The influence of temporary cements on dental adhesive systems for luting cementation

doi:10.1016/j.jdent.2011.01.004

Journal of Dentistry

Volume 39, Issue 3, March 2011, Pages 255-262

https://doi.org/10.1016/j.jdent.2011.01.004 Get rights and content

Abstract

Objective

This study tested the hypothesis that bond strength of total- and self-etching adhesive systems to dentine is not affected by the presence of remnants from either eugenol-containing (EC) or eugenol-free (EF) temporary cements after standardized cleaning procedures.

Methods

Thirty non-carious human third molars were polished flat to expose dentine surfaces. Provisional acrylic plates were fabricated and cemented either with EC, EF or no temporary cements. All specimens were incubated for 7 days in water at 37 °C. The restorations were then taken out and the remnants of temporary cements were mechanically removed with a dental instrument. The dentine surfaces were cleaned with pumice and treated with either total-etching (TE) or self-etching (SE) dental adhesive systems. Atomic force microscopy was used to examine the presence of remnants of temporary cements before and after dentine cleaning procedures. Composite resin build-ups were fabricated and cemented to the bonded dentine surfaces with a resin luting cement. The specimens were then sectioned to obtain 0.9 mm² beams for microtensile bond strength testing. Fractographic analysis was performed by optical and scanning electron microscopy.

Results

ANOVA showed lower mean microtensile bond strength in groups of specimens treated with EC temporary cement than in groups treated with either no cement or an EF cement (p < 0.05). Mean microtensile bond strength was lower in groups employing the SE rather than the TE adhesive system (p < 0.001). SE samples were also more likely to fail during initial processing of the samples. There was no evidence of interaction between cement and adhesive system effects on tensile strength. Fractographic analysis indicated different primary failure modes for SE and TE bonding systems, at the dentine-adhesive interface and at the resin cement–resin composite interface, respectively.

Conclusion

The use of eugenol-containing temporary cements prior to indirect bonding restorations reduce, to a statistically similar extent, the bond strength of both total- and self-etching adhesive systems to dentine.

Introduction

Advances in adhesive dentistry and the growing demand for cosmetic restorations have been interrelated over the past years. They have been followed by an increase in the choice of resin luting cements for indirect ceramic and composite restorations. These resin cements present the advantages of bonding to both tooth structure and restoration, reduced solubility and, for these reasons, the accuracy of fit is less of a concern compared with non-adhesive luting cements.1, 2 Moreover, indirect bonded restorations provide better proximal contacts, occlusal morphology and marginal accuracy, with reduced shrinkage of the composite cement, compared with direct restorations.³ However, as indirect procedures require multiple appointments, the use of temporary restorations and cements becomes a factor for the protection of the pulp, amongst other factors before the patient's cosmetic and functional needs are fully restored.4, 5

Although temporary cements are removed prior to bonding the indirect restoration, it has been shown that their complete elimination from the dentine surface is difficult.⁶ Mechanical cleaning and pumice have been shown not to be completely effective⁴ and the use of soap with pumice produced a negative effect on the subsequent bonding procedure.⁷ Treatment with acids showed some efficacy,⁸ but residual particles of temporary cements were still detected microscopically and with energy dispersive spectroscopy.⁶ However, the effect of these particles on the bond strength of resin to dentine has not been yet determined.

The presence of temporary materials’ remnants could change the wettability, permeability and reactivity of dentine, and alter the contact angle of liquids, such as adhesives, on it.⁹ Also, due to eugenol presence, resin polymerization could be inhibited.5, 10, 11 Whilst studies have suggested that residues of temporary cementation, regardless of the eugenol content, decrease the tensile bond strength12, 13 and shear bond strength¹⁴ of adhesive systems, other studies have shown that the routine procedures required for adhesive cementation, such as mechanical cleaning, pumice, water spray and acid conditioning of dentine, would neutralize the inhibitory effect on bond strength by reducing the amount of residual particles of temporary cement.15, 16, 17

Self-etching adhesive systems (SE) have been increasingly used in recent clinical practice. They simplify the adhesive procedure by eliminating the need for rinsing the dentine surface after etching, since the primers contain acidic polymerizable monomers which dissolve or incorporate the smear layer into the bonding interface.18, 19 Thus, these systems would be less technique-sensitive than total-etching adhesive systems (TE) because there would be no need to control the hydration of the demineralized collagen matrix, which is critical for TE systems that utilize separate acid conditioning and rinsing steps.20, 21, 22 In the presence of remnants of temporary cements, it is reasonable to believe that self-etching primers would also incorporate those particles in the hybrid layer, since they would not be washed away by rinsing as occurs with TE systems.²³ Thus, the bonding effectiveness of SE systems could be more affected than that of TE systems by the presence of remnants.

