Effect of different aging methods on the mechanical behavior of multi-layered ceramic structures

OBJECTIVE

To evaluate the effect of two aging methods (mechanical cycling and autoclave) on the mechanical behavior of veneer and framework ceramic specimens with different configurations (monolithic, two and three-layers).

METHODS

Three ceramics used as framework for fixed dental prostheses (YZ-Vita In-Ceram YZ; IZ-Vita In-Ceram Zirconia; AL-Vita In-Ceram AL) and two veneering porcelains (VM7 and VM9) were studied. Bar-shaped specimens were produced in three different designs: monolithic, two layers (porcelain-framework) and three layers (porcelain-framework-porcelain). Specimens were tested for three-point flexural strength at 1MPa/s in 37°C artificial saliva. Three different experimental conditions were evaluated (n=10): control; mechanical cycling (2Hz, 37°C artificial saliva); and autoclave aging (134°C, 2 bars, 5h). Bi-layered specimens were tested in both conditions: with porcelain or framework ceramic under tension. Fracture surfaces were analyzed using stereomicroscope and scanning electron microscopy. Results were statistically analyzed using Kruskal-Wallis and Student-Newman-Keuls tests.

RESULTS

Only for AL group, mechanical cycling and autoclave aging significantly decreased the flexural strength values in comparison to the control (p<0.01). YZ, AL, VM7 and VM9 monolithic groups showed no strength degradation. For multi-layered specimens, when the porcelain layer was tested in tension (bi and tri-layers), the aging methods evaluated also had no effect on strength (p≥0.05). Total and partial failure modes were identified.

SIGNIFICANCE

Mechanical cycling and autoclave aging protocols had no effect on the flexural strength values and failure behavior of YZ and IZ ceramic structures. Yet, AL monolithic structures showed a significant decrease in flexural strength with any of the aging methods.

Effect of ceramic infrastructure on the failure behavior and stress distribution of fixed partial dentures

OBJECTIVES

The effect of the ceramic infrastructure (IS) on the failure behavior and stress distribution of fixed partial dentures (FPDs) was evaluated.

METHODS

Twenty FPDs with a connector cross-section of 16 mm(2) were produced for each IS and veneered with porcelain: (YZ) Vita In-Ceram YZ/Vita VM9 porcelain; (IZ) Vita In-Ceram Zirconia/Vita VM7 porcelain; (AL) Vita In-Ceram AL/Vita VM7 porcelain. Two experimental conditions were evaluated (n = 10). For control specimens, load was applied in the center of the pontic at 0.5 mm/min until failure, using a universal testing machine, in 37°C deionized water. For mechanical cycling (MC) specimens, FPDs were subjected to MC (2 Hz, 140 N, 10(6) cycles) and subsequently tested as described for the control group. For YZ, an extra group of 10 FPDs were built with a connector cross-section of 9 mm(2) and tested until failure. Fractography and FEA were performed. Data were analyzed by ANOVA and Tukey's test (α = 0.05).

RESULTS

YZ16 showed the greatest fracture load mean value, followed by YZ16-MC. Specimens from groups YZ9, IZ16, IZ16-MC, AL16 and AL16-MC showed no significant difference for the fracture load.

SIGNIFICANCE

The failure behavior and stress distribution of FPDs was influenced by the type of IS. AL and IZ FPDs showed similar fracture load values but different failure modes and stress distribution. YZ showed the best mechanical behavior and may be considered the material of choice to produce posterior FPDs as it was possible to obtain a good mechanical performance even with a smaller connector dimension (9 mm(2)).

Effect of elasticity on stress distribution in CAD/CAM dental crowns: Glass ceramic vs. polymer-matrix composite

OBJECTIVES

Further investigations are required to evaluate the mechanical behaviour of newly developed polymer-matrix composite (PMC) blocks for computer-aided design/computer-aided manufacturing (CAD/CAM) applications. The purpose of this study was to investigate the effect of elasticity on the stress distribution in dental crowns made of glass-ceramic and PMC materials using finite element (FE) analysis.

METHODS

Elastic constants of two materials were determined by ultrasonic pulse velocity using an acoustic thickness gauge. Three-dimensional solid models of a full-coverage dental crown on a first mandibular molar were generated based on X-ray micro-CT scanning images. A variety of load case-material property combinations were simulated and conducted using FE analysis. The first principal stress distribution in the crown and luting agent was plotted and analyzed.

