Peumans Marleen, Valjakova Emilija Bajraktarova, De Munck Jan, Mishevska Cece Bajraktarova, Van Meerbeek Bart
J Adhes Dent. 2016;18(4):289-302. doi: 10.3290/j.jad.a36155.
To evaluate the influence of different surface treatments of six novel CAD/CAM materials on the bonding effectiveness of two luting composites.
Six different CAD/CAM materials were tested: four ceramics - Vita Mark II; IPS Empress CAD and IPS e.max CAD; Celtra Duo - one hybrid ceramic, Vita Enamic, and one composite CAD/CAM block, Lava Ultimate. A total of 60 blocks (10 per material) received various mechanical surface treatments: 1. 600-grit SiC paper; 2. sandblasting with 30-μm Al2O3; 3. tribochemical silica coating (CoJet). Subsequent chemical surface treatments involved either no further treatment (control), HF acid etching (HF), silanization (S, or HF acid etching followed by silanization (HF+S). Two specimens with the same surface treatment were bonded together using two dual-curing luting composites: Clearfil Esthetic Cement (self-etching) or Panavia SA Cement (self-adhesive). After 1 week of water storage, the microtensile bond strength of the sectioned microspecimens was measured and the failure mode was evaluated.
The bonding performance of the six CAD/CAM materials was significantly influenced by surface treatment (linear mixed models, p < 0.05). The luting cement had a significant influence on bond strength for Celtra Duo and Lava Ultimate (linear mixed models, p < 0.05). Mechanical surface treatment significantly influenced the bond strength for Celtra Duo (p = 0.0117), IPS e.max CAD (p = 0.0115), and Lava Ultimate (p < 0.0001). Different chemical surface treatments resulted in the highest bond strengths for the six CAD/CAM materials: Vita Mark II and IPS Empress CAD: S, HF+S; Celtra Duo: HF, HF+S; IPS e.max CAD: HF+S; Vita Enamic: HF+S, S. For Lava Ultimate, the highest bond strengths were obtained with HF, S, HF+S. Failure analysis showed a relation between bond strength and failure type: more mixed failures were observed with higher bond strengths. Mainly adhesive failures were noticed if no further surface treatment was done. The percentage of adhesive failures was higher for CAD/CAM materials with higher flexural strength (Celtra Duo, IPS e.max CAD, and Lava Ultimate).
The bond strength of luting composites to novel CAD/CAM materials is influenced by surface treatment. For each luting composite, an adhesive cementation protocol can be specified in order to obtain the highest bond to the individual CAD/CAM materials.
评估六种新型CAD/CAM材料的不同表面处理对两种粘接性树脂水门汀粘接效果的影响。
测试了六种不同的CAD/CAM材料：四种陶瓷——Vita Mark II、IPS Empress CAD和IPS e.max CAD；一种混合陶瓷Celtra Duo、Vita Enamic以及一种复合CAD/CAM块体Lava Ultimate。总共60个块体（每种材料10个）接受了各种机械表面处理：1. 600目碳化硅砂纸打磨；2. 用30μm氧化铝喷砂；3. 摩擦化学硅涂层（CoJet）。随后的化学表面处理包括不做进一步处理（对照）、氢氟酸蚀刻（HF）、硅烷化处理（S）或氢氟酸蚀刻后进行硅烷化处理（HF+S）。使用两种双固化粘接性树脂水门汀将两个经过相同表面处理的试件粘接在一起：Clearfil Esthetic Cement（自酸蚀型）或Panavia SA Cement（自粘接型）。在水储存1周后，测量切片微观试件的微拉伸粘接强度并评估失效模式。
六种CAD/CAM材料的粘接性能受表面处理的显著影响（线性混合模型，p<0.05）。对于Celtra Duo和Lava Ultimate，粘接性树脂水门汀对粘接强度有显著影响（线性混合模型，p<0.05）。机械表面处理对Celtra Duo（p=0.0117）、IPS e.max CAD（p=0.0115）和Lava Ultimate（p<0.0001）的粘接强度有显著影响。不同的化学表面处理使六种CAD/CAM材料获得了最高的粘接强度：Vita Mark II和IPS Empress CAD：S、HF+S；Celtra Duo：HF、HF+S；IPS e.max CAD：HF+S；Vita Enamic：HF+S、S。对于Lava Ultimate，HF、S、HF+S处理获得了最高粘接强度。失效分析表明粘接强度与失效类型之间存在关联：粘接强度越高，观察到的混合失效越多。如果不做进一步表面处理，主要观察到粘接失效。对于具有较高弯曲强度的CAD/CAM材料（Celtra Duo、IPS e.max CAD和Lava Ultimate），粘接失效的百分比更高。
粘接性树脂水门汀与新型CAD/CAM材料的粘接强度受表面处理影响。对于每种粘接性树脂水门汀，可以指定一种粘接固位方案，以便与每种CAD/CAM材料获得最高粘接强度。