This investigation compared the bond strength between natural tooth surfaces that had been treated with eugenol-free (EF) and eugenol-containing (EC) temporary cements in combination with later use of total- and self-etching adhesive systems. If EC and/or EF temporary cements leave remnants after standardized cleaning procedures, one would expect to see a main effect of cement on bond strength testing; further, if this cement effects varies with the etching treatment, one would also expect to see an interaction between cement and adhesive systems on bond strength.

Section snippets

Material and methods

Thirty freshly extracted, non-carious human third molars were selected for the study. The teeth were collected under a protocol approved by the Ethical Committee of the Federal University of Ceará Dental School, after obtaining informed patient consent. All teeth were cleaned and stored at 4 °C in a saturated solution of thymol in distilled water for up to 6 months prior to preparation and testing procedures.²⁴

Results

Processing resulted in a differential survival rate. A complete description of processing failures in the six combinations of cement and bonding systems is shown in Table 1. Over all levels of cement, 46.3% of the specimens available from the SE group failed whilst only 21.7% of those from the TE group failed. A two-tailed test for the difference in independent proportions indicated a statistically greater failure rate in the SE than the TE specimens (z = 6.20, p = 0.002). There was no statistical

Discussion

Indirect aesthetic restorations in most cases require the use of temporary restorations which are fixed with provisional cements. Therefore, when full ceramic or resin restorations are luted, they will be cemented to dentine which has been in contact with temporary cements. Previous studies using SEM and optical microscopy reported that remnants of temporary materials were left on dentine surfaces, even after mechanical cleaning and etching with 37% phosphoric acid.4, 6, 23, 31, 32, 33

In the

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Cited by (43)

