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Diken Türksayar AA, Demirel M, Donmez MB, Olcay EO, Eyüboğlu TF, Özcan M. Comparison of wear and fracture resistance of additively and subtractively manufactured screw-retained, implant-supported crowns. J Prosthet Dent 2024; 132:154-164. [PMID: 37479623 DOI: 10.1016/j.prosdent.2023.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/23/2023]
Abstract
STATEMENT OF PROBLEM Additively manufactured resins indicated for fixed definitive prostheses have been recently marketed. However, knowledge on their wear and fracture resistance when fabricated as screw-retained, implant-supported crowns and subjected to artificial aging is limited. PURPOSE The purpose of this in vitro study was to evaluate the volume loss, maximum wear depth, and fracture resistance of screw-retained implant-supported crowns after thermomechanical aging when fabricated using additively and subtractively manufactured materials. MATERIAL AND METHODS Two additively manufactured composite resins (Crowntec [CT] and VarseoSmile Crown Plus [VS]) and 2 subtractively manufactured materials (1 reinforced composite resin, Brilliant Crios [BC] and 1 polymer-infiltrated ceramic network, Vita Enamic [EN]) were used to fabricate standardized screw-retained, implant-supported crowns. After fabrication, the crowns were cemented on titanium base abutments and then tightened to implants embedded in acrylic resin. A laser scanner with a triangular displacement sensor (LAS-20) was used to digitize the pre-aging state of the crowns. Then, all crowns were subjected to thermomechanical aging (1.2 million cycles under 50 N) and rescanned. A metrology-grade analysis software program (Geomagic Control X 2020.1) was used to superimpose post-aging scans over pre-aging scans to calculate the volume loss (mm3) and maximum wear depth (mm). Finally, all crowns were subjected to a fracture resistance test. Fracture resistance and volume loss were evaluated by using 1-way analysis of variance and Tukey Honestly significant difference (HSD) tests, whereas the Kruskal-Wallis and Dunn tests were used to analyze maximum wear depth. Chi-squared tests were used to evaluate the Weibull modulus and characteristic strength data (α=.05). RESULTS Material type affected the tested parameters (P<.001). CT and VS had higher volume loss and maximum wear depth than BC and EN (P<.001). EN had the highest fracture resistance among tested materials (P<.001), whereas BC had higher fracture resistance than CT (P=.011). The differences among tested materials were not significant when the Weibull modulus was considered (P=.199); however, VE had the highest characteristic strength (P<.001). CONCLUSIONS Additively manufactured screw-retained, implant-supported crowns had higher volume loss and maximum wear depth. All materials had fracture resistance values higher than the previously reported masticatory forces of the premolar region; however, the higher characteristic strength of the subtractively manufactured polymer-infiltrated ceramic network may indicate its resistance to mechanical complications.
