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9 protocols using variolink 2

1

Cementation and Fatigue Testing of FDPs

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FDPs were etched with 5% hydrofluoric acid (Fórmula e Ação Farmácia, São Paulo, Brazil) for 1 min, rinsed with water, and dried. Adhesive and optimizer agent were applied following the same steps aforementioned.
A dual-cured resin cement (Variolink II, Ivoclar Vivadent, Schaan, Liechtenstein) was poured and mixed as recommended by the manufacturer and applied to the intaglio surfaces of the FDPs, which were seated on the preparations. Each bridge was then held in position by a metal rod (26.45 oz) positioned in the center of the occlusal surface, excess cement was removed, and each abutment was light-activated for 40 s on the buccal, lingual, and occlusal surfaces by a LED curing light with a wavelength ranging from 440 to 480 nm (Radii-cal, SDI). Then, the cemented sets (Fig. 3A) were positioned in a rectangular metallic matrix, which was filled by polyurethane (F 16 and F 16 ISO, Axson Technologies, Eaton Rapids, MI, USA) until 1mm apart from the finishing line of preparations (Fig. 3B). This made possible an easily insertion of the polyurethane blocks on the device designed for mechanical testing (Fig. 3C). After the polyurethane was cured, the sets were stored in grade 3 distilled water for five days before the fatigue test.
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2

In-vitro Bonding Evaluation of Ceramic Crowns

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Prior to cementation, the fit of each crown was checked on the resin composite (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent) abutments using a black fit-checker (Fit Checker Black, GC Europe, Leuven, Belgium) under x20 magnification to identify any areas of friction. The cementation surfaces of the crowns were etched with hydrofluoric acid 5% (IPS Empress Gel, Ivoclar Vivadent) for 20 seconds. Silane coupling agent (Monobond Plus, Ivoclar Vivadent) was applied one coat and waited for its reaction for 5 minutes and then adhesive resin (Heliobond, Ivoclar Vivadent) was applied using a microbrush.
The abutments were air-abraded with alumina particles coated with silica (CoJet Sand, 3M ESPE, Seefeld, Germany) for 20 seconds (2.5 bar, distance: 10 mm). One coat of silane (Monobond Plus) was applied, allowed to react for 5 minutes and then adhesive resin (Heliobond) was applied. The crowns were cemented to their corresponding abutments with dual-polymerized resin cement (Variolink II, Ivoclar Vivadent) under a constant static load of 50 N. After the excess cement was removed, the specimens were polymerized with an LED polymerization device (Radii-Cal, SDI, Bayswater Victoria, USA) for 40 seconds at each direction from a distance of 2 mm (light intensity: 1.200 mw/cm 2 ). The specimens were then stored in distilled water at 37°C for 7 days prior to testing.
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3

Cementation of Crowns using Variolink II

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The crown intaglio surface was coated with Monobond Plus (IvoclarVivadent, Schaan, Liechtenstein), applied with a microbrush and left undisturbed for 5 min. Before cementation, the teeth were etched with 37% phosphoric acid for 15 s and washed thoroughly with water. Adper Scotchbond Multi-purpose adhesive (3M™ ESPE™) was then applied in two layers (primer and adhesive) by means of a microbrush and cured for 20 s. Cementation was performed with Variolink II (IvoclarVivadent), whose base and catalyst were applied in equal proportions. The cement was applied on the inner side walls of the crown, which was brought into position and kept under a constant load of 750 g. The assembly was cured for 40 s on the buccal, lingual and occlusal sides (total time, 120 s). The cemented crowns were stored in distilled water for 24 h prior to being fatigue-tested.
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4

Epoxy-Resin Abutment Surface Treatment

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The epoxy-resin abutments were treated with hydrofluoric acid (10% Condac Porcelana, FGM) for 1 min, rinsed, dried, and then coated with silane (RelyX™ Ceramic Primer, 3M ESPE). The intaglio surfaces of the restorations were first abraded with 30-μm silica-modified alumina particles (Rocatec Soft, 3M ESPE) and then coated with silane. Dual-cure resin cement was applied to the abutments (Variolink II, Ivoclar Vivadent AG), and the FDPs were placed under a load of 750 g. The excess cement was removed with a brush, and the assembly was photo-activated (Radii-Cal, SDI) for 40 s on the buccal, lingual, and occlusal surfaces of each abutment crown. After, the bottom part of abutments was embedded into polyurethane (F 16Polyol and F 16 ISO, Axson Technologies).
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5

