absorption and solubility and surface microhardness of resin ceramics (P<.05). Group IV exhibited the lowest water absorption and the highest microhardness values (P<.05). Immersion periods had no effect on the microhardness of hybrid ceramic materials (P>.05). CONCLUSION: Surface finishing and polishing procedures might negatively affect physical properties of hybrid ceramic materials. Nevertheless, immersion periods do not affect the microhardness of the materials. Final polishing by using diamond polishing paste can be recommended for all CAD/CAM materials.
Absorption ; Aluminum Oxide ; Ceramics ; Computer-Aided Design ; Dental Polishing ; Diamond ; Immersion ; Rubber ; Silicon ; Silicones ; Solubility ; Water

PURPOSE: The aim of this study is to evaluate the effects of various primers on the microtensile bond strength (µTBS) of resin cements to cobalt-chromium (Co-Cr) dental casting alloy. MATERIALS AND METHODS: Four adhesive primers (Universal primer, Metal primer II, Alloy primer, and Metal/Zirconia primer) and two resin cements (Panavia F2.0, G-CEM LinkAce) were tested. One hundred fifty Co-Cr beams were prepared from Co-Cr ingots via casting (6 mm length × 1 mm width × 1 mm thick). The metal beams were randomly divided into ten groups according to the adhesive primers and resin cements used; the no-primer groups served as the control (n = 15). After sandblasting with aluminum oxide (125 µm grain), the metal and resin cements were bonded together using a silicone mold. Prior to testing, all metal-resin beams were examined under stereomicroscope, and subjected to the µTBS test. The mean value of each group was analyzed via one-way ANOVA with Tukey's test as post hoc (α = .05) using SPSS software. RESULTS: The mean µTBS of all groups was ranged from 20 to 28 MPa. There is no statistically significant difference between groups (P > .05). Mixed failure, which is the combination of adhesive and cohesive failures, is the most prevalent failure mode in both the Panavia F2.0 and G-Cem LinkAce groups. CONCLUSION: The µTBS of all tested groups are relatively high; however, the primers used in this study result in no favorable effect in the µTBS of Panavia F2.0 and G-Cem LinkAce resin cement to Co-Cr alloy.
Adhesives ; Alloys ; Aluminum Oxide ; Fungi ; Resin Cements ; Silicon ; Silicones

Ceramic articulation has gained popularity in total hip arthroplasty (THA); however, one of the most important concerns about the use of ceramic materials is the potential for breakage. Importantly, almost all ceramic fractures occur within the first six years after surgery. Here, we present a case report of a 52-year-old female patient who experienced an atraumatic ceramic head fracture at the 16th year after surgery. Key parameters that may be associated with ceramic head fracture are considered to be the use of a 28-mm head and high body mass index (BMI); the patient described here had a BMI of 34.3 kg/m2. Surgical treatment of the case included removal of the broken ceramic head and replacement with an alumina matrix composite ceramic head. At the 12th month follow-up visit, the patient was mobilized independently and could perform her daily activities. Ceramic head fracture after THA may occur even in late periods after surgery. For the treatment of fractures of ceramic material, the fractured component must be removed together with extensive soft tissue excision to ensure that no residual fragments are left behind.
Aluminum Oxide ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Body Mass Index ; Ceramics ; Female ; Follow-Up Studies ; Head ; Hip ; Hip Prosthesis ; Humans ; Middle Aged

