Photodynamic Therapy (PDT) in Prosthodontics: Disinfection of Human Teeth Exposed to Streptococcus mutans and the Effect on the Adhesion of Full Ceramic Veneers, Crowns, and Inlays: An In Vitro Study

The use of PDT in prosthodontics as a disinfection protocol can eradicate bacteria from tooth surfaces by causing the death of the microorganisms to which the photosensitizer binds, absorbing the energy of laser light during irradiation. The aim of the study was to investigate the capacity of PDT to increase the bond strength of full ceramic restorations. In this study, 45 extracted human teeth were prepared for veneers, crowns, and inlays and contaminated with Streptococcus mutans. Tooth surfaces decontamination was performed using a diode laser and methylene blue as a photosensitizer. The disinfection effect and the impact on tensile bond strength were evaluated by scanning electron microscopy (SEM) and pull-out tests of the cemented ceramic prosthesis. Results show that the number of bacteria was reduced from colonized prepared tooth surfaces, and the bond strength was increased when PDT was used. In conclusion, the present study indicates that using PDT as a protocol before the final adhesive cementation of ceramic restorations could be a promising approach, with outstanding advantages over conventional methods.

Predictable bonding of adhesive indirect restorations: factors for success

Adhesive indirect restorations are a popular restorative treatment option. This article discusses the many factors that contribute to their successful adhesive cementation, including a review of how to surface treat and manage contaminants across the wide range of indirect materials available.

Adhesion to Zirconia: A Systematic Review of Surface Pretreatments and Resin Cements

This systematic review aims to evaluate the different pretreatments of the zirconia surface and resin cement in order to determine a valid operative protocol for adhesive cementation. Methodologies conducted for this study followed the Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. An electronic search was performed in four databases. The established focus question was: “What type of surface conditioning method is the one that obtains the best adhesion values to zirconia over time by applying a resin cement?” Forty-five relevant papers were found to qualify for final inclusion. In total, 260 different surface pretreatment methods, mainly combinations of air-abrasion protocols and adhesive promoters, were investigated. Altogether, the use of two artificial aging methods, three types of cement and four testing methods was reported. The results showed that mechanicochemical surface pretreatments offered the best adhesive results. Self-adhesive cement and those containing 10-MDP obtained the best results in adhesion to zirconia. Artificial aging reduced adhesion, so storage in water for 30 days or thermocycling for 5000 cycles is recommended. A standardized adhesive protocol has not been established due to a lack of evidence

Use of Self-Adhesive Resin Cements in Dentistry: a Literature Review

Self-adhesive resin cements (SARCs) are cementing agents and have the objective of simplifying adhesive cementation, with a simplified use protocol. The aim of this article was to review the literature on SARCs with a focus on the advantages of their use, highlighting their adhesion and biocompatibility mechanism. Thus, the Health Sciences Descriptors “Self-Adhesive Resin Cement”, “Dental Cements”, “Adhesion” and “Dental Prosthesis” were used, as well as their Portuguese counterparts in the online databases SciELO, PubMed and Bireme in the period of time between the years 2000 to 2020. According to the studies, SARCs have excellent physical and mechanical properties, which include low solubility in the oral environment, adhesion to the dental substrate and the prosthetic part, color mimicry, biocompatibility and fluoride release, in addition to being applied in a single step, optimizing the operator's working time. In addition, self-adhesive cements seem to offer a promising new approach in indirect restorative procedures, which may present a performance similar to conventional ones, however more studies are needed to support their long-term applicability. Keywords: Resin Cements. Dental Cements. Adhesion. Dental Prosthesis. ResumoOs cimentos resinosos autoadesivos (CRAAs) são agentes de cimentação e possuem o objetivo de simplificar a cimentação adesiva, com um protocolo simplificado de utilização. Assim, o objetivo deste trabalho foi revisar na literatura acerca dos CRAAs com enfoque nas vantagens de sua adequada utilização, evidenciando seu mecanismo de adesão e biocompatibilidade. Dessa forma, foram utilizados os descritores em Ciências da Saúde (DeCS) “Cimento Resinoso Autoadesivo”, “Cimentos Dentários”, “Adesão” e “Prótese Dentária”, assim como seus correspondentes na língua inglesa nas bases de dados online SciELO, PubMed e Bireme no período de tempo entre os anos 2000 a 2020. De acordo com os estudos, os CRAAs apresentam excelentes propriedades físicas e mecânicas, que incluem baixa solubilidade no meio bucal, adesão ao substrato dental e a peça protética, mimetização de cores, biocompatibilidade e liberação de fluoretos, além de serem aplicados em uma única etapa clínica, otimizando o tempo de trabalho do operador. Além disso, os cimentos autoadesivos oferecem uma nova abordagem promissora em procedimentos restauradores indiretos, podendo apresentar um desempenho semelhante aos convencionais, porém são necessários mais estudos que sustentem sua aplicabilidade a longo prazo. Palavras-chave: Cimentos de Resina. Cimentos Dentários. Adesão. Prótese Dentária.