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Affiliation(s)
- Almira Ada Diken Türksayar
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey; and Guest Researcher, ADMiRE Research Center-Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Villach, Austria
| | - Münir Demirel
- Assistant Professor, Oral and Dental Health, Vocational School, Biruni University, Istanbul, Turkey
| | - Mustafa Borga Donmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; and Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Emin Orkun Olcay
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey
| | - Tan Fırat Eyüboğlu
- Associate Professor, Department of Endodontics, Istanbul Medipol University, Faculty of Dentistry, Istanbul, Turkey
| | - Mutlu Özcan
- Professor and Head, Clinic of Masticatory Disorders and Dental Biomaterials, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
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Ortega NM, Revilla-León M, Ortega R, Gómez-Polo C, Barmak AB, Gómez-Polo M. Comparison of surface roughness of additively manufactured implant-supported interim crowns fabricated with different print orientations. J Prosthodont 2024; 33:141-148. [PMID: 36634341 DOI: 10.1111/jopr.13645] [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: 09/02/2022] [Revised: 12/10/2022] [Accepted: 01/01/2023] [Indexed: 01/14/2023] Open
Abstract
PURPOSE To assess the influence of print orientation on the surface roughness of implant-supported interim crowns manufactured by using digital light processing (DLP) 3D printing procedures. MATERIALS AND METHODS An implant-supported maxillary right premolar full-contour crown was obtained. The interim restoration design was used to fabricate 30 specimens with 3 print orientations (0, 45, and 90 degrees) using an interim resin material (GC Temp PRINT) and a DLP printer (Asiga MAX UV) (n = 10). The specimens were manufactured, and each was cemented to an implant abutment with autopolymerizing composite resin cement (Multilink Hybrid Abutment). Surface roughness was assessed on the buccal surface of the premolar specimen by using an optical measurement system (InfiniteFocusG5 plus). The data were analyzed with a Shapiro-Wilk test, resulting in a normal distribution. One-way ANOVA and the Tukey HSD tests were selected (α = 0.05). RESULTS Statistically significant discrepancies were found in the surface roughness mean values among the groups tested (p < 0.001). The lowest mean ± standard deviation surface roughness was found with the 90-degree group (1.2 ± 0.36 μm), followed by the 0-degree orientation (2.23 ± 0.18 μm) and the 45-degree group (3.18 ± 0.31 μm). CONCLUSIONS Print orientation parameter significantly impacted the surface roughness of the implant-supported interim crowns manufactured by using the additive procedures tested.
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Affiliation(s)
- Nuria Martín Ortega
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Rocío Ortega
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
| | - Cristina Gómez-Polo
- Department of Dentistry, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Abdul B Barmak
- Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, Director of postgraduate program of Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Ramzy NA, Azer AS, Khamis MM. Evaluation of the marginal adaptation and debonding strength of two types of CAD-CAM implant-supported cement-retained crowns. BMC Oral Health 2023; 23:967. [PMID: 38053146 PMCID: PMC10696722 DOI: 10.1186/s12903-023-03711-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND In-vitro data from a clinically well-known lithium disilicate ceramic reference was used to assess the expected performance of resin-based materials in implant dentistry. The purpose of the study was to compare the bond strength and marginal adaptation of nano-ceramic hybrid composite crowns cemented to stock cement-retained abutments to lithium disilicate crowns. METHODS Twenty abutment analogs were embedded into auto-polymerizing acrylic resin blocks. The blocks were divided into 2 groups according to the restorative crown material. The 2 groups were divided as follows: Resin nano-ceramic group and lithium disilicate group. Abutment analogs in both groups were scanned using a laboratory scanner, and the restorations were designed, manufactured, and cemented with resin cement over the corresponding group. All samples were tested for marginal adaptation and bond strength after storage for 24 hours at 37 °C in 100% humidity. Data were collected, tabulated, and statistically analysed using the appropriate tests. Normality was checked using Shapiro Wilk test and Q-Q plots. Data were normally distributed. Variables were presented using mean, 95% Confidence Interval (CI) and standard deviation in addition to median and Inter Quartile Range (IQR). Differences between groups regarding debonding forces was assessed using independent t test. Two Way ANOVA was performed to assess the effect of material and bonding on marginal gap. All tests were two tailed and p value was set at < 0.05. RESULTS Marginal gap and debonding force values were significantly different according to the type of material used (P < .05). Resin nano-ceramic crowns presented lower marginal gap values before (20.80 ± 8.87 μm) and after (52.11 ± 22.92 μm) bonding than lithium disilicate crowns. The debonding force value for resin nano-ceramic crowns (284.30 ± 26.44 N) was significantly higher than that for lithium disilicate crowns (253.30 ± 33.26 N). Adhesive failure mode was detected in all the specimens in both groups. CONCLUSIONS The type of material used for implant-supported cement-retained crowns had a statistically significant effect on marginal adaptation and bond strength. Resin nano-ceramic implant-supported cement-retained crowns had better marginal adaptation and higher bond strength than those manufactured using lithium disilicate.
