51
|
Horsch L, Kronsteiner D, Rammelsberg P. Survival and complications of implant-supported cantilever fixed dental prostheses with zirconia and metal frameworks: A retrospective cohort study. Clin Implant Dent Relat Res 2022; 24:621-629. [PMID: 35924816 DOI: 10.1111/cid.13125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 06/21/2022] [Accepted: 07/06/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Current evidence about long-term survival of all-ceramic implant-supported cantilever fixed dental prostheses (cFDP) is limited. PURPOSE To evaluate the survival and complication rates of all-ceramic and metal-ceramic implant-supported cFDPs located in anterior and posterior sites, under consideration of risk factors. METHODS OF STUDY The retrospective analysis compared an experimental group (75 implant-supported cFDPs among 48 patients [mean age 60.47 ± 9.25 years; 21 men]; mean observation period 3.56 years) with a control group (300 implant-supported non-cantilever FDPs [ncFDP] among 241 patients [mean age 62.85 ± 10.72 years; 109 men]; mean observation period 7.25 years). Kaplan-Meier estimates were used to describe the long-term survival and success of both groups. Log-rank tests were used for group comparisons. Mixed-effects Cox proportional hazards regression models were used to examine the effects of restoration- and site-specific risk factors. A random intercept was included in the models to take multiple FDPs per patient into account. RESULTS Five-year cumulative survival until loss of restoration was 97.1% (95% confidence interval [CI] 0.93-1.00) for cFDPs and 97.0% (95% CI 0.95-0.99) for ncFDPs. Ten-year survival was 93.7% (95% CI 0.86-1.00) for cFDPs and 92.8% (95% CI 0.87-0.98) for ncFDPs, no difference between the survival curves of these groups was observed. Success differed between cFDPs and ncFDPs (pLog = 0.002), zirconia and metal frameworks (pLog < 0.001), and provisional and definitive cements (pLog = 0.025). The effects of the variables "framework material" and "attachment method" were confirmed in a mixed-effects Cox regression model. Loss of retention was the predominant complication for both cFDPs and ncFDPs and usually affected provisionally cemented FDPs. CONCLUSIONS cFDPs do not differ from ncFDPs with regard to long-term failure, whereas additional complications were higher for cFDPs. Fewer complications were observed for zirconia frameworks without occlusal veneers and definitive cemented FDPs. CLINICAL TRIAL REGISTRATION the trial has no registration number because it commenced before January 31, 2017.
Collapse
Affiliation(s)
- Laura Horsch
- Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Dorothea Kronsteiner
- Institute of Medical Biometry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
52
|
Hatanaka A, Sawada T, Sen K, Saito T, Sasaki K, Someya T, Hattori M, Takemoto S. Wear Behavior between Aesthetic Restorative Materials and Bovine Tooth Enamel. MATERIALS 2022; 15:ma15155234. [PMID: 35955169 PMCID: PMC9369959 DOI: 10.3390/ma15155234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/14/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023]
Abstract
Tooth enamel wear occurs because of daily mastication and occlusion. This study investigated the wear behavior of bovine teeth against aesthetic restorative materials in vitro. Abrader specimens were fabricated using four tooth-colored restorative materials (zirconia, lithium disilicate glass ceramic, dental porcelain, and resin composite), with bovine tooth enamel as a control. Flattened bovine tooth enamel was used as the substrate specimen. These materials were characterized by Vickers hardness tests and surface roughness measurements. Two-body wear tests between the abrader and substrate specimens were performed, and the worn topographies were evaluated using a contour-measuring instrument and 3D laser microscope. The restorative materials and bovine tooth enamel had similar surface roughness but different hardness and wear behaviors. Bovine teeth showed the largest wear in tooth–tooth contact as the abrader and substrate specimens. Compared to bovine teeth, zirconia, lithium disilicate glass ceramic, and dental porcelain showed greater hardness and less wear on their surfaces, and less substrate wear of the opposite tooth enamel. The lowest hardness resin composite showed intermediate wear on its surface, resulting in the lowest substrate wear. Accordingly, dentists should pay attention to the selection of restorative materials to reconstruct their morphologies owing to different wear behaviors.
Collapse
Affiliation(s)
- Akihiko Hatanaka
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3694, Iwate, Japan; (A.H.); (K.S.); (S.T.)
| | - Tomofumi Sawada
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3694, Iwate, Japan; (A.H.); (K.S.); (S.T.)
- Correspondence: ; Tel.: +81-19-651-5110
| | - Kazuyo Sen
- School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka-shi 020-8505, Iwate, Japan; (K.S.); (T.S.)
| | - Takahiro Saito
- School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka-shi 020-8505, Iwate, Japan; (K.S.); (T.S.)
| | - Kaori Sasaki
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3694, Iwate, Japan; (A.H.); (K.S.); (S.T.)
| | - Tomoko Someya
- Department of Dental Materials Science, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan; (T.S.); (M.H.)
| | - Masayuki Hattori
- Department of Dental Materials Science, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan; (T.S.); (M.H.)
| | - Shinji Takemoto
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3694, Iwate, Japan; (A.H.); (K.S.); (S.T.)
| |
Collapse
|
53
|
Passia N, Chaar MS, Kern M. Clinical outcome of posterior cantilever resin-bonded fixed dental prostheses using two different luting agents. J Prosthodont Res 2022; 67:161-163. [PMID: 35851047 DOI: 10.2186/jpr.jpr_d_22_00033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials,
Christian-Albrechts University at Kiel, Kiel, Germany.,Department of Prosthodontics, Faculty of Medicine Carl Gustav Carus,
TU Dresden, Dresden, Germany
| | - M Sad Chaar
- Department of Prosthodontics, Propaedeutics and Dental Materials,
Christian-Albrechts University at Kiel, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials,
Christian-Albrechts University at Kiel, Kiel, Germany
| |
Collapse
|
54
|
Dudley J. Fixed prosthodontics clinical unit completions in an undergraduate curriculum: A 10-year retrospective study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022. [PMID: 35822395 DOI: 10.1111/eje.12836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/15/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Providing undergraduate dental students with a range of clinical experiences in fixed prosthodontics procedures is an important component of dental education. The aim of this retrospective study was to analyse the types of laboratory-fabricated fixed prosthodontics clinical units completed by undergraduate students over 10 consecutive years and determine any significant trends. MATERIALS AND METHODS The fixed prosthodontics treatment registers from 2012 to 2021 were reviewed and the different types of completed fixed prosthodontics units and total number of fixed prosthodontics units were recorded for each year. Completed units were categorised according to the type of restoration and expressed in whole numbers and as a percentage of the total number of units completed in each year. The data were presented in table and graph form. Mann-Kendall tests were performed to statistically analyse for trends in the different restoration types. RESULTS Throughout all study years, porcelain bonded to metal (PBM) crowns (48.25%, range 35.70%-59.91%) were the most frequently completed fixed prosthodontics unit followed by full gold crowns (FGC) (20.84%, range 14.89%-27.30%) and all-ceramic crowns (ACC) (12.70%, range 3.67%-24.41%). Collectively, PBM, FGC and ACC comprised 81.80% of all completed fixed prosthodontics units. There were observed trends of increased use of all types of all-ceramic containing restorations, all types of all-gold containing restorations, all types of partial coverage restorations and specifically ceramic onlays and gold onlays. There were observed trends of reduced use of cast gold post-cores and all types of bridges. CONCLUSION PBM crowns were the mainstay laboratory-fabricated fixed prosthodontic unit completed over 10 years of undergraduate student fixed prosthodontics clinical practice.
Collapse
Affiliation(s)
- James Dudley
- Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
55
|
Do tooth-supported zirconia restorations present more technical failures related to fracture or loss of retention? Systematic review and meta-analysis. Clin Oral Investig 2022; 26:5129-5142. [PMID: 35660957 DOI: 10.1007/s00784-022-04573-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This systematic review was performed to determine the main cause of technical failure of tooth-supported zirconia crowns and fixed partial dentures (FPDs), categorizing them as fracture/chipping or loss of retention/decementation. MATERIALS AND METHODS Electronic and manual searches were performed for randomized clinical trials, prospective clinical trials, and prospective cohort studies that reported the technical failure rates of zirconia restorations. The Cochrane Collaboration risk-of-bias tool and Newcastle-Ottawa scale were used to assess the quality of the studies. RESULTS Fifty-two studies were included and most of them had unclear risk of bias. Considering all reported fractures/chipping, for veneered crowns with 1 to 3 years of follow-up, the relative risk (RR) of fracture in relation to loss or retention was 3.95 (95% CI 1.18-13.23; p = 0.03). For 4 to 6 years of follow-up, the RR was 5.44 (95% CI 1.41-20.92; p = 0.01). For veneered FPDs with 1 to 3 years of follow-up, the RR was 5.98 (95% CI 2.31-15.01; p = 0.0002). For 4 to 6 years of follow-up, the RR was 3.70 (95% CI 1.63-8.41; p = 0.002). For 7 years or more of follow-up, the RR was 3.45 (95% CI 1.84-6.46; p = 0.0001). When only framework fractures were considered, there were no significant differences for the RR in all follow-up periods (p > 0.05). CONCLUSIONS Higher RR for fracture/chipping in relation to decementation for veneered zirconia crowns and FPDs at all follow-up times. For framework fractures, no difference was observed between the risk of failure of the restoration due to fracture or decementation. CLINICAL RELEVANCE Zirconia crowns and FPDs showed relatively high success and survival rates. However, considering the technical failures, there is approximately four times higher chance of fracture/chipping than loss of retention for both single and multi-unit tooth-supported veneered zirconia restorations.
Collapse
|
56
|
Hensel J, Reise M, Liebermann A, Buser R, Stawarczyk B. Impact of multiple firings on fracture load of veneered zirconia restorations. J Mech Behav Biomed Mater 2022; 130:105213. [DOI: 10.1016/j.jmbbm.2022.105213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/23/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022]
|
57
|
Begand S, Spintzyk S, Geis-Gerstorfer J, Bourauel C, Keilig L, Lohbauer U, Worpenberg C, Greuling A, Adjiski R, Jandt KD, Lümkemann N, Stawarczyk B, Güllmar A, Kailer A, Oberle N, Stephan M. Fracture toughness of 3Y-TZP ceramic measured by the Chevron-Notch Beam method: A round-robin study. Dent Mater 2022; 38:1128-1139. [PMID: 35618552 DOI: 10.1016/j.dental.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/03/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This interlaboratory round robin test investigated the robustness of the Chevron-Notch Beam (CNB) test method and the effect of the processing and testing variations on the fracture toughness of a dental 3Y-TZP ceramic. METHODS The round robin test was performed precisely following the procedures recommended in ISO 24370:2005 and applied on a commercial 3Y-TZP ceramic (product information). A total of 335 test specimens with dimensions 3×4 x 45 mm³ was equally distributed among 10 participating laboratories of varying experience in fracture toughness testing. A standard operating procedure was defined with either narrow processing tolerances or alternative (wider) processing tolerances (as proposed in ISO 24370). Fracture toughness data (series 2) was analyzed using one way ANOVA followed by post hoc Tukey HSD test and 95% Confidence Intervals (CI) were computed (p < 0.05). A further, preceding round-robin (series 1) test was conducted with - more possible variations of test conditions regarding CNB notch processing and storage conditions. Those results are summarized in the supplement and discussed with the actual ISO 24370 test. RESULTS Fracture toughness of the 3Y-TZP ceramic material, summarized over all laboratories was measured to KIc = 4.48 ± 0.11 MPam0.5 for the standard processing tolerance and KIc = 4.55 ± 0.31 MPam0.5 for the alternative tolerance. The results revealed a significant influence of cutting offset and notch geometry on KIc when using CNB method. The test medium also has a significant influence on KIc in terms of reduced fracture toughness under the influence of water. With defined testing conditions the number of valid tests and reduced standard deviation increased. In case of strictly following such standard operation procedures, KIc can be determined with high reliability. There is no difference between the involved laboratories, but significant influence of cutting offset on KIC was observed. SIGNIFICANCE The CNB method is suitable method for determination of KIc on fine-grained ceramics such as 3Y-TZP ceramic. By using tighter tolerances for processing and testing, i.e. closely following the ISO 24370 procedure, a highly-precise evaluation of fracture toughness with low data variation is achievable. The information of the storage medium should always be reported along with the data. CNB fracture toughness testing is an alternative method compared to Single-edge V-notch beam (SEVNB), especially for fine-grained ceramics.