RESULTS

The glass-ceramic crown had stress concentrations on the occlusal surface surrounding the area of loading and the cemented surface underneath the area of loading, while the PMC crown had only stress concentration on the occlusal surface. The PMC crown had lower maximum stress than the glass-ceramic crown in all load cases, but this difference was not substantial when the loading had a lateral component. Eccentric loading did not substantially increase the maximum stress in the prosthesis.

CONCLUSIONS

Both materials are resistant to fracture with physiological occlusal load. The PMC crown had lower maximum stress than the glass-ceramic crown, but the effect of a lateral loading component was more pronounced for a PMC crown than for a glass-ceramic crown.

CLINICAL SIGNIFICANCE

Knowledge of the stress distribution in dental crowns with low modulus of elasticity will aid clinicians in planning treatments that include such restorations.

Accuracy and precision of fractal dimension measured on model surfaces

OBJECTIVES

To develop a method, which is precise, accurate, and insensitive to the angle of inclination for determining the fractal dimensional increment (D*) of a surface.

METHODS

Brownian interpolation was used to generate simulated ceramic fracture surfaces having known D* values of 0.1, 0.2, 0.3, and 0.4 with 10 surfaces at each D* value. Each surface was inclined at four angles (0°, 3°, 5°, and 7°) from horizontal. The 160 (40×4) surfaces were analyzed by a variety of methods including Minkowski Cover (MC), Root Mean Square Roughness vs. Area (RMS), Kolmogorov Box (KB), Hurst Exponent (HE), Slit Island Box (SIB), and Slit Island Richardson (SIR). The coefficient of variation (CV) and mean error were used to identify the methods with best precision (lowest CV) and accuracy (lowest mean error), respectively, and three-way ANOVA followed by Turkey's HSD (α=0.05) was used to identify significant effects.

RESULTS

CV was significantly affected by fractal dimension (p=0.002) and method (p<0.001) but not by angle of inclination (p=0.765). The CV value for MC was lower than those for other methods (p≤0.05). Mean error was significantly affected by three-way interaction between fractal dimension, method, and angle of inclination (p<0.001). The mean error for KB was higher than those for other methods (p≤0.05) for inclined surfaces.

SIGNIFICANCE

MC was determined to have the best combination of precision, accuracy, and lack of sensitivity to angle of inclination for Brownian interpolation surfaces having D* values in the range commonly reported for ceramic fracture surfaces.

Evidence of yttrium silicate inclusions in YSZ-porcelain veneers

This report introduces the discovery of crystalline defects that can form in the porcelain veneering layer when in contact with yttria-stabilized zirconia (YSZ). The focus was on dental prostheses and understanding the defects that form in the YSZ/porcelain system; however the data reported herein may have broader implications toward the use and stability of YSZ-based ceramics in general. Specimens were cut from fully sintered YSZ plates and veneering porcelain was applied (<1 mm thick) to one surface and fired under manufacturer's recommended protocol. Scanning electron microscopy (SEM) with integrated electron dispersive X-ray (EDAX) was used for microstructural and elemental analysis. EDAX, for chemical analysis and transmission electron diffraction (TED) for structural analysis were both performed in the transmission electron microscope (TEM). Additionally, in order to spatially resolve Y-rich precipitates, micro-CT scans were conducted at varying depths within the porcelain veneer. Local EDAX (SEM) was performed in the regions of visible inclusions and showed significant increases in yttrium concentration. TEM specimens also showed apparent inclusions in the porcelain and selected area electron diffraction was performed on these regions and found the inclusions to be crystalline and identified as either yttrium-silicate (Y2 SiO5 ) or yttrium-disilicate (Y2 Si2 O7 ). Micro-CT data showed that yttrium-silicate precipitates were distributed throughout the thickness of the porcelain veneer. Future studies are needed to determine whether many of the premature failures associated with this materials system may be the result of crystalline flaws that form as a result of high temperature yttrium diffusion near the surfaces of YSZ.

