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RESULTS
The present in vitro study was conducted to comparatively evaluate the shear bond strength of the bond between ceramic and enamel pretreated with different etching methods.
Thirty three recently extracted central incisors were sectioned and mounted in acrylic using a custom-made stainless steel mounting jig. The teeth were prepared using a custom-made preparation guide limiting the depth of the preparation to the enamel. The teeth were divided into three groups, namely, Group A, Group B and Group C and subjected to three different surface treatments, namely, acid etching, laser etching and a combination of acid etching followed by laser etching respectively. One surface treated tooth from each test group was randomly selected for SEM analysis. A total of 30 pressed ceramic blocks were fabricated and bonded to the surface treated teeth. The test samples were subjected to aging and tested for shear bond strength in a universal testing machine until they debonded and the shear bond strength was calculated in MPa. The results obtained from this study were then subjected to statistical analysis. One debonded test sample from each test group was randomly selected for a qualitative assessment of the mode of failure by SEM analysis.
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Table I shows basic values and mean value of shear bond strength for Group A test samples (acid etching).
Table II shows basic values and mean value of shear bond strength for Group B test samples (laser etching).
Table III shows basic values and mean value of shear bond strength for Group C test samples (combination of acid etching followed by laser etching).
Table IV shows the comparison between mean shear bond strength values of Group A (acid etching), Group B (laser etching) and Group C (combination of acid etching followed by laser etching) test samples using One-way ANOVA.
Table V shows the comparison between mean shear bond strength values of Group A (acid etching) and Group B (laser etching) test samples using Tukey HSD.
Table VI shows the comparison between mean shear bond strength values of Group A (acid etching) and Group C (combination of acid etching followed by laser etching) test samples using Tukey HSD.
Table VII shows the comparison between mean shear bond strength values of Group B (laser etching) and Group C (combination of acid etching followed by laser etching) test samples using Tukey HSD.
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Graph I shows the basic values of shear bond strength of Group A test samples (acid etching).
Graph II shows the basic values of shear bond strength of Group B test samples (laser etching).
Graph III shows the basic values of shear bond strength of Group C test samples (combination of acid etching followed by laser etching).
Graph IV shows the comparison between mean values of shear bond strength values of Group A (acid etching), Group B (laser etching) and Group C (combination of acid etching followed by laser etching) test samples.
Graph V shows the comparison between mean values of shear bond strength values of Group A (acid etching) and Group B (laser etching) test samples.
Graph VI shows the comparison between mean values of shear bond strength values of Group A (acid etching) and Group C (combination of acid etching followed by laser etching) test samples.
Graph VII shows the comparison between mean values of shear bond strength values of Group B (laser etching) and Group C (combination of acid etching followed by laser etching) test samples.
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Table I:Basic values and mean value of shear bond strength for Group A (acid etching) test samples
Sample no. Shear Bond Strength
1 10.86 2 12.73 3 11.74 4 13.25 5 11.49 6 11.64 7 12.31 8 12.84 9 11.44 10 11.17 Mean 11.9470
Table II: Basic values and mean value of shear bond strength for Group B (laser etching) test samples
Sample No. Shear Bond Strength
1 7.87 2 13.26 3 12.77 4 11.81 5 13.11 6 13.83 7 14.72 8 12.68 9 13.26 10 14.33 Mean 12.7640
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Table III: Basic values and mean value of shear bond strength for Group C (combination of acid etching followed by laser etching)
test samples
Sample no. Shear Bond Strength
1 11.04 2 12.04 3 11.65 4 11.49 5 10.03 6 10.76 7 11.9 8 12.61 9 10.38 10 10.86 Mean 11.2760
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Table IV: Comparison between mean shear bond strength values of Group A (acid etching), Group B (laser etching) and Group C (combination of acid etching followed by laser etching) test samples using
One-way ANOVA
GROUP Number of samples
Mean Shear Bond Strength (MPa) Standard Deviation P–value A 10 11.9470 +/-0.79081 0.049* B 10 12.7640 +/-1.91180 C 10 11.2760 +/-0.80199
*P-value<0.05 denotes significance at the 5% level
Inference: On comparison between the mean shear bond strengths of Group A, Group B and Group C using One-way ANOVA it was found that there was a statistically significant difference between the mean shear bond strength of the three groups. Group B (laser etching) had the highest mean shear bond strength followed by Group A (acid etching) and the lowest shear bond strength value was observed in Group C (combination of acid etching followed by laser etching).
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Table V: Comparison of mean shear bond strength values of Group A (acid etching) and Group B (laser etching) test samples using Tukey
HSD test
GROUP Number of samples
Mean Shear Bond Strength (MPa) Standard Deviation P–value A 10 11.9470 +/-0.79081 0.342 B 10 12.7640 +/-1.91180 P-value > 0.05; insignificant
Inference: On comparison between the mean shear bond strengths of Group A and Group B it was found that Group B had exhibited a higher mean shear bond strength value compared to Group A. On statistical analysis using Tukey HSD, it was found that the p-value >0.05, denoting no statistically significant difference between these two groups.