Collapse
Affiliation(s)
- Sabine Begand
- Fraunhofer Institute for Ceramics Technologies and Systems IKTS, Michael-Faraday-Str. 1, 07629 Hermsdorf, Germany.
| | - Sebastian Spintzyk
- University Hospital Tübingen, Section "Medical Materials Science & Technology", Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Jürgen Geis-Gerstorfer
- University Hospital Tübingen, Section "Medical Materials Science & Technology", Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Christoph Bourauel
- University Hospital Bonn, Oral Technology, School of Dentistry, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Ludger Keilig
- University Hospital Bonn, Oral Technology, School of Dentistry, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Ulrich Lohbauer
- University of Erlangen-Nuremberg, Dental Clinic 1 - Operative Dentistry and Periodontology, Glueckstrasse 11, 91054 Erlangen, Germany
| | - Christin Worpenberg
- Hannover Medical School, Clinic for Dental Prosthetics, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Andreas Greuling
- Hannover Medical School, Clinic for Dental Prosthetics, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Ranko Adjiski
- Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany
| | - Klaus D Jandt
- Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany
| | - Nina Lümkemann
- Department of Prosthetic Dentistry, University Hospital, Dental School, Ludwig-Maximilians-University Munich, Goethestraße 70, 80336 Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, Dental School, Ludwig-Maximilians-University Munich, Goethestraße 70, 80336 Munich, Germany
| | - André Güllmar
- University Hospital Jena, Polyclinic for Conservative Dentistry, An der Alten Post, 407743 Jena, Germany
| | - Andreas Kailer
- Fraunhofer IWM, Freiburg, Wöhlerstraße 11, 79108 Freiburg im Breisgau, Germany
| | - Natalie Oberle
- Fraunhofer IWM, Freiburg, Wöhlerstraße 11, 79108 Freiburg im Breisgau, Germany
| | - Marc Stephan
- Materials Competence Center bei Institut Straumann AG, Peter-Merian-Weg 12, CH-4002 Basel, Switzerland
| |
Collapse
|
58
|
Kim M, Kim RH, Lee SC, Lee TK, Hayashi M, Yu B, Jo DW. Evaluation of Tensile Bond Strength between Self-Adhesive Resin Cement and Surface-Pretreated Zirconia. MATERIALS 2022; 15:ma15093089. [PMID: 35591424 PMCID: PMC9101034 DOI: 10.3390/ma15093089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 02/01/2023]
Abstract
The tensile bond strength between zirconia subjected to different surface-pretreatment methods and methacryloyloxydecyl-dihydrogen-phosphate (MDP)-containing self-adhesive resin cement was evaluated herein. Eighty-eight cylindrical zirconia specimens were randomly divided into the following four groups based on the pretreatment method: (1) no treatment, (2) air abrasion, (3) HNO3/HF etching, and (4) zirconia-nanoparticle coating. The tensile bond strength of the zirconia−resin-cement complexes was investigated. One-way ANOVA and post hoc tests were performed at a 95% significance level, and the Weibull modulus was calculated. Fracture patterns were visualized by SEM. The surface roughness of the specimens without resin bonding was evaluated by AFM. The tensile bond strength of the specimens decreased as follows: Groups 3 > 4 > 2 > 1 (28.2 ± 6.6, 26.1 ± 5.7, 16.6 ± 3.3, and 13.9 ± 3.0 MPa, respectively). Groups 3 and 4 had significantly higher tensile bond strengths (p < 0.05) and lower fracture probabilities than those of Groups 1 and 2. They also showed both mixed failure and resin-cement cohesive failure, whereas Groups 1 and 2 showed mixed failure exclusively. The zirconia−resin tensile bond was stronger after HNO3/HF etching or ZrO2-nanoparticle coating than after air abrasion or no treatment. The estimated surface roughness decreased as follows: Groups 3 > 4 > 2 > 1. The combination of zirconia pretreated with HNO3/HF etching or ZrO2-nanoparticle coating and an MDP-containing self-adhesive resin cement can increase the clinical longevity of zirconia restorations by preventing their decementation.
Collapse
Affiliation(s)
- Mijoo Kim
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Reuben H. Kim
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Samuel C. Lee
- California Smile Dental Studio, Gardena, CA 90247, USA;
| | - Thomas K. Lee
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Marc Hayashi
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Bo Yu
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Deuk-Won Jo
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam 13620, Korea
- Correspondence: ; Tel.: +82-31-787-7548
| |
Collapse
|
59
|
Fardin VP, Bonfante G, Coelho PG, Bergamo ETP, Bordin D, Janal MN, Tovar N, Witek L, Bonfante EA. Residual stress estimated by nanoindentation in pontics and abutments of veneered zirconia fixed dental prostheses. J Appl Oral Sci 2022; 30:e20210475. [PMID: 35476114 PMCID: PMC9041093 DOI: 10.1590/1678-7757-2021-0475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 01/10/2022] [Accepted: 01/19/2022] [Indexed: 11/22/2022] Open
Abstract
Glass ceramics' fractures in zirconia fixed dental prosthesis (FDP) remains a clinical challenge since it has higher fracture rates than the gold standard, metal ceramic FDP. Nanoindentation has been shown a reliable tool to determine residual stress of ceramic systems, which can ultimately correlate to failure-proneness. OBJECTIVES To assess residual tensile stress using nanoindentation in veneered three-unit zirconia FDPs at different surfaces of pontics and abutments. METHODOLOGY Three composite resin replicas of the maxillary first premolar and crown-prepared abutment first molar were made to obtain three-unit FDPs. The FDPs were veneered with glass ceramic containing fluorapatite crystals and resin cemented on the replicas, embedded in epoxy resin, sectioned, and polished. Each specimen was subjected to nanoindentation in the following regions of interest: 1) Mesial premolar abutment (MPMa); 2) Distal premolar abutment (DPMa); 3) Buccal premolar abutment (BPMa); 4) Lingual premolar abutment (LPMa); 5) Mesial premolar pontic (MPMp); 6) Distal premolar pontic (DPMp); 7) Buccal premolar pontic (BPMp); 8) Lingual premolar pontic (LPMp); 9) Mesial molar abutment (MMa); 10) Distal molar abutment (DMa); 11) Buccal molar abutment (BMa); and 12) Lingual molar abutment (LMa). Data were assessed using Linear Mixed Model and Least Significant Difference (95%) tests. RESULTS Pontics had significantly higher hardness values than premolar (p=0.001) and molar (p=0.007) abutments, suggesting lower residual stress levels. Marginal ridges yielded higher hardness values for connectors (DPMa, MMa, MPMp and DPMp) than for outer proximal surfaces of abutments (MPMa and DMa). The mesial marginal ridge of the premolar abutment (MPMa) had the lowest hardness values, suggesting higher residual stress concentration. CONCLUSIONS Residual stress in three-unit FDPs was lower in pontics than in abutments. The outer proximal surfaces of the abutments had the highest residual stress concentration.
Collapse
Affiliation(s)
- Vinicius Pavesi Fardin
- Universidade de São PauloFaculdade de Odontologia de BauruDepartamento de Prótese e PeriodontiaBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, São Paulo, Brasil.
| | - Gerson Bonfante
- Universidade de São PauloFaculdade de Odontologia de BauruDepartamento de Prótese e PeriodontiaBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, São Paulo, Brasil.
| | - Paulo G. Coelho
- New York University College of DentistryDepartment of BiomaterialsNew YorkUnited StatesNew York University College of Dentistry, Department of Biomaterials, New York, United States.
- New York University TandonSchool of EngineeringDepartment of Mechanical and Aerospace EngineeringBrooklynNew YorkUnited StatesNew York University Tandon, School of Engineering, Department of Mechanical and Aerospace Engineering, Brooklyn, New York, United States.
- New York University Grossman School of MedicineHansjörg Wyss Department of Plastic SurgeryNew YorkUnited StatesNew York University Grossman School of Medicine, Hansjörg Wyss Department of Plastic Surgery, New York, United States.
| | - Edmara T. P. Bergamo
- Universidade de São PauloFaculdade de Odontologia de BauruDepartamento de Prótese e PeriodontiaBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, São Paulo, Brasil.
| | - Dimorvan Bordin
- Universidade de GuarulhosGuarulhosSão PauloBrasilUniversidade de Guarulhos (UNG) – UNIVERITAS, Guarulhos, São Paulo, Brasil.
| | - Malvin N. Janal
- New York University College of DentistryDepartment of Epidemiology and Health PromotionNew YorkUnited StatesNew York University College of Dentistry, Department of Epidemiology and Health Promotion, New York, United States.
| | - Nick Tovar
- New York University College of DentistryDepartment of BiomaterialsNew YorkUnited StatesNew York University College of Dentistry, Department of Biomaterials, New York, United States.
| | - Lukasz Witek
- New York University College of DentistryDepartment of BiomaterialsNew YorkUnited StatesNew York University College of Dentistry, Department of Biomaterials, New York, United States.
- New York UniversityNYU Tandon School of EngineeringDepartment of Biomedical EngineeringBrooklynNYUnited StatesNew York University, NYU Tandon School of Engineering, Department of Biomedical Engineering, Brooklyn, NY, United States.
| | - Estevam A. Bonfante
- Universidade de São PauloFaculdade de Odontologia de BauruDepartamento de Prótese e PeriodontiaBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, São Paulo, Brasil.
| |
Collapse
|
60
|
Effect of Different Surface Treatments on the Micro-Shear Bond Strength and Surface Characteristics of Zirconia: An In Vitro Study. Int J Dent 2022; 2022:1546802. [PMID: 35464102 PMCID: PMC9023206 DOI: 10.1155/2022/1546802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To study the effect of different surface treatments on the micro-shear bond strength and surface characteristics of zirconia. Methods Two types of zirconia ceramics were tested: opaque (O) and translucent (T). Each type of zirconia was further allotted into four groups based on the type of surface treatment method. The four groups were: control (C), air abrasion with 110 µm Al2O3 particles (A), etching with Zircos–E Etching solution for 2 hours (E), and a combination of air abrasion and etching (AE). After the surface treatment, all specimens were ultrasonically cleaned and 10 resin cement cylinders were attached to the zirconia discs in each group. A micro-shear bond strength test was performed in a universal testing machine at a crosshead speed of 0.5 mm/min. The fracture surfaces were assessed under a compound microscope. SEM, EDAX, and AFM analyses were done for the zirconia specimens after being subjected to surface treatment. Statistical analysis for the bond strength test was done using the Shapiro–Wilk test, one-way analysis of variance (ANOVA), and Post hoc Tukey test. Results The micro-shear bond strength values for the groups were as follows in megapascals (MPa): OC 18.96 (5.54), OA 22.66 (2.51), OE 28.48 (4.50), OAE 28.63 (4.53), TC 22.82 (5.46), TA 25.36 (5.17), TE 28.12 (4.76), and TAE 32.00 (3.47). The one-way analysis of variance (ANOVA) and post hoc Tukey HSD tests were done which showed significant results in the groups. In opaque zirconia, significant differences were seen in the etching and air abrasion with etching groups when compared with the control and air abrasion groups. There was no difference between the etching and air abrasion with etching groups. For translucent zirconia, the only significant difference was seen in the air abrasion with etching group in comparison with the control and air abrasion groups. The mode of failure was majorly adhesive. The surface topography and surface roughness showed significant differences between the groups. The EDAX results showed material loss that occurred due to sandblasting in the air abrasion groups. Conclusions Etching with Zircos–E Etching solution significantly increased the bond strength of zirconia to resin cement when compared with other surface treatment methods. In translucent zirconia, the best results can be achieved by combining etching with air abrasion.
Collapse
|
61
|
Pol CWP, Raghoebar GM, Cune MS, Meijer HJA. Three-unit fixed dental prostheses supported by either two abutment implants or two abutment teeth: A comparative retrospective cohort study. Clin Exp Dent Res 2022; 8:497-505. [PMID: 35384361 PMCID: PMC9033541 DOI: 10.1002/cre2.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES In general, similar restorative constructions are made on natural teeth and on dental implants. The assumption is made that implants and their restoration perform the same as natural roots and their prosthetic restoration. Evaluating cohorts of three-unit bridges on teeth and on implants, this retrospective clinical study aimed to compare implants and teeth as supporting units, including the reconstructions, in terms of survival, success, clinical, radiographic, and patient-reported outcomes. MATERIAL AND METHODS From an 8-year period, all patients treated with a posterior three-unit fixed reconstruction on either implants or teeth, with a follow-up of at least 2 years, were identified. For each implant-supported reconstruction, a comparable tooth-supported reconstruction was selected, based on the length of follow-up, the material of the reconstruction, and the location in either the maxilla or mandible. RESULTS For the Implant-group, 24 patients could be matched with 24 best matching patients with tooth-supported fixed dental prostheses (FPDs). Supporting implants and implant-supported reconstructions were all in function with a mean follow-up of 52 ± 23 months. Two tooth-supported reconstructions had been replaced (91.7% survival) (mean follow-up: 52 ± 19 months). Radiographic bone levels and soft tissue conditions were favorable in both groups with minor differences. There was no significant difference in overall patient satisfaction. The modified USPHS-score revealed an 87.5% overall success in the Implant-group and 91.7% in the Tooth-group. CONCLUSIONS Implant-supported three-unit FDPs are a reliable treatment option with survival and success rates not significantly different from the results of tooth-supported three-unit FDPs.