Nanopore formation on the surface oxide of commercially pure titanium grade 4 using a pulsed anodization method in sulfuric acid

Titanium and its alloys form a thin amorphous protective surface oxide when exposed to an oxygen environment. The properties of this oxide layer are thought to be responsible for titanium and its alloys biocompatibility, chemical inertness, and corrosion resistance. Surface oxide crystallinity and pore size are regarded to be two of the more important properties in establishing successful osseointegration. Anodization is an electrochemical method of surface modification used for colorization marking and improved bioactivity on orthopedic and dental titanium implants. Research on titanium anodization using sulphuric acid has been reported in the literature as being primarily conducted in molarity levels 3 M and less using either galvanostatic or potentiostatic methods. A wide range of pore diameters ranging from a few nanometers up to 10 μm have been shown to form in sulfuric acid electrolytes using the potentiostatic and galvanostatic methods. Nano sized pores have been shown to be beneficial for bone cell attachment and proliferation. The purpose of the present research was to investigate oxide crystallinity and pore formation during titanium anodization using a pulsed DC waveform in a series of sulfuric acid electrolytes ranging from 0.5 to 12 M. Anodizing titanium in increasing sulfuric acid molarities showed a trend of increasing transformations of the amorphous natural forming oxide to the crystalline phases of anatase and rutile. The pulsed DC waveform was shown to produce pores with a size range from ≤0.01 to 1 μm(2). The pore size distributions produced may be beneficial for bone cell attachment and proliferation.

Fatigue loading and R-curve behavior of a dental glass-ceramic with multiple flaw distributions

OBJECTIVES

To determine the effects of surface finish and mechanical loading on the rising toughness curve (R-curve) behavior of a fluorapatite glass-ceramic (IPS e.max ZirPress) and to determine a statistical model for fitting fatigue lifetime data with multiple flaw distributions.

MATERIALS AND METHODS

Rectangular beam specimens were fabricated by pressing. Two groups of specimens (n=30) with polished (15 μm) or air abraded surface were tested under rapid monotonic loading in oil. Additional polished specimens were subjected to cyclic loading at 2 Hz (n=44) and 10 Hz (n=36). All fatigue tests were performed using a fully articulated four-point flexure fixture in 37°C water. Fractography was used to determine the critical flaw size and estimate fracture toughness. To prove the presence of R-curve behavior, non-linear regression was used. Forward stepwise regression was performed to determine the effects on fracture toughness of different variables, such as initial flaw type, critical flaw size, critical flaw eccentricity, cycling frequency, peak load, and number of cycles. Fatigue lifetime data were fit to an exclusive flaw model.

RESULTS

There was an increase in fracture toughness values with increasing critical flaw size for both loading methods (rapid monotonic loading and fatigue). The values for the fracture toughness ranged from 0.75 to 1.1 MPam(1/2) reaching a plateau at different critical flaw sizes based on loading method.

SIGNIFICANCE

Cyclic loading had a significant effect on the R-curve behavior. The fatigue lifetime distribution was dependent on the flaw distribution, and it fit well to an exclusive flaw model.

Three-dimensional finite element modelling of all-ceramic restorations based on micro-CT

OBJECTIVES

To describe and apply a method of modelling dental crowns and three-unit fixed partial dentures (FPD) for finite element analyses (FEA) from 3D images obtained using a micro-CT scanner.

METHODS

A crown and a three-unit fixed partial denture (FPD) made of a ceramic framework (Y-TZP) and veneered with porcelain (VM9) were scanned using an X-ray micro-CT scanner with a pixel size of 6.97 μm. Slice images from both structures were generated at each 0.034 mm and processed by an interactive image control system (Mimics). Different masks of abutments, framework and veneer were extracted using thresholding and region growing tools based on X-ray image brightness and contrast. 3D objects of each model were incorporated into non-manifold assembly and meshed simultaneously. Volume meshes were exported to the FEA software (ABAQUS), and the load-generated stress distribution was analyzed.

RESULTS

FEA models showed great shape resemblance with the structures. The use of non-manifold assembly ensured matching surfaces and coinciding nodes between different structural parts. For the crown model, tensile stresses were concentrated in the internal surface of the core, near to the applied load. For the FPD model, the highest tensile stresses were located in the framework, on the cervical area of connectors and pontic.

CONCLUSIONS

Valid 3D models of dental crown and FPD can be generated by combining micro-CT scanning and Mimics software, emphasizing its importance as design tool in dental research.

CLINICAL SIGNIFICANCE

The 3D FEA method described in this work is an important tool to predict the stress distribution, assisting on structural design of dental restorations.

