Correlation between clinical performance and degree of conversion of resin cements: a literature review

AbstractResin-based cements have been frequently employed in clinical practice to lute indirect restorations. However, there are numerous factors that may compromise the clinical performance of those cements. The aim of this literature review is to present and discuss some of the clinical factors that may affect the performance of current resin-based luting systems. Resin cements may have three different curing mechanisms: chemical curing, photo curing or a combination of both. Chemically cured systems are recommended to be used under opaque or thick restorations, due to the reduced access of the light. Photo-cured cements are mainly indicated for translucent veneers, due to the possibility of light transmission through the restoration. Dual-cured are more versatile systems and, theoretically, can be used in either situation, since the presence of both curing mechanisms might guarantee a high degree of conversion (DC) under every condition. However, it has been demonstrated that clinical procedures and characteristics of the materials may have many different implications in the DC of currently available resin cements, affecting their mechanical properties, bond strength to the substrate and the esthetic results of the restoration. Factors such as curing mechanism, choice of adhesive system, indirect restorative material and light-curing device may affect the degree of conversion of the cement and, therefore, have an effect on the clinical performance of resin-based cements. Specific measures are to be taken to ensure a higher DC of the luting system to be used

Influence of light-curing mode on the cytotoxicity of resin-based surface sealants

Background Surface sealants have been successfully used in the prevention of erosive tooth wear. However, when multiple tooth surfaces should be sealed, the light-curing procedure is very time-consuming. Therefore, the aim of this study was to investigate whether reduced light-curing time (while maintaining similar energy density) has an influence on resin-based surface sealant cytotoxicity. Methods Bovine dentine discs were treated as follows: group 1: untreated, groups 2–5: Seal&Protect and groups 6–9: experimental sealer. Groups 2 and 6 were light-cured (VALO LED light-curing device) for 40 s (1000 mW/cm2), groups 3 and 7 for 10 s (1000 mW/cm2), groups 4 and 8 for 7 s (1400 mW/cm2) and groups 5 and 9 for 3 s (3200 mW/cm2). Later, materials were extracted in culture medium for 24 h, and released lactate dehydrogenase (LDH) activity as a measure of cytotoxicity was determined photometrically after cells (dental pulp cells and gingival fibroblasts) were exposed to the extracts for 24 h. Three independent experiments, for both sample preparation and cytotoxicity testing, were performed. Results Overall, lowest cytotoxicity was observed for the unsealed control group. No significant influence of light-curing settings on the cytotoxicity was observed (p = 0.537 and 0.838 for pulp cells and gingival fibroblasts, respectively). No significant difference in the cytotoxicity of the two sealants was observed after light-curing with same light-curing settings (group 2 vs. 6, 3 vs. 7, 4 vs. 8 and 5 vs. 9: p > 0.05, respectively). Conclusions Shortening the light-curing time, while maintaining constant energy density, resulted in no higher cytotoxicity of the investigated sealants

Influence of a proximal margin elevation technique on marginal adaptation of ceramic inlays

PURPOSE: Evaluating the effect of a proximal margin elevation technique on marginal adaptation of ceramic inlays. METHODS: Class II MOD-cavities were prepared in 40 human molars and randomly distributed to four groups (n = 10). In group EN (positive control) proximal margins were located in enamel, 1 mm above the cementoenamel junction, while 2 mm below in groups DE-1In, DE-2In and DE. The groups DE-1In, DE-2In and DE simulated subgingival location of the cervical margin. In group DE-1In one 3 mm and in group DE-2In two 1.5 mm composite layers (Tetric) were placed for margin elevation of the proximal cavities using Syntac classic as an adhesive. The proximal cavities of group DE remained untreated and served as a negative control. In all groups, ceramic inlays (Cerec 3D) were adhesively inserted. Replicas were taken before and after thermomechanical loading (1.200.000 cycles, 50/5°C, max. load 49 N). Marginal integrity (tooth-composite, composite-inlay) was evaluated with scanning electron microscopy (200×). Percentage of continuous margin (% of total proximal margin length) was compared between groups before and after cycling using ANOVA and Scheffé post-hoc test. RESULTS: After thermomechanical loading, no significant differences were observed between the different groups with respect to the interface composite-inlay and tooth-composite with margins in dentin. The interface tooth-composite in enamel of group EN was significantly better compared to group DE-2In, which was not different to the negative control group DE and DE-1In. CONCLUSION: Margin elevation technique by placement of a composite filling in the proximal box before insertion of a ceramic inlay results in marginal integrities not different from margins of ceramic inlays placed in dentin