Collapse
Affiliation(s)
- Christiaan W P Pol
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marco S Cune
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands.,Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, University of Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Henny J A Meijer
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
62
|
Comparative Assessment of the Functional Parameters for Metal-Ceramic and All-Ceramic Teeth Restorations in Prosthetic Dentistry-A Literature Review. BIOLOGY 2022; 11:biology11040556. [PMID: 35453755 PMCID: PMC9024664 DOI: 10.3390/biology11040556] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 12/16/2022]
Abstract
Simple Summary In the last decades, the science and technology of all-ceramic teeth restorations witnessed the fastest-growing field of restorative materials in research and development for fixed prosthodontics. Due to their properties, characterized by a high level of biocompatibility, excellent optical properties, and high fracture resistance, all-ceramic material can also be used in the posterior areas of the dental arches. However, metal-ceramic fixed partial dentures are still perceived as the golden standard for those restorations, thanks to the positive clinical outcomes. Irrespective of the materials of which fixed partial dentures are performed, their success rates depend on the expected outcome and on how they perform in the oral environment. Such conditions of failure restorations may include biological factors (i.e., secondary decay, loss of vitality, periodontal disease, or abutment fracture) or technical factors (i.e., chipping, ceramic fracture, framework fracture, or loss of retention). Our aim is to provide the current evidence for the efficacy of metal-ceramics and all-ceramics in the treatment of multiple posterior edentulous spaces. Moreover, we aim to compare the survival rates of metal-ceramic and all-ceramic fixed partial dentures in terms of functionality and biocompatibility in all the aforementioned clinical situations. Our results have shown that all all-ceramic systems, especially densely sintered zirconia and reinforced glass ceramics, have a promising future to satisfy both practitioners and patients. However, technical and biological complications need to be taken into account when planning multi-unit fixed partial dentures for the posterior areas. Abstract The metal-ceramic fixed partial prosthesis is the golden standard for posterior tooth restorations. Following the demands of patients and clinicians for metal-free restorations, all-ceramic materials were developed as they offer an adequate alternative with better optical qualities and good mechanical properties. This study aims to carry out a bibliographic review to assess the survival rate and the biological and technical complications of all-ceramic and metal-ceramic fixed partial dentures. An electronic search for articles in the English language literature was performed using PubMed (MEDLINE). This literature review focused on research studies between 2010 and 2020 that performed clinical studies on tooth-supported fixed partial dentures with a mean follow-up of at least 3 years. All the studies, which analyzed the survival and complications of tooth-supported fixed partial dentures, were included. Thus, 14 studies reporting on 756 all-ceramic and 160 metal-ceramic fixed partial dentures met the inclusion criteria. A comparative analysis was carried out based on all the data existing in the studies included in this review. The metal-ceramic fixed partial dentures showed survival rates of 95% to 100% at 3-, 5-, and 10-year follow-up periods. Zirconia fixed partial dentures were reported to have survival rates of 81% to 100% at 3-, 5-, 9-, 10-year follow-up evaluations. The reinforced glass-ceramic fixed partial dentures showed survival rates of 70% to 93.35% at 5 years, while the alumina FPDs showed a survival rate of 68% at 3 years follow-up. The incidence of caries and loss of vitality were reported as higher for all-ceramic prostheses as compared to the metal-ceramic ones. A significant framework fracture was reported for glass-infiltrated alumina fixed partial dentures in comparison to metal-ceramic fixed partial dentures. All-ceramic and metal-ceramic restorations showed similar survival rates after 3 years, although all-ceramic restorations have problems with technical complications such as chipping, which can lead to framework fractures over time.
Collapse
|
63
|
The effect of aging on the wear performance of monolithic zirconia. Dent Mater 2022; 38:e136-e146. [DOI: 10.1016/j.dental.2022.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 03/06/2022] [Accepted: 04/01/2022] [Indexed: 11/24/2022]
|
64
|
Hensel J, Reise M, Liebermann A, Buser R, Stawarczyk B. Impact of multiple firings on thermal properties and bond strength of veneered zirconia restorations. J Mech Behav Biomed Mater 2022; 128:105134. [DOI: 10.1016/j.jmbbm.2022.105134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
|
65
|
Retrospective Study Comparing Clinical Outcomes of Fixed Dental Prostheses in Matched Groups of Bruxer and Nonbruxer Patients. Int J Dent 2022; 2022:6818170. [PMID: 35386548 PMCID: PMC8977310 DOI: 10.1155/2022/6818170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/12/2022] [Indexed: 02/03/2023] Open
Abstract
Background Tooth-supported fixed dental prosthesis (FDP) is one of the most reliable treatment options to replace missing teeth. The longevity of the treatment could, however, be affected by several general and local factors, especially bruxism. Objective To investigate the influence of bruxism on the long-term survival of tooth-supported FDPs in bruxers compared to a matched group of nonbruxers, taking several clinical variables into account. Materials and Methods The present retrospective cohort study was based on records of patients treated with 3–7-unit tooth-supported FDPs with a minimum follow-up time of 6 months after prosthesis delivery. The criteria for the diagnosis of “possible” and “probable” sleep or awake bruxism were used. A matched group of nonbruxers was selected on the basis of similarities in four factors, patients' gender and age, number of prosthetic units of the FDPs, and follow-up time. The paired-samples t-test or Wilcoxon signed rank test were used to compared mean values between the two groups. Contingency tables of categorical data were analyzed by McNemar's test. Results The cohort group consisted of 62 noncantilevered FDPs in each group, followed up for a mean of 110.1 and 106.5 months (bruxers and nonbruxers, respectively). Tooth-supported FDPs in bruxers presented significantly higher failure rate than in nonbruxers (32.3% vs. 25.8%, respectively; p = 0.001). Loss of retention and tooth loss were the main reasons for failures in both groups. For nonsmokers, the FDP failure rate was higher in nonbruxers. Technical and biological complications were significantly more prevalent in bruxers compared to nonbruxers. Conclusions Bruxism is suggested to increase technical and biological complications and FDP failure.
Collapse
|
66
|
Alqutaibi AY, Ghulam O, Krsoum M, Binmahmoud S, Taher H, Elmalky W, Zafar MS. Revolution of Current Dental Zirconia: A Comprehensive Review. Molecules 2022; 27:1699. [PMID: 35268800 PMCID: PMC8911694 DOI: 10.3390/molecules27051699] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/16/2022] [Accepted: 03/02/2022] [Indexed: 01/27/2023] Open
Abstract
The aim of this article is to comprehensively review the revolution of dental zirconia (Zir), including its types, properties, applications, and cementation procedures. A comprehensive search of PubMed and Embase was conducted. The search was limited to manuscripts published in English. The final search was conducted in October 2021. Newly developed monolithic Zir ceramics have substantially enhanced esthetics and translucency. However, this material must be further studied in vitro and in vivo to determine its long-term ability to maintain its exceptional properties. According to the literature, monolithic translucent Zir has had promising results and a high survival rate. Thus, the utilization of this material is indicated when strength and esthetics are needed. Both the materials and methods used for cementation of monolithic Zir have significantly improved, encouraging dentists to use this material, especially when a conservative approach is required. Zir restorations showed promising outcomes, particularly for monolithic Zir crowns supported with implant and fixed dental prostheses.
Collapse
Affiliation(s)
- Ahmed Yaseen Alqutaibi
- Department of Prosthodontics, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia;
- Department of Prosthodontics, College of Dentistry, Ibb University, Ibb 70270, Yemen
| | - Omar Ghulam
- Dental Department, Prince Mohammad bin Abdulaziz Hospital (Ministry of National Guard-Health Affairs), Madinah 42324, Saudi Arabia; (O.G.); (M.K.); (H.T.)
| | - Majid Krsoum
- Dental Department, Prince Mohammad bin Abdulaziz Hospital (Ministry of National Guard-Health Affairs), Madinah 42324, Saudi Arabia; (O.G.); (M.K.); (H.T.)
| | - Suhail Binmahmoud
- Dental Department, Prince Sultan Armed Forces Hospital, Madinah 42375, Saudi Arabia;
| | - Hasan Taher
- Dental Department, Prince Mohammad bin Abdulaziz Hospital (Ministry of National Guard-Health Affairs), Madinah 42324, Saudi Arabia; (O.G.); (M.K.); (H.T.)
| | - Wael Elmalky
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia;
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| |
Collapse
|
67
|
Dhital S, Rodrigues C, Zhang Y, Kim J. Metal-ceramic and porcelain-veneered lithium disilicate crowns: a stress profile comparison using a viscoelastic finite element model. Comput Methods Biomech Biomed Engin 2022; 25:412-423. [PMID: 34289770 PMCID: PMC9903966 DOI: 10.1080/10255842.2021.1955869] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/08/2021] [Accepted: 07/12/2021] [Indexed: 02/09/2023]
Abstract
Metal-ceramics (MC) are one of the oldest dental restorative systems, which are considered to be the gold standard for full crown restoration. Porcelain-veneered lithium disilicate (PVLD), on the other hand, are newer material systems that have shown high survival rate in clinical follow-ups but needs to be studied more. This study compares the stresses developed in the single crowns made from newer PVLD system against those with MC configuration. For this comparison, influence of the layer thickness and cooling rates is also taken into consideration. An experimentally validated viscoelastic finite element model (VFEM) has been developed to predict the stress profile in these systems. Three-dimensional rotationally symmetric crowns were analyzed using this validated model for both material systems, three veneer to core thickness ratios (2:1, 1:1, 1:2), and two cooling rates: slow cooling at 1.74E-5 W/mm2K (∼30 K/min) and fast cooling at 1.74E-4 W/mm2K (∼300 K/min). PVLD showed lower values of transient and residual stresses than MC. The maximum tensile residual stresses in MC systems were observed in the cusp area, whereas those in PVLD were located in the central fossa. With the reduction in veneer layer, there was reduction in residual stress in MC; however, the veneer thickness had little to no effect in PVLD. The effect of cooling rate was also evident as slow cooling resulted in lower residual and tensile stresses for both material systems.
Collapse
Affiliation(s)
- Sukirti Dhital
- Department of Civil and Environmental Engineering, University of Connecticut, Storrs, CT, USA
| | - Camila Rodrigues
- Graduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Yu Zhang
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - Jeongho Kim
- Department of Civil and Environmental Engineering, University of Connecticut, Storrs, CT, USA
| |
Collapse
|
68
|
Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up. Clin Oral Investig 2022; 26:4327-4335. [PMID: 35142924 PMCID: PMC9203772 DOI: 10.1007/s00784-022-04396-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022]
Abstract
Objectives To evaluate and to compare the clinical performance and survival rate of posterior monolithic and veneered zirconia fixed partial dentures (FPDs). Material and methods Sixty 3-unit posterior FPDs were included in the study. The patients were randomly distributed into two groups (n = 30 each) to receive either a monolithic (Zenostar T, Wieland Dental) or veneered zirconia (IPS e.max ZirCAD, Ivoclar Vivadent) FPD. Each patient received only 1 FPD. Tooth preparations were scanned (Trios 3, 3Shape), designed (Dental System 2016, 3 Shape), milled (Zenotec CAM 3.2, Wieland Dental), and cemented with a resin cement. Technical and biological outcomes and periodontal parameters were assessed. Data analysis was made using the Friedman and the Wilcoxon signed-rank tests with the Bonferroni correction and the Mann–Whitney U test. Results The survival rate at 3 years was 100% for veneered and 90% for monolithic zirconia restorations. Three monolithic zirconia FPDs were lost because of biologic complications. The main complication in the veneered zirconia FPDs was the fracture of the veneering ceramic in 4 of the veneered zirconia FPDs. No fracture of the frameworks was observed in any of the groups. All restorations were assessed as satisfactory after 3 years. No differences in periodontal parameters were observed between the groups. Conclusions The results of this study suggest that monolithic zirconia and complete digital flow could be a viable alternative to veneered zirconia in the posterior regions. Clinical relevance The monolithic zirconia restorations with a digital workflow can be a viable alternative in posterior fixed partial dentures, with good periodontal outcomes. Clinical trial registration number ClinicalTrials.gov (Identifier NCT 04,879,498).