Effect of the microstructure on the lifetime of dental ceramics

OBJECTIVES

To evaluate the effect of the microstructure on the Weibull and slow crack growth (SCG) parameters and on the lifetime of three ceramics used as framework materials for fixed partial dentures (FPDs) (YZ - Vita In-Ceram YZ; IZ - Vita In-Ceram Zirconia; AL - Vita In-Ceram AL) and of two veneering porcelains (VM7 and VM9).

METHODS

Bar-shaped specimens were fabricated according to the manufacturer's instructions. Specimens were tested in three-point flexure in 37°C artificial saliva. Weibull analysis (n=30) and a constant stress-rate test (n=10) were used to determine the Weibull modulus (m) and SCG coefficient (n), respectively. Microstructural and fractographic analyzes were performed using SEM. ANOVA and Tukey's test (α=0.05) were used to statistically analyze data obtained with both microstructural and fractographic analyzes.

RESULTS

YZ and AL presented high crystalline content and low porosity (0.1-0.2%). YZ had the highest characteristic strength (σ(0)) value (911MPa) followed by AL (488MPa) and IZ (423MPa). Lower σ(0) values were observed for the porcelains (68-75MPa). Except for IZ and VM7, m values were similar among the ceramic materials. Higher n values were found for YZ (76) and AL (72), followed by IZ (54) and the veneering materials (36-44). Lifetime predictions showed that YZ was the material with the best mechanical performance. The size of the critical flaw was similar among the framework materials (34-48μm) and among the porcelains (75-86μm).

SIGNIFICANCE

The microstructure influenced the mechanical and SCG behavior of the studied materials and, consequently, the lifetime predictions.

Fatigue testing of laser treated endosseous implants with an internal trilobe connection

This study investigated the effect of laser treatment on the fatigue resistance of a 3.5-mm diameter implant with an internal trilobe connection. Twenty two implants were embedded into acrylic resin blocks. Half the specimens were used as control group, and the other half were laser treated circumferentially around the 1.5-mm polished collar with argon shielding. Implants were fatigue tested using a step-stress accelerated lifetime test in a servo-hydraulic test machine. Despite the trend pointing towards higher fatigue resistance of laser treated specimens versus controls, step-stress analysis did not determine significant differences in the fatigue lifetimes.

Effects of stress rate and calculation method on subcritical crack growth parameters deduced from constant stress-rate flexural testing

OBJECTIVES

To more efficiently determine the subcritical crack growth (SCG) parameters of dental ceramics, the effects of stressing rate and choice of statistical regression model on estimates of SCG parameters were assessed.

METHODS

Two dental ceramic materials, a veneering material having a single critical flaw population (S) and a framework material having partially concurrent flaw populations (PC), were analyzed using constant stress-rate testing, or "dynamic fatigue", with a variety of testing protocols. For each material, 150 rectangular beam specimens were prepared and tested in four-point flexure according to ISO6872 and ASTM1368. A full-factorial study was conducted on the following factors: material, stress rate assumed vs. calculated, number of stress rates, and statistical regression method.

RESULTS

The proportion of specimens for which the statistical models over-estimated reliability was not significantly different based on regression method for Material S (P = 0.96, power = 94%) and was significantly different based on regression method for Material PC (P < 0.001). The standard method resulted in SCG parameters, n and l nB, of 35.9 and -11.1 MPa(2)s for Material S and 12.4 and 9.61 MPa(2)s for Material PC, respectively.

SIGNIFICANCE

The method of calculation that uses only the median strength value at each stress rate provided the most robust SCG parameter estimates. Using only two stress rates resulted in fatigue parameters comparable to those estimated using four stress rates having the same range. The stress rate of each specimen can be assumed to be the target stress rate with negligible difference in SCG parameter estimates.

Fatigue behavior in water of Y-TZP zirconia ceramics after abrasion with 30 μm silica-coated alumina particles

OBJECTIVE

The use of a 30 μm alumina-silica coated particle sand (CoJet™ Sand, 3M Espe), has shown to enhance the adhesion of resin cements to Y-TZP. The question is whether or not sandblasting 30 μm particles does negatively affect the fatigue limit (S-N curves) and the cumulative survival of Y-TZP ceramics.

