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The objective of this study was to assess the bonding performance of a new universal self-adhesive cement RelyX Unicem (RXU) to dentin and enamel compared to four currently used luting systems, using a shear bond strength test with and without thermocycling. Median bond strengths were determined after 24 h storage, and after thermocycling (6,000 cycles, 5-55 degrees C) for RXU and compared to Syntac/Variolink II (SynC/V) as a standard for luting conventional ceramics, ED-Primer II/Panavia F2.0 (EDII/PF2), Prime and Bond NT/Dyract Cem Plus (PBNT/DyCP), and a glass ionomer cement, Ketac Cem (KetC), as a standard for luting high-strength ceramic and metal-based restorations. Data (n=10 per group) were statistically analyzed using the Mann-Whitney-Wilcoxon test at the 0.05 level of significance. The bond strength (MPa) of RXU to dentin (10.8) was not statistically different from those of SynC/V (15.1), EDII/PF2 (10.5) or PBNT/DyCP (10.1), and statistically higher than KetC (4.1). The bond strength of RXU to enamel (14.5) was significantly lower than those of SynC/V (32.8), EDII/PF2 (23.6), and PBNT/DyCP (17.8), but higher than KetC (6.1). After thermocycling, the bond strength of RXU to enamel significantly decreased, but was still significantly higher than that of KetC. RelyX Unicem may be considered an alternative to Ketac Cem for high-strength ceramic or metal-based restorations, and may be used for luting conventional ceramic crowns with little or no enamel left.

This study retrospectively evaluated the clinical performance of 287 all-ceramic restorations placed during routine patient care in the University setting in the past 7 years. All patients (n = 106) with ceramic inlays or partial ceramic crowns (PCC), placed during 1988-1994 (n = 327) by five experienced dentists were asked to take part in a clinical investigation, and 92 patients with 287 restorations (232 inlays, 55 PCC) agreed to do so. The following ceramics were used: 44 (15.3%) Dicor (Dentsply), 126 (43.9%) IPS-Empress (Ivoclar), 82 (28.7%) Mirage II, 33 (11.5%) Cerec-Vita-Mark 1 (Vita), and 2 (0.7%) Duceram LFC (Ducera) restorations. The restorations were placed using the following luting composites: 73 (25.4%) Dual Cure Luting Cement (Optec), 81 (28.3%) Variolink high viscosity (Ivoclar), 32 (11.1%) Microfill Pontic C (Kulzer), 51 (17.8%) Dual Zement (Ivoclar), 40 (13.9%) Dicor Light Activated Cement (Dentsply), and 10 (3.5%) Vita Cerec Duo Cement (Vita). Restorations were evaluated according to the modified USPHS criteria. Kaplan-Meier analysis was used to calculate the probability of survival. Of the 287 restorations 270 (94.2%) were still in function without any need of intervention. Fourteen restorations (4.8%) had failed before starting the clinical investigation, and in three a fracture was found during the investigation. These 17 failed restorations consisted of 14 PCC and 3 ceramic inlays. The results of the clinical investigation revealed 59.2% Alpha-ratings for marginal adaptation. Only one restored tooth showed recurrent caries. The probability of survival (95% confidence interval) for 7 years was 98% (97.99-98.01%) for ceramic inlays and 56% (46-66%) for PCC. Our findings show that ceramic inlays can be regarded as an acceptable alternative to cast gold restorations within the methodological limitations of the present study. For PCC further experience with more recent ceramics is warranted.

Induced pluripotent stem cell (iPSC)-derived retinal pigment epithelium (RPE) has widely been appreciated as a promising tool to model human ocular disease emanating from primary RPE pathology. Here, we describe the successful reprogramming of adult human dermal fibroblasts to iPSCs and their differentiation to pure expandable RPE cells with structural and functional features characteristic for native RPE. Fibroblast cultures were established from skin biopsy material and subsequently reprogrammed following polycistronic lentiviral transduction with OCT4, SOX2, KLF4 and L-Myc. Fibroblast-derived iPSCs showed typical morphology, chromosomal integrity and a distinctive stem cell marker profile. Subsequent differentiation resulted in expandable pigmented hexagonal RPE cells. The cells revealed stable RNA expression of mature RPE markers RPE65, RLBP and BEST1. Immunolabelling verified localisation of BEST1 at the basolateral plasma membrane, and scanning electron microscopy showed typical microvilli at the apical side of iPSC-derived RPE cells. Transepithelial resistance was maintained at high levels during cell culture indicating functional formation of tight junctions. Secretion capacity was demonstrated for VEGF-A. Feeding of porcine photoreceptor outer segments revealed the proper ability of these cells for phagocytosis. IPSC-derived RPE cells largely maintained these properties after cryopreservation. Together, our study underlines that adult dermal fibroblasts can serve as a valuable resource for iPSC-derived RPE with characteristics highly reminiscent of true RPE cells. This will allow its broad application to establish cellular models for RPE-related human diseases.Electronic supplementary materialThe online version of this article (doi:10.1007/s12017-014-8308-8) contains supplementary material, which is available to authorized users.

