Short answer

When designing or specifying indirect composite restorations bonded with self-adhesive cements, prioritize the selection of the resin cement itself, as surface pre-treatments offer no discernible benefit.

Field: Final Production
Source: Journal of Clinical and Experimental Dentistry (2015)
Method: Experimental comparative study
Evidence: Moderate effect

Pre-treatment of indirect composite restorations with silane and adhesive does not significantly enhance bond strength when using self-adhesive resin cements. This final production research insight is drawn from a 2015 study published in Journal of Clinical and Experimental Dentistry. Using Experimental comparative study, researchers explored how this design variable affects real-world outcomes. The key design takeaway: When designing or specifying indirect composite restorations bonded with self-adhesive cements, prioritize the selection of the resin cement itself, as surface pre-treatments offer no discernible benefit.

Study

Final ProductionHigh ImpactModerate effect

Surface Treatment Inconsequential to Indirect Composite Bond Strength with Self-Adhesive Cements

Pre-treatment of indirect composite restorations with silane and adhesive does not significantly enhance bond strength when using self-adhesive resin cements.

Journal of Clinical and Experimental Dentistry · 2015

Key Findings

01Resin cement type significantly influenced bond strength.
02Neither composite surface treatment (silane/adhesive) nor its interaction with the cement type significantly affected dentin bond strength.
03All tested self-adhesive resin cements exhibited lower bond strength compared to the total-etch control cement.
04RelyX Unicem and G-Cem showed higher bond strength among the self-adhesive cements.
05Smartcem2 and Maxcem Elite experienced a high percentage of pre-test failures.

Application

Design takeaway

How to apply

When developing or selecting materials for indirect restorations, focus research and development efforts on optimizing the inherent properties of the resin cements rather than on complex surface preparation techniques for the composite.

Project actions

01When testing adhesives, consider testing different types of adhesives with a standardized substrate preparation.
02Ensure your testing method accurately reflects real-world application stresses.

Method & Evidence

AimTo evaluate the impact of different surface treatments on the microtensile bond strength between indirect composite restorations and dentin when using various self-adhesive resin cements.

MethodExperimental comparative study

ProcedureComposite overlays were prepared and subjected to either no surface treatment or silane application followed by an adhesive. These were then bonded to dentin using different self-adhesive resin cements and a control total-etch cement. Bond strength was measured using a microtensile test after 24 hours.

ContextDental restorative materials and procedures

Variables

IV["Surface treatment of composite overlay (none vs. silane + adhesive)","Type of resin cement (self-adhesive cements and one total-etch control)"]

DVMicrotensile bond strength

CV["Composite material type","Dentin substrate","Abrasion method for composite surface","Curing method for cements","Testing conditions (temperature, humidity)"]

Strengths & Limitations

Strengths

+Direct comparison of multiple self-adhesive cements.
+Inclusion of a standard total-etch control for benchmarking.

Limitations

This study used specific brands of materials. Results might differ with other products. Long-term wear and tear were not assessed.

Reliability & validity

The use of microtensile testing and statistical analysis (ANOVA, SNK) enhances the reliability and validity of the findings regarding bond strength differences. However, the study's validity might be limited by the specific materials chosen and the absence of long-term aging studies.

Think critically

If surface treatments don't improve bond strength, what other factors related to the composite overlay or the dentin substrate might be more influential?

Design Principles

"Material performance is often dictated by inherent properties rather than extrinsic modifications."

This finding challenges common assumptions in dental material selection and fabrication. Designers and manufacturers of dental prosthetics and restorative materials need to understand that complex surface treatments may not always yield improved performance, guiding more efficient and cost-effective production processes.

What This Means for Your Design

When sticking fake teeth (composites) back into a real tooth (dentin) using special glue (self-adhesive cement), how you prepare the fake tooth surface doesn't really make the glue stick better. What matters most is picking the right kind of glue.

How to use in your project

1.Reference this study when discussing the selection of bonding agents or the preparation of substrates for indirect restorations in your design project.

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Quick Cite

Paragraph starter

Research indicates that for indirect composite restorations bonded with self-adhesive resin cements, surface pre-treatments such as silane application do not significantly improve bond strength to dentin. The primary determinant of bond strength in such applications appears to be the selection of the resin cement itself, suggesting that design efforts should focus on optimizing cement properties rather than complex substrate preparation protocols.

Source

Journal of Clinical and Experimental Dentistry

Effect of indirect composite treatment microtensile bond strength of self-adhesive resin cements

journal · 2015

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Questions About This Research

What does the research say about surface treatment inconsequential to indirect composite bond strength with self-adhesive cements?: When designing or specifying indirect composite restorations bonded with self-adhesive cements, prioritize the selection of the resin cement itself, as surface pre-treatments offer no discernible benefit. Evidence: Journal of Clinical and Experimental Dentistry (2015).
Why does "Surface Treatment Inconsequential to Indirect Composite Bond Strength with Self-Adhesive Cements" matter for design?: This finding challenges common assumptions in dental material selection and fabrication. Designers and manufacturers of dental prosthetics and restorative materials need to understand that complex surface treatments may not always yield improved performance, guiding more efficient and cost-effective production processes.
How can designers apply this research?: When designing or specifying indirect composite restorations bonded with self-adhesive cements, prioritize the selection of the resin cement itself, as surface pre-treatments offer no discernible benefit.
What were the main findings?: Resin cement type significantly influenced bond strength.. Neither composite surface treatment (silane/adhesive) nor its interaction with the cement type significantly affected dentin bond strength.. All tested self-adhesive resin cements exhibited lower bond strength compared to the total-etch control cement.. RelyX Unicem and G-Cem showed higher bond strength among the self-adhesive cements.
What research method was used?: Experimental comparative study.
How strong is the evidence?: Evidence strength is rated Moderate effect, based on a 2015 journal from Journal of Clinical and Experimental Dentistry.
What should I do differently in my next project?: When developing or selecting materials for indirect restorations, focus research and development efforts on optimizing the inherent properties of the resin cements rather than on complex surface preparation techniques for the composite.
What are the limitations?: The study focused on specific materials and a single type of pre-treatment; results may vary with different composites, cements, or surface preparation methods. The study did not assess long-term durability.