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The objective is to evaluate the effect of different surface treatments and storage on the shear strength of ultratranslucent zirconia. 36 blocks of ultra-translucent zirconia were fabricated (7x7x2mm) and sintered. Then, divided into 12 groups according to the "surface treatment" (C -Primer; Al -Sandblasting with Al2O3 + Primer; Si -Silicate + Primer; Gl -Glaze + HF + Primer; Z -Zirlink; Zp -Zirlink + Primer) and "storage" factors (ST-with 150 days/37º and without). After surface treatment, five cylinders (Ø=2mm; h=2.0mm) of resin cement (n=15) were constructed in each ceramic block; at the end, the shear strength test was performed (1mm/min, 50Kgf), and analysis of surface failures. 60 additional samples (2x2x2mm) were made for extras analysis (surface roughness, MEV, and EDS). Bond strength and surface roughness data were statistically evaluated by ANOVA (2 factors/1 factor), Tukey test (5%), and Weibull analysis, respectively. ANOVA (2-way) revealed that all factors were statistically significant for bond strength. The silicatization groups (SiST: 30.47AMPa; Si: 29.21AMPa) showed the highest bond strength values, regardless of storage (Tukey's test). While the groups treated with Zirlink (ZST: 2.76FMPa; Z: 5.27EFMPa) showed the lowest values, just similar to the GlST group (5.14EFMPa). The Weibull modulus (m) showed a statistical difference between groups (p=0.000). ANOVA (1 factor) revealed that the "surface treatment" factor (p=0.0000) was statistically significant for surface roughness. Therefore, the application of Zirlink and Glaze on pre-sintered zirconia did not promote efficient adhesion of the ultratranslucent zirconia to the resin cement, even when associated with a primer containing MDP.

The aim of this in vitro study was to evaluate the surface roughness, translucency, fatigue failure load (FFL), and number of cycles for fatigue failure (CFF) of a recently released lithia-based material called advanced lithium disilicate and three other ceramics indicated for monolithic restorations. First, ALD (advanced lithium disilicate, CEREC Tessera, Dentsply Sirona), LD (lithium disilicate, IPS e. max CAD, Ivoclar), LS (lithium silicate-disilicate, Suprinity, Vita Zahnfabrik), and 4Y-PSZ (Yttria-stabilized zirconia, IPS e.max ZirCAD MT, Ivoclar) discs (n = 15, Ø = 10 mm and thickness = 1.0 mm) were fabricated from CAD/CAM blocks/discs, A2 shade. The discs were sintered/crystallized and subsequently analyzed by a rugosimeter (Mitutoyo SJ-410) to determine Ra and Rz surface roughness parameters. Next, they were evaluated to determine the translucency parameter (TP) using a bench-top spectrophotometer (SP60, EX-Rite). The discs were subsequently cemented to glass fiber epoxy resin discs, and the specimens were tested under cyclic loading (Step-test), immersed in distilled water at a frequency of 20 Hz, with an initial cyclic load of 200 N for 5,000 cycles and increments of 50 N every 10,000 cycles until failure. Fatigue failure load (FFL) and number of cycles for fatigue failure (CFF) were recorded for subsequent Kaplan Meier analysis, with post-hoc Mantel-Cox and Weibull analysis (α = 0.05). Complementary fractographic, topographic and energy dispersive spectroscopy analyses (EDS) were performed. 4Y-PSZ showed higher survival (p < 0.05), with higher FFL and CFF (1077 N; 180,333 cycles), followed by LD (980 N; 161,000 cycles), LS (937 N; 152,333 cycles) and ALD (910 N; 147,000 cycles). No differences were observed between the tested groups regarding Weibull modulus. ALD presented TP (28.14) equal to DL (28.27) and higher than LS (25.51). All lithia-based materials had higher translucency than 4Y-PSZ (TP = 8.62) (p < 0.05). ALD appears to have a similar elemental composition to LD and LSD for oxygen and silicon. ALD and LSD have a similar zirconium content. Fractures originated on the cemented surface of the ceramic discs. Lithia-based ceramics showed lower surface roughness, with ALD (Ra = 0.04 μm; Rz = 0.66 μm) showing the lowest values (p < 0.05). Despite showing lower FFL when compared to LD and 4Y-PSZ, ALD has compatible translucency and mechanical fatigue performance with its indication for fabricating monolithic, anterior and posterior adhesively cemented single-unit restorations. However, further studies are needed to substantiate its clinical performance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

When partial and/or non-retentive preparation, such as those for occlusal veneers, is indicated, a proper and stable adhesion is essential. Therefore, the aim of this in vitro study was to evaluate the effect of loss of adhesion in different regions of the bonding interface on the fatigue behavior of simplified lithium disilicate restorations. For this, lithium disilicate (IPS e.max CAD) discs (1 mm thick and Ø = 10 mm) were fabricated, polished with #400-, #600-, #1200-grit silicon carbide (SiC) papers, and crystallized. As substrate, fiber-reinforced resin epoxy discs (2.5 mm thick and Ø = 10 mm) were fabricated and polished with #600-grit SiC paper. The ceramic bonding surface was treated with 5% hydrofluoric acid and a silane-containing primer (Monobond N), while the substrate was etched with 10% hydrofluoric acid followed by the application of the bonding system primers (Primer A + B). A lacquer (nail polish) was used to simulate the loss of adhesion in specific areas according to the study design to compose the testing groups: bonded (control; did not received nail polish application); - non-bonded (loss of adhesion in the whole specimen area); - margin (loss of adhesion in the ceramic margin); - center (loss of adhesion in the ceramic central area). The adhesive area of partially bonded groups was 50% of the adhesive surface. Then, the discs (n = 12) were bonded to the respective substrate using a resin cement (Multilink N), light-cured, water-stored for 90 days, and subjected to thermocycling (25,000 cycles, 5° to 55 °C) before testing. A cyclic fatigue test was run (20 Hz, initial load of 200 N for 5000 cycles, 50 N step size for 10,000 cycles each until specimen failure), and the fatigue failure load and number of cycles for failure were recorded. As complementary analysis, finite element analysis (FEA) and scanning electron microscopy analysis were performed. Kaplan-Meier log-rank (Mantel-Cox) was conducted for survival analysis. The results showed that as the loss of adhesion reaches the central area, the worse is the fatigue behavior and the higher is the stress peak concentration in the ceramic bonding surface. The bonded specimens presented better fatigue behavior and stress distribution compared to the others. In conclusion in a non-retentive preparation situation, proper adhesion is a must for the restoration fatigue behavior even after aging; while the loss of adhesion reaches central areas the mechanical functioning is compromised., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This laboratory study aimed to evaluate the influence of endodontic sealer and cervical limit of root filling on the discoloration of root canal treated teeth. Bovine incisors were randomly distributed into six experimental groups and control (n=21/group), according to the endodontic sealer used [AH Plus (AP); MTA Fillapex (MF) and Sealer Plus BC (SPB)] and the cervical limit of root filling [dental cervix (DC) or 2 mm in apical direction (2mm-AD)]. Tooth discoloration (ΔE) was evaluated by a digital spectrophotometer using the CIED2000 method. Color assessments were performed immediately before (baseline), 1 week, 1, 3, 6 months, and 1 year after obturation. Data were analyzed by ANOVA and Tukey's post-hoc tests (α=5%). Teeth filled with the three sealers showed perceptible tooth discoloration (ΔE≥2.7) in 1 week, maintaining similar values over time. There was a significant difference between MF and SPB sealers in the 2mm-AD groups. In addition, 2mm-AD groups promoted significantly lower discoloration than DC groups for AH (3 months) and SPB (1 and 3 months) sealer,s. Teeth filled with AP, MF, and SPB sealers displayed discoloration from 1 week to one year, with differences between MF and SPB sealers. A cervical limit of filling material at 2 mm from the dental cervix seems more advisable, promoting lower crown discoloration.