No adverse effect of eugenol-based temporary materials on bonding to dentin after 14 days: A systematic review and meta-analysis of in vitro studies
2023, International Journal of Adhesion and Adhesives
Eugenol reacts with free radicals and may inhibit the polymerization of resin monomers, including adhesive systems, consequently reducing their bond strength values.
To evaluate through a systematic review and meta-analysis the time elapsed after eugenol-based temporary materials restorations on bonding adhesive systems to dentin.
A literature search was conducted at PubMed, Web of Science, and Scopus electronic databases. Laboratory studies that evaluated the influence of eugenol-based temporary materials on bonding of adhesive systems to dentin were searched with no year or language restriction. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Meta-analysis was performed using the inverse variance and a random-effects model (p < 0.05). In addition, heterogeneity was assessed with the Cochran Q test and I² statistics.
From 603 potentially eligible studies, 35 were selected for full-text analysis, 27 were included in the systematic review, and 26 in the meta-analysis. Eugenol-based temporary materials were associated with lower bond strength values (p < 0.00001). Subgroup analysis considering the exposure time of eugenol-based temporary materials also showed a significant reduction of bond strength after 24 h (p = 0.003) and seven days (p < 0.00001) from placement, but no significant effect was observed after 14 days–~~45 days~~ from eugenol-based temporary materials application (p = 0.92). Subgroup analysis considering luting cement (p = 0.02), total-etch systems (p = 0.0003), and self-etch systems (p = 0.0001) separately also showed a significant reduction of bond strength.
The meta-analysis based on laboratory evidence suggests that the adverse effect of eugenol-based temporary materials on adhesive systems’ bond strength to dentin is no longer perceived after 14 days of placement.
The impact of provisional intraradicular retainers cementation with temporary methacrylate-based resin in the bond strength of glass fiber posts to root dentin
2022, Journal of the Mechanical Behavior of Biomedical Materials
Chemical composition of temporary cements interferes in the bond strength and quality of the bond interface of glass fiber posts to root dentin. The aim of the present study was to evaluate the influence of different temporary cements on the bond strength of fiberglass posts and resin cement. Thirty-two maxillary central incisor roots were standardized at 15 mm length. The root canals were prepared with Reciproc R50 and filled with a R50 single cone and AH Plus. Ten mm of filling material was removed with a heated Schilder condenser, leaving 5 mm of apical filling material. The roots were randomly distributed into 4 groups (n = 8). In the control group, the root canal was prepared with a standard drill according to the post diameter (DC #1, FGM, Joinville, Brazil), irrigated with 5 mL of distilled water and immediately received the fiberglass post cemented with self-adhesive resin cement. For the other groups, cores were made with temporary intraradicular retainers cemented with different temporary cements: methacrylate-based resin (Bifix Temp - Voco), calcium hydroxide-based (Provicol - Voco) and zinc oxide-based – eugenol-free (Relyx Temp NE - 3M). After 7 days, mechanical removal of the temporary retainers, preparation, irrigation of the root canal and cementation of the fiberglass post were performed, following the same protocol that had been performed in the control group. The roots were sectioned to obtain 3 slices per root third. The most cervical section of each third was used for the push-out test and failure pattern analysis, while the most apical section was subjected to analysis of the adhesive interface by scanning electron microscopy (SEM). The BS data were compared between groups using the two-way ANOVA and Tukey post-test. The failure pattern results were expressed in percentage and compared between groups using the chi-square test and the material adaptation data at the bond interface were evaluated using the Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. The results showed higher BS in the cervical third, with a higher value in the control group (10.8 ± 0.94) and Bifix Temp group (9.78 ± 0.71), with no statistically significant difference between these groups (P > .05). The middle and apical thirds showed no statistically significant difference (P > .05). As regards the type of failure, a higher percentage of mixed adhesive failures was observed for all groups. Analysis of the adhesive interface by SEM showed that the temporary cement Bifix Temp showed greater adaptation at the bond interface. It was concluded that the methacrylate-based resin temporary cement showed the highest bond strength values and best adaptation to root dentin than the zinc oxide-based and calcium hydroxide-based temporary cements.
Substantial in-vitro and emerging clinical evidence supporting immediate dentin sealing
2021, Japanese Dental Science Review
Citation Excerpt :
As indirect bonded restorations fabricated with conventional technique requires placement of provisional restorations until the final restoration is inserted, therefore, contamination of the first precured resin adhesive surface during the provisional phase may affect the final bond strength. Several studies have shown that the contamination of resin adhesive with provisional cements reduces bond strength of resin cement for the final cementation [64,70–76]. The selection of provisional cement has been shown to exert a significant effect on the bond strength of the final restorations.
The application of resin adhesive to freshly cut dentin after teeth preparation, the so-called immediate dentin sealing (IDS) has been suggested as an alternative to the delayed dentin sealing (DDS), a technique in which resin adhesive is applied just before final bonding of indirect restorations.
The aim of this review is to demonstrate the evidence of the claimed advantages made by the proponents of IDS technique.
The results of this review revealed substantial in-vitro evidence supporting the IDS benefits including improved bond strength, reduced dentin permeability, improved restorations’ adaptation, and increased fracture strength of the restorations. Clinical studies have shown that IDS improves survival of ceramic laminate veneers bonded to prepared teeth with increased exposure of dentin. Moreover, it has been shown that IDS reduces post-cementation hypersensitivity in full coverage restorations, which is characterized by exposure of a large number of dentinal tubules. The selection of filled resin adhesive that is capable of producing thick adhesive layer appears to contribute to the success of the technique. Furthermore, careful management of the oxygen inhibition layer before conventional impression making and proper cleaning of the residual temporary cement used with provisional restorations appears to affect the outcome of the restorations.
Effect of conditioning agents combined with two adhesive resin cements on Micro-Tensile Bond Strength to polymeric CAD/CAM materials
