Fig. 1: Representation of the failure mode percentage after the MTBS test: cohesive within the ceramic; cohesive within the resin cement (almost all of the surface was covered with resin cement); mixed (both ceramic surface and a cement layer were visible); adhesive (complete ceramic surface was visible). (Image: Dr Ludovichetti)
The present study compared the efficacy of a universal adhesive containing silane, bis-GMA and 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) monomer with that of silane applied alone or combined with bis-GMA or 10-MDP, but in separate steps, on the microtensile bond strength of a CAD/CAM leucite-reinforced glass-ceramic to a resin cement.
Materials and methods: Sixty-four blocks from IPS Empress CAD (Ivoclar Vivadent) were etched (5% hydrofluoric acid) and treated with:
(1) RelyX Ceramic Primer (3M ESPE; control group; group 1);
(3) Single Bond Universal Adhesive (3M ESPE; group 3);
(4) CLEARFIL PORCELAIN BOND ACTIVATOR + CLEARFIL SE BOND PRIMER (both Kuraray Noritake Dental; group 4).
The blocks were bonded in pairs with RelyX ARC (3M ESPE) and sectioned into microbars, which were submitted to microtensile testing. Microtensile bond strength data (MPa) were analyzed by 1-way ANOVA and Tukey tests (α = 0.05). Failure mode was determined under a stereomicroscope (×20).
Results: The control group, group 2 and group 4 exhibited microtensile bond strength values not statistically different from each other, but higher than those of group 3. Group 2 presented the lowest percentage of adhesive failures and the highest percentage of cohesive failures within the resin cement.
Conclusion: The universal adhesive showed the worse performance on the microtensile bond strength of a CAD/CAM leucite-reinforced glass-ceramic with a resin cement when compared with that of silane applied alone or combined with bis-GMA or 10-MDP, but in separate steps. Long-term studies investigating how these groups behave when submitted to hydrothermal aging, simulating the oral environment over time, are necessary.
Dr. Ludovichetti, why did you conduct the research reported on in this paper?
The efficacy of a universal adhesive containing silane, bis-GMA and 10-MDP with that of silane applied alone or combined with bis-GMA or 10-MDP, but in separate steps, on the microtensile bond strength of a CAD/CAM leucite-reinforced glass-ceramic with a resin cement had not previously been studied, and there is a gap in the literature regarding this topic.
For what reasons could others cite your paper?
This paper could be cited owing to the novel results shown. It could be decisive in the choice of the technique to be used.
How could your study’s findings have an impact on dentistry?
This study showed that the microtensile bond strength of a CAD/CAM leucite-reinforced glass-ceramic with a resin cement was improved by the use of the “separate steps” technique. This could help dentists in choosing the adhesive and the technique to be used
What is the relevance of your study’s findings to the daily practice of a dentist?
In daily practice, dentists should opt for the use of silane applied alone or combined with bis-GMA or with 10-MDP, but in separate steps, when using a resin cement and a CAD/CAM leucite-reinforced glass-ceramic.
What are your recommendations for further investigation of the topic of your article?
Further investigation should study the behavior of a universal adhesive containing silane, bis-GMA and 10-MDP compared with that of silane applied alone or combined with bis-GMA or 10-MDP, but in separate steps, when submitted to hydrothermal aging, simulating the oral environment over time.
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