MATERIALS AND METHODS

The objective of this study was to evaluate the shear bond strength between feldspathic ceramic material and dentin substrate. It was an invitro study conducted with 2 different bonding agents and 2 different surface treatments. In this study 40 cylinders were milled from CEREC Blocs through CAD/CAM technology (computer assisted design and computer assisted manufacture). The milled CEREC Blocs were bonded to the tooth surface of dentin.

MATERIALS CEREC Blocs CEREC Blocs are industrially manufactured, finestructured feldspathic ceramic blocks used to produce inlays, onlays, crowns and veneers. The key advantage of CEREC Blocs is that restorations can be inserted

immediately after the milling operation. (Fig-1)

CEREC Blocs are available in up to six brightness steps: Three areas for the value of the color, saturation or chroma (translucent, medium and opaque) and three as polychromatic CEREC Blocs. The following table shows different dimensions and sizes of CEREC Blocs and polychromatic CEREC Blocs.

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Size 8 10 CEREC Blocs 12 14 Pc12 CEREC chromatic Blocs poly Pc14 Pc14/14

Dimensions 8815 mm 81015mm 101215mm 121418mm 101215mm 121418mm 141418mm

The

following

tables

give

chemical

composition

and

physical properties of CEREC Blocs

Trade name

Manufacturer

Composition SiO2 56-64%

Al2O3 20-23% CEREC blocs Sirona Na2O K2O Cao TIO2 6-9 % 6-8% 0.3-0.6% 0.0-0.1%

Physical properties Property Unit measure Coefficient of thermal expansion (20-500c) Density 10 - 6 K - 1 g/cm3 2.440.01 15415 9.40.1 of Value

Flexural strength (ISO Mpa

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6872) Fracture toughness Youngs modulus Transformation area Knoop hardness Refractive index Mpa . m GPa 1.70.1 4.50.5 780-790 5218 1.5010.001

VARIOLINK II It is a radiopaque, dual-curing composite system for the adhesive cementation of indirect all -ceramic, Ceromer and composite restorations. The composite cement consists of the following two components (Fig-2)

Catalyst: Available in Two shades - transparent and yellow Two consistencies - high and low viscosity.

Base: Available in One consistency Six shades - bleach XL, transparent, white, yellow, brown, and white opaque.

The particle size was 0.04-0.3um The mean particle size was 0.7um. Mixing ratio: Base paste and catalyst in 1:1 ratio.

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The following table gives composition of Variolink II

Trade name

Manufacturer Composition Bis-GMA, Urethane dimethacrylate,

Triethyleneglycoldimethacrylate, VARIOLINK II Ivoclar Inorganic fillers like barium

glass,ytterbium trifluoride, Ba-Al-flurosilicate spheroid mixed oxide. Catalysts, pigments stabilizers and glass &

tycolor10 12 14 PC12 PC14 PC14/14 Monomer Base Catalyst low viscosity Catalyst high viscosity 26.3 27.9 22.0 Filler%wt 73.4 71.2 77.2 Filler%vol 46.7 43.6 52.0

BONDING AGENTS Prime &Bond NT It is a universal self-priming dental adhesive designed to bond light cured composites and dyract compomer materials to enamel and dentine as well as to metals and ceramic. Prime & bond NT combines primer and adhesive in a single bottle. (Fig-3)

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The following table gives the composition of Prime & Bond NT Trade name Di-and trimethacrylate resins. Functionalised amorphous Prime &bond NT Dentsply silica PENTA(dipentaerythritol pentaacrylatemonophosphate) Photoinitiators Stabilizers Cetylamine hydrofluoride Acetone Manufacturer Composition

Xeno III Self Etch Bonding Agent(Fig -4) Composition Trade name Manufacturer

Liquid A

Liquid B

HEMA, Highly dispersed silicon dioxide Xeno III Dentsply Purified water, Ethanol Urethane

Phosphoric acid Modified polymethacrylate resin Mono fluoro phosphazene Modified

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Dimethacrylate resin Butylated hydroxytoluene (BHT

methacrylate resin Urethane dimethacrylate resin Butylated hydroxytoluene (BHT), Camphorquinone, Ethyl-4dimethylaminobenz oate

HYDROFLUORIC ACID < 5% (Fig -5) Trade name Manufacturer Composition

Ceramic

etching Ivoclar vivadent

< 5% hydrofluoric acid

gel / Atzgel

PHOSPHORIC ACID 37% (Fig -6) Trade name Manufacturer Composition

N-Etch

Ivoclar vivadent

37% acid

phosphoric

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SILANE COUPLING AGENT Used to silanize silicate coated metal or porcelain (silane with an attached methacrylic group). The following table gives the composition of silane coupling agent of ESPE-Sil.(Fig-7)