The aim of this study was to evaluate the surface properties and fatigue mechanical behavior of an advanced lithium disilicate ceramic in comparison to lithium disilicate and zirconia. First, discs (n = 15, diameter = 13.5 mm and thickness = 1.2 mm) were made from the following materials: 4Y-PSZ - 4% mol yttria-stabilized zirconia (IPS e.max ZirCAD A2); LD - lithium disilicate (IPS e.max CAD); ALD - advanced lithium disilicate (CEREC Tessera). The specimens were crystalized/sintered and subsequently analyzed by a rugosimeter (Mitutoyo SJ-410) to determine surface roughness (parameters Ra and Rz). Specimens were subjected to biaxial flexural fatigue testing using the step-test method (20 Hz; 10,000 cycles per step; initial stress of 200 MPa; and step size of 25 MPa) until specimen fracture. Statistical analyses included Shapiro-Wilk, Kruskal-Wallis, and post-hoc tests for roughness data, while survival analysis (Kaplan-Meier and Mantel-Cox) and reliability analysis (Weibull modulus) were applied to flexural fatigue strength data. Hardness (Vickers) results were submitted to analysis of variance (1-way ANOVA) and Tukey's test. Zirconia (4Y-PSZ) showed higher FFS, CFF (467 MPa and 115216 cycles) and survival compared to the other materials. ALD had the lowest FFS, CFF (215 MPa and 11,908 cycles) and survival. ALD showed lower Weibull modulus (m = 6.63 for FFS; m = 1.27 for CFF) than LD for FFS (m = 17.33), and lower than LD (m = 4.64) and 4Y-PSZ (m = 6.69) for CFF. ALD showed the lowest Ra (0.07 μm) and Rz (1.05 μm) values, while 4Y-PSZ (Ra = 0.22 μm; Rz = 1.91 μm) and LD (Ra = 0.21 μm; Rz = 2.17 μm) showed higher and similar values. Zirconia (4-YPSZ) was the hardest material, while lithia-based ceramics (LD and ALD) presented the lowest and similar hardness values. Fractures originated in surface defects in the tensile stress concentration region. ALD has lower flexural fatigue strength compared to the other tested materials, along with higher variability (lower structural reliability)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

This study evaluated the effect of resin cement coating with high and low viscosities on the flexural fatigue strength of machined lithium disilicate glass-ceramic. Discs (IPS e.max CAD; Ivoclar Vivadent) were prepared and divided according to the surface condition (machining [M]-CEREC inLab; and polishing [P]-laboratory procedures), resin cement coating (with or without), and cement viscosity (high [H] and low [L]). The ceramic bonding surface was etched/primed by a one-step primer application followed by resin cement application (Variolink N base + high or low viscosity catalyst; Ivoclar Vivadent). Biaxial flexural fatigue strength was evaluated on a piston-on-three-ball set by the step-test method (n = 15) (initial stress: 60 MPa; incremental steps: 20 MPa; 10,000 cycles/step, at 20 Hz). Weibull statistics were used for fatigue data. Contact angle, topographic, and fractographic analysis were also performed. Machining produced statistically lower contact angle than polishing and a significant detrimental effect on the fatigue behavior (σ 0 M = 247.2 [246.9-268.3]; σ 0 P = 337.4 [297.8-382.4]). Machined groups followed by resin cement coating (σ 0 MH = 297.9 [276.0-321.5]; σ 0 Ml = 301.2 [277.1-327.4]) behaved similarly to the polished and coated groups (σ 0 PH = 342.0 [308.9-378.5]; σ 0 PL = 357.3 [324.7-393.1]), irrespective of the cement viscosity. Therefore, cement coating has able to revert the detrimental effects of the machining on the fatigue strength of lithium disilicate glass-ceramic. High and low viscosity cements behaved similarly in the improvement of CAD-CAM lithium disilicate fatigue strength., (© 2022 Wiley Periodicals LLC.)