PURPOSE: The purpose of this in vitro study is to examine the effects of a nano-structured alumina coating on the adhesion between resin cements and zirconia ceramics using a four-point bending test. MATERIALS AND METHODS: 100 pairs of zirconium bar specimens were prepared with dimensions of 25 mm × 2 mm × 5 mm and cementation surfaces of 5 mm × 2 mm. The samples were divided into 5 groups of 20 pairs each. The groups are as follows: Group I (C) – Control with no surface modification, Group II (APA) – airborne-particle-abrasion with 110 µm high-purity aluminum oxide (Al2O3) particles, Group III (ROC) – airborne-particle-abrasion with 110 µm silica modified aluminum oxide (Al₂O₃ + SiO2) particles, Group IV (TCS) – tribochemical silica coated with Al2O3 particles, and Group V (AlC) – nano alumina coating. The surface modifications were assessed on two samples selected from each group by atomic force microscopy and scanning electron microscopy. The samples were cemented with two different self-adhesive resin cements. The bending bond strength was evaluated by mechanical testing. RESULTS: According to the ANOVA results, surface treatments, different cement types, and their interactions were statistically significant (P < .05). The highest flexural bond strengths were obtained in nanostructured alumina coated zirconia surfaces (50.4 MPa) and the lowest values were obtained in the control group (12.00 MPa), both of which were cemented using a self-adhesive resin cement. CONCLUSION: The surface modifications tested in the current study affected the surface roughness and flexural bond strength of zirconia. The nano alumina coating method significantly increased the flexural bond strength of zirconia ceramics.
Aluminum Oxide ; Cementation ; Ceramics ; In Vitro Techniques ; Methods ; Microscopy, Atomic Force ; Microscopy, Electron, Scanning ; Resin Cements ; Silicon Dioxide ; Zirconium

PURPOSE: The purpose of this study was to evaluate the efficiency of a gas-phase fluorination method under different fluorination periods through using two resin cements. MATERIALS AND METHODS: 84 zirconia specimens in dimensions of 5 mm × 5 mm × 2 mm were prepared and surface treated with 50 µm aluminum oxide particles or gas phase fluorination for 2 min, 5 min, or 10 min. One specimen in each group was surface analyzed under scanning electron microscope. The remaining specimens were bonded to composite cylinders in dimensions of 2 mm diameter and 3 mm high with Panavia SA Plus or Variolink N. Then, the specimens were stored in 37℃ distilled water for 24 hours and shear bond strength test was applied at a speed of 1 mm/min. RESULTS: The highest shear bond strength values were observed in the samples fluorinated for 5 minutes and cemented with Panavia SA Plus. Variolink N did not elicit any statistical differences between surface treatments. Panavia SA Plus resin cement and Variolink N resin cements featured statistically significant difference in shear bond strength values only in the case of 5 minutes of fluorination treatment. CONCLUSION: According to the results of this study, application of 5 minutes of fluorination with 10-methacryloyloxydecyl dihydrogen phosphate monomer (MDP) containing Panavia SA Plus resin cement increased the resin bond strength of zirconia. Fluorination of the zirconia surface using conventional resin cement, Variolink N, did not lead to an increase in bond strength.
Aluminum Oxide ; Ceramics ; Halogenation ; In Vitro Techniques ; Methods ; Resin Cements ; Water

OBJECTIVE: We aimed to perform in-vitro evaluation to compare 1) shear bond strength (SBS), adhesive remnant index (ARI), and color change between self-etched and acid-etched primers; 2) the SBS, ARI and color change between direct and indirect bonding; and 3) the enamel roughness (ER) between 12-blade bur and aluminum oxide polisher debonding methods. METHODS: Seventy bovine incisors were distributed in seven groups: control (no bonding), direct (DTBX), and 5 indirect bonding (ITBX, IZ350, ISONDHI, ISEP, and ITBXp). Transbond XT Primer was used in the DTBX, ITBX, and ITBXp groups, flow resin Z350 in the IZ350 group, Sondhi in the ISONDHI group, and SEP primer in the ISEP group. SBS, ARI, and ER were evaluated. The adhesive remnant was removed using a low-speed tungsten bur in all groups except the ITBXp, in which an aluminum oxide polisher was used. After coffee staining, color evaluations were performed using a spectrophotometer immediately after staining and prior to bonding. RESULTS: ISONDHI and ISEP showed significantly lower SBS (p < 0.01). DTBX had a greater number of teeth with all the adhesive on the enamel (70%), compared with the indirect bonding groups (0–30%). The ER in the ITBX and ITBXp groups was found to be greater because of both clean-up techniques used. CONCLUSIONS: Direct and indirect bonding have similar results and all the primers used show satisfactory adhesion strength. Use of burs and polishers increases the ER, but polishers ensure greater integrity of the initial roughness. Resin tags do not change the color of the teeth.
Adhesives ; Aluminum Oxide ; Coffee ; Dental Enamel* ; Incisor ; Shear Strength ; Tooth ; Tungsten