Objectives A new universal adhesive with corresponding luting composite was recently marketed which can be used both, in a self-etch or in an etch-and-rinse mode. In this study, the clinical performance of partial ceramic crowns (PCCs) inserted with this adhesive and the corresponding luting material used in a self-etch or selective etch approach was compared with a self-adhesive universal luting material. Material and methods Three PCCs were placed in a splitmouth design in 50 patients. Two PCCs were luted with a combination of a universal adhesive/resin cement (Scotchbond Universal/RelyX Ultimate, 3M ESPE) with (SB+E)/without (SB−E) selective enamel etching. Another PCC was luted with a self-adhesive resin cement (RelyX Unicem 2, 3M ESPE). Forty-eight patients were evaluated clinically according to FDI criteria at baseline and 6, 12 and 18 months. For statistical analyses, the chi-square test (α = 0.05) and Kaplan-Meier analysis were applied. Results Clinically, no statistically significant differences between groups were detected over time. Within groups, clinically significant increase for criterion Bmarginal staining^was detected for SB−E over 18 months. Kaplan-Meier analysis revealed significantly higher retention rates for SB+E (97.8 %) and SB−E (95.6 %) in comparison to RXU2 (75.6 %). Conclusion The 18-month clinical performance of a new universal adhesive/composite combination showed no differences with respect to bonding strategy and may be recommended for luting PCCs. Longer-term evaluation is needed to confirm superiority of SB+E over SB−E. Clinical relevance At 18 months, the new multi-mode adhesive, Scotchbond Universal, showed clinically reliable results when used for luting PCCs.

SUMMARYThis in vitro study tested the effects of two different ceramic thicknesses, two preparation designs and two different luting agents on the marginal integrity and fracture resistance of partial ceramic crowns (PCC). Eighty extracted human molars were prepared according to the following preparation designs: a) Coverage of functional cusps/butt joint (n=40), b) Horizontal reduction of functional cusps (n=40). PCC (Vita Mark II, Cerec3 System) were fabricated and the ceramic thickness of the functional cusps was adjusted to 1): 0.5-1.0 mm and 2): 1.5-2.0 mm. PCC were adhesively luted to the cavities with either Excite/VariolinkII (VL) or RelyX Unicem (RX). The specimens were exposed to thermocycling and central mechanical loading (5000 x 5°C-55°C; 30 second/cycle; 50,0000 x 72.5N, 1.6Hz). For fracture resistance and the marginal integrity of adhesively bonded partial ceramic crowns (PCC), the choice of ceramic thickness and luting material are more important than preparation design. PCC fabricated from industrially sintered feldspathic ceramic should have at least a thickness of 1.5-2.0 mm in stress bearing areas. -test. Dye penetration data indicated that ceramic thickness and luting agent had a statistically significant influence upon marginal integrity in general, irrespective of all other parameters (ERM): RX showed significantly lower microleakage along the RL interface than VL. VL revealed significantly lower microleakage at the TL interface than RX. Fifteen PCC of group 1 (0.5-1.0 mm) and two PCC of group 2 (1.5-2.0 mm) were fractured after thermocycling and central mechanical loading, with the difference being statistically significant. PCC fabricated from industrially sintered feldspathic ceramic should have at least a thickness of 1.5-2.0 mm in stress-bearing areas.

The self-adhesive resin cement RXU can be used in conjunction with selective enamel etching, because survival rates of PCCs in the RXU + E group were not lower but, as a trend, even better than without enamel etching.