Statement of Problem: Whether procedures performed before the cementation of computer-aided design and computer-aided manufacturing (CAD-CAM) glass-ceramic restorations, including milling, fitting adjustment, and hydrofluoric acid etching introduce defects on the ceramic surface that affect the mechanical and surface properties is unclear., Purpose: A systematic review and meta-analysis were conducted to assess the effect of milling, fitting adjustments, and hydrofluoric acid etching (HF) on the flexural strength and roughness (Ra) of CAD-CAM glass-ceramics., Material and Methods: Literature searches were performed up to June 2020 in the PubMed/MEDLINE, Web of Science, and Scopus databases, with no publication year or language limits. The focused question was "Do milling, fitting adjustments, and hydrofluoric acid etching affect the flexural strength and roughness of CAD-CAM glass-ceramics?" For the meta-analysis, flexural strength and Ra data on milling, fitting adjustment, and HF etching versus control (polishing) were analyzed globally. A subgroup analysis assessed the effect of etching parameters (HF concentration and time) on the flexural strength and roughness of CAD-CAM glass-ceramics with different microstructures. Comparisons were performed with random-effect models at 5% significance., Results: Fourteen studies from 2764 potentially relevant records were included in the qualitative syntheses, and 12 in the meta-analysis. Milling and fitting adjustments increased roughness and reduced the flexural strength of CAD-CAM glass-ceramics. The effect of HF etching was dependent on the glass-ceramic microstructure, HF concentration, and etching time. For feldspathic- and leucite-reinforced ceramics, HF 5% applied for between 30 and 120 seconds increased roughness without affecting flexural strength. For lithium disilicate glass-ceramics, HF concentrations greater than 4.9% used for 20 seconds or more reduced the strength without affecting the surface roughness., Conclusions: The flexural strength of CAD-CAM glass-ceramic is reduced by grinding procedures such as milling and fitting adjustment. Ceramic microstructure, HF concentration, and etching time determined the effect of hydrofluoric acid etching on the flexural strength and surface roughness of glass-ceramic materials., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate whether an adhesive application after surface treatment on a lithium disilicate ceramic (LD) has an influence on its load-bearing capacity under fatigue., Methods: LD discs (Ø= 10 mm; thickness= 1 mm) were allocated into 8 groups (n= 15), considering 3 factors: "ceramic surface treatment" - HF: hydrofluoric acid + universal primer application; or MEP: single-component ceramic primer; "adhesive application" - with or without; and "aging protocol" - baseline: 24 h to 7 days; or aging: 180 days of storage + 25,000 thermal cycles. The LD discs were adhesively bonded to glass fiber-reinforced epoxy resin discs (Ø= 10 mm; thickness= 2 mm) and stored according to the condition and each group. Cyclic fatigue testing (initial load= 100 N; step size= 100 N until600 N and after step size= 25 N to failure; 10,000 cycles/step; 20 Hz frequency) was performed. Fractographic and adhesive interface analyzes were also performed. The collected data were then analyzed by Kaplan Meier and Mantel-Cox tests and One-way ANOVA., Results: The adhesive application in the baseline condition had no influence on the load-bearing capacity under fatigue when the HF surface treatment was performed, however, adhesive application for the MEP treatment led to worse results than without it. The adhesive application in the aged condition showed worse fatigue outcomes for both treatments. All specimens presented radial cracks. MEP treatment followed by adhesive application presented the thickest luting layer., Conclusion: The adhesive application after surface treatments of a lithium disilicate glass-ceramic is detrimental to its load-bearing capacity under fatigue when adhesively luted onto a supporting substrate., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the effect of different acid etching time and bonding agent (silane and/or adhesive system) on biaxial flexural strength and physico-chemical properties of a lithium disilicate ceramic., Material and Methods: One hundred twenty ceramic discs were made and divided into 8 groups (n = 15) according to factors "etching time" (20 and 120 s) with hydrofluoric acid (HF) and "bonding agent" (C, no bonding agent; S, silane, A, adhesive; and SA, silane + adhesive). After surface treatment, a resin cement layer was applied to the surface and all specimens were subjected to biaxial flexural strength (BFS) test with treated surfaces loaded in tension (1 mm/min). The Weibull analyses and complementary analyses were also performed. Statistical analysis was done with 2-way ANOVA and the Tukey test (α = 0.05)., Results: ANOVA revealed that the factors "etching time" (p = 0.0003) and "bonding agent" (p = 0.007) were statistically significant. In the overall analysis, the HF120S group (272.02 ± 35.30 A MPa) presented significantly higher BFS than that of HF120C (218.45 ± 17.15 CD MPa) and HF20S (228.40 ± 37.83 BCD MPa). On the other hand, the HF20A group (208.92 ± 31.16 D MPa) had significantly lower BFS than HF120S (272.02 ± 35.30 A ), HF120A (254.42 ± 26.87 ABC ) and HF120SA (259.30 ± 36.55 AB ) groups (Tukey). The Weibull modulus (m) of all groups was significantly different from each other (p = 0.000)., Conclusions: Regardless of etching time, the application of silane alone is sufficient to increase the flexural strength of glass ceramic, eliminating the need for the application of adhesive systems. Moreover, if only silane or adhesive is applied, 120-s HF application should increase the flexural resistance of the lithium disilicate ceramic., Clinical Significance: Applications of adhesive systems after silanization can be suppressed from the surface treatment protocol of glass ceramics, since it does not improve their mechanical strength., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To understand the stress development in porcelain-veneered zirconia (PVZ) and porcelain-veneered lithium disilicate (PVLD) crowns with different veneer/core thickness ratios and cooling rates. To provide design guidelines for better performing bilayer restorations with the aid of Viscoelastic Finite Element Method (VFEM)., Methods: The VFEM was validated by comparing the predicted residual stresses with experimental measurements. Then, the model was used to predict transient and residual stresses in the two bilayer systems. Models with two different veneer/core thickness ratios were prepared (2:1 and 1:1) and two cooling protocols were simulated (Fast: ∼300 °C/min, Slow: ∼30 °C/min) using the heat transfer module, followed by stress analysis in ABAQUS. The physical properties of zirconia, lithium disilicate, and the porcelains used for the simulations were determined as a function of