Ceramic Crown Fabrication Techniques

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A typodont maxillary first premolar was prepared for an all-ceramic crown in accordance with the IPS I -Vivadent, Liechten-Y M y matched to dentine (Alpha die, Schütz GmbH). Three different crown fabrication techniques were used (n=20): (i) Manually applied wax spacer and pressed-crown; (ii) digitally scanned preparation, CAD-printed wax-pattern (D76PLUS, Solidscape Inc.) and pressed-crown; (iii) digitally scanned preparation and machined-crown (CEREC-inLab® v3.6 Sirona GmbH). Resin-based cement (Variolink-II®, Ivoclar-Vivadent, Liechtenstein) was employed with a standardised mechanised cementation technique to apply a controlled axial cementation pressure [Universal testing machine (Lloyd LRX®, Lloyd Materials Testing Inc)]. The samples were subjected to fatigue life testing with a cyclic impact load of 453N for 1.25x10 6 C 1Hz frequency until the point of fracture.
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6

Simplified Ceramic Bonding Technique

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Twenty ceramic samples were fabricated from IPS emax CAD® ceramic (Ivoclar Vivadent) and divided into two groups (G1 and G2) (n=10). The conventional technique was applied to G1 samples, and the simplified technique to G2 samples. A resin cement cylinder was bonded to each sample using ExcITE® adhesive (Ivoclar Vivadent) and Variolink II® luting agent (base and catalyzer) (Ivoclar Vivadent) ( Table 2). Afterwards, the samples were stored for 24 hours at 37º in a humid atmosphere. They then underwent shear bond strength testing in a Shimadzu® AGX 100 KN universal test machine. Statistical analysis of the data applied the Mann-Whitney non-parametric test (p <0.05).
Product compositions.
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7

Ceramic Systems and Resin Cements Evaluation

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Two ceramic systems -Feldspathic (Super Porcelain EX-3, Kuraray Noritake Dental Inc, Miyoshi Japan) and Lithium-disilicate pressed glass ceramic (Ivoclar-Vivadent, Schaan, Liechtenstein) -cemented with two A3 shade resin cements -Rely X ARC (3M ESPE, St. Paul, MN, USA) and Variolink II (Ivoclar-Vivadent) -were evaluated (Table 1). Ten disk-shaped ceramic specimens (1.5 mm thick and 10 mm diameter) were fabricated for each ceramic system and had their dimensions confirmed with a digital calliper (Mitutoyo Corp., Tokyo, Japan). Silicon carbide paper #320, #600, #1200 and #2000 was used to provide surface standardization. Glaze application and firing cycle were performed as recommended by the manufacturer. The specimens were ultrasonically cleaned using distilled water for 10 min. The disk-shaped ceramics were divided in four groups (n=5).
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8

Bonding Lithium Disilicate Truncated Cones

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The other 150 specimens (N = 15) were bonded (two truncated cones per bonding assembly) at the bases with a dual-cured resin cement (Variolink II; Ivoclar-Vivadent) (Fig. 1). The resin cement was light-cured for 40 sec using a light-emitting diode-type curing unit (Radii-Cal LED; SDI, Bayswater, Victoria, Australia).

Specimen dimensions. (a) Lithium disilicate truncated cone. (b) Hourglass-shaped specimen.

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9

Adhesive Cementation of Glass-Ceramic on Dentin

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The acrylic resin-embedded dentin specimens were conditioned and prepared for cementation following the manufacturer's recommendations. Each dentin surface was conditioned with 37% phosphoric acid for 15 s. This was followed by copious water-rinsing for 15 seconds. The surface was briefly blown-dry. ScotchBond Universal (3M ESPE) dentin adhesive was applied to the etched dentin for 20 s, dried for 10 s, and light-cured for 10 s using a light-emitting diode (LED) light-curing unit (Radii-Cal LED; SDI, Bayswater, Victoria, Australia) with an energy output of 800 mW/cm2.
Each glass-ceramic specimen was bonded to the adhesive-coated dentin using a dual-cured resin cement (Variolink II; Ivoclar-Vivadent, Schaan, Lichtenstein). The resin cement was light-cured for 40 s directly at the interface between the glass-ceramic and dentin specimens.
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