OBJECTIVE: To investigate the effects of 3 surface different treatments on the crystal structure, shear bond strength,roughness value and flexural strength of zirconia. METHODS: The zirconia specimens were prepared and randomly divided into 4 groups and received the following treatments: (1) blank control group,the specimens without treatments; (2)sandblasting with alumina group, sandblasting the specimens with 110 μm alumina particles for 21 s as working pressure 0.25 MPa and working distance 10 mm; (3)laser etching group, coating the surface of the specimens with graphite powder and using Er:Yttrium Aluminum Garnet (Er:YAG) laser to irradiate the surface 30 s; (4) hot-etching group, putting the specimens in a closed reactor within a 1:1 mixture of 40% (mass traction) nitric acid and 68%(mass traction) hydrofluoric acid liquid, the reaction of 30 min in a water bath at 100 degrees centigrade. The changes of crystal structure, shear bond strength(SBS) and flexural strength of zirconia after different surface treatments were tested. RESULTS: The X-ray diffractometer (XRD) patterns showed that the volume percentage of monoclinic phase of the 4 groups was 0.91%, 12.50%, 6.64% and 17.81% respectively. The roughness value for the four groups were as follows: blank control group,(0.29±0.01) μm; sandblasting with alumina group, (1.05±0.11) μ m; laser etching group, (0.73±0.04) μm; hot-etching group, (1.31±0.06) μm, respectively(P<0.05). Mean SBS was (7.09±0.46) MPa in blank control group, (12.14±1.51) MPa in sandblasting with alumina group, (8.82±0.74) MPa in laser etching group and (11.97±0.99) MPa in hot-etching group. There was no statistically significant difference between sandblasting with alumina group and hot-etching group (P>0.05), but the difference between the other groups were statistically significant(P<0.05). Mean three-point bending was (933.70±44.13) MPa in blank control group, (850.95±60.66) MPa in sandblasting with alumina group, (771.53±68.08) MPa in laser etching group and (766.27±57.49) MPa in hot-etching group. There was no statistically significant difference between sandblasting with alumina group and hot-etching group (P>0.05), but the difference between the other groups were statistically significant (P<0.05). CONCLUSION After different surface treatments, the surface of zirconia has changed from tetrago-nal to monoclinic phases in varying degrees. In addition, surface treatments could improve the bond strength of zirconia to resin cement, and also lead to a decrease in the flexural strength of zirconia.
Aluminum Oxide ; Dental Bonding ; Materials Testing ; Microscopy, Electron, Scanning ; Resin Cements ; Shear Strength ; Surface Properties ; Zirconium

OBJECTIVES: This study compared the effect of hexamethyldisiloxane (HMDSO) and ammonia (NH₃) plasmas on the bond strength of resin cement to fiber posts with conventional treatments. MATERIALS AND METHODS: Sixty-five fiber posts were divided into 5 groups: Control (no surface treatment); H₂O₂ (24% hydrogen peroxide for 1 min); Blasting (blasting with aluminum oxide for 30 sec); NH₃ (NH₃ plasma treatment for 3 min); HMDSO (HMDSO plasma treatment for 15 min). After the treatments, the Ambar adhesive (FGM Dental Products) was applied to the post surface (n = 10). The fiber post was inserted into a silicon matrix that was filled with the conventional resin cement Allcem Core (FGM). Afterwards, the post/cement specimens were cut into discs and subjected to a push-out bond strength (POBS) test. Additionally, 3 posts in each group were evaluated using scanning electron microscopy. The POBS data were analyzed by one-way analysis of variance and the Tukey's honest significant difference post hoc test (α = 0.05). RESULTS: The Blasting and NH₃ groups showed the highest POBS values. The HMDSO group showed intermediate POBS values, whereas the Control and H₂O₂ groups showed the lowest POBS values. CONCLUSION: Blasting and NH₃ plasma treatments were associated with stronger bonding of the conventional resin cement Allcem to fiber posts, in a procedure in which the Ambar adhesive was used.
Adhesives ; Aluminum Oxide ; Ammonia ; Hydrogen Peroxide ; Microscopy, Electron, Scanning ; Plasma* ; Resin Cements* ; Silicon