METHOD

Four zirconia materials tested were: Zeno (ZW) (Wieland), Everest ZS (KV) (KaVo), Lava white (LV) and Lava colored (LVB) (3M Espe). Fatigue testing (S-N) was performed on 66bar of 3 mm × 5 mm × 40 mm with beveled edges for each zirconia material provided by the manufacturers. One half of the specimens were CoJet sandblasted in the middle of the tensile side on a surface of 5 mm × 6 mm. Cyclic fatigue (N=30/group) (sinusoidal loading/unloading at 10 Hz between 10% and 100% load) was performed in 3-point-bending in a water tank. Stress levels were lowered from the initial static value (average of N=3) until surviving 1 million cycles. Fatigue limits were determined from trend lines. Kaplan-Meier survival analysis was performed to determine the failure stress at the median percentile survival level for 1 million of cycles before and after sandblasting. The statistical analyses used the log-rank test. Characterization of the critical flaw was performed by SEM for the majority of the failed specimens.

RESULTS

The fatigue limits "as received" (ctr) were: LV=720 MPa, LVB=600 MPa, KV=560 MPa, ZW=470 MPa. The fatigue limits "after CoJet sandblasting" were: LV=840 MPa, LVB=788 MPa, KV=645 MPa, ZW=540 MPa. The increase in fatigue limit after sandblasting was 15% for Zeno (ZW) and Everest (KV), 17% for Lava (LV) and 31% for Lava colored (LVB). The KM median survival stresses in MPa were: ZW(ctr)=549 (543-555), ZW(s)=587 (545-629), KV(ctr)=593 (579-607), KV(s)=676 (655-697), LVB(ctr)=635 (578-692), LVB(s)=809 (787-831), LV(ctr)=743 (729-757), LV(s)=908 (840-976). Log-rank tests were significantly different (p<0.001) for all sandblasted groups vs. the "as received" except for Zeno (Wieland) (p=0.295). Failures started from both intrinsic and machined flaws.

SIGNIFICANCE

30 μm particle sandblasting did significantly improve the fatigue behavior of three out of four Y-TZP ceramic materials and can therefore be recommended for adhesive cementation procedures. This study was supported in part by grants from the Swiss Society for Reconstructive Dentistry (SSRD) and 3M Espe.

Analysis of subcritical crack growth in dental ceramics using fracture mechanics and fractography

OBJECTIVES

The aim of this study was to test the hypothesis that the flexural strengths and critical flaw sizes of dental ceramic specimens will be affected by the testing environment and stressing rate even though their fracture toughness values will remain the same.

METHODS

Ceramic specimens were prepared from an aluminous porcelain (Vitadur Alpha; VITA Zahnfabrik, Bad Säckingen, Germany) and an alumina-zirconia-glass composite (In-Ceram Zirconia; VITA Zahnfabrik). Three hundred uniaxial flexure specimens (150 of each material) were fabricated to dimensions of 25 mmx4 mmx1.2 mm according to the ISO 6872 standard. Each group of 30 specimens was fractured in water using one of four different target stressing rates ranging on a logarithmic scale from 0.1 to 100 MPa/s for Vitadur Alpha and from 0.01 to 10 MPa/s for In-Ceram Zirconia. The fifth group was tested in inert environment (oil) with a target stressing rate of 100 MPa/s for Vitadur Alpha and 1000 MPa/s for In-Ceram Zirconia. The effects of stressing rate and environment on flexural strength, critical flaw size, and fracture toughness were analyzed statistically by Kruskal-Wallis one-way ANOVA on ranks followed by post hoc comparisons using Dunn's test (alpha=0.05). In addition, 20 Vitadur Alpha specimens were fabricated with controlled flaws to simplify fractography. Half of these specimens were fracture tested in water and half in oil at a target stressing rate of 100 MPa/s, and the results were compared using Mann-Whitney rank sum tests (alpha=0.05). A logarithmic regression model was used to determine the fatigue parameters for each material.

RESULTS

For each ceramic composition, specimens tested in oil had significantly higher strength (P<or=0.05) and smaller critical flaw size (significant for Vitadur Alpha, P<or=0.05) than those tested in water but did not have significantly different fracture toughness (P>0.05). Specimens tested at faster stressing rates had significantly higher strength (P<or=0.05) but did not have significantly different fracture toughness (P>0.05). Regarding critical flaw size, stressing rate had a significant effect for In-Ceram Zirconia specimens (P<or=0.05) but not for Vitadur Alpha specimens (P>0.05). Fatigue parameters, n and lnB, were 38.4 and -12.7 for Vitadur Alpha and were 13.1 and 10.4 for In-Ceram Zirconia.