temperature., Results: PVLD showed lower residual stresses than PVZ. The maximum tensile stresses in PVZ were observed in the cusp area, whereas those in PVLD were located in the central fossa. The 1:1 thickness ratio decreased stresses in both layers of PVZ. Slow cooling slightly decreased residual stresses in both systems. However, the cooling rate effect was more evident in transient stresses., Significance: Slow cooling is preferable for both systems. A thinner porcelain layer over zirconia lowers stresses throughout the restoration. The different stress distributions between PVZ and PVLD may affect their failure modes. Smaller mismatches in modulus, CTE, and specific heat between the constituents, and the use of low T g porcelains can effectively reduce the deleterious transient and residual tensile stresses in bilayer restorations., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: This study evaluated the effect of dwell time (conventional or extended) and cooling protocol (fast or slow) of self-glaze firings on the mechanical (flexural strength and crack propagation) and optical (color and translucency) properties of a porcelain-veneered zirconia system., Methods: Bilayer disc-shaped samples were prepared (Vita VM9 + In-Ceram YZ) and divided according to the final thermal treatment: glaze firing followed by slow cooling (furnace opening at 200 °C) (G-S) or fast cooling (furnace opening at 600 °C) (G-F, manufacturer-recommended protocol), extended glaze firing (15 min of dwell time) followed by slow cooling (EG-S) or fast cooling (EG-F), or no thermal treatment (CTRL). Porcelain roughness (Ra and Rz) was measured before and after glaze firings. Color (ΔE 00 ) and translucency (TP 00 ) alteration were also evaluated. Flexural strength was measured with the piston-on-three-ball test and crack propagation analysis was performed after Vickers indentations. Complementary analyzes of crystalline phase and scanning electron microscopy were carried out., Results: Significant effect of dwell time was observed, with extended glaze leading to higher flexural strength and shorter crack lengths. Cracks of EG groups were observed to end in clusters of crystals. Color and translucency changed below perceptibility thresholds. All treatments led to a smoother surface and EG groups reached the lowest Rz values. An extra SiO 2 peak was revealed in control and EG groups. No effect of cooling protocol was found., Significance: Extended glaze firing was able to improve the resistance to crack initiation and propagation of porcelain-veneered zirconia without clinically perceptible changes in optical properties., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

It aims on evaluate the effect of the test environment on static fatigue behavior of lithium disilicate-based (LD), and yttrium oxide-stabilized zirconia (YSZ) ceramics. Specimens of LD (IPS e.max CAD, Ivoclar Vivadent) and YSZ (IPS e.max ZirCAD MO, 3 mol% Y2O3, Ivoclar Vivadent) were randomly allocated into three groups: tested in air, inert (paraffin oil, Sigma Aldrich) or distilled water. The static fatigue test (n=15) was performed using a piston-on-three ball assembly, adapted from ISO 6872, as follows: starting load 100 N for LD and 300 N for YSZ; loading application time set to 1 hour for each loading step; step size of 50 N for LD and 100 N for YSZ, applied successively until fracture. Data from static fatigue strength (MPa) and time to fracture (hours) were recorded. Fractographic analysis was executed. Survival analysis corroborates absence of influence of environment on static fatigue outcomes (fatigue strength, time to fracture and survival rates) for YSZ. For LD, specimens tested in air presented statistically superior survival rate and static fatigue strength (p= 0.025). In regards of time to fracture, LD tested in air were superior than when tested in distilled water (p=0.019) or inert (p=0.017) environments. No statistical differences for Weibull modulus were observed. Failures started on the tensile stress surface. Thus, the test environment did not affect slow crack growth (SCG) mechanisms during static fatigue test of YSZ ceramics, but it plays a significant role for the static fatigue behavior of lithium disilicate-based glass ceramics, indicating a high susceptibility to SCG.

The aim of the study was to compare the outcomes for the fatigue mechanical behavior of bonded simplified lithium disilicate restorations, with and without an internal adjustment by grinding with diamond bur in running two fatigue tests: Staircase and Step-stress testing approaches. Ceramic discs (IPS e.max CAD) were prepared (Ø = 10 mm; thickness = 1.0 mm), submitted to an in-lab simulation of CAD/CAM milling (#60 SiC paper) and allocated into 2 groups according to the internal adjustment by grinding of the cementation surface: no adjustment (CTRL); or grinding with a coarse diamond bur (GR). Adhesive cementation (Multilink N) was performed onto epoxy resin discs (Ø = 10 mm; thickness = 2 mm) after ceramic/epoxy surface treatments. The cemented assemblies of each group were randomly assigned into 2 subgroups considering two fatigue tests (n = 15): Staircase - SC (250,000 cycles; 20 Hz), or Step-stress - SS (10,000 cycles per step; 20 Hz). Roughness, topographic and fractographic analyses were additionally performed. Statistical analyses were carried out using the Dixon and Mood method for Staircase data, and Kaplan-Meier and Mantel-Cox (log-rank) tests for Step-stress data. Ceramic restorations having its intaglio surface ground (GR group: SC test = 306.67 N; SS test = 646.67 N) presented lower fatigue failure load (FFL) values than the CTRL group (SC test = 879.28 N; SS test = 1090.00 N), regardless of the fatigue testing approach. The percentage of mean FFL decrease comparing the CTRL to GR group was higher for SC (65.1%) than the SS (40.7%) approach. However, a different total number of cycles was applied for each method. Both fatigue tests were able to detect the negative effect of internal adjustments of lithium disilicate glass-ceramic simplified restorations on their mechanical behavior. Therefore, both methods can be applied for similar evaluations (fatigue testing for ceramic restorations)., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This study evaluated the influence of occlusal resin cement space on the fatigue performance of bonded-leucite crowns to a dentin-analogue material. Leucite anatomical crowns were adhesively cemented to dentin-like preparations having distinct occlusal cement space (50, 100 and 300 μm) (n = 18), and subjected to step-stress fatigue testing (150 N - 350 N; step-size: 25 N; 20,000 cycles/step; 20 Hz). Fatigue data (load and number of cycles for failure) were analyzed using Kaplan-Meier and Mantel-Cox (log-rank) tests (p <0.05). Fractographic analysis and occlusal internal space measurements were also performed. There was no significant difference for the distinct occlusal cement layer (50 μm: 289 N, 136,111 cycles; 100 μm: 285 N, 132,778 