Clinical Relevance Mechanical surface roughening of the titanium-abutment base is necessary to increase the pull-off bond strength of the lithium disilicate abutment material. Additional chemical surface treatment may further increase the bond strength, but the effects are product specific. SUMMARY Objective: The titanium-cement interface of a Ti-Base implant crown must be able to resist intraoral pull-off forces. The purpose of this study was to evaluate the effect of mechanical and chemical surface treatments of a titanium-abutment base (Ti-Base, Dentsply/Sirona) on the pull-off bond strength of a lithium disilicate abutment coping. Methods and Materials: Ti-Bases were divided into nine groups of 10 copings each that varied in both mechanical surface treatment (none; Al 2 O 3 air abrasion; CoJet silicoating, 3M ESPE) and chemical treatments (none; Monobond Plus, Ivoclar Vivadent; Alloy Primer, Kuraray). Lithium disilicate abutment copings (IPS e.max CAD, Ivoclar Vivadent) were designed and milled. After crystallization, the copings were cemented onto the Ti-Bases with a resin cement (MultiLink Hybrid-Abutment Cement, Ivoclar Vivadent) according to the manufacturer's recommendations. The copings were torqued to a mounted implant, and the access channel was sealed with composite. After 24-hour storage and 2000 thermal-cycles in distilled water, the copings were subjected to a removal force parallel to the long axis of the interface until fracture. Data were analyzed with multiple one-way analyses of variance and Tukey post hoc tests (α=0.05). Results: Significant differences were found between groups based on type of surface treatment ( p <0.05). Conclusions: Chemical surface treatment with Monobond Plus and mechanical surface treatment with CoJet silicoating or Al 2 O 3 air abrasion resulted in the greatest pull-off bond strength. Alloy Primer did not provide a statistically significant increased pull-off bond strength when the surfaces were mechanically treated with Al 2 O 3 air abrasion or CoJet silicoating. The lack of any mechanical surface treatment resulted in the lowest pull-off bond strength regardless of the type of chemical surface treatment.

SUMMARY A new nanofiber-reinforced hybrid composite (NovaPro Fill, Nanova) was recently introduced with reportedly improved mechanical properties. The purpose of this study was to compare the properties (flexural strength/modulus, degree of conversion [DC], depth of cure, and polymerization shrinkage) of the nanofiber composite to those of traditional hybrid composites (Filtek Z250, 3M ESPE; Esthet-X HD, Dentsply). To determine flexural strength and modulus, composite was placed in a rectangular mold, light-cured, stored for 24 hours, and then fractured in a universal testing machine. For degree of conversion, composite was placed in a cylindrical mold, light-cured, and stored for 24 hours. Measurements were made at the top and bottom surfaces using Fourier Transform Infrared Spectroscopy. To determine depth of cure, composite was placed in a cylindrical mold and light-cured. Uncured composite was scraped until polymerized resin was reached. Remaining composite was measured and divided by two. Polymerization shrinkage was determined by placing the composite material on a pedestal in a video-imaging device while light-curing. Shrinkage was determined after 10 minutes. Data were analyzed with one-way analysis of variance and Tukey post hoc test per property (α=0.05). Compared to Filtek Z250, NovaPro Fill had significantly lower flexural strength and modulus, greater volumetric shrinkage, and similar depth of cure, but greater top and bottom DC. Compared to Esthet-X HD, NovaPro Fill had similar flexural strength, shrinkage, and top and bottom DC, but significantly greater depth of cure and flexural modulus.

SUMMARY The purpose of this study was to compare the whitening efficacy of a novel bleaching agent containing a unique tribarrel hydremide-peroxide gel (KöR) with a traditional bleaching system of hydrogen peroxide or carbamide peroxide (Opalescence). Bovine incisors were mounted into a custom resin, arch-shaped mounting device. Four groups of 10 teeth were created using mounting devices containing five teeth each. The in-office and home bleaching gels of KöR and Opalescence were applied to the teeth alone and in trays to simulate a combination of in-office and home bleaching or home bleaching only. Spectrophotometer readings of L* a* b* were performed at baseline, the end of active bleaching (immediate), and three and six months postbleaching. Immediately postbleaching, the use of Opalescence gel resulted in greater change in ΔE* and Δb* (less yellow) for combined and home bleaching techniques compared with KöR. After six months, Opalescence had significantly greater ΔE* and Δb* compared with KöR for home bleaching only. There was no significant difference in ΔL* between Opalescence and KöR at any time period with either technique.