Collapse
|
69
|
Bracket Bonding to All-Ceramic Materials with Universal Adhesives. MATERIALS 2022; 15:ma15031245. [PMID: 35161189 PMCID: PMC8839010 DOI: 10.3390/ma15031245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023]
Abstract
The need for bracket bonding to ceramic restorations is increasing. The aim of this study was to evaluate the effect of universal adhesives on bracket adhesion to polished or glazed lithium disilicate (LDS) and monolithic zirconia (MZ) surfaces. One hundred and twenty brackets (N = 10) were bonded to either polished or glazed LDS (e.max CAD B32, Ivoclar Vivadent, Schaan, Liechtenstein) and MZ (In-Ceram® YZ, VITA, Bad Sackingen, Germany) blocks using three different adhesives combined with Transbond™ XT Paste (3M Unitek, Monrovia, CA, USA). Tested universal adhesives were Scotchbond™ Universal Adhesive (SU, 3M St. Paul, MN, USA) and Assure Plus (AP, Reliance, Itasca, IL, USA). Transbond™ XT Primer (XTP, 3M Unitek, Monrovia, CA, USA) served as a control adhesive. Bracket bond strength was measured in shear mode (SBS). Failure type was determined by the Modified Adhesive Remnant Index (ARI). Data were statistically analyzed. On polished LDS, SU yielded bracket SBS significantly superior to those of AP and XTP. On polished MZ, the use of SU and AP significantly enhanced bracket retention as compared with XTP. Low SBS values, below the threshold of clinical acceptability, were reached by all tested adhesives on glazed LDS and MZ specimens. SBS measurements corresponded with failure type observations. Universal adhesives SU and AP could be considered for use on polished LDS and MZ surfaces.
Collapse
|
70
|
Mavriqi L, Valente F, Murmura G, Sinjari B, Macrì M, Trubiani O, Caputi S, Traini T. Lithium disilicate and ZLS glass-ceramics for CAD/CAM dental restorations. Biocompatibility, mechanical and microstructural properties after crystallization.: Microstructure and Properties of Glass Ceramics for CAD/CAM Applications. J Dent 2022; 119:104054. [PMID: 35122936 DOI: 10.1016/j.jdent.2022.104054] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/31/2021] [Accepted: 01/31/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES The objective of this study was to define the impact of heating rate on the crystal growth, the mechanical properties, and the biocompatibility of three different kinds of CAD/CAM glass-ceramics treated with a conventional furnace. METHODS Lithium disilicate (IPS EMax-CAD, Ivoclar Vivadent) (LS2) and two zirconia reinforced lithium silicate (ZLS) ceramics (Vita Suprinity PC, VITA Zahnfabrik; Celtra Duo, Dentsply Sirona) (ZLSS; ZLSC) were used. The mechanical properties and the crystal growth were evaluated on 42 specimens (n=14 per group). The thermal treatments recommended by the manufacturers were carried out. All groups were tested for fracture toughness (Ft) and Vickers hardness (Hv). Scanning electron microscope (SEM) images were taken after a slight surface etching with hydrofluoric acid solution (1% for 20 sec). Differential Thermal Analysis (DTA) was performed and cellular adhesion with human periodontal ligament stem cells (hPDLSCs) culture was qualitatively assayed. Data were analysed with Repeated Measurements ANOVA and ANOVA followed by Tukey post hoc test. RESULTS The crystals' mean size (±SD) after heat treatment was 1650.0 (±340.0) nm for LS2, 854.5 (±155.0) nm for ZLSS and 759.9 (±118.4) nm for ZLSC (p<0.05 among the groups). As consequence of crystallization, the Hv was 6.1±0.3 GPa for LS2, 7.6±0.7 GPa for ZLSS and 7.1±0.5 GPa for ZLSC (p<0.05 for LS2 vs ZLSS and ZLSC), while the Ft was 2.2±0.1 MPa m1/2 for LS2, 4.7±0.8 MPa m1/2 for ZLSS and 3.8±0.6 MPa m1/2 for ZLSC (p<0.05 among the groups). The DTA curves showed a crystallization process for LS2, ZLSS and ZLSC at a temperature range 810°C to 840°C. The amount of adherent hPDLSCs was superior on LS2 than on ZLS. CONCLUSIONS All the CAD/CAM materials can be properly crystallized if heat treated following the manufacturers' instructions. The crystallization process highly depends on temperature. ZLS glass ceramics show significantly inferior crystals dimensions and higher fracture toughness and Vickers hardness than LS2 ceramic. hPDLSCs cultured on LS2 have a superior adhesion than those cultured on ZLS. CLINICAL SIGNIFICANCE The clinical interest of this study relies on the demonstration that a proper heat-treatment of CAD/CAM lithium disilicate and ZLS glass ceramics generates products that are suitable for clinical service. The differences highlightable in mechanical properties and biocompatibility behaviour do not affect their successful clinical application.
Collapse
Affiliation(s)
- Luan Mavriqi
- Department of Dentistry, Albanian University, 1001 Tirana, Albania
| | - Francesco Valente
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Giovanna Murmura
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Bruna Sinjari
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Monica Macrì
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Oriana Trubiani
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Sergio Caputi
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Tonino Traini
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
| |
Collapse
|
71
|
Sailer I, Karasan D, Todorovic A, Ligoutsikou M, Pjetursson BE. Prosthetic failures in dental implant therapy. Periodontol 2000 2022; 88:130-144. [PMID: 35103329 PMCID: PMC9305548 DOI: 10.1111/prd.12416] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Both fixed and removable implant-supported prostheses are well-established methods for replacing missing teeth in partially or fully edentulous patients. Numerous systematic reviews have been performed in recent years to evaluate the survival and complication rates of implant-retained fixed dental prostheses and implant-retained overdentures, displaying high 5-year survival rates ranging from 97.1% for fixed dental prostheses to 95%-100% for implant-retained overdentures. However, the survival rates only represent the prostheses remaining in use for a defined follow-up time, and do not account for the potential prosthetic complications that may have arisen and influence the general success of the implant treatment. The most common technical complications of fixed implant-retained single crowns are crown fracture, fractures of ceramic implant abutments, and esthetic problems. The predominant technical complication at multiple-unit, implant-retained fixed dental prostheses is fracture/chipping of the veneering ceramic. Reported technical complications for implant-retained overdentures are overdenture fracture or chipping of the veneer materials, whereas mechanical complications include implant fracture, attachment failure, and attachment housing or insert complications. To reduce the risk of such failures, a comprehensive pretreatment diagnostic work-up is essential, including defining the prosthetic goal with the aid of a wax-up or set-up and the associated ideal, prosthetically oriented three-dimensional implant position. Furthermore, selection of the ideal type of prosthesis, including the respective implant components and materials, is important for clinical long-term treatment success.
Collapse
Affiliation(s)
- Irena Sailer
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Duygu Karasan
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Ana Todorovic
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
- Division of ProsthodonticsFaculty of Dental MedicineUniversity of BelgradeBelgradeSerbia
| | - Maria Ligoutsikou
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Bjarni Elvar Pjetursson
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
- Department of Reconstructive DentistryFaculty of OdontologyUniversity of IcelandReykjavikIceland
| |
Collapse
|
72
|
Hinz S, Bensel T, Bömicke W, Henningsen A, Rudolph J, Boeckler AF. Impact of the Veneering Technique and Framework Material on the Failure Loads of All-Ceramic Computer-Aided Design/Computer-Aided Manufacturing Fixed Partial Dentures. MATERIALS 2022; 15:ma15030756. [PMID: 35160701 PMCID: PMC8836578 DOI: 10.3390/ma15030756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/08/2022] [Accepted: 01/15/2022] [Indexed: 02/04/2023]
Abstract
Objectives: Zirconia (Y-TZP) ceramics are considered as posterior fixed partial denture (FPD) materials; however, their applications are limited due to chipping. The use of monolithic lithium disilicate (LiDi) glass ceramics in posterior FPDs can be advantageous. This in vitro study aims to compare the loads until failure of posterior Y-TZP-FPDs and LiDi-FPDs before and after aging.
Collapse
Affiliation(s)
- Sebastian Hinz
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
- Correspondence: (S.H.); (T.B.)
| | - Tobias Bensel
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
- Correspondence: (S.H.); (T.B.)
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany;
| | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Judith Rudolph
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
| | - Arne F. Boeckler
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
| |
Collapse
|
73
|
Prospective Clinical Evaluation of Posterior Third-Generation Monolithic Zirconia Crowns Fabricated with Complete Digital Workflow: Two-Year Follow-Up. MATERIALS 2022; 15:ma15020672. [PMID: 35057389 PMCID: PMC8780337 DOI: 10.3390/ma15020672] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
Clinical studies on the behavior of posterior translucent monolithic zirconia restorations are lacking. We assessed the clinical outcome and survival rate of posterior third-generation monolithic zirconia crowns over a 2-year period. A total of 24 patients, requiring 30 posterior full-contour restorations were selected. All abutments were scanned, and crowns were milled and cemented with a self-adhesive dual cure cement. Crowns were assessed using the California Dental Association’s criteria. Gingival status was assessed by evaluating the gingival index, plaque index, periodontal probing depth of the abutments and control teeth, and the margin index of the abutment teeth. Statistical analyses were performed using the Friedman and the Wilcoxon signed-rank tests. During the 2-year follow-up, no biological or mechanical complications were observed, and the survival and success rate was 100%. All restorations ranked as satisfactory throughout the follow-up period. The gingival index and plaque index were worse at the end of the 2-year follow-up. The margin index was stable during the 2 years of clinical service. No significant differences were recorded in periodontal parameters between crowns and control teeth. Third-generation monolithic zirconia could be a reliable alternative to posterior metal–ceramic and second-generation monolithic zirconia posterior crowns.
Collapse
|
74
|
Pontic site development for fixed dental prostheses with and without soft tissue grafting: 1-year results of a cohort study. Clin Oral Investig 2022; 26:6305-6316. [PMID: 35776200 PMCID: PMC9525322 DOI: 10.1007/s00784-022-04582-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/09/2022] [Indexed: 12/24/2022]
Abstract
AIM To describe and compare the pontic site development for fixed-dental prostheses (FDPs) with and without soft tissue grafting up to one-year post insertion of FDPs. MATERIALS AND METHODS A convenience sample of 24 patients participating in an ongoing RCT was provided with three-unit tooth-borne FDPs. Six patients received a subepithelial connective tissue graft (SCTG) at the pontic site, whereas 18 patients were treated without any soft tissue graft (CONTROL). Digital impressions were taken prior to tooth preparation, after tooth preparation, after insertion of the final FDP, and at the 1 year of follow-up. The obtained stereolithography files (STL) were superimposed and profilometric as well as linear changes of the soft tissue profile were assessed at the pontic regions. Profilometric outcomes included changes of the ridge contour, the alveolar ridge width, and the crown height of the pontic. Further outcomes assessed included: the papilla index, the pink esthetic score (PES), probing depth (PD), bleeding on probing (BOP), and plaque control record (PCR). Descriptive and nonparametric statistics were applied for all outcome measures. RESULTS The median profilometric contour between tooth preparation and 1 year after the insertion of the final FDP decreased by - 0.25 mm [Q1, Q3: - 0.36, 0.14] in the CONTROL group and increased by 0.61 mm [Q1, Q3: - 0.18, 1.06] in the SCTG group (intergroup p = 0.038). The alveolar ridge width between prior to tooth preparation and the one-year follow-up amounted to - 0.12 mm [Q1, Q3: - 0.74, 0.70] (= loss) in the CONTROL group and to 2.23 mm [Q1, Q3: 0.62, 3.86] (= gain) in the SCTG group (intergroup p = 0.032). At one year, the median crown height of the pontic tended to decrease by - 1.24 mm [Q1, Q3: - 2.05, - 1.05] in the SCTG group (intragroup p = 0.094) and by - 0.22 mm [Q1, Q3: - 0.58, 0.66] in the CONTROL group (intragroup p = 0.831), with significant differences between the groups (intergroup p = 0.022). The papilla index between prior to tooth preparation and one year of follow-up improved significantly in both groups (p < 0.05). Between FDP delivery and one year of follow-up, the PES values decreased significantly in the CONTROL group (intragroup p = 0.007), while in the SCTG group the change was not significant (intragroup p = 0.875). Clinical parameters (PD, BOP, and PCR) remained stable over time and did not differ between the groups at any time point (intergroup p > 0.05). CONCLUSION Within the limitations of the present study, soft tissue grafting tends to limit contour changes at pontic sites, thus maintaining the esthetic outcomes over time. The lack of soft tissue grafting results in stable clinical outcomes; however, it may lead to a decrease in aesthetic outcomes over time. CLINICAL RELEVANCE Autogenous soft tissue grafting seems to be a valid therapeutic option for the development of the pontic site to restore ridge defects prior to the delivery of fixed dental prostheses and to limit dimensional changes over time.