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Affiliation(s)
- Nada Ahmed Ramzy
- Faculty of Dentistry, Alexandria University, Alexandria, 8, Abbas Alhalawany Street Ibrahemia, Egypt.
| | - Amir Shoukry Azer
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Moataz Khamis
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Kui A, Manziuc M, Petruțiu A, Buduru S, Labuneț A, Negucioiu M, Chisnoiu A. Translucent Zirconia in Fixed Prosthodontics-An Integrative Overview. Biomedicines 2023; 11:3116. [PMID: 38137337 PMCID: PMC10740999 DOI: 10.3390/biomedicines11123116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
Over the past two decades, dental ceramics have experienced rapid advances in science and technology, becoming the fastest-growing field of dental materials. This review emphasizes the significant impact of translucent zirconia in fixed prosthodontics, merging aesthetics with strength, and highlights its versatility from single crowns to complex bridgework facilitated by digital manufacturing advancements. The unique light-conducting properties of translucent zirconia offer a natural dental appearance, though with considerations regarding strength trade-offs compared to its traditional, opaque counterpart. The analysis extends to the mechanical attributes of the material, noting its commendable fracture resistance and durability, even under simulated physiological conditions. Various zirconia types (3Y-TZP, 4Y-TZP, 5Y-TZP) display a range of strengths influenced by factors like yttria content and manufacturing processes. The study also explores adhesive strategies, underlining the importance of surface treatments and modern adhesives in achieving long-lasting bonds. In the realm of implant-supported restorations, translucent zirconia stands out for its precision, reliability, and aesthetic adaptability, proving suitable for comprehensive dental restorations. Despite its established benefits, the review calls for ongoing research to further refine the material's properties and adhesive protocols and to solidify its applicability through long-term clinical evaluations, ensuring its sustainable future in dental restorative applications.
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Affiliation(s)
- Andreea Kui
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Manuela Manziuc
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Adrian Petruțiu
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, 13 Victor Babes Street, 400008 Cluj-Napoca, Romania
| | - Smaranda Buduru
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Anca Labuneț
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Marius Negucioiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Andrea Chisnoiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
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Tuncer B, Aktas G, Baris Guncu M, Deniz D, Muhtarogullari M, Al-Haj Husain N, Özcan M. Effects of Surface Treatments and Cement Type on Shear Bond Strength between Titanium Alloy and All-Ceramic Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6240. [PMID: 37763518 PMCID: PMC10532757 DOI: 10.3390/ma16186240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 09/29/2023]
Abstract
This study aimed to evaluate the effects of surface treatments and resin cement on the adhesion of ceramic and ceramic-like materials to titanium. A total of 40 specimens (5 mm diameter) of each material (lithium disilicate glass ceramic (LDGC-IPS e.maxCAD), lithium silicate glass ceramic (LSGC-VITA Suprinity) and a polymer-infiltrated ceramic network (PICN-Vita Enamic)) were fabricated using CAD/CAM technologies. In total, 120 titanium (Ti) specimens were divided into 12 groups, and half of the titanium specimens were tribochemically coated using CoJet. The titanium and all-ceramic specimens were cemented using either Self-curing adhesive cement (SCAC-Panavia 21) or a Self-curing luting composite (SCLC-Multilink Hybrid Abutment). After 5000 cycles of thermal aging, the shear bond strength (SBS) test was conducted using a universal testing machine. The failure modes of the specimens were analyzed using stereomicroscopy, and additionally, the representative specimens were observed using Scanning Electron Microscopy. ANOVA was used for the statistical analysis (p < 0.05). The post-hoc Duncan test was used to determine significant differences between the groups. The mean SBS values (mean ± STD) ranged from 15 ± 2 MPa to 29 ± 6 MPa. Significantly higher SBS values were acquired when the titanium surface was tribochemically coated (p < 0.05). The SCLC showed higher SBS values compared to the SCAC. While the LDGC showed the highest SBS values, the PICN presented the lowest. The tribochemical coating on the cementation surfaces of the titanium increased the SBS values. The specimens cemented with the SCLC showed higher SBS values than those with the SCAC. Additionally, the SCLC cement revealed a more significant increase in SBS values when used with the LDGC. The material used for restoration has a high impact on SBS than those of the cement and surface conditioning.