2018, International Journal of Adhesion and Adhesives
Citation Excerpt :
By some researchers, the test is seen as a versatile and reliable method to test the bonding performance [25]. With the rational that due to the reduced bonding area, a lower force is required which does not exceed the cohesive strength of the substrates, it is stated that true adhesive failures can be found by using this method [26]. In contrast, Söderholm et al. [27] concluded after a stress distribution analysis that the test does not predict clinical bond failure well.
To test the µ-tensile bond strength (µTBS) between resin composite cements and non-/conditioned CAD/CAM polymers.
PMMA (artBlock Temp) and exp. resin composite CAD/CAM blocks were fabricated, polished and air-abraded. The specimens were conditioned: i. “Monobond Plus/Heliobond”, ii. “visio.link”, iii. “Ambarino P60”, iv. “exp. VP connect”, v. non-conditioned as control group (CG) and luted with a self-adhesive resin composite cement Clearfil SA Cement or an adhesive resin composite cement Variolink II. The blocks were cut into 10 specimens and stored for 24 h at 37 °C water. Half of specimens were thermal cycled (5000×, 5 °C/55 °C). µTBS with failure types were assessed. Data was analysed using 4-way ANOVA, Kruskal-Wallis, Mann-Whitney U-, and Chi²-test (α = 0.05).
The highest influence on µTBS was exerted by conditioning method (partial eta squared η_P² = 0.715, p < 0.001), followed by aging level (η_P² = 0.260, p < 0.001), cement (η_P² = 0.196, p < 0.001) and substrate material (η_P² = 0.135, p < 0.001). Visio.link showed the highest µTBS, regardless of the substrate material and aging level. Adhesive resin composite cement groups in combination with visio.link and Ambarino P60 showed no impact of aging. Remaining groups presented a negative impact of aging on µTBS. No impact of cements was observed for PMMA without/conditioning using visio.link and composite conditioned using VP connect. Specimens luted using self-adhesive resin composite cement showed higher µTBS than specimens luted using adhesive resin composite cement. Visio.link and VP connect combined with self-adhesive resin composite cement showed higher µTBS on PMMA than on exp. resin composite. No impact of substrate was found for non-aged Monobond Plus/Heliobond in combination with self-adhesive resin composite cement. The remaining groups showed higher µTBS values on experimental resin composite substrate.
For long-term bonding of CAD/CAM polymers an adequate pretreatment method is necessary.
Influence of immediate dentin sealing and interim cementation on the adhesion of indirect restorations with dual-polymerizing resin cement
2018, Journal of Prosthetic Dentistry
Citation Excerpt :
In general, interim cement residue can act as a barrier, inhibiting the interactions between functional acid monomers and the inorganic components of the dentin.5 Previous studies using SEM5,9 and atomic force microscopy10 reported that interim material residue remained on the dentin surface even after mechanical cleaning and conditioning with 37% phosphoric acid. However, in other studies this residue was not sufficient to interfere with the interaction between adhesive systems and resin cements, with or without eugenol.11,14
Dentin surface contamination before the cementation of indirect restorations may impact bonding effectiveness.
The purpose of this in vitro study was to analyze the influence of immediate dentin sealing (IDS) and interim cementation on the adhesion of indirect restorations with a dual-polymerizing resin cement.
Composite resin inlays were placed in class V cavities prepared in the buccal and lingual surfaces of 30 extracted human molars with a dual-polymerizing resin cement in 3 different ways (n=10): CG, directly on dentin; PG, after 14 days interim cementation; SG, after IDS and 14 days interim cementation. Buccal restorations were sectioned into sticks and submitted to the microtensile bond strength (μTBS) test. Lingual restorations were submitted to micro-Raman spectroscopy (MRS). Data were analyzed with 1-way ANOVA and the Tukey-Kramer post hoc test (α=.05).
Significantly higher μTBS results were found for SG (35.7 ±8.2 MPa) when compared with CG (23.1 ±7.1 MPa) and PG (17.0 ±6.0 MPa) (P<.05), but no differences were observed between CG and PG. MRS showed that the diffusion zone in SG (3.7 ±0.5 μm) was significantly thicker than that of CG (1.8 ±1.2 μm) or PG (1.5 ±0.3 μm) (P<.05). Additionally, a new interface peak (at approximately 1330 cm^-1) was found in SG, indicating a chemical interaction.
The use of IDS before cementation resulted in a chemical interaction at the interface and significantly higher μTBS and diffusion zone thickness values. Interim cementation did not interfere with adhesion quality when compared with the control group.
Effect of interim cement application on bond strength between resin cements and dentin: Immediate and delayed dentin sealing
2017, Journal of Prosthetic Dentistry
Despite the advances in materials and techniques, adhesion to dentin is challenging because of the complex composition of dentin’s mineral, organic, and fluid phases.
The purpose of this in vitro study was to evaluate the bond strength of 2 different resin cements (conventional and self-adhesive) with or without previous dentin sealing and the effect of interim cement.
Forty-five molars were embedded into acrylic resin blocks and a flat dentin surface was exposed. Twenty teeth (n=5 per group) were treated with the conventional resin cement associated with etch-and-rinse or self-etch adhesive approaches, applied before (immediate dentin sealing) or after (delayed dentin sealing) the application/removal of interim cement. Another 25 teeth (n=5, per group) were treated with self-adhesive resin cement with (self-etch mode [immediate dentin sealing or delayed dentin sealing]) or without adhesive application. Furthermore, in the self-adhesive resin cement group, the application of polyacrylic acid for dentin etching before cementation was evaluated. Composite resin blocks were cemented onto flat, treated dentin surfaces, and the assemblies were sectioned into bar-shaped specimens for microtensile bond strength testing. The data were subjected to 1-way ANOVA followed by the post-hoc Tukey test (α=.05). The failure patterns were classified as cohesive, adhesive, or mixed.
The application of adhesive before interim cement (immediate dental sealing) promoted the highest values of bond strength for both resin cements (P<.001). For self-adhesive resin cement, polyacrylic acid-enhanced bond strength after the application of interim cement.
The application of dental adhesive immediately after tooth preparation (immediate dentin sealing) and before the use of an interim cement promoted the highest values of bond strength to dentin with the resin cements tested.

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The influence of temporary cements on dental adhesive systems for luting cementation

Abstract

Objective

Methods

Results

Conclusion

Introduction

Section snippets

Material and methods

Results

Discussion

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