Bond integrity and microleakage of dentin-bonded crowns cemented with bioactive cement in comparison to resin cements: in vitro study

Objective: The aim was to compare restorative marginal integrity of ceramic crowns luted with bioactive and resin cements using micro-computed tomography (micro-CT) microleakage evaluations and bond strength assessment. Methods: Thirty molar teeth were prepared by sectioning and polishing for dentin exposure for resin cement build-ups. Teeth were randomly divided among three groups of cements: (1) bioactive (ACTIVA); (2) glass ionomer cement (GIC; Ketac Cem); and (3) resin luting agent (Nexus 3). Bonding regime and build-ups (4 mm × 2 mm) were performed using the recommended protocol. For microleakage assessment, 30 premolar teeth were prepared for dentin-bonded crowns using lithium disilicate ceramic and the computer-aided design and computer-aided manufacturing technique. Crowns were cemented with standard load, cement amount, and duration using three cements (Group A: bioactive; Group B: GIC; Group C: resin) and photopolymerized. Cemented crowns were evaluated for volumetric infiltration using micro-CT (Skyscan, Bruker 1173- at 86 kV, 93 µA, 620 ms) after immersion in 50% solution of silver nitrate (AgNO3) (24 hours). Shear bond strength (SBS) was assessed by fracture of cement build-ups at a cross-head speed of 0.5 mm/min in a universal testing machine. Results: Mean SBS among bioactive (21.54 ± 3.834 MPa) specimens was significantly higher than that for GIC (14.08 ± 3.25 MPa) specimens (p < 0.01), but they were comparable to resin samples (p > 0.05) (24.73 ± 4.32 MPa). Microleakage was significantly lower in crowns luted with bioactive (0.381 ± 0.134) cement compared to GIC (1.057 ± 0.399 mm3) (p < 0.01) and resin (0.734 ± 0.166 mm3) (p = 0.014) cemented crowns. The type of luting agent had a significant influence on the microleakage of crowns and bond strength to dentin (p < 0.05). Conclusion: Bioactive cement exhibited less microleakage and comparable SBS to resin luting agents in in vitro conditions.