Effectiveness of Self-Adhesive Resin Luting Cement in CAD-CAM Blocks—A Systematic Review and Meta-Analysis

Abstract

Self-adhesive resin cements (SARCs) are used because of their mechanical properties, ease of cementation protocols, and lack of requirements for acid conditioning or adhesive systems. SARCs are generally dual-cured, photoactivated, and self-cured, with a slight increase in acidic pH, allowing self-adhesiveness and increasing resistance to hydrolysis. This systematic review assessed the adhesive strength of SARC systems luted to different substrates and computer-aided design and manufacturing (CAD/CAM) ceramic blocks. The PubMed/MedLine and Science Direct databases were searched using the Boolean formula [((dental or tooth) AND (self-adhesive) AND (luting or cement) AND CAD-CAM) NOT (endodontics or implants)]. Of the 199 articles obtained, 31 were selected for the quality assessment. Lava Ultimate (resin matrix filled with nanoceramic) and Vita Enamic (polymer-infiltrated ceramic) blocks were the most tested. Rely X Unicem 2 was the most tested resin cement, followed by Rely X Unicem > Ultimate > U200, and μTBS was the test most used. The meta-analysis confirmed the substrate-dependent adhesive strength of SARCs, with significant differences between them and between SARCs and conventional resin-based adhesive cement (α < 0.05). SARCs are promising. However, one must be aware of the differences in the adhesive strengths. An appropriate combination of materials must be considered to improve the durability and stability of restorations.

Influence of different immediate dentin sealing strategies on bond strength of indirect resin nanoceramic restorations

“…The highest shear bond strength was observed in the single visit approach group. Supporting this finding, a systematic review by Calheiros-Lobo et al [18] concluded that immediate dentin sealing enhanced the bond strength of dentin to CAD/CAM ceramics, and single-visit approaches generated better bond strength than multiple visits, which was also confirmed in previous studies [43,44]. In addition, Burtscher et al [45] demonstrated that co-polymerization between sealed dentin and luting resin is highly productdependent on the rate of free radical extinction; therefore, a long provisional interval may have an adverse effect on the interface's durability and quality.…”

“…The nanoceramic materials selected in this study are resistant to cracking and chipping, less brittle, easy finishing, and polishing [40], and can be milled without sintering. The CAD/CAM technology was used to mill the samples, aiming for a standardized protocol and high-quality materials [18]. Successful bonding of an indirect restoration to a tooth requires a complex adhesive joint with two interfaces: the dentin-resin cement and the resin cement-indirect restoration interfaces.…”

“…Currently, the computer-aided design/computer-aided manufacturing (CAD/CAM) technique is increasingly used in dentistry. Because of the widespread adoption of digital technology involving image-capturing scanner equipment, software, and integrated CAD/CAM systems, CAD/CAM material rehabilitation has become a frequent dental procedure [18]. There are various CAD/CAM restorative materials; ceramics, composite resins, and hybrid materials are available for clinicians to produce high-quality indirect restorations [19,20].…”

A Polymer-Infiltrated Ceramic as Base Adherent in an Experimental Specimen Model to Test the Shear Bond Strength of CAD-CAM Monolithic Ceramics Used in Resin-Bonded Dental Bridges

“…The interface between the cement and dental tissue is essential, and the connection between the cement and the surface of the restorative material also plays a crucial role [3,34,35]. This process involves adhesion and cohesion [35][36][37], the first between substrates and the second within each substrate. CAD-CAM restorative materials require a multistep bonding procedure, and the specific bonding strategy for each material is determined based on its composition [1,3,20,38,39].…”

Shear Bond Strength of Simulated Single-Retainer Resin-Bonded Bridges Made of Four CAD/CAM Materials for Maxillary Lateral Incisor Agenesis Rehabilitation

“…Delivered precrystallized, it is an interesting material for anterior RBBs because of its aesthetics, biocompatibility, mechanical properties, and more straightforward adhesive protocol. 13,14,23 Clinical data remain scarce, often controversial, and limited to short-term observational periods. 24,25 Medical ABS (acrylonitrile butadiene styrene; Smart Materials 3D, Jaén, Spain; ISO 10993-1) is a lightweight bisphenol A (BPA) free thermoplastic polymer that attains tensile strengths ranging from 15 to 38 MPa with an elastic modulus of 1,300 to 1,800 MPa.…”