Collapse
|
75
|
Nilsson S, Stenport VF, Nilsson M, Göthberg C. A retrospective clinical study of fixed tooth- and implant-supported prostheses in titanium and cobalt-chromium-ceramic: 5-9-year follow-up. Clin Oral Investig 2022; 26:6097-6103. [PMID: 35767046 PMCID: PMC9525405 DOI: 10.1007/s00784-022-04559-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 05/20/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this retrospective study was to evaluate the clinical outcome of fixed tooth- and implant-supported protheses manufactured in porcelain veneered cobalt-chromium (CoCr) or titanium with a follow-up period of 5-9 years. MATERIALS AND METHODS This study included 63 patients with a total of 86 fixed dental protheses (FDPs) (53 implant-supported and 33 tooth-supported). In total, 67 were short-span FDPs (3-5 units) and 19 were long-span FDPs (6-12 units). The FDPs were evaluated using a modified version of the California Dental Association (CDA). RESULTS The binary regression analysis indicated that neither CoCr nor titanium had a statistically significant effect on the odds of success or survival of either tooth- or implant-supported FDPs. However, the success of FDPs was negatively affected by greater FDP length and general tooth wear. The survival of FDPs was negatively affected by increased FDP longevity. CONCLUSIONS This study found no statistically significant effect on the odds of success and survival outcomes for any combination of tooth-supported, implant-supported, porcelain-veneered CoCr, or porcelain-veneered titanium FDPs. As the number of FDPs was limited, the results should be interpreted with caution. CLINICAL RELEVANCE This study shows that the choice between CoCr porcelain and titanium porcelain in fixed protheses did not have a statistically significant effect on the outcome.
Collapse
Affiliation(s)
- Sheida Nilsson
- grid.8761.80000 0000 9919 9582The Sahlgrenska Academy, Department of Prosthodontics, Institute of Odontology, University of Gothenburg, Box 450, 405 30 Göteborg, Sweden
| | - Victoria Franke Stenport
- grid.8761.80000 0000 9919 9582The Sahlgrenska Academy, Department of Prosthodontics, Institute of Odontology, University of Gothenburg, Box 450, 405 30 Göteborg, Sweden
| | - Marco Nilsson
- grid.118888.00000 0004 0414 7587School of Education and Communication, Jönköping University, Box 1026, 551 11 Jönköping, Sweden
| | - Catharina Göthberg
- The Institute for Postgraduate Dental Education in Jönköping, Box 1030, 551 11 Jönköping, Sweden
| |
Collapse
|
76
|
Blatz MB, Hariton‐Gross K, Anadioti E, Mante F, Zhang Y, Saleh N. Prospective 5-year clinical evaluation of posterior zirconia fixed dental prostheses veneered with milled lithium disilicate (CADon). J ESTHET RESTOR DENT 2022; 34:136-144. [PMID: 35083844 PMCID: PMC9934977 DOI: 10.1111/jerd.12877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Bi-layer zirconia-based posterior fixed dental prostheses (FDPs) have reportedly a high incidence of veneering ceramic fractures. The CADon technique employs zirconia frameworks veneered with milled lithium disilicate glass-ceramic to overcome these shortcomings but long-term clinical studies are missing. This study evaluated the clinical efficacy of posterior 3-unit CADOn FDPs over a 5-year period. MATERIALS AND METHODS A total of 25 patients, 16 male and 9 female with a mean age of 55.6 years, received a total of 25 posterior three-unit CADOn FDPs. Patients were recalled for baseline and for follow-up visits at 6, 12, 24, and 60 months. Parameters evaluated were fracture, marginal adaptation, marginal discoloration, wear, polish, color match, surface staining, and retention of these restorations as well as secondary caries of the abutment teeth. RESULTS A total of 21 FDPs evaluated at 60-months revealed a 100% survival rate. All evaluated clinical parameters were satisfactory (alpha or bravo) and there was no statistically significant difference at different time points, except for surface staining, which was also worse at 60 months compared to baseline (p ≤ 0.001). CONCLUSIONS CADOn three-unit posterior FDPs demonstrate excellent fracture resistance after 5 years of clinical function. All evaluated clinical parameters were satisfactory, except for surface stain, which also increased over time. CLINICAL SIGNIFICANCE Conventionally veneered bi-layer zirconia-based posterior FDPs have limited clinical success. Based on this study, alternative methods such as zirconia frameworks veneered with milled lithium disilicate glass-ceramic provide a viable alternative with excellent long-term clinical outcomes.
Collapse
Affiliation(s)
- Markus B. Blatz
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Karina Hariton‐Gross
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Evanthia Anadioti
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Francis Mante
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Yu Zhang
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Najeed Saleh
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| |
Collapse
|
77
|
Nawafleh N, Elshiyab S, Öchsner A, George R. In Vitro Fatigue and Fracture Load of Monolithic Ceramic Crowns Supported by Hybrid Abutment. Open Dent J 2021. [DOI: 10.2174/1874210602115010664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
This study evaluated the performance of zirconia and lithium disilicate crowns supported by implants or cemented to epoxy resin dies.
Methods:
Eigthy zirconia and lithium disilicate crowns each were prepared and assigned in four groups according to the crown material and supporting structure combinations (implant-supported zirconia, die-supported zirconia, implant-supported lithium disilicate, and die-supported lithium disilicate). Ten crowns in each group acted as control while the rest (n=10) underwent thermocycling and fatigue with 100 N loading force for 1.5 million cycles. Specimens were then loaded to fracture in a universal testing machine. Data were analysed using one-way ANOVA and Tukey multiple comparison test with a 95% level of significance.
Results:
No implants or crown failure occurred during fatigue. The mean fracture load values (control, fatigued) in newton were as follows: (4054, 3344) for implant-supported zirconia, (3783, 3477) for die-supported zirconia, (2506, 2207) for implant-supported lithium disilicate, and (2159, 1806) for die-supported lithium disilicate. Comparing the control with the corresponding fatigued subgroup showed a significantly higher fracture load mean of the control group in all cases. Zirconia showed a significantly higher fracture load mean than lithium disilicate (P=0.001, P<0.001). However, comparing crowns made from the same material according to the supporting structure showed no significant difference (P=0.923, P=0.337).
Conclusion:
Zirconia and lithium disilicate posterior crowns have adequate fatigue and fracture resistance required for posterior crowns. However, when heavy fatigue forces are expected, zirconia material is preferable over lithium disilicate. Zirconia and lithium disilicate implant-supported crowns cemented to hybrid abutments should have satisfactory clinical performance.
Collapse
|
78
|
Tobar C, Rodriguez V, Lopez-Suarez C, Pelaez J, Suarez MJ. Influence of Digital Technologies and Framework Design on the Load to Fracture of Co-Cr Posterior Fixed Partial Denture Frameworks. J Prosthodont 2021; 31:606-613. [PMID: 34860426 DOI: 10.1111/jopr.13458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To compare the load to fracture of cobalt-chromium (Co-Cr) 3-unit posterior fixed partial denture (FPD) frameworks manufactured by conventional and digital techniques and to evaluate the influence of the framework design on the fracture load. MATERIAL AND METHODS Eighty 3-unit Co-Cr posterior FPD frameworks were fabricated with two designs: intermediate pontic (n = 40) and cantilever (n = 40). Each design was randomly divided into four groups (n = 10): casting, direct metal laser sintering, soft metal milling, and hard metal milling. After thermal cycling, all specimens were subjected to a 3-point bending test until fracture. Data were statistically analyzed using one-way ANOVA, Welch and Brown-Forsythe test, Ryan-Einot-Gabriel-Welsch F and Tamhane T2 post hoc test, Student's t test, and Weibull statistics (α = 0.05). RESULTS Significant differences (p < 0.001; F = 39.59) were found among intermediate pontic frameworks (except between laser sintering and hard metal milling), and cantilevered frameworks (F = 36.75) (except between laser sintering and hard metal milling, and casting and soft metal milling). The cantilever groups showed load to fracture values significantly lower than those of the intermediate pontic (p < 0.001; F = 28.29). The Weibull statistics corroborated the results. CONCLUSIONS Hard metal milling and laser sintered frameworks exhibited the highest load to fracture values. However, all tested frameworks demonstrated clinically acceptable load to fracture values. The framework design directly affected the fracture load, with drastically lower values in cantilevered frameworks.
Collapse
Affiliation(s)
- Celia Tobar
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Veronica Rodriguez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Carlos Lopez-Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Jesus Pelaez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Maria J Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| |
Collapse
|
79
|
WANG D, ZHANG X, ZHANG C, JIANG L, DENG C, ZHAO B. Clinical assessment of food impaction after implant restoration: a retrospective analysis. FOOD SCIENCE AND TECHNOLOGY 2021. [DOI: 10.1590/fst.56320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
80
|
de Lima E, Tanaka CB, Meira JBC, Santos KF, Arashiro L, Cribari L, Gonzaga CC, Cesar PF. Effect of processing methods on the chipping resistance of veneered zirconia. J Mech Behav Biomed Mater 2021; 126:104995. [PMID: 34875502 DOI: 10.1016/j.jmbbm.2021.104995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To evaluate the edge chipping resistance (ReA) and the fracture toughness (KC) of 3Y-TZP bilayers produced with the following materials/processing combinations: fluorapatite glass-ceramic applied on zirconia using the traditional layering and hot-pressing (press-on) techniques; feldspathic porcelain using rapid layer technology (RLT); and lithium disilicate glass-ceramic using CAD-on method. The influence of the cooling rate (slow and fast) was analyzed for layering and hot-pressing. METHODS Bilayer bars (25x4x2 mm) were made following manufacturers' instructions. The edge chipping test was performed in an universal testing machine, using a coupled Vickers indenter. ReA was calculated dividing the critical load at fracture by the edge distance. Fracture toughness was calculated by a regression fit with a fixed slope of 1.5 correlating the critical chipping load regarding edge distance and also with indentation fracture (IF) method. Data were statistically analyzed using ANOVA and Tukey's test (α = 5%). RESULTS ReA and KC was significantly higher for the CAD-on bilayers. RLT showed intermediate ReA means, and layering and hot-pressing techniques showed the lowest ReA values. For both processing methods there was no effect of the cooling protocol on the ReA and fracture toughness. CONCLUSIONS There is a significant effect of the material/processing association on the edge chipping resistance and fracture toughness of the bilayers. There was no effect of the cooling protocol on the edge chipping resistance and fracture toughness for the specimens processed by both the layering and hot-pressing techniques.