Trade name

Manufacturer

Composition

ESPE-Sil

3M ESPE

Silane Ethanol

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METHOD
Preparation of metal die A metal die in the form of a cylinder was made using stainless steel material, which was fabricated in a

mechanical lathe. The dimensions of the die were 6mm in diameter and 5 mm in length.(Fig -8)

Procedure for milling CEREC Blocs Using elastomeric impression material an index was made for the metal die.(Fig-9) An Opti spray is used over the index before scanning.(Fig-10) Then the index with 6mm diameter and 5mm length was scanned using CEREC 3.65 software(Fig-11&12) and resultant image was milled using CEREC inlab MCXL milling machine. (Fig -13&14)

Preparation of natural teeth for bonding Forty recently extracted human molars were collected and scaling done using a hand instrument and teeth were stored in saline solution at room temperature until testing. The roots of each tooth were embedded in a plastic cylinder with an external diameter of 20 mm and a height of 40mm, filled with an autopolymerised acrylic resin. The crowns were sectioned 90to the long axis of the teeth with a diamond rotary cutting instrument of medium grit to expose the dentin surface. The dentin surface was finished to create a very smooth surface and reduced any micromechanical
46

interlocking that could affect the real bonding influence of adhesive cements. (Fig-15) For standardising the bonding surface cellophane sheet with an internal diameter of 6mm is placed over the dentin surface.

Sample distribution The samples were divided in to 4 groups

(A1,A2,B1,B2)each one formed by 10 cylinders. In A1 group 10 ceramic cylinders were treated with < 5% hydrofluoric acid and bonded using Prime & Bond NT and Variolink II. In the A2 group the ceramic surface was treated with < 5% hydrofluoric acid and silane coupling agent, the treated ceramic surfaces were bonded to dentin surface using Prime & Bond NT and Variolink II. In group B1 the bonding surface of ceramic were treated with < 5% hydrofluoric acid and bonded using Xeno III and variolink II. In B2 group the bonding surfaces of ceramic were treated with < 5% hydrofluoric acid and silane coupling agent,the treated ceramic surface was bonded to tooth structure using Xeno III and variolink II.

Preparation of samples for bonding Group A1: Dentin surface of tooth was etched with 37% phosphoric acid for 15 sec,washed with water and air dried. Prime & Bond NT bonding agent is applied over the dentin surface and light cured for 15 sec. The bondi ng surface of the ceramic cylinders was treated with < 5% hydrofluoric acid, washed with water and air dried. Prime & Bond NT is
47

applied over the surface,light cured for 15 sec and

then

bonded to the dentin surface using dual polymerizing resin cement variolink II and light cured.

Group A2: Dentin surface was etched with 37% phosphoric acid for 15 sec, washed with water and air dried. Prime & Bond NT bonding agent is applied over dentin surface and light cured for 15 sec. The bonding surface of the ceramic cylinders were treated with < 5% hydrofluoric acid and

silane coupling agent for 60 sec, Prime & Bond NT is applied over the surface, light cured for 15 sec and bonded to the dentin surface using dual polymerizing resin cement Variolink II and light cured.(Fig-16)

Group B1: Dentin surface was etched with 37% phosphoric acid for 15 sec, washed with water and air dried. Xeno III is applied over the dentin surface which is a self etching bonding agent and light cured for 15 sec. The bonding surface of the ceramic cylinder was treated with < 5% hydrofluoric acid, washed with water and air dried. Xeno III is applied over the surface bond ing surface of ceramic cylinder and bonded to the dentin surface using dual polymerizing resin cement variolink II and light cured.

Group B2: Dentin surface was etched with 37% phosphoric acid for 15 sec, washed with water and air dried. A self etching bonding agent Xeno III is applied over the dentin surface and light cured for 15 sec. The bonding surface of
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the ceramic cylinders were treated with < 5% acid, and silane coupling agent for 60sec,

hydrofluoric Xeno III is

applied over this surface and bonded to the dentin surface using dual polymerizing resin cement variolink II and light cured.(Fig-17)

Testing procedure for shear bond strength samples: The specimens were stored in water at room

temperature for 24 hours after cementation.(Fig -18) The specimens were submitted to a shear bond strength test to check the strength of adhesion between the two substrates, dentin and ceramic. This test was defined as a test in which two materials are connected by an adhesive agent and loaded in shear until separation occurs. Specimens were mounted on the jig of a universal testing machine Instron 3385 with 10-KN load.(Fig- 19)The chisel end of the rod was positioned at the interface between the porcelain surface and the samples were secured tightly in place to

ensure that the cylinder was always at 90 to the vertical plane and shear force was loaded at a crosshead speed of 1.0 mm/min until they are fractured. (Fig -20)The calculated shear bond strength was determined by dividing the strength at which bond failure occurred by the bonding area.

Fractured surfaces of each specimen were inspected with an optical microscope.(Fig -21) The data were

evaluated by T-Test to assess quantitative differences for the shear bond strength between groups of specimens
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treated with a different bonding agents treatments of the ceramic surface.

and

different

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