SIGNIFICANCE

Moisture assisted subcritical crack growth had a more deleterious effect on In-Ceram Zirconia core ceramic than on Vitadur Alpha porcelain. Fracture surface analysis identified fracture surface features that can potentially mislead investigators into misidentifying the critical flaw.

Recent advances in materials for all-ceramic restorations

The past 3 years of research on materials for all-ceramic veneers, inlays, onlays, single-unit crowns, and multi-unit restorations are reviewed in this article. The primary changes in the field were the proliferation of zirconia-based frameworks and computer-aided fabrication of prostheses, and a trend toward more clinically relevant in vitro test methods. This article includes an overview of ceramic fabrication methods, suggestions for critical assessment of material property data, and a summary of clinical longevity for prostheses constructed of various materials.

Comparative Analysis of Endodontic Pathfinders

Because no scientific literature exists regarding endodontic pathfinders, the aim of this study was to compare such instruments. Ten different pathfinder-type files were analyzed with respect to dimensional characteristics, pitch, and rigidity; efficiency, wear, and distortion were assessed by using an in vitro simulation exercise. SEM cross-sections and tip images were obtained and analyzed. To assess efficacy and distortion, 10 operators attempted to achieve patency with the files in small, S-shaped canals in acrylic blocks. Trends in canal negotiation efficiency and file distortion were recorded. Results showed that the Hi-5 (Miltex, York, PA) and C+ files (Dentsply/Maillefer, Johnson City, TN) were the least flexible, whereas the Pathfinder CS (SybronEndo, Glendora, CA) and Pathfinder SS (SybronEndo) files were the most. Pathfinder SS, S finder (JSDental/Sendoline, Ridgefield, CT), and D finder (Mani, Tochigi-ken, Japan) were the most efficient during the simulation exercise. Within the parameters of this study, pitch, taper, cross-section, heat tempering, metal type, tip geometry, and operator skills all influenced pathfinder efficiency.

Effect of abutment angulation on the strain on the bone around an implant in the anterior maxilla: A finite element study

STATEMENT OF PROBLEM

Angled abutments are often used to restore dental implants placed in the anterior maxilla due to esthetic or spatial needs. The effect of abutment angulation on bone strain is unknown.

PURPOSE

The purpose of the current study was to measure and compare the strain distribution on the bone around an implant in the anterior maxilla using 2 different abutments by means of finite element analysis.

MATERIAL AND METHODS

Two-dimensional finite element models were designed using software (ANSYS) for 2 situations: (1) an implant with a straight abutment in the anterior maxilla, and (2) an implant with an angled abutment in the anterior maxilla. The implant used was 4x13 mm (MicroThread). The maxillary bone was modeled as type 3 bone with a cortical layer thickness of 0.5 mm. Oblique loads of 178 N were applied on the cingulum area of both models. Seven consecutive iterations of mesh refinement were performed in each model to observe the convergence of the results.

RESULTS

The greatest strain was found on the cancellous bone, adjacent to the 3 most apical microthreads on the palatal side of the implant where tensile forces were created. The same strain distribution was observed around both the straight and angled abutments. After several iterations, the results converged to a value for the maximum first principal strain on the bone of both models, which was independent of element size. Most of the deformation occurred in the cancellous bone and ranged between 1000 and 3500 microstrain. Small areas of cancellous bone experienced strain above the physiologic limit (4000 microstrain).

CONCLUSIONS

The model predicted a 15% higher maximum bone strain for the straight abutment compared with the angled abutment. The results converged after several iterations of mesh refinement, which confirmed the lack of dependence of the maximum strain at the implant-bone interface on mesh density. Most of the strain produced on the cancellous and cortical bone was within the range that has been reported to increase bone mass and mineralization.

Influence of remaining coronal tooth structure location on the fracture resistance of restored endodontically treated anterior teeth

STATEMENT OF PROBLEM

A restored endodontically treated tooth is less likely to fracture when there is axial tooth structure between the core base and preparation finish line. However, an accurate prognosis requires knowing whether fracture resistance depends on a complete circumferential distribution of tooth structure or tooth structure in a specific location related to the applied force.

PURPOSE

This in vitro study investigated the fracture resistance of restored endodontically treated teeth when residual axial tooth structure was limited to one half the circumference of the crown preparation.