Collapse
Affiliation(s)
- Erick de Lima
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Carina Baptiston Tanaka
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil; School of Mechanical and Manufacturing Engineering, University of New South Wales, (UNSW Sydney), Sydney NSW 2052, Australia
| | - Josete Barbosa Cruz Meira
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Karina Felix Santos
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Lidia Arashiro
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Lisiane Cribari
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Carla Castiglia Gonzaga
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil.
| | - Paulo Francisco Cesar
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
81
|
Pousette Lundgren G, Davidson T, Dahllöf G. Cost analysis of prosthetic rehabilitation in young patients with Amelogenesis imperfecta. J Dent 2021; 115:103850. [PMID: 34656659 DOI: 10.1016/j.jdent.2021.103850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/01/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES Children and adolescents with amelogenesis imperfecta (AI) have extensive treatment needs, but costs have not been explored previously. We calculated the costs of prosthetic rehabilitation and analyzed whether costs of treatment begun in early adolescence are lower compared with in early adulthood. METHODS Data from the dental records of 25 patients with AI and 25 age- and sex-matched controls were analyzed. Patients were followed for a mean period of 12.3 ± 1.5 years. Number of dental visits, dental treatment costs, and indirect costs were calculated during three time periods, before, during and after prosthetic therapy. Swedish national reference prices for general and specialist dental care were used. RESULTS The mean number of visits was significantly higher in the AI group: 43.3 ± 19.7 (controls: 17.5 ± 19.8; p < .001). Mean total costs were 8.5 times higher for patients with AI: €16,257 ± 5,595 (controls: €1,904 ± 993). Mean number of crowns made in patients with AI was 12 ± 7 (range 1 - 31). Indirect costs were significantly higher in the AI group and constituted 22% of the total costs. After crown therapy, costs between groups ceased to differ significantly. Calculations of total costs in the hypothetical scenario (discount rate at 3% annually) were €18,475 for prosthetic rehabilitation began at age 12 years compared with €20,227 if treatment began at 20 years of age. CONCLUSIONS Prosthetic rehabilitation costs for children and adolescents with AI can be high. Early crown therapy is associated with lower costs and a lower number of dental visits. CLINICAL IMPLICATIONS Early crown therapy in children and adolescents with severe AI is a cost-reducing treatment associated with few complications and reduced need of dental care during adolescence compared with treatment begun at age 20.
Collapse
Affiliation(s)
- Gunilla Pousette Lundgren
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Thomas Davidson
- Division of Health Care Analysis, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Göran Dahllöf
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden; Center for Oral Health Services and Research, Mid-Norway, TkMidt, Trondheim, Norway
| |
Collapse
|
82
|
Cinel Sahin S, Celik E. The effect of different cleaning agents and resin cement materials on the bond strength of contaminated zirconia. Microsc Res Tech 2021; 85:840-847. [PMID: 34617647 DOI: 10.1002/jemt.23953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to examine the effect of different cleaning methods and resin cements on the shear bond strength (SBS) of contaminated zirconia. A total of 92 disc-shaped zirconia specimens were contaminated with different procedures. Then, the specimens were grouped according to cleaning methods and resin cements: no cleaning + Variolink Esthetic DC (CNV ), no cleaning + Panavia V5 (CNP ), sandblasted + Variolink Esthetic DC (SBV ), sandblasted + Panavia V5 (SBP ), Ivoclean + Variolink Esthetic DC (ICV ), Ivoclean + Panavia V5 (ICP ), Katana Cleaner + Variolink Esthetic DC (KCV ), and Katana Cleaner + Panavia V5 (KCP ). Following an aging protocol in a 37°C for 1 week, SBS analysis was performed with a universal test machine. For the surface topography and elemental analysis, scanning electron microscopy and energy-dispersive X-ray spectroscopy (EDS) were used. Significance was evaluated as p < .05 and p < .01. The highest SBS results were found in the SBP group, showing a statistically significant difference from all other groups (p < .05). For the same cleaning method, Panavia V5 showed statistically significantly higher SBS values than Variolink Esthetic DC (p < .01), except the CNP -CNV (p = .880) and KCP -KCV (p = .082) groups. The most detected surface elements by EDS were Zr, O, C, and N, respectively. The contaminated zirconia surfaces must be cleaned for successful adhesion. The use of phosphate-containing adhesives in combination with sandblasting will increase the adhesion strength, and universal cleaning agents can be a good alternative to sandblasting.
Collapse
Affiliation(s)
- Sezgi Cinel Sahin
- Department of Prosthodontics, Pamukkale University Faculty of Dentistry, Denizli, Turkey
| | - Ersan Celik
- Department of Prosthodontics, Ordu University Faculty of Dentistry, Ordu, Turkey
| |
Collapse
|
83
|
Cimões R, Pinho RCM, Gurgel BCDV, Borges SB, Marcantonio Júnior E, Marcantonio CC, Melo MARDC, Piattelli A, Shibli JA. Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation. Braz Oral Res 2021; 35:e101. [PMID: 34586215 DOI: 10.1590/1807-3107bor-2021.vol35.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 01/21/2023] Open
Abstract
When periodontal disease is diagnosed, it is difficult to predict the clinical response of treatment of a tooth over time because the result of treatment is affected by several factors and will depend on the maintenance and support of periodontal treatment. Rehabilitation with removable dental prostheses, fixed prostheses, and dental implants makes it possible to restore the function and esthetics of patients with tooth loss due to periodontal disease. The predictive factors of tooth loss in periodontitis patients should be assessed by dentists to inform their clinical decision-making during dental treatment planning. This will provide detailed individualized information and level of risk of patients considered suitable for dental rehabilitation. Therefore, the aim of this article was to review the subject of "Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation" and the effect of fixed, removable, and implant-supported prostheses in periodontal patients.
Collapse
Affiliation(s)
- Renata Cimões
- Universidade Federal de Pernambuco - UFPE, Health Sciences Centre, Department of Prosthesis and Oral and Maxillofacial Surgery, Recife, PE, Brazil
| | | | | | - Samuel Batista Borges
- Universidade Federal do Rio Grande do Norte - UFRN, Health Sciences Centre, Department of Dentistry, Natal, RN Brazil
| | - Elcio Marcantonio Júnior
- Universidade Estadual Paulista Júlio de Mesquita Filho - Unesp, Faculdade de Odontologia de Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Camila Chierici Marcantonio
- Universidade Estadual Paulista Júlio de Mesquita Filho - Unesp, Faculdade de Odontologia de Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | | | - Adriano Piattelli
- University of Chieti, Dental School, Department of Medical, Oral and Biotechnological Sciences, Chieti, Italy
| | - Jamil Awad Shibli
- Universidade de Guarulhos - UnG, Dental Research Division, Department of Periodontology and Oral Implantology, Guarulhos, SP, Brazil
| |
Collapse
|
84
|
Waldecker M, Behnisch R, Rammelsberg P, Bömicke W. Five-year clinical performance of monolithic and partially veneered zirconia single crowns-a prospective observational study. J Prosthodont Res 2021; 66:339-345. [PMID: 34556602 DOI: 10.2186/jpr.jpr_d_21_00024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to prospectively evaluate the medium-term clinical performance and esthetics of monolithic and partially (i.e., facially) veneered zirconia single crowns (MZ-SC and PZ-SC, respectively). METHODS Between September 2011 and June 2013, 68 participants received 90 MZ-SC and 72 PZ-SC. Clinical study documentation was performed at crown cementation (baseline), at 6-month follow-up, and then yearly thereafter using standardized report forms. Three participants with four MZ-SC dropped out during clinical follow-up. Thus, 65 participants (n = 31, 47.7% men) fitted with 158 restorations (86 MZ-SC, 72 PZ-SC) were evaluated. The mean observation period of the restorations was 5.8 ±2.5 years; 6.3 ±2.2 for MZ-SC and 5.2 ±2.6 for PZ-SC. RESULTS The 5-year rate of complication-free survival (success) was 87.0% for MZ-SC and 95.8% for PZ-SC (log-rank test, p = 0.026). The 5-year failure-free survival rate was 93.1% for MZ-SC and 96.2% for PZ-SC (log-rank test, p = 0.111), and the 5-year ceramic fracture-free survival rate was 100% for MZ-SC and 98.6% for PZ-SC (log-rank test, p = 0.274). Crowns of both designs were awarded excellent scores for esthetics by participants and dentists. CONCLUSIONS Monolithic and partially veneered zirconia crowns can be used clinically with high medium-term survival and success and uncompromised esthetic results.
Collapse
Affiliation(s)
- Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| |
Collapse
|
85
|
Effects of thickness of different types of high-translucency monolithic multilayer precolored zirconia on color accuracy: An in vitro study. J Prosthet Dent 2021; 126:587.e1-587.e8. [PMID: 34446291 DOI: 10.1016/j.prosdent.2021.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM High-translucency monolithic multilayer precolored zirconia provides acceptable esthetics and eliminates chipping of the veneering porcelain. However, the color is not always consistent with the standard Vita shade guide, and the color saturation may vary with the thickness of the zirconia. PURPOSE The purpose of this in vitro study was to characterize the effect of thickness on the color accuracy of high-translucency monolithic multilayer precolored zirconia. MATERIAL AND METHODS Plate-shaped (20×20 mm) Vita A2 shade high-translucency monolithic multilayer precolored zirconia specimens of 3 types (SHT Multilayer, AT Multilayer, and 3D Multilayer) in 4 thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were fabricated (N=120, n=10). A spectrophotometer was used to measure the color attributes (CIELab) against gray or A2 substrates to evaluate the color accuracy based on differences in color (ΔE) (versus the Vita shade guide) and chroma. Statistical analysis was performed by using the Pearson correlation, 2-way ANOVA, and post hoc Scheffé test (α=.05). RESULTS Against gray substrates, thickness was significantly positively correlated with all color attributes. Against A2 substrates, L∗ values increased with an increase in thickness; however, a∗, b∗, and chroma values remained stable. Zirconia with a thickness of 1.0 mm exhibited the lowest ΔE, regardless of the type, except for AT Multilayer against A2 substrates, where the lowest ΔE was achieved at 0.5 mm. At thicknesses ≥1.0 mm, the ΔE between the 2 substrates was imperceivable. CONCLUSIONS Thickness affected the color accuracy of different high-translucency monolithic multilayer precolored zirconia types. It appears that the optimal thickness in terms of color accuracy is 1.0 mm. These results could be used as a reference for the selection and preparation of abutments in clinical applications.
Collapse
|
86
|
Staehle HJ, Sekundo C, Hieronymus H, Büsch C, Frese C. Replacing single missing teeth in the posterior region using direct composite restorations: Survival and clinical quality. J Dent 2021; 113:103754. [PMID: 34333054 DOI: 10.1016/j.jdent.2021.103754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 07/14/2021] [Accepted: 07/25/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this pilot study was to test the survival and clinical quality of frugal methods to replace single missing teeth in the posterior region with direct composite restorations of different categories. METHODS We performed a detailed intraoral examination and assessed the clinical quality of the restorations according to modified FDI-criteria. Irreparable loss of a restoration was recorded as "failure" (F). Damaged restorations that could be repaired were defined as "survival with repair" (SR). Restorations without any unfavorable events were classified as "success" (S). RESULTS The average follow-up time of restorations was 5.07 ± 5.24 years with 15.1% having a follow-up time of more than 10 years. Three unfavorable events were documented. Two restorations (3.8%) were classified as F, one restoration (1.9%) as SR, and the remaining 50 restorations (94.3%) as S. The estimated overall and functional survival rate at 5 years using the Kaplan-Meier method was 96.2% (confidence interval [CI]:85.5% to 99%) and 98% (CI:86.9% to 99.7%), respectively. Ninety-four percent of the restorations were evaluated as good or excellent clinical quality. Most restorations showed no periodontal complications, however, restorations in the mandible showed significantly more plaque accumulation (p=0.002). CONCLUSIONS These conservative frugal methods to replace single missing teeth in the posterior region showed promising clinical survival data and quality parameters. CLINICAL SIGNIFICANCE Direct composite restorations of different categories can be considered as additional treatment option for gap closure in specific clinical situations.
Collapse
Affiliation(s)
- Hans Joerg Staehle
- Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Department of Conservative Dentistry, Heidelberg, Germany
| | - Caroline Sekundo
- Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Department of Conservative Dentistry, Heidelberg, Germany
| | - Hanna Hieronymus
- Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Department of Conservative Dentistry, Heidelberg, Germany
| | - Christopher Büsch
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Cornelia Frese
- Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Department of Conservative Dentistry, Heidelberg, Germany.
| |
Collapse
|
87
|
Technical and Biological Complications of Screw-Retained (CAD/CAM) Monolithic and Partial Veneer Zirconia for Fixed Dental Prostheses on Posterior Implants Using a Digital Workflow: A 3-Year Cross-Sectional Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5581435. [PMID: 34307657 PMCID: PMC8279852 DOI: 10.1155/2021/5581435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/10/2021] [Accepted: 06/28/2021] [Indexed: 01/31/2023]
Abstract
Objective The introduction of CAD/CAM and the development of zirconia-based restorations have allowed clinicians to use less expensive materials and faster manufacturing procedures. The purpose of the study was to analyze the differences, in terms of mechanical and biological complication, in multiunit zirconia fixed dental prosthesis (FPDs) on posterior implants produced using a digital workflow. Method and Materials. This study was a retrospective investigation, and patients treated with screw-retained monolithic or partial veneer FPDs on dental implants were selected. Periapical radiographs were taken at baseline and at the 3-year follow-up. Complications were recorded and classified as technical and biological ones. Results The study population included 25 patients. The occlusal and interproximal corrections were not clinically significant. In the study sample, the survival rate and success rate of the FPDs after 3 years were 100% and 96%, respectively. One implant failed immediately after placement. Conclusion Monolithic zirconia FPDs and partial veneer FPDs showed a 100% survival rate, presenting an interesting alternative to metal ceramic restorations. The partial veneer FPDs had a higher technical complication rate than the monolithic FPDs; however, no statistically significant difference was found.