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Affiliation(s)
| | - Guliz Aktas
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey; (G.A.); (M.B.G.); (D.D.); (M.M.)
| | - Mustafa Baris Guncu
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey; (G.A.); (M.B.G.); (D.D.); (M.M.)
| | - Diler Deniz
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey; (G.A.); (M.B.G.); (D.D.); (M.M.)
| | - Mehmet Muhtarogullari
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey; (G.A.); (M.B.G.); (D.D.); (M.M.)
| | - Nadin Al-Haj Husain
- Clinic of Chewing Function Disturbances and Dental Biomaterials, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland;
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Mutlu Özcan
- Clinic of Chewing Function Disturbances and Dental Biomaterials, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland;
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Demirel M, Diken Türksayar AA, Donmez MB. Fabrication trueness and internal fit of hybrid abutment crowns fabricated by using additively and subtractively manufactured resins. J Dent 2023; 136:104621. [PMID: 37453654 DOI: 10.1016/j.jdent.2023.104621] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES To evaluate the fabrication trueness and internal fit of hybrid abutment crowns fabricated by using additively and subtractively manufactured restorative materials. METHODS A maxillary first premolar crown with a screw access channel was designed onto a digitized master titanium base abutment. This file was used to fabricate 40 crowns additively (Crowntec (CT) and VarseoSmile Crown Plus (VS)) or subtractively (Brilliant Crios (BC) and Vita Enamic (EN)) (n = 10). Crowns were digitized with an intraoral scanner and root mean square method was used to evaluate fabrication trueness. Master abutment and the crowns when seated on the abutment were also digitized with the same intraoral scanner and triple scan method was used to evaluate internal fit. Data were analyzed either with 1-way ANOVA (surface deviations) or Kruskal-Wallis (internal fit) tests (α= 0.05). RESULTS CT had the highest overall, external, and marginal surface deviations (P≤.030), whereas BC had the lowest external (P≤.001) and VS and EN had the lowest marginal surface deviations (P≤.007). BC had the highest intaglio surface deviations (P<.001). BC and EN had higher average gap values CT and VS (P≤.006); however, the differences within additively and subtractively manufactured materials were nonsignificant (P≥.858). CONCLUSIONS One of the tested additively manufactured resins (CT) resulted in mostly lower trueness than that of other materials. However, deviations at the intaglio and marginal surfaces were generally small and the maximum mean difference among test groups when average gap was considered was 17.4 µm. Therefore, clinical fit of hybrid abutment crowns fabricated with tested materials may be similar.