Comparison of two curing protocols during adhesive cementation: can the step luting technique supersede the traditional one?

This study aims to compare the degree of conversion of two different curing protocols used during adhesive cementation. The following resin luting agents were tested: Hri Flow (MF) and pre-heated Hri Micerium (MH); light-cure Nexus Third Generation (NX3L) and dual-cure Nexus Third Generation (NX3D); dual cured RelyX Ultimate (RXU) and light-cure RelyX Veneers (RXL). For each tested material, ten samples were prepared and divided into two groups which had different curing protocols (P1 and P2): in P1, samples were cured for 40 s; in P2, samples were cured for 5 s, and then, after 20 s, cured again for additional 40 s. The degree of conversion (DC) was evaluated both during the first 5 min of the curing phase and after 1, 2, 7, 14 and 28 days (p = 0.05). Different trends were observed in DC values after 5 min by comparing P1 and P2. In both P1 and P2, DC decreased as follows, MH > MF > NX3L > RXL > RXU > NX3D. There were significant differences of DC values among all resin luting agents (p < 0.05) in P1, while no significant differences existed between MH and MF, and NX3L and RXL in P2. At 1, 2, 7, 14 and 28 days the light curing luting agents had a higher DC than the dual luting agents (p < 0.05). P1 and P2 were not statistically different at each time point (p > 0.05). Both P1 and P2 protocols let achieve an acceptable DC after 28 days. The tested P2 can be safely used to lute indirect restorations, simplifying the removal of cement excesses.

Tensile Strength and Failure Types of Direct and Indirect Resin Composite Copings for Perio-Overdentures Luted Using Different Adhesive Cementation Modalities

Perio-overdenture design helps to reduce periodontal diseases and secondary caries on abutment teeth. Composite copings can be cemented adhesively to the abutment teeth with different techniques. In this study, direct/indirect resin composite copings for perio-overdentures, luted using different adhesive cementation modalities were compared. Human teeth (N = 40) were prepared to receive spherical attachment copings and randomly divided into four groups: (1) resin-composite copings bonded directly (DC), (2) composite copings made indirectly, luted with dual-polymerized resin cement (ICV), (3) composite copings made indirectly, bonded with resin composite (ICT), (4) composite copings made indirectly, bonded with resin composite after the immediate dentin sealing method (IDS). Specimens were tested for tensile failure and one-way ANOVA (alpha = 0.05) was performed and the two-parameter Weibull modulus, scale (m) and shape (0) were calculated. Mean tensile load (N) was significantly higher for Group IDS (238 ± 81) than for the other groups (144 ± 53–184 ± 46) (p < 0.05). Group IDS (0.54 ± 0.25 mm) showed significantly higher deformation (mm) than other groups (0.2 ± 0.1–0.32 ± 0.15) (p < 0.05). Weibull distribution presented lower shape (0) for DC (3.33) compared to other groups (3.57–4.99). Cohesive coping failures were more frequent in Group IDS (60%) and mixed failures in other groups (40–60%). In conclusion, IDS copings could be preferred over other fabrication and adhesion modalities.

Effects of 10-MDP Based Primer on Shear Bond Strength between Zirconia and New Experimental Resin Cement

To date, numerous materials in the dental field are marketed to ensure stable adhesive cementation of zirconia ceramics (Y-TZP). The aims of this study were to assess the shear bond strength of the new experimental cement Surgi Dual Flo’ Zr to Y-TZP compared to Panavia V5 cement, and to evaluate the effect of 10-MDP (10-methacryloyloxydecyl dihydrogen phosphate) containing primer on their bond strength. Twenty composite cylinders and Y-TZP disks were adhesively luted and divided into four groups based on cement type used and application or not of 10-MDP. The groups (n = 5 each) were S 10MDP (Surgi Dual Flo’ Zr with 10-MDP); S no 10MDP (Surgi Dual Flo’ Zr without 10-MDP); P 10MDP (Panavia V5 with 10-MDP); P no 10MDP (Panavia V5 without 10-MDP). Maximum load resistance (ML) and shear bond strength (SBS) were tested and mode of failure qualitative documented via scanning electron microscopy. The data were analyzed with one-way ANOVA, Holm-Sidak method, and Bayesian analysis. ML and SBS were significantly higher in S 10MDP than in S no 10MDP; and in P 10MDP than in P no 10MDP (p < 0.05). No significant differences were found between S 10MDP and P 10MDP; S no 10MDP and P no 10MDP (p > 0.05). Cohesive, adhesive, and mixed failure occurred among the groups. Bond strength between the experimental resin-based cement and Y-TZP was adequate for clinical application when 10-MDP was added. 10-MDP containing primer was effective improving the bond strength to Y-TZP more than the different type of resinous cement.