Collapse
|
88
|
Laumbacher H, Strasser T, Knüttel H, Rosentritt M. Long-term clinical performance and complications of zirconia-based tooth- and implant-supported fixed prosthodontic restorations: A summary of systematic reviews. J Dent 2021; 111:103723. [PMID: 34119611 DOI: 10.1016/j.jdent.2021.103723] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To present an overview on systematic reviews on prosthodontic zirconia restorations and to discuss long-term complications as well as information on anatomical and functional changes to the masticatory system. DATA/SOURCES MEDLINE, EMBASE, Trip medical, and Cochrane Library databases were searched for systematic reviews up to February 2021. Bias was assessed and clinical survival and complications were analyzed. STUDY SELECTION 38 eligible articles published between 2006 and 2021 were included. The reviews were based on 128 in vivo studies on approximately 10,000 zirconia restorations. 5-year cumulative survival rates varied between 91.2% and 95.9% for tooth-supported (TS) single crowns (SC), 89.4% and 100% for TS multi-unit fixed dental prostheses (FDP), 97.1% and 97.6% for implant-supported (IS) SCs and 93.0% and 100% for IS FDPs. Chipping was the most often technical complication, followed by framework fracture, loss of retention, marginal discrepancies/discoloration, occlusal roughness and abutment/screw loosening. Color mismatch was the only esthetic complication. Biological complications were caries, endodontic complications, tooth fracture, periodontal disease, abrasion/attrition, persisting pain, high sensitivity, peri‑implantitis and soft tissue issues. Patients with bruxism were only examined sporadically. CONCLUSIONS 5-year results for zirconia restorations were satisfactory. The predominant technical problem of veneering fractures could be overcome with adapted design or fabrication and application of monolithic restorations, but reviews of clinical studies on this subject are rare. The impact of zirconia restorations on the masticatory system remains unclear. CLINICAL SIGNIFICANCE Zirconia restorations are experiencing a rapidly increasing use in dental practice. Being highly wear-resistant, hard and durable, it can be assumed that they do not follow natural abrasion and changes in the masticatory system. Possible long-term effects on the stomatognathic system as a whole should therefore be considered.
Collapse
Affiliation(s)
- Harald Laumbacher
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Thomas Strasser
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, 93042 Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany.
| |
Collapse
|
89
|
Saravi B, Vollmer A, Hartmann M, Lang G, Kohal RJ, Boeker M, Patzelt SBM. Clinical Performance of CAD/CAM All-Ceramic Tooth-Supported Fixed Dental Prostheses: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14102672. [PMID: 34065202 PMCID: PMC8161295 DOI: 10.3390/ma14102672] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/16/2021] [Accepted: 05/18/2021] [Indexed: 12/29/2022]
Abstract
Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported zirconia- and lithium disilicate-based fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5-, and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates excluding failures, but including any other types of intervention were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication excluding failures but requiring intervention was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with seven studies associated with low risk of bias, eight studies with a moderate risk of bias, and three studies with serious risk of bias. The current meta-analysis on CAD/CAM-supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature.
Collapse
Affiliation(s)
- Babak Saravi
- Medical Center—University of Freiburg, Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
- Correspondence:
| | - Andreas Vollmer
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany;
| | - Maja Hartmann
- Private Practice, Kantstraße 10, 60316 Frankfurt am Main, Germany;
| | - Gernot Lang
- Medical Center—University of Freiburg, Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
| | - Ralf-Joachim Kohal
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany; (R.-J.K.); (S.B.M.P.)
| | - Martin Boeker
- Medical Center—University of Freiburg, Institute of Medical Biometry and Medical Statistics, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
| | - Sebastian B. M. Patzelt
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany; (R.-J.K.); (S.B.M.P.)
- Private Practice, Am Dorfplatz 3, 78658 Zimmern o.R., Germany
| |
Collapse
|
90
|
Kim JE, Kwon YC, Kim S, Park YB, Shim JS, Moon HS. Effect of Acid Mixtures on Surface Properties and Biaxial Flexural Strength of As-Sintered and Air-Abraded Zirconia. MATERIALS 2021; 14:ma14092359. [PMID: 34062894 PMCID: PMC8125152 DOI: 10.3390/ma14092359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022]
Abstract
The aim of this work was to evaluate the effects of application time of an acid mixture solution on the surface roughness, phase transformation, and biaxial flexural strength of 3Y-TZP after sintering or air abrasion. For the biaxial flexural strength measurement, 220 3Y-TZP disk-shaped specimens were prepared after as-sintering or air abrasion. The etching solution comprised a mixture of hydrofluoric acid, sulfuric acid, hydrogen peroxide, methyl alcohol, and purified water. The samples were divided into 11 subgroups according to the etching times (Control, 1, 2, 3, 5, 8, 10, 12, 15, 20, and 30 min). The results showed that acid treatment on both as-sintered and air-abraded 3Y-TZP surfaces increased the surface roughness. However, it had no significant effects on the monoclinic phase or flexural strength of as-sintered zirconia. The monoclinic phase and flexural strength of air-abraded zirconia increased sharply after air abrasion; however, they gradually decreased after acid treatment, to a similar level to the case of the untreated surface. Surface treatment with acid mixture increased the roughness, but the lack of increase of monoclinic phase is thought to be because the loose monoclinic particles remaining on the surface were removed through the etching process.
Collapse
Affiliation(s)
- Jong-Eun Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
| | - Yong-Chan Kwon
- CLF Dental Laboratory, 227 Moraenae-ro, Seodaemun Gu, Seoul 03695, Korea;
| | - Sunjai Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
| | - Young-Bum Park
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
| | - June-Sung Shim
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
| | - Hong-Seok Moon
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
- Correspondence: ; Tel.: +82-2-2228-3155
| |
Collapse
|
91
|
Corcodel N, Herpel C, Seceleanu I, Rion K, Hassel AJ, Rammelsberg P. Effect of grinding adjustments on the color of monolithic zirconia. J Prosthet Dent 2021; 128:1075-1083. [PMID: 33896619 DOI: 10.1016/j.prosdent.2021.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Monolithic zirconia restorations have become popular because of their excellent mechanical properties and acceptable esthetics. While the biomechanical properties of zirconia have been investigated, research into their esthetic properties is sparse. Zirconia can be colored by infiltration before sintering, although how occlusal adjustment can affect restoration color is unclear. PURPOSE The purpose of this in vitro study was to analyze the color of differently characterized monolithic white and precolored zirconia specimens after standardized grinding. MATERIAL AND METHODS White and precolored monolithic zirconia plates (Cercon ht) (n=36) were stained by infiltration with target colors Vita A2, A3.5, and A4. In a standardized experimental arrangement, all plates were ground in 9 steps, and the color was measured with a spectroradiometer at each step. Color differences (ΔE00) were analyzed by using regression analysis, the Kruskal-Wallis test, and the inverse prediction with confidence intervals (α=.05). RESULTS Mechanical material removal had a significant effect on the color stability (P<.05) of both white and precolored monolithic zirconia. For each grinding step and each target color, the precolored groups had a significantly lower ΔE00 mean than the white groups (P<.05), except at the 20-μm step for groups W-A4 and P-A4 (P>.05). For target color A2, the difference was significant with P<.001 at all 9 grinding steps. For target color A3.5, the difference was significant with P=.003 at grinding level 20 μm, and P<.001 for all other grinding steps. For target color A4, the difference was not significant with P=.603 at grinding level 20 μm, whereas the difference was significant with P=.007 at grinding level 50 μm, and with P<.001 for all other grinding steps. CONCLUSIONS Precolored zirconia had less color change after grinding than white zirconia. This study established grinding depths for white and precolored zirconia corresponding to color perceptibility and acceptability thresholds.
Collapse
Affiliation(s)
- Nicoleta Corcodel
- Assistant Professor, Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.
| | - Christopher Herpel
- Assistant Professor, Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Irina Seceleanu
- Associate Professor, Department of Mathematics, Bridgewater State University, Bridgewater, Mass
| | - Kevin Rion
- Associate Professor, Department of Mathematics, Bridgewater State University, Bridgewater, Mass
| | - Alexander Jochen Hassel
- Associate Professor, Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Professor and Head, Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
92
|
Rauch A, Schrock A, Schierz O, Hahnel S. Material preferences for tooth-supported 3-unit fixed dental prostheses: A survey of German dentists. J Prosthet Dent 2021; 126:91.e1-91.e6. [PMID: 33849738 DOI: 10.1016/j.prosdent.2021.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM Different material options are available for fixed dental prostheses (FDPs), but valid data on the favored materials of German dentists for 3-unit FDPs are lacking. It is unclear whether preferences depend on the individual characteristics of the dentists or their dental practices. PURPOSE The purpose of this survey was to identify the preferred material selection of German dentists for the fabrication of tooth-supported 3-unit FDPs depending on the location of the abutment teeth and the individual characteristics of the dentist or the dental practice. MATERIAL AND METHODS A survey was developed that included questions on the demographic characteristics (sex, area of expertise, age group, time since graduation, number of inhabitants, and the postal code of the dental practice or dental school) of the participating dentist and their preferred materials for the fabrication of tooth-supported 3-unit FDPs. Three clinical scenarios (anterior maxillary FDP, posterior maxillary FDP, posterior mandibular FDP) were presented. The dentists were allowed to select from predefined options or to give a free answer. For comparisons of characteristic associations, the number of inhabitants was chosen to represent the characteristics of the dental practice, and sex and time since graduation were selected to represent the characteristics of the dentist. Group comparisons were conducted with Chi-square tests (α=.05). RESULTS A response of 721 dentists from all parts of Germany was received, and data from 688 dentists were included in the analyses. Ceramic was the most preferred material for the fabrication of 3-unit FDPs independent of the location of the abutment teeth with veneered zirconia as the favored option. Metal-ceramic was ranked second. The time since graduation ≤15 years was associated with a preference of ceramic over metal-ceramic for the anterior restoration (P<.001). CONCLUSIONS Most participating dentists selected appropriate restorative materials depending on the individual clinical setting presented in the survey. For the anterior 3-unit FDP, time since graduation was associated with the preference for a restorative material. Some dentists selected lithium-X-silicate ceramics for situations beyond their recommended indication range.
Collapse
Affiliation(s)
- Angelika Rauch
- Assistant Professor, Department of Prosthetic Dentistry and Dental Materials Science, University of Leipzig, Leipzig, Germany.
| | - Annett Schrock
- Data Manager, Institute for Medical Informatics, Statistics and Epidemiology (IMISE) and Department of Prosthetic Dentistry and Dental Materials Science, University of Leipzig, Leipzig, Germany
| | - Oliver Schierz
- Assistant Professor, Department of Prosthetic Dentistry and Dental Materials Science, University of Leipzig, Leipzig, Germany
| | - Sebastian Hahnel
- Professor, Department of Prosthetic Dentistry and Dental Materials Science, University of Leipzig, Leipzig, Germany
| |
Collapse
|
93
|
Mazza LC, Lemos CAA, Pesqueira AA, Pellizzer EP. Survival and complications of monolithic ceramic for tooth-supported fixed dental prostheses: A systematic review and meta-analysis. J Prosthet Dent 2021; 128:566-574. [PMID: 33745685 DOI: 10.1016/j.prosdent.2021.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 01/11/2023]
Abstract
STATEMENT OF PROBLEM Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the survival and biological and technical complication rates of monolithic single crowns and fixed partial dentures (FPDs). MATERIAL AND METHODS An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE, Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk of bias tool were used to assess the quality and risk of bias of the included studies. Meta-analysis was performed by using the R software program. RESULTS The search identified 763 articles, 18 of which met the eligibility criteria. A total of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate, 461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36 lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed a direct comparison between monolithic and veneered ceramic restorations, and no significant difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91; P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29). CONCLUSIONS The use of monolithic ceramic can be considered a favorable treatment for tooth-supported single crowns and FPDs, with high survival and low complication rates. However, further randomized controlled trials are needed to reassess these clinical performances, mainly by comparing them with the performance of veneered restorations.