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Table VI: Comparison of mean shear bond strength values of Group A (acid etching) and Group C (combination of acid etching followed by
laser etching) test samples using Tukey HSD test
GROUP Number of samples
Mean Shear Bond Strength (MPa) Standard Deviation P–value A 10 11.9470 +/-0.79081 0.480 C 10 11.2760 +/-.80119 P-value > 0.05; insignificant
Inference: On comparison between the mean shear bond strengths of Group A and Group C it was found that Group A had exhibited a higher mean shear bond strength value compared to Group C. On statistical analysis using Tukey HSD, it was found that the p-value >0.05, denoting no statistically significant difference between these two groups.
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Table VII: Comparison of mean shear bond strength values of Group B (laser etching) and Group C (combination of acid etching followed by
laser etching) test samples using Tukey HSD test
GROUP Number of samples
Mean Shear Bond Strength (MPa) Standard Deviation P–value B 10 12.7640 +/-1.91180 0.039* C 10 11.2760 +/-0.80119
*P-value < 0.05; significant at 5% level
Inference: On comparison between the mean shear bond strengths of Group B and Group C it was found that Group B had exhibited a higher mean shear bond strength value compared to Group C. On statistical analysis using Tukey HSD, it was found that the p-value <0.05, denoting a statistically significant difference between these two groups.
Qualitative analysis of surface topography of pretreated enamel surfaces
of Group A, Group B and Group C before bonding by scanning electron
microscope under 10x, 500x and 1000x magnifications
Group A inference :
The SEM photomicrograph of the Group A enamel sample, surface treated with 37% phosphoric acid shows a frosty appearance at a lower 10x magnification. Under 500x and 1000x magnifications it shows a uniformly microretentive surface with a clear presence of the key hole pattern of enamel. A random etching pattern of the enamel prisms corresponding to a type III pattern is visible: areas where the prism core is etched with the periphery intact (as indicated by the orange arrow) and areas where the core is intact and the peripheries are etched (as indicated by the blue arrow)
Fig.55 : Group A sample at 500x Fig.54 : Group A sample at 10x
Group B inference:
The SEM photomicrograph of the Group B enamel sample, etched with Er;Cr:YSGG laser at a lower magnification of 10x shows a pronounced irregular surface with ridge-like elevations. There is a smoother untouched area (as indicated by red arrow). Under 500x and 1000x magnifications the lased surface shows slot-type pattern of enamel ablation indicating selective ablation of the enamel prisms over the lased surface. There is a definite microretentive surface with the presence of elevations and depressions of varying degrees. There was no recrystallization of enamel observed.
Fig.57: Group B sample at 10x Fig.58: Group B sample at 500x
Group C inference:
The SEM photomicrograph of the Group C enamel sample, surface treated with 37% phosphoric acid followed by Er;Cr:YSGG laser revealed a similar surface topography as seen with the Group B enamel sample, but to a much lesser extent at 10x magnification. Under 500x and 1000x magnifications a heterogeneous topography was revealed, showing both acid induced porosities (as indicated by orange arrow) and laser induced surface roughness (as indicated by red arrow). The elevations and depressions induced by laser ablation are far less pronounced as compared to that of Group B sample.
Fig.62: Group C sample at 1000x
Qualitative analysis of the mode of failure of the debonded test samples of ceramic bonded to enamel of Group A, Group B and Group C by scanning electron microscope under 10x, 500x and 1000x magnifications
Group A Inference:
The SEM photomicrograph of the Group A sample at 10x magnification revealed a mixed failure pattern. There is a predominant cohesive failure within the cement and an adhesive pattern of failure between the enamel and cement. This can be clearly seen with the elevated cement layer (as indicated by red arrow) adjacent to the enamel layer at 500x and 1000x magnifications. The enamel layer shows the presence of prisms indicating areas of adhesive failure between enamel and the cement.
Fig.64 : Group A sample at 500x Fig.63 : Group A sample at 10x
Group B inference:
The SEM photomicrograph of the tested Group B sample at 10x
magnification reveals a predominantly cohesive mode of failure in the cement with few areas of adhesive failure. Higher magnifications of 500x and 1000x reveal the clear presence of the cement layer.
Fig.66: Group B sample at 10x Fig.67: Group B sample at 500x
Group C inference:
The SEM photomicrograph of the tested Group C sample at 10x magnification reveals a predominantly adhesive failure pattern. At 500x and 1000x magnifications the surface topography correlated with the pretreatment surface topography showing the heterogenous enamel surface with mixed areas of laser etched enamel and acid induced porosities without the presence of resin tags (as indicated by orange arrow).
Fig.71 : Group C sample at 1000x
Fig.70 : Group C sample at 500x Fig.69: Group C sample at 10x
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