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Affiliation(s)
- Münir Demirel
- Assistant Professor, Oral and Dental Health, Vocational School, Biruni University, Istanbul, Turkey
| | - Almira Ada Diken Türksayar
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey; Guest Researcher, ADMiRE Research Center-Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Villach, Austria
| | - Mustafa Borga Donmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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Ribera OK, Mendes JM, Mendes J, Barreiros P, Aroso C, Silva AS. Influence of Popular Beverages on the Fracture Resistance of Implant-Supported Bis-Acrylic Resin Provisional Crowns: An In Vitro Study. Polymers (Basel) 2023; 15:3411. [PMID: 37631468 PMCID: PMC10458795 DOI: 10.3390/polym15163411] [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: 07/10/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Implant-supported provisional restorations are critical for improving the esthetics and shaping of the peri-implant tissue. The mechanical properties of these provisional materials can be influenced by saliva, food, beverages, and interactions between these materials in the oral environment. Therefore, the integrity of provisional restorations should be preserved throughout the treatment period. This study aimed to evaluate the fracture strength of implant-supported polymethyl methacrylate (PMMA) provisional restorations made of computer-aided design and computer-aided manufacturing when immersed in different solutions at a controlled temperature of 37 °C for 7 days. Each analog-pillar-crown set was submerged in different liquids: 10 pieces were placed in distilled water then in tea, coffee, red wine, and Coca Cola® for 1 week at a controlled oral temperature of 37 °C. The samples were then subjected to fracture forces. The moment of fracture of the crown was recorded and compared with those of the other samples. Specimens immersed in distilled water (control group) had the highest fracture resistance (mean [M] = 1331.00 ± 296.74 N), while those immersed in tea had the lowest mean resistance to fracture (mean [M] = 967.00 ± 281.86 N). Nutritional deficiency and inappropriate eating habits influence the fracture strength of temporary crowns, thereby rendering them more elastic or less resistant to fractures.
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Affiliation(s)
- Oriana Karolina Ribera
- Department of Oral Rehabilitation, Instituto Universitário de Ciências da Saúde, Rua Central da Gandra 1317, 4585-116 Gandra, Portugal;
| | - José Manuel Mendes
- UNIPRO–Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU), Rua Central da Gandra 1317, 4585-116 Gandra, Portugal; (J.M.M.); (J.M.); (P.B.)
| | - Joana Mendes
- UNIPRO–Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU), Rua Central da Gandra 1317, 4585-116 Gandra, Portugal; (J.M.M.); (J.M.); (P.B.)
| | - Pedro Barreiros
- UNIPRO–Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU), Rua Central da Gandra 1317, 4585-116 Gandra, Portugal; (J.M.M.); (J.M.); (P.B.)
| | - Carlos Aroso
- UNIPRO–Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU), Rua Central da Gandra 1317, 4585-116 Gandra, Portugal; (J.M.M.); (J.M.); (P.B.)
| | - António Sérgio Silva
- UNIPRO–Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU), Rua Central da Gandra 1317, 4585-116 Gandra, Portugal; (J.M.M.); (J.M.); (P.B.)
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Bein L, Rauch A, Schmidt M, Rosentritt M. In vitro fatigue and fracture testing of temporary materials from different manufacturing processes in implant-supported anterior crowns. Clin Oral Investig 2023; 27:4215-4224. [PMID: 37133699 DOI: 10.1007/s00784-023-05038-7] [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: 03/14/2023] [Accepted: 04/22/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the in vitro fatigue and fracture force of temporary implant-supported anterior crowns made of different materials with different abutment total occlusal convergence (TOC), with/without a screw channel, and with different types of fabrication. MATERIALS AND METHODS One hundred ninety-two implant-supported crowns were manufactured (4° or 8° TOC; with/without screw channel) form 6 materials (n = 8; 2 × additive, 3 × subtractive, 1 × automix; reference). Crowns were temporarily cemented, screw channels were closed (polytetrafluoroethylene, resin composite), and crowns were stored in water (37 °C; 10 days) before thermal cycling and mechanical loading (TCML). Fracture force was determined. STATISTICS Kolmogorov-Smirnov, ANOVA; Bonferroni; Kaplan-Meier; log-rank; α = 0.05. RESULTS Failure during TCML varied between 0 failures and total failure. Mean survival was between 1.8 × 105 and 4.8 × 105 cycles. The highest impact on survival presented the material (η2 = 0.072, p < .001). Fracture forces varied between 265.7 and 628.6 N. The highest impact on force was found for the material (η2 = 0.084, p < .001). CONCLUSION Additively and subtractively manufactured crowns provided similar or higher survival rates and fracture forces compared to automix crowns. The choice of material is decisive for the survival and fracture force. The fabrication is not crucial. A smaller TOC led to higher fracture force. Manually inserted screw channels had negative effects on fatigue testing. CLINICAL RELEVANCE The highest stability has been shown for crowns with a low TOC, which are manufactured additively and subtractively. In automix-fabricated crowns, manually inserted screw channels have negative effects.