cycles; 300 μm: 246 N, 101,667 cycles). Occlusal internal space analysis showed a mean thickness of 120.4 (50 μm), 174.9 (100 μm) and 337.2 (300 μm). All failures were radial cracks originating at the ceramic-cement interface. Distinct occlusal cement spaces had no effect on the fatigue behavior of anatomical leucite crowns., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This study evaluated the effects of diamond bur grinding the intaglio surface of second (yttria partially-stabilized zirconia polycrystals, PSZ) and third-generation zirconia (fully-stabilized zirconia polycrystals, FSZ) adhesively cemented to dentin analogue substrate on the fatigue failure load, cycle number until failure, surface micromorphology and phase transformation. Disc-shaped specimens were produced from second (Katana ML-HT, Kuraray) and third-generation zirconia (Katana STML, Kuraray) and randomly allocated (n = 15) into two groups according to the intaglio surface treatment: Control - Ctrl (without grinding); Grinding - Gr (grinding at the center of the intaglio surface). The ceramic discs were adhesively cemented (Multilink Automix System) onto dentin analogue discs. Fatigue tests were executed by the step-stress method. The obtained data were analyzed by Kaplan Meier and Mantel-Cox tests. In addition, surface topography, roughness, phase transformation and fractography analyses were performed. SEM analysis showed that grinding increased the surface roughness and introduced defects in zirconia from both generations. Grinding increased the fatigue failure load, number of cycles to failure and survival rates of the second-generation zirconia statistically (control: 1373.33 N < grinding: 1600 N), while these same outcomes were reduced by grinding for the third-generation zirconia significantly (control: 766.67 N > grinding: 620 N). Thus, clinical adjustments with diamond burs damage the fatigue behavior of adhesively cemented third-generation zirconia., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Considering the long time spent in low frequency cyclic fatigue tests, this study aimed to evaluate the influence of loading frequency (2 Hz and 20 Hz) on the flexural fatigue strength (FFS) and on the time and number of cycles to failure of a leucite-reinforced glass-ceramic. Disc-shaped specimens were produced using leucite-reinforced glass-ceramic CAD/CAM blocks (IPS Empress CAD), according to ISO 6872/2015. Two fatigue tests were performed. The FFS (n = 17) was determined by staircase approach at a lifetime of 500,000 cycles, for 2 Hz (control - chewing frequency estimative) and 20 Hz (accelerated approach). To determine the time and the number of cycles to failure in flexural fatigue, discs (n = 20) were submitted to a cyclic loading ranging from 10 MPa to 99 MPa (60% of the monotonic strength), until a maximum of 500,000 cycles. Means, standard deviation and confidence intervals (CI) at 95% for FFS were calculated, whereas statistical differences were detected based on maximum likelihood estimations and overlapping of 95% CIs. Kaplan Meier (α = 0.05) and log rank post-hoc tests were used to analyze the time (in minutes) and the number of cycles to failure in the lifetime test. FFS did not differ significantly between 2 Hz (mean: 78 MPa; 95% CI: 69-88 MPa) and 20 Hz (mean: 84 MPa; 95% CI: 78-90 MPa). Regarding the lifetime test, there was no difference (p = 0.3) in the time to failure for 2 Hz (mean: 13 min; 95% CI: 6-20 min) and 20 Hz (mean: 69 min; 95% CI: 9-128 min). However, the group tested with 20 Hz survived a significantly (p < 0.01) higher number of cycles (mean: 82,247 cycles; 95% CI: 11,450-153,044) than the group tested with 2 Hz (mean: 1588 cycles; 95% CI: 779-2397). Therefore, in leucite-reinforced glass-ceramic fatigue strength tests, limited to a lifetime of 500,000 cycles, the use of loading frequencies up to 20 Hz did not influence the FFS estimations when compared to 2 Hz (chewing frequency estimative), and may be an alternative to accelerate data collection in this type of mechanical test. However, in lifetime tests, the use of higher loading frequencies, as 20 Hz, did not save time, since a higher number of cycles was necessary to promote the failure, when compared to 2 Hz., Competing Interests: Declaration competing of interest No conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: A systematic review of in vitro studies was conducted to assess the effect of thermal treatments on flexural strength or critical load to failure of porcelain-veneered zirconia (PVZ)., Sources: Literature searches were performed up to June 2018 in PubMed/MEDLINE, Scopus and Web of Science databases, with no publication year or language limits., Data: From 393 relevant studies, 21 were selected for full-text analysis, from which 7 failed to meet the inclusion criteria. The 14 remaining papers were included in the systematic review: 8 for meta-analysis and 6 restricted to descriptive analyses. Hand searching of reference lists resulted in no additional papers., Study Selection: In vitro studies using PVZ specimens testing the influence of thermal treatments on the fracture resistance to monotonic or cyclic loading. Papers evaluating cooling rate were divided into those applying fast cooling from above the porcelain glass transition temperature (T g ), or from below it. Meta-analyses were performed separately for flexural strength and critical load to failure, using random effects at a 5% significance level., Conclusions: Delaying furnace opening at a temperature below the porcelain T g is advised for PVZ restorations, in order to improve their fracture resistance. Additional information is required to confirm the apparent beneficial effect of self-glaze and repeated veneer firings on the mechanical properties of these restorations. Finally, in order to obtain conclusive and relevant evidence regarding thermal treatments and the fracture resistance of PVZs, future studies should concentrate on anatomically-correct crown specimens., (Copyright © 2019 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: To compare file-splitting multilayer (fused and cemented) with monolithic Y-TZP on the fatigue flexural strength and finite element analysis (FEA) stresses. Additionally, to verify the effect of the material under tension in multilayer Y-TZP., Methods: Disc-shaped (diameter: 14.4mm; thickness: 1.4mm) monolithic Y-TZP (IPS e.max ZirCAD - Ivoclar Vivadent) and trilayer specimens with Y-TZP framework (IPS e.max ZirCAD), intermediate layer of fusion ceramic (IPS e.max CAD Crystall./Connect) or resin cement (Multilink Automix) and lithium disilicate veneer (IPS e.max CAD) were divided into five groups (n=20): monolithic Y-TZP (M), fused file-splitting with framework under tension (F-FT), cemented file-splitting with framework under tension (C-FT), fused file-splitting with veneer under tension (F-VT) and cemented file-splitting with veneer under tension (C-VT). Fatigue flexural strength was determined (piston-on-three ball) by the