Collapse
Affiliation(s)
- Letícia Cerri Mazza
- MSc student, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Division of Prosthodontics, Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Aldiéris Alves Pesqueira
- Assistant Professor, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil.
| | - Eduardo Piza Pellizzer
- Titular Professor, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil
| |
Collapse
|
94
|
Elraggal A, Silikas N. Effect of Air-Abraded Versus Laser-Fused Fluorapatite Glass-Ceramics on Shear Bond Strength of Repair Materials to Zirconia. MATERIALS 2021; 14:ma14061468. [PMID: 33802778 PMCID: PMC8002453 DOI: 10.3390/ma14061468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
Zirconia repair could be a feasible alternative option to total replacement in fractured zirconia-based restorations. Maximising the bond strength by enriching zirconia with fluorapatite glass-ceramics (FGC) powder has been addressed and compared to other surface treatments. Besides resin composite, other repair materials have been proposed and compared. Zirconia blocks received different surface treatments (A-sandblasting with tribochemical silica-coated alumina (CoJet). B-sandblasting with FGC powder (FGC), C-fluorapatite glass-ceramic coat+ neodymium-doped yttrium aluminum garnet laser irradiation (FGC + Nd: YAG), and D-no surface treatment). The surface roughness, topography, and crystallinity were investigated by a profilometer, scanning electron microscopy (SEM), and X-ray diffraction (XRD) analyses, respectively. For each surface treatment, three repair materials (feldspathic porcelain, lithium disilicate, and resin composite) were bonded to zirconia with 10, Methacryloyloxydecyl dihydrogen phosphate (MDP)-Monobond Plus/ Multilink Automix. Bonded specimens were thermocycled for 10,000 cycles and tested for shear bond strength (SBS) at a speed of 1 mm/min, followed by the analysis of the mode of failure. FGC + Nd: YAG laser group reported the highest surface roughness and monoclinic content compared to CoJet, FGC, and control groups. The highest mean SBS was found in FGC-blasted zirconia, followed by FGC + Nd: YAG laser and CoJet treated groups. However, the lowest SBS was found in control groups regardless of the repair material. Sandblasting zirconia with FGC powder increased SBS of resin to zirconia with lower monoclinic phase transformation compared to FGC + Nd: YAG or CoJet groups.
Collapse
Affiliation(s)
- Alaaeldin Elraggal
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK;
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria 21568, Egypt
- Correspondence: ; Tel.: +20-1145096263
| | - Nikolaos Silikas
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK;
| |
Collapse
|
95
|
Radiographic periapical healing associated with root-treated teeth accessed through existing crowns: a historical controlled cohort study. Clin Oral Investig 2021; 25:5807-5814. [PMID: 33730213 DOI: 10.1007/s00784-021-03885-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of this study was to determine the periapical healing rate and complications arising from non-surgical root canal treatment (NSRCT) conducted through the existing and retained restoration, compared to that conducted after removal of restoration (direct or indirect) with subsequent placement of a new crown. MATERIALS AND METHODS Two-hundred-and-forty-five teeth met the inclusion criteria and were followed up for 2 years. One-hundred-and-six teeth had NSRCT completed through existing cast restorations, and 57 and 82 had the existing crowns and direct restorations removed (respectively) and received a new crown after NSRCT. Periapical healing was assessed radiographically using strict (complete healing) and loose (complete and incomplete healing) criteria. Multivariable logistic regression models were used to investigate the effect of prior restoration removal on periapical healing following NSRCT, adjusting for potential confounding (p < 0.05). RESULTS There was no significant (p > 0.05) difference in the periapical healing rates amongst teeth accessed through existing crowns (72%, 90%) versus those where crowns (79%, 93%) or direct restorations (77%, 90%) were removed for NSRCT. The findings were adjusted for the significant influencing factor: size of pre-operative radiolucency (p < 0.05). Of the 109 teeth that were initially accessed through existing crowns, 9 (8%) displayed porcelain fracture or crown de-cementation. CONCLUSION Performing root canal treatment through an existing full coverage restoration did not compromise periapical healing and was associated with a low incidence of associated complications. CLINICAL RELEVANCE Crown removal before NSRCT is not mandatory for periapical healing but requires a judicious pre-assessment of current and future marginal and restorative integrity.
Collapse
|
96
|
Haralur SB, Al Ghaseb GA, Alqahtani NA, Alqahtani B. Comparison of microleakage between different restorative materials to restore marginal gap at crown margin. PeerJ 2021; 9:e10823. [PMID: 33665019 PMCID: PMC7916530 DOI: 10.7717/peerj.10823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 01/02/2021] [Indexed: 12/30/2022] Open
Abstract
Background An occurrence of secondary caries around the indirect restoration margin is reported to remain a leading cause of failures. Objective This study aimed to test the interfacial microleakage of conventional glass-ionomer (CGI), resin-modified glass ionomer (RMGI) and Nano-hybrid composite (CR) restorations at a full veneer margin crown. Methods Ninety human extracted molar teeth were divided into three groups (n = 30). Each group was subdivided into three subgroups (n = 10) according to the extent of the structural defects; The structural defect in G1 had a depth of 1.5 mm, width and length at 2 mm and 1 mm intrusion within the crown cervical margin. The corresponding structural defect dimension values for G2 were 2, 5, 4 and 2 mm with defects extending onto the root structure. Meanwhile, G3: structural deficiency of 2 mm depth, 3 mm width and 3 mm length and with 1.5 mm extension into the prepared teeth. These structural defects in each subgroup were restored with CGI, RMGI and CR. Artificial carious lesion formation was induced at the cervical finish line with a demineralizing solution. The artificial carious lesions were restored as per the group distribution. Subsequently, teeth samples were prepared and cemented with Nickel-chromium full coverage restorations utilizing glass-ionomer luting cement. Teeth samples were thermocycled, isolated with nail varnish, and immersed in 0.1% methylene blue for 24 h. The teeth samples were sectioned longitudinally, dye penetration was evaluated with a stereomicroscope. The data were analyzed with Kruskal–Wallis and Mann–Whitney U tests. Results CGI-G1 recorded the highest micro-leakage score at 1.450; while CR-G3 recorded the least score (0.350). At a cementum-restoration interface, CR-G1 (0.850) documented the lowest micro-leakage; RMGI-G3 had a greater value at 1.700. Conclusions The hybrid CR could be effectively used to restore the restoration of a marginal gap around crown margins.
Collapse
Affiliation(s)
- Satheesh B Haralur
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Asir, Saudi Arabia
| | - Ghaseb Ahmed Al Ghaseb
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Asir, Saudi Arabia
| | - Norah Ali Alqahtani
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Asir, Saudi Arabia
| | - Bader Alqahtani
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Asir, Saudi Arabia
| |
Collapse
|
97
|
Performance of fixed dental prostheses up to 6 years-A massive data analysis. J Prosthet Dent 2021; 128:350-354. [PMID: 33622552 DOI: 10.1016/j.prosdent.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM Metal and metal-ceramic fixed dental prostheses (FDPs) have been clinically determined to provide long-term durable restorations. However, data on their performance under practice conditions are sparse. PURPOSE The purpose of this clinical study was to evaluate the longevity of FDPs under practice conditions by analyzing a large insurance claims database. MATERIAL AND METHODS Data were extracted from the data warehouse of a major German national health insurance company (BARMER). The analysis focused on the FDP types with the lowest deductibles in the insurance system. All metal-based FDPs replacing up to 3 adjacent teeth were included. Ceramic veneering was optional and only approved on the labial surfaces of maxillary teeth mesial to the first molar and mandibular teeth mesial to the second premolar. Fee codes allowed clinical courses to be traced on a day count basis. Three groups with FDPs replacing 1 tooth, 2 teeth, and 3 teeth were formed. Kaplan-Meier survival analyses were conducted for the target events removal or extraction, indicating FDP failure and extraction of an abutment tooth. RESULTS The sample comprised 124 660 FDPs that replaced 1 tooth (76.5%), 2 teeth (19.8%), or 3 teeth (3.7%). The cumulative survival rates for removal or extraction at 6 years differed significantly, with 83.0% for 1-pontic FDPs, 78.1% for 2-pontic FDPs, and 74.0% for 3-pontic FDPs. Thus, approximately 1 of 6 one-pontic FDPs, 1 of 5 two-pontic FDPs, and 1 of 4 three-pontic FDPs failed. The cumulative survival rates for extraction of an abutment tooth at 6 years showed no significant difference, with 96.0% for 1-pontic FDPs, 95.6% for 2-pontic FDPs, and 95.1% for 3-pontic FDPs. CONCLUSIONS The survival rates of FDPs according to insurance data were lower than those reported by clinical studies, indicating a gap between efficacy and effectiveness.
Collapse
|
98
|
Evaluation of gingival displacement methods in terms of periodontal health at crown restorations produced by digital scan: 1-year clinical follow-up. Lasers Med Sci 2021; 36:1323-1335. [PMID: 33566189 DOI: 10.1007/s10103-021-03266-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
Abstract
The purpose of this clinical study was to compare the effects of the gingival displacement techniques of retraction cord, cordless paste system, and Er,Cr:YSGG laser troughing on the periodontal tissues around the crown restoration produced using a digital scan. This was analyzed by recording the probing depth (PD), plaque index, gingival index (GI), mobility, sensitivity, and bleeding on probing (BOP) index. This study included 60 mandibular 1st molars from 52 participants (20 males and 32 females) requiring crown restoration. The margin lines of the crown preparations were placed 1 mm subgingivally. Based on the gingival displacement technique used, the patients were divided into three groups: retraction cord, cordless paste system, and Er,Cr:YSGG laser troughing. A digital scan of the prepared tooth was performed. Follow-up appointments were scheduled at five different times: 1st day, 1st month, 3rd month, 6th month, and 1st year. Six periodontal indices were used to assess the periodontal health. The chi-square test was used to compare categorical variables depending on the groups. There was a significant difference in the PD, GI, and BOP index scores among the three techniques during the 1-year clinical monitoring (p < 0.001). The PD in the three zones of the buccal surface showed a significant increase with time in the retraction cord and cordless paste system groups (p < 0.001). The highest GI scores were observed in the retraction cord group on the 1st day. The Er,Cr:YSGG laser troughing procedure produced lower PD, GI, and BOP index scores as compared to the retraction cord and cordless paste system procedures in the 1-year period.
Collapse
|
99
|
Mecholsky JJ, Hsu SM, Jadaan O, Griggs J, Neal D, Clark AE, Xia X, Esquivel-Upshaw JF. Forensic and reliability analyses of fixed dental prostheses. J Biomed Mater Res B Appl Biomater 2021; 109:1360-1368. [PMID: 33527747 DOI: 10.1002/jbm.b.34796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/18/2020] [Accepted: 12/15/2020] [Indexed: 11/12/2022]
Abstract
This article describes the protocol for determining the cause of failure for retrieved failed implant supported fixed dental prostheses (FDPs) in a clinical study of three-unit bridges. The results of loading of flexure bars of different veneer compositions at different stress rates were presented for two veneer materials (leucite reinforced and fluorapatite glass-ceramic veneers) and a Y-TZP core zirconia ceramic used in the clinical study. From these results, the strengths of the fast loading conditions were used to determine the fracture toughness of these materials. Fractal dimension measurements of the flexure bars and selected FDPs of the same materials demonstrated that the values were the same for both the bars and the FDPs. This allowed the use of fracture toughness values from the flexure bars to determine the strengths of the FDPs. The failure analysis of clinically obtained FDP replicates to determine the size of the fracture initiating cracks was then performed. Using the information from the flexure bars and the size of the fracture initiating cracks for the failed FDPs, the strengths of the FDPs were determined. The clinical failures were determined to be most likely the result of repeated crack growth due to initial overload and continuous use after initial cracking.
Collapse
Affiliation(s)
- John J Mecholsky
- Department of Materials Science Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, Florida, USA
| | - Shu-Min Hsu
- Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Osama Jadaan
- Department of Engineering, University of North Florida, Jacksonville, Florida, USA
| | - Jason Griggs
- Department of Biomaterials, University of Mississippi, Jackson, Mississippi, USA
| | - Daniel Neal
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Arthur E Clark
- Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Xinyi Xia
- Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Josephine F Esquivel-Upshaw
- Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| |
Collapse
|
100
|
Liu C, Eser A, Albrecht T, Stournari V, Felder M, Heintze S, Broeckmann C. Strength characterization and lifetime prediction of dental ceramic materials. Dent Mater 2021; 37:94-105. [DOI: 10.1016/j.dental.2020.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/20/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
|