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Affiliation(s)
- Laila Bein
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Angelika Rauch
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Michael Schmidt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany.
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Graf T, Schweiger J, Stimmelmayr M, Erdelt K, Schubert O, Güth JF. Influence of monolithic restorative materials on the implant-abutment interface of hybrid abutment crowns: An in vitro investigation. J Prosthodont Res 2023; 67:450-459. [PMID: 36517017 DOI: 10.2186/jpr.jpr_d_22_00115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Purpose This in vitro study aimed to investigate the long-term performance, stability, and fracture mode of monolithic hybrid abutment crowns, and the effect of different materials on the implant-abutment interface (IAI).Methods Eighty monolithic hybrid abutment crowns luted on titanium bases were manufactured from 3Y-TZP zirconia (ZY3), "Gradient Technology" zirconia (ZY35), 5Y-TZP zirconia (ZY5), lithium disilicate ceramic (LDS), zirconia-reinforced lithium silicate ceramic (ZLS), polymer-infiltrated ceramic network (MHY), polymethylmethacrylate (PMA), and 3D-printed hybrid composite (PHC) (n = 10 for each material). Eighty implants (Camlog Progressive-Line, diameter: 3.8 mm) were embedded in accordance with ISO standard 14801, and crowns were mounted. After artificial aging (1.2 × 106 cycles, 50 N, thermocycling), intact specimens were loaded 30° off-axis in a universal testing machine until failure.Results Seven specimens in the PHC group failed during artificial aging, and all the others survived. There were two subgroups based on the one-way analysis of variance and Dunnett's test (P < 0.05) of the mean fracture load values. The first comprised Z3Y, ZY35, Z5Y, and LDS, with mean fracture loads between 499.4 and 529.7 N, while the second included ZLS, MHY, and PMA, with values in the 346.2-416.0 N range. ZY3, ZY35, ZY5, and LDS exhibited irreversible, visible deformations of the implant shoulders with varying dimensions after load-to-fracture tests.Conclusions Crowns made of LDS, ZLS, MHY, and PMA may act as potential stress breakers, and prevent possible deformation at IAIs. Further clinical studies need to assess if these materials also withstand relevant loads in-vivo.
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Affiliation(s)
- Tobias Graf
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Kurt Erdelt
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Jan-Frederik Güth
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Germany
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Lin J, Cai P, Zhuo Y, Lin L, Zheng Z. Effect of abutment design on fracture resistance of resin-matrix ceramic crowns for dental implant restoration: an in vitro study. BMC Oral Health 2023; 23:410. [PMID: 37344826 DOI: 10.1186/s12903-023-03100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/01/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND The purpose of this study is to investigate the performance and fracture resistance of different resin-matrix ceramic materials for use in implant-supported single crowns with respect to the abutment design (crown thickness: 1 mm, 2 and 3 mm). METHODS Forty-eight abutments and crowns were fabricated on implants in the right lower first molar. Two resin-matrix ceramic materials for dental crowns were selected for study: (1) a glass-ceramic in a resin interpenetrating matrix (Vita Enamic, Vita, Germany) and (2) a resin-based composite with nanoparticle ceramic filler (Lava Ultimate, 3 M ESPE, USA). Three types of abutments were designed: 1 mm thick crown + custom titanium abutment, 2 mm thick crown + custom titanium abutment and 3 mm thick crown + prefabricated titanium abutment. The experiment was divided into 6 groups (n = 8) according to the crown materials and abutment designs. After 10,000 thermocycles, fracture resistance was measured using a universal testing machine. The statistical significance of differences between various groups were analysed with ANOVA followed by a post hoc Tukey's honestly significant difference test. The surfaces of the fractured specimens were examined with scanning electron microscopy (SEM