staircase approach (750,000 cycles; 20Hz). Mean and confidence intervals (CI) were calculated. FEA was evaluated under the application of the experimental mean fatigue load., Results: The fatigue strength was statistically different for all groups. Means and CI (MPa) were: M - 405.92 (CI 397.58-414.26), F-FT - 377.73 (CI 374.59-380.88), C-FT - 346.54 (CI 340.62-352.46), F-VT - 154.79 (CI 151.86-157.72) and C-VT - 100.34 (CI 97.42-103.26). FEA tensile stresses were similar to the mean experimental values (up to ≅10MPa of variation), with the most discrepant calculated stresses for C-FT (≅20MPa higher than experimental result)., Significance: Monolithic specimens showed the highest flexural fatigue strength and fused file-splitting resulted in higher fatigue strength than cemented file-splitting. Groups with the framework under tension exhibited higher flexural fatigue strength., (Copyright © 2019 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: It is unclear whether an extended glaze firing could improve the long-term mechanical performance of densely sintered CAD-CAM ceramics., Purpose: The purpose of this in vitro study was to analyze the effect of an extended glaze firing on the flexural fatigue strength (FFS) of densely sintered milled (hard-machined) leucite-based (LEU) and lithium disilicate-based (DIS) ceramics., Material and Methods: Disks were machined from ceramic blocks and divided into 6 groups (n=20) according to the material, LEU or DIS, and to the applied glaze firing: manufacturer-recommended glaze (G group), extended glaze (EG group), and control/no firing (C group). The surface roughness of the disks was measured before and after firing by using a contact profilometer, and data were compared by paired sample tests. Specimens were submitted to fatigue by using the staircase test design in water (piston-on-3 balls; 500 000 cycles, 20 Hz, and sinusoidal loading). Mean (±SD) FFS values were then calculated and analyzed by using 1-way analysis of variance and post hoc Tukey test (α=.05)., Results: Surface roughness did not change after the firing (P>.05). The highest FFS value in both ceramics was obtained after EG firing (LEU-EG=80.52 ±6.3 MPa; DIS-EG=147.25 ±10.5 MPa), which was statistically superior to G firing (LEU-G=73 ±6.8 MPa, P=.003; DIS-G=134.34 ±15.6 MPa; P=.023) and C group (LEU-C=61.94 ±6.3 MPa; P<.001; DIS-C=134.13 ±17.3 MPa; P=.023)., Conclusions: EG firing optimized the biaxial flexural fatigue strength of hard-machined leucite and lithium disilicate ceramics compared with conventional glaze firing., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate the effect of intaglio surface adjustment of simplified lithium disilicate ceramic restorations adhesively cemented to a dentin-like material on its fatigue behavior., Methods: Ceramic discs (IPS e.max CAD) were prepared and an in-Lab simulation of machining roughness was performed by grinding with SiC paper (#60). Ceramic discs were divided into 4 groups according to the internal adjustment of the cementation surface: no adjustments (CTRL); adjustment with a medium (M), fine (F), or extra fine (FF) diamond bur. Dentin-like material discs were also produced. Ceramic disc intaglio surfaces were etched (5% hydrofluoric acid; 20s) and received a silane coating. Dentin-like material discs were etched (10% hydrofluoric acid; 1min) and received a primer coating. Pairs of ceramic/dentin-like material were adhesively cemented (Multilink Automix), and fatigue failure load tests were performed using the Staircase approach (250,000 cycles; 20Hz). Roughness, topographic and fractographic analyses were performed. Statistical analyses were carried out through ANOVA tests., Results: All ground groups (M=521.3 N; F=536.9 N; FF=676.2 N) presented lower fatigue failure load values than the control (1241.6 N). M diamond bur created a rougher surface than F (Ra and Rz parameters). However, FF was similar to F and M for Ra, and similar to F for Rz., Significance: Bur adjustments on the intaglio surface of simplified lithium disilicate ceramic restorations greatly decreased the fatigue failure load even using an extra-fine diamond bur. Care should be taken when internal adjustments are needed., (Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Causes of failures of bilayer yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) restorations include the processing technique and the properties of the veneer ceramic. The effect of the veneering method on the mechanical behavior of veneered Y-TZP remains unclear., Purpose: The purpose of this systematic review was to assess the effect of the veneering method on the flexural strength and failure load of bilayer Y-TZP., Material and Methods: This study followed the Preferred Reporting Items for the Systematic Reviews and Meta-Analyses (PRISMA) statement. Searches were performed through August 2017 in PubMed/MEDLINE, Web of Science (Core Collection), Scopus, and Embase, with no year or language limit, targeting in vitro studies evaluating the effect of the veneering technique on the flexural strength and load-to-failure of bilayer Y-TZP immediately or after aging. Statistical analyses were conducted using an appropriate software. Comparisons were drawn with random effect models (α=.05)., Results: From 3242 identified studies, 241 were selected for full-text analysis; from these, 33 studies were included. Manual searching yielded no additional papers. The meta-analysis consisted of 32 studies. Meta-analysis was performed separately for flexural strength and failure load data to compare the hand-layered method (control) with pressed, fused, and cemented veneering techniques. The cemented and fused methods were analyzed using subgroups depending on the veneering material being examined (predominantly glass-ceramics and particle-filled glass-ceramics), and the results were compared with those of the hand-layered method. The pressed group presented flexural strength (7 studies) (P=.150) and failure load (19 studies) (P=.140) values that were similar to those of the hand-layered group. Subgroup analysis revealed that the fused group with particle-filled glass-ceramics (7 studies) produced higher load-to-failure (P=.006) values than the hand-layered group. Subgroup analyses showed a statistical difference that favored the hand-layered over the cemented method, with predominantly glass-ceramic materials (5 studies) (P=.002)., Conclusions: The fused technique with particle-filled glass-ceramics seems more appropriate for the veneering of Y-TZP, with improved failure load, than the hand-layered method with predominantly glass-ceramic materials. The use of predominantly glass-ceramics for the cemented method is not recommended as failure load was lower than for the hand-layered group. Pressed veneers showed failure load and flexural strength values similar to those of the the hand-layered technique., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: The color stability of luting agents influences the esthetics of ceramic