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  • Title: Bonding effectiveness of tooth-colored materials to resin cement provided by self-etching silane primer after short- and long-term storage.
    Author: Murillo-Gómez F, De Goes MF.
    Journal: J Prosthet Dent; 2019 Apr; 121(4):713.e1-713.e8. PubMed ID: 30871938.
    Abstract:
    STATEMENT OF PROBLEM: Glass-ceramic materials are typically treated with hydrofluoric acid (HF) and silane to improve their bond to composite resin; however, HF may be harmful to human tissues and the integrity of the material, and its application is a technique-sensitive procedure. A novel self-etching ceramic primer has been introduced with the claim that it can solve those problems. However, independent scientific evidence regarding its performance is scarce. PURPOSE: The purpose of this in vitro study was to evaluate the effect of self-etching silane primer on glass-ceramic surface roughness and on long-term bonding between glass-ceramic and composite resin cement. MATERIAL AND METHODS: Plates of 3 materials (n=10), lithium disilicate glass-ceramic (LDC) (IPS e.max CAD), leucite-based glass-ceramic (LEU) (IPS Empress CAD), and resin-modified ceramic (PIC) (VITA ENAMIC), were treated in the following ways: no treatment (C), HF (5%) applied during the recommended time for each material (HF), and self-etching ceramic primer (Monobond Etch & Prime [MBEP]). Surface roughness (Sa) was analyzed with a laser 3D profiler. Ceramic sticks were subjected to (n=20) no treatment (C); treatment with hydrofluoric acid plus silane (HF+S); and treatment with self-etching ceramic primer (MBEP) bonded to prepolymerized composite resin sticks with composite resin cement (Variolink II) and stored for 24 hours and 1 year (n=10). The assemblies were submitted to microtensile bond strength testing (μTBS). Data were analyzed using ANOVA and the Tukey pairwise, post hoc test (α=.05). Failure pattern and surface and interface morphology were assessed using scanning electron microscopy. RESULTS: Only individual factors resulted in statistically significant differences for both variables (material: P<.001; surface treatment: P=.020), interaction (P=.570). HF group (0.49 ±0.11 μm) showed statistically higher roughness values (P≤.05) than control groups (0.44 ±0.97 μm), while MBEP (0.48 ±0.11 μm) was comparable with both. HF produced greater surface alterations than MBEP and C. PIC (0.60 ±0.051 μm) exhibited significantly higher roughness values (P≤.05) than LDC (0.37 ±0.07 μm) and LEU (0.45 ±0.04). Regarding μTBS, the general mean of PIC (24.6 ±10.1 MPa) was higher (P≤.05) than LEUs (14.7 ±6.7 MPa) and LDCs (13.1 ±4.8 MPa), while treatment groups HF+S (17.9 ±10.0 MPa) and MBEP (20.5 ±9.7 MPa) produced higher μTBS values than control groups (14.2 ±5.5 MPa). Adhesive failure was associated with low μTBS values and aged specimens, while cohesive failure within the composite resin-cement layer and mixed failures were associated with higher μTBS values. Interface debonding was detected in C groups for LDC and LEU. PIC exhibited better interface stability. CONCLUSIONS: MBEP produced smoother surfaces than HF. HF+S and MBEP significantly improved ceramic and composite resin cement bonding.
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