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Surface pretreatment and cement influence on bond strength of three-dimensional printed permanent restorations
André Moreira1,2,3, Bruno Areias3,4, Sónia Simões3,4
1BoneLab, Faculty of Dental Medicine, University of Porto, Porto, Portugal.
Context:
Indirect permanent restorations re-establish strength, aesthetics, and function in compromised teeth. Three-dimensional (3D) printing has expanded to permanent restorations. Cementation and surface pretreatment critically influence adhesion and longevity, yet optimal protocols for 3D-printed restorations remain insufficiently established.
Aims:
Evaluate the influence of surface pretreatment, cement type, and their combined effects on tensile bond strength (TBS), surface topography, and roughness of a definitive 3D-printed resin.
Materials And Methods:
One hundred and eighty cubic specimens were 3D-printed with VarseoSmile Crown Plus. For surface pretreatment analysis, specimens were bonded with adhesive resin cement (ARC) after one of four protocols: No pretreatment (Control), Al2O3 airborne-particle abrasion (Air), diamond bur instrumentation (Bur), or polishing (Polished). Surface morphology and roughness parameters (Sq, Sp, Sv, Sz, and Sa) were characterized by digital microscopy and a scanning electron microscope. For cement type comparison, additional groups were prepared using Bur pretreatment combined with ARC, self-adhesive resin cement (SaRC), or resin-modified glass ionomer cement (RmGIC). All bonded pairs (n = 15 per group) underwent macro-tensile testing in a universal testing machine at a crosshead speed of 1 mm/min.
Statistical Analysis:
One-way ANOVA was conducted. Bonferroni post hoc testing was performed for pairwise comparisons, with a significance level set at α =0.05 for all tests.
Results:
TBS was significantly influenced by pretreatment (P < 0.001), with Bur producing the highest values and Polished the lowest (44.47 ± 37.24); no differences were observed among Control (180.53 ± 101.77), Air (155.92 ± 54.17), and Bur (238.87 ± 68.62). Surface analysis revealed significant differences only for Sv (P = 0.023), while Sq, Sp, Sz, and Sa remained comparable (P > 0.05). Cement type strongly affected TBS (P < 0.001), with ARC + silane achieving the highest values (238.87 ± 68.62), followed by SaRC (105.93 ± 20.70) and RmGIC (19.53 ± 18.61).
Conclusions:
Cement type influenced critically on the TBS of the 3D permanent restoration; ARC protocols incorporating silane offered superior outcomes. None of the surface pretreatment protocols enhanced significantly TBS, and minimally influenced surface roughness.
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