laminate veneers. Clinical studies that have evaluated the color changes of veneers cemented to enamel with light- and dual-polymerizing resin cement are lacking., Purpose: The purpose of this split-mouth randomized clinical trial was to evaluate the color change and marginal discoloration of dual- and light-polymerizing cement used for cementation of ceramic laminate veneers., Material and Methods: In 10 participants, 0.3-mm-thick ceramic laminate veneers were cemented on the buccal surface of the second premolars without tooth preparation. A randomized application of light-polymerized cement was used on one side and a dual-polymerized cement on the contralateral side. The operator and participants were blinded to the activation mode. Color was evaluated by a blinded evaluator with a spectrophotometer at 24 hours and at 2, 6, 12, and 24 months after cementation. The CIELab (ΔE* ab ) and CIEDE2000 (ΔE* 00 ) formulas were used to quantify color alteration, and Δa*, Δb*, and ΔL* were calculated between the first and subsequent measurements. US Public Health Service guidelines were used to evaluate the marginal discoloration., Results: Wilcoxon tests did not show a statistical difference in ΔE* ab and ΔE* 00 between the groups (P>.05). At 24 months, the median ΔE* ab was 2.31 (interquartile ranges [IQR]: 3.34) for the light-polymerizing mode and 1.57 (IQR: 0.41) for the dual-polymerizing mode, while the median ΔE* 00 was 1.65 for the light-polymerizing mode (IQR: 2.34) and 1.18 for the dual-polymerizing mode (IQR: 0.25). The thresholds for clinically acceptable color changes ΔE* ab >3.46 and ΔE* 00 >2.25 were found for both curing modes. Marginal discoloration was observed from the 2-year assessment., Conclusions: The color stability of ceramic laminate veneers was similar for both of the polymerizing modes for all evaluated periods. Marginal discoloration increased over a 2-year period for both the light- and the dual-polymerizing modes., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: To assess the effect of machining on the flexural fatigue strength and on the surface roughness of different computer-aided design, computer-aided manufacturing (CAD/CAM) ceramics by comparing machined and polished after machining specimens., Methods: Disc-shaped specimens of yttria-stabilized polycrystalline tetragonal zirconia (Y-TZP), leucite-, and lithium disilicate-based glass ceramics were prepared by CAD/CAM machining, and divided into two groups: machining (M) and machining followed by polishing (MP). The surface roughness was measured and the flexural fatigue strength was evaluated by the step-test method (n=20). The initial load and the load increment for each ceramic material were based on a monotonic test (n=5). A maximum of 10,000 cycles was applied in each load step, at 1.4Hz. Weibull probability statistics was used for the analysis of the flexural fatigue strength, and Mann-Whitney test (α=5%) to compare roughness between the M and MP conditions., Results: Machining resulted in lower values of characteristic flexural fatigue strength than machining followed by polishing. The greatest reduction in flexural fatigue strength from MP to M was observed for Y-TZP (40%; M=536.48MPa; MP=894.50MPa), followed by lithium disilicate (33%; M=187.71MPa; MP=278.93MPa) and leucite (29%; M=72.61MPa; MP=102.55MPa). Significantly higher values of roughness (Ra) were observed for M compared to MP (leucite: M=1.59μm and MP=0.08μm; lithium disilicate: M=1.84μm and MP=0.13μm; Y-TZP: M=1.79μm and MP=0.18μm)., Significance: Machining negatively affected the flexural fatigue strength of CAD/CAM ceramics, indicating that machining of partially or fully sintered ceramics is deleterious to fatigue strength., (Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Considering the interest of the research community in the fatigue behavior of all-ceramic restorations and the time consumed in low-frequency cyclic fatigue tests, this study aimed to investigate the influence of the loading frequency on the zirconia fatigue strength. The biaxial flexural fatigue strength of Y-TZP discs was determined by the staircase approach after 500,000 cycles. The investigated frequencies were 2Hz (control-simulation of the chewing activity; n=20), 10Hz (n=20), 20Hz (n=20), and 40Hz (n=21). The fatigue strength data were analyzed using one-way ANOVA and post-hoc Tukey׳s test (α=0.05). Pearson coefficient (r) was calculated to assess the existence of a correlation between fatigue strength and loading frequency. X-ray diffraction analysis was used to determine the relative amount of monoclinic phase under each fatigue test condition. The fatigue strength was significantly higher for 40Hz group (630.7±62.1MPa) and did not differ among the groups 2Hz (550.3±89.7MPa), 10Hz (574.0±47MPa) and 20Hz (605.1±30.7MPa). Pearson correlation coefficient indicated a significantly moderate correlation (r=0.57) between fatigue strength and loading frequency. The percentage of monoclinic phase was similar among the groups. Therefore, the use of loading frequencies up to 20Hz seems a good alternative to expedite the cycling strength fatigue tests in polycrystalline ceramics without significantly changing the fatigue behavior showed by zirconia in tests employing the frequency of the masticatory cycle., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Purpose: To investigate the effects of a novel tribochemical silica coating technique with powders made from feldspathic ceramic and leucite-based ceramic on the bond strength of zirconia to resin cement before and after aging., Materials and Methods: Zirconia blocks were divided into 3 groups according to the material used for airborne-particle abrasion: 1) SP (control): silica-coated alumina particles; 2) FP: feldspathic ceramic powder; 3) LP: leucite glass-ceramic powder. After silanization, composite resin cylinders were cemented on the zirconia surface using a dual-curing resin cement. Prior to the shear bond strength (SBS) test, half of the samples (n = 15) were stored in distilled water for 24 h; the other half (n = 15) were submitted to aging (10,000 thermocycles of 5°C to 55°C; 150 days of water storage). The bond strength data were analyzed using two-way ANOVA and Tukey's test (α = 0.05). Scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), and x-ray diffraction analysis were performed., Results: The initial bond strengths did not differ significantly between the groups (p = 0.053). However, after aging procedures, airborne-particle abrasion with feldspathic ceramic powder (FP) resulted in higher values of bond strength (p = 0.0001). SEM and EDS indicated that all the treatments promoted silica deposition on the Y-TZP surface ceramic. Airborne-particle abrasion with FP and LP induced a lower percentage of the monoclinic phase., Conclusion: Airborne abrasion with fine feldspathic ceramic particles is a novel tribochemical technique and appears to be suitable for improving the bond strength between zirconia and resin cements.