SUMMARY The carving of a complex amalgam restoration may occasionally result in light proximal contact with the adjacent tooth. The purpose of this study was to investigate the strength of complex amalgam restorations repaired with a proximal slot amalgam preparation. Extracted human third molars of similar coronal size were sectioned 1 mm apical to the height of the contour using a saw and were randomly distributed into 9 groups of 10 teeth each. One pin was placed at each line angle of the flattened dentinal tooth surface. A metal matrix band was placed and an admixed alloy was condensed and carved to create a full crown contour but with a flat occlusal surface. A proximal slot was prepared with or without a retention groove and repaired using a single-composition spherical amalgam 15 minutes, 24 hours, one week, or six months after the initial crown condensation. The specimens were stored for 24 hours in 37°C water before fracture at the marginal ridge using a round-ended blade in a universal testing machine. The control group was not repaired. The mean maximum force in newtons and standard deviation were determined per group. Data were analyzed with a 2-way analysis of variance as well as Tukey and Dunnett tests (α=0.05). Significant differences were found between groups based on type of slot preparation ( p =0.017) but not on time ( p =0.327), with no significant interaction ( p =0.152). No significant difference in the strength of the marginal ridge was found between any repair group and the unrepaired control group ( p >0.076). The proximal repair strength of a complex amalgam restoration was not significantly different from an unrepaired amalgam crown. Placing a retention groove in the proximal slot preparation resulted in significantly greater fracture strength than a slot with no retention grooves. Time of repair had no significant effect on the strength of the repair.

SUMMARY Newer bulk-fill composites claim a greater depth of cure than conventional resin-based composites. To facilitate complete curing, the manufacturer of SonicFill (Kerr) recommends curing from the occlusal, as well as the buccal and lingual, surfaces of the tooth. The purpose of this study was to quantify the degree of curing light attenuation as it passes through natural tooth structure, and how this attenuation affects the depth of cure of different posterior resin composites. Ten noncarious extracted mandibular third molars were sectioned to produce 5-mm-thick pieces of buccal tooth structure. Sanding 0.5-mm increments from the flattened surface produced 4.5-, 4.0-, 3.5-, 3.0-, 2.5-, 2.0-, and finally 1.5-mm-thick sections. A Bluephase G2 (Ivoclar) curing light with an 8-mm-diameter light guide set on high for 20 seconds was used for measurement of irradiance as it passed through different thicknesses of tooth structure and air. The average irradiance (mW/cm 2 ) was measured with a MARC-RC Resin Calibrator with a 4-mm-diameter sensor (BlueLight Analytics). To measure depth of cure of a conventional hybrid composite (Herculite Ultra; Kerr) vs a bulk-fill hybrid composite (SonicFill) through varying thicknesses of tooth structure, composites were cured in a 4-mm-diameter × 10.25-mm-long split mold according to International Organization for Standardization 4049. A mean and standard deviation was determined per group. Data were analyzed with a one-way analysis of variance (ANOVA)/Tukey test and two-way ANOVA/Tukey test (α=0.05). One-way ANOVA/Tukey found a significant decrease in irradiance based on thickness of tooth structure or distance through air ( p <0.001). Two-way ANOVA/Tukey found a significant decrease in depth of cure based on thickness of tooth structure ( p <0.001) and on composite type ( p <0.001) with no significant interaction ( p =0.623). SonicFill had a significantly greater depth of cure than Herculite Ultra.

SUMMARY Purpose Universal bonding agents have been introduced for use as self-etch or etch-and-rinse adhesives depending on the dental substrate and clinician's preference. The purpose of this study was to evaluate the shear bond strength (SBS) of composite to enamel using universal adhesives compared to a self-etch adhesive when applied in self-etch and etch-and-rinse modes over time. Methods and Materials Extracted human third molars were used to create 120 enamel specimens. The specimens were ground flat and randomly divided into three groups: two universal adhesives and one self-etch adhesive. Each group was then subdivided, with half the specimens bonded in self-etch mode and half in etch-and-rinse mode. The adhesives were applied as per manufacturers' instructions, and composite was bonded using a standardized mold and cured incrementally. The groups were further divided into two subgroups with 10 specimens each. One subgroup was stored for 24 hours and the second for six months in 37°C distilled water and tested in shear. Failure mode was also determined for each specimen. Results A three-way analysis of variance (ANOVA) found a significant difference between groups based on bonding agent ( p <0.001) and surface treatment ( p <0.001) but not on time ( p =0.943), with no significant interaction ( p >0.05). Clearfil SE in etch-and-rinse and self-etch modes had more mixed fractures than either universal adhesive in either mode. Conclusions Etching enamel significantly increased the SBS of composite to enamel. Clearfil SE had significantly greater bond strength to enamel than either universal adhesive, which were not significantly different from each other.

SUMMARY The purpose of this study was to compare the shear bond strengths to dentin of two dual-cure resin cements, one with a unique initiator, NX3 (Kerr Corp), and the other with a traditional redox-initiator system, Calibra (Dentsply), when used in combination with simplified or nonsimplified adhesive agents. The two dual-cure resin cements, in either self- or dual-cure activation modes, were bonded to human dentin with four dental adhesives to create 16 subgroups of 10 specimens each. After 24 hours of storage in distilled water at 37°C, the specimens were tested in shear in a universal testing machine. With both NX3 and Calibra, bond strengths significantly increased when the specimens were dual cured. In addition, with either cement in either mode, the nonsimplified adhesives performed significantly better than did the simplified adhesive bonding agents. When used specifically with simplified adhesives in either cure mode, NX3 did not produce significantly higher bond strengths than did Calibra. In general, lower dentin bond strengths were found with simplified adhesives or self-cure activation with either resin cement.