MATERIAL AND METHODS

Fifty extracted maxillary anterior teeth were sectioned 18 mm from their apices, endodontically treated, and divided into 5 groups of 10 teeth each. Four groups were prepared with full shoulder crown preparations having axial wall heights of 2 mm around the preparation circumferences. In 3 of the groups with axial tooth structure, one half of the axial tooth structure was removed, palatally, labially, or proximally, and groups were identified according to the site of retained coronal tooth structure. For the fifth group, all axial tooth structure was removed to the level of the preparation shoulder. Thus, in 1 group the axial walls were circumferential, 360 degrees around the preparations (Complete group), in 3 groups the axial walls were continuous for 180 degrees (Palatal, Labial, and Proximal groups), and the last group had no retained coronal tooth structure incisal to the finish line (Level group). All 50 prepared teeth were then restored with quartz fiber posts (Bisco), composite resin (Bisco) cores, and metal crowns. A universal testing machine compressively loaded the tooth specimens from the palatal at a crosshead speed of 0.5 cm/min at an angle of 135 degrees to the long axis of teeth until failure occurred. A survival analysis was conducted using a log-rank test followed by Holm-Sidak pairwise tests (alpha=.05) to detect significant differences in median failure load between groups. The mode of failure was determined by visual inspection of all specimens.

RESULTS

The median failure load (P<.001) was 607 N, 782 N, 358 N, 375 N, and 172 N for the Complete, Palatal, Labial, Proximal, and Level groups, respectively. The predominant mode of failure was an oblique palatal to facial root fracture for the groups with remaining coronal tooth structure. In the Level group, post debonding was the predominant mode of failure.

CONCLUSION

For restored endodontically treated teeth that do not have complete circumferential tooth structure between the core and preparation finish line, the location of the remaining coronal tooth structure may affect their fracture resistance.

Immediate Bonding to Bleached Enamel

When immediate bonding to bleached enamel is to be implemented, organic-solvent based adhesives are not capable of eliminating or reducing the adverse effect of bleaching systems on bond strength.

Resin bonding to sclerotic, noncarious, cervical lesions

Noncarious, cervical, wedge-shaped, sclerotic lesions are commonly encountered in clinical practice. In such lesions, dentin has been pathologically altered, often resulting in partial or complete obliteration of the dentinal tubules. These lesions are known to respond to etching and bonding differently from normal dentin, leading to complications during clinical treatment. A search of the literature was performed to obtain background information on the most commonly cited etiologic factors, clinical diagnoses, and morphologic and chemical characterizations along with an extensive review of all potential obstacles to bonding the most recent adhesives to such a dentinal substrate. Recent progress in adaptive strategies to render dentin more receptive to resin bonding is emphasized in this article, and the major drawbacks of these strategies are discussed.

Fracture resistance of three all-ceramic restorative systems for posterior applications

STATEMENT OF PROBLEM

The failure loads of all-ceramic crowns are influenced not only by the fracture resistance of the component materials but also by prosthesis geometry and size and location of flaws, thus there is a need for a study that compares the fracture resistance of all-ceramic systems using a simple and reproducible specimen geometry that includes flaws occurring at material interfaces.

PURPOSE

The research aim was to compare the in vitro fracture resistance and origin of failure of simulated first molar crowns fabricated using 3 all-ceramic systems, IPS Empress 2, Procera AllCeram, and In-Ceram Zirconia.

MATERIAL AND METHODS

Twenty axisymmetric crowns of each system were fabricated to fit a preparation with 1.5- to 2.0-mm occlusal reduction. The center of the occlusal surface on each of 15 specimens per ceramic system was axially loaded to fracture in a universal testing machine, and the maximum load (N) was recorded. Fractured surfaces were examined using optical and electron microscopy to determine the most prevalent origin of failure in each ceramic system. Five crowns per system were sectioned, and thickness of the luting agent, core material, and veneer porcelain layers were measured. The 95% confidence intervals of the Weibull modulus and characteristic failure load were compared between the 3 systems. Two-way multivariate analysis of variance was used to analyze the thickness of the luting agent, ceramic core, and veneer porcelain layers (alpha=.05).

RESULTS

The 95% confidence intervals for Weibull modulus were 1.8 to 2.3 (IPS Empress 2), 2.8 to 3.6 (Procera AllCeram), and 3.9 to 4.9 (In-Ceram Zirconia). The 95% confidence intervals for characteristic failure load were 771 to 1115 N (IPS Empress 2), 859 to 1086 N (Procera AllCeram), and 998 to 1183 (In-Ceram Zirconia). The origin of failure was most commonly found at the interface between the ceramic core and veneer porcelain for IPS Empress 2 and between the ceramic core and luting agent layer for the other systems.