Purpose: The purpose of the current study was to evaluate different approaches for bonding composite to the surface of yttria stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics., Methods: One hundred Y-TZP blocks were embedded in acrylic resin, had the free surface polished, and were randomly divided into 10 groups (n=10). The tested repair approaches included four surface treatments: tribochemical silica coating (TBS), methacryloxydecyldihidrogenphosphate (MDP)-containing primer/silane, sandblasting, and metal/zirconia primer. Alcohol cleaning was used as a "no treatment" control. Surface treatment was followed by the application (or lack thereof) of an MDP-containing resin cement liner. Subsequently, a composite resin was applied to the ceramic surface using a cylindrical mold (4-mm diameter). After aging for 60 days in water storage, including 6000 thermal cycles, the specimens were submitted to a shear test. Analysis of variance and the Tukey test were used for statistical analyses (α=0.05)., Results: Surface treatment was a statistically significant factor (F=85.42; p<0.0001). The application of the MDP-containing liner had no effect on bond strength (p=0.1017). TBS was the only treatment that had a significantly positive effect on bond strength after aging., Conclusion: Considering the evaluated approaches, TBS seems to be the best surface treatment for Y-TZP composite repairs. The use of an MDP-containing liner between the composite and Y-TZP surfaces is not effective.

Purpose: This study evaluated the adhesive quality of simplified self-adhesive and conventional resin cements to Y-TZP in dry and aged conditions., Methods: Y-TZP ceramic blocks (N = 192) (5 x 5 x 2 mm) were embedded in acrylic resin and randomly divided into two groups, based on surface conditioning: 96% isopropanol or chairside tribochemical silica coating and silanization. Conditioned ceramics were divided into four groups to receive the resin cements (Panavia F 2.0, Variolink II, RelyX U100 and Maxcem). After 24 hours, half of the specimens (n = 12) from each group were submitted to shear bond strength testing (0.5 mm/minute). The remaining specimens were tested after 90 days of water storage at 37 degrees C and thermocycling (12,000x, 5 degrees C-55 degrees C). Failure types were then assessed. The data were analyzed using three-way ANOVA and the Tukey's test (alpha = 0.05)., Results: Significant effects of ceramic conditioning, cement type and storage conditions were observed (p < 0.0001). The groups cleaned using alcohol only showed low bond strength values in dry conditions and the bond strength was reduced dramatically after aging. Groups conditioned using silica coating and silanization showed higher bond strengths both in dry and aged conditions. A high number of specimens failed prematurely prior to testing when they were cleaned using 96% isopropanol., Conclusion: Overall, silica coating and silanization showed higher, stable bond strengths with and without aging. The durability of resin-ceramic adhesion varied, depending on the adhesive cement type.

The aim of this study was to evaluate the influence of silica coating and 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based primer applications upon the bonding durability of a MDP-based resin cement to a yttrium stabilized tetragonal zirconia (Y-TZP) ceramic. Ninety-six Y-TZP tabs were embedded in an acrylic resin (free surface for adhesion: 5 × 5 mm(2)), ground finished and randomly divided into four groups (N = 24) according to the ceramic surface conditioning: (1) cleaning with isopropanol (ALC); (2) ALC + phosphoric acid etching + MDP-based primer application (MDP-primer); (3) silica coating + 3-methacryloyloxypropyl trimethoxysilane (MPS)-based coupling agent application (SiO2 + MPS-Sil); and (4) SiO2 + MDP-primer. The MDP-based resin cement was applied on the treated surface using a cylindrical mold (diameter= 3 mm). Half of the specimens from each surface conditioning were stored in distilled water (37 °C, 24 h) before testing. Another half of the specimens were stored (90 days) and thermo-cycled (12,000 x) during this period (90 d/TC) before testing. A shear bond strength (SBS) test was performed at a crosshead speed of 0.5 mm/min. Two factors composed the experimental design: ceramic conditioning strategy (in four levels) and storage condition (in two levels), totaling eight groups. After 90 d/TC (Tukey; p < 0.05), SiO2 + MDP-primer (24.40 MPa) promoted the highest SBS. The ALC and MDP-primer groups debonded spontaneously during 90 d/TC. Bonding values were higher and more stable in the SiO2 groups. The use of MDP-primer after silica coating increased the bond strength.

Purpose: The objective of the present study was to evaluate the behaviour of the wearers of removable dentures in relation to cleaning and maintaining the prosthesis., Materials and Methods: Two hundred and thirty-one people were interviewed, most of whom were females, over 60 years of age and participants in the Center for Integrated Study and Support to the Elderly., Results: After analysing the responses, it was verified that most people brush their dentures three times a day using dentifrice and only go to the clinician when they have a complaint. They do not receive follow-up appointments for checkups, do not use immersion cleaners for their dentures and do not remove their dentures during the night., Conclusions: It was concluded that the study sample did not receive proper orientation for the conservation of removable dentures, which may consequently reduce the useful life of dentures and cause social and functional problems.

This work evaluated two resin cements and a glass-ionomer cement and their bond strength to gold-palladium (Au-Pd), silver-palladium (Ag-Pd), and nickel-chromium-beryllium (Ni-Cr-Be) alloys, utilizing three surface treatments over a period of six months. Eight hundred ten pieces were cast (in a button shape flat surfaces) in one of three alloys. Each alloy group was assigned to three other groups, based on the surface treatment utilized. Specimens were fabricated by bonding similar buttons in using one of three adhesive cements. The 405 pairs were thermocycled and stored in saline solution (0.9% NaCl) at 37 degrees C. The tensile bond strengths were measured in a universal testing machine after storage times of 2, 90, or 180 days. The highest mean bond strength value was obtained with the base metal alloy (10.9 +/- 8.6 MPa). In terms of surface treatment, oxidation resulted in the highest mean bond strength (13.7 +/- 7.3 MPa), followed by sandblasting (10.3 +/- 5.5 MPa) and polishing (3.0 +/- 6.4 MPa). Panavia Ex (13.2 +/- 9.3 MPa) showed significantly higher bond strengths than the other two cements, although the storage time reduced all bond strengths significantly.