CONCLUSIONS

There was no significant difference in fracture resistance; however, there was a significant difference in failure origin between the all-ceramic systems studied.

Effect of no ferrule on failure of teeth restored with bonded posts and cores

This study investigated how the absence of a ferrule affected the failure load of teeth that had been restored with bonded fiber posts and resin cores. There was a significant difference (p < 0.001) between the ferrule and nonferrule groups' load to failure. For the ferrule group, root fracture was the predominant mode of failure; in the nonferrule group, debonding failures were predominant.

Influence of powder/liquid mixing ratio on porosity and translucency of dental porcelains

STATEMENT OF PROBLEM

Dental technicians use a variety of techniques when condensing dental porcelains. It is unclear whether these techniques affect the total porosity and translucency of dental porcelains.

PURPOSE

The objective of this study was to determine whether varying the powder/liquid ratio during condensation affects porosity and translucency of porcelains. Material and methods Duceram LFC dentin, Duceram LFC incisal, IPS Eris dentin, and IPS Eris incisal porcelains were studied. For each specimen, 1.0 g of porcelain powder was mixed with 1 of 3 different volumes of deionized water to form a slurry with a thin, medium, or thick consistency. The slurries were condensed in a plastic syringe mold, fired, and polished to a 3-microm finish to form 12 groups of 4 specimens each (14-mm diameter, 1.10-mm thickness). The apparent density (g/mL) of each specimen was measured using Archimedes method, and the porosity (%) calculated. Each specimen was coupled to standard ceramic tiles using an immersion liquid, and the color shade was measured in CIE Yxy coordinates using a tristimulus colorimeter. Translucency was assessed by calculating the contrast ratio of shade value (Y) in front of black versus white backgrounds. Two-way analysis of variance and Tukey's multiple comparison tests (alpha = .05) were used to test for significant effects of factors.

RESULTS

Porcelain type and powder/liquid ratio had a significant interactive effect on the apparent density (P < .001) and on total porosity (P = .003); however, there was no consistent trend. The powder/liquid ratio did not significantly affect translucency (P = .28), but porcelain type had a significant effect on translucency (P < .001).

CONCLUSION

In this in vitro study, total porosity of specimens prepared using 4 porcelains was found to be sensitive to powder/liquid ratio; whereas translucency was found to be insensitive to powder/liquid ratio.

SEM/EDS evaluation of porcelain adherence to gold-coated cast titanium

The adhesion between titanium and dental porcelain is related to the diffusion of oxygen to the reaction layer formed on cast-titanium surfaces during porcelain firing. The diffusion of oxygen could be suppressed by coating the titanium surface with a thin gold layer. This study characterized the effects of gold coating on titanium-ceramic adhesion. ASTM grade II CP titanium was cast into a MgO-based investment (Selevest CB, Selec). The specimen surfaces were air abraded with 110-microm Al(2)O(3) particles. Gold coating was applied on titanium surfaces by three methods: gold-paste (Deck Gold NF, Degussa-Ney) coating and firing at 800 degrees C for three times, single gold-paste coating and firing followed by sputter coating (40 mA, 500 s), and sputter coating (40 mA, 1000 s). Surfaces only air abraded with Al(2)O(3) particles were used as controls. An ultra-low-fusing dental porcelain (Vita Titankeramik, Vident) was fused on titanium surfaces. Specimen surfaces were characterized by SEM/EDS and XRD. The titanium-ceramic adhesion was evaluated by a biaxial flexure test (N = 8), and area fraction of adherent porcelain (AFAP) was determined by EDS. Numerical results were statistically analyzed by one-way ANOVA and the Student-Newman-Keuls test at alpha = 0.05. SEM fractography showed a substantial amount of porcelains remaining on the gold-sputter-coated titanium surfaces. A new Au(2)Ti phase was found on gold-coated titanium surface after the firing. Significantly higher (p <.05) AFAP values were determined for the gold-sputter-coated specimens compared to the others. No significant differences were found among the other groups and the control. Results suggested that gold coatings used in this study are not effective barriers to completely protect titanium from oxidation during the porcelain firing, and porcelain adherence to cast titanium can be improved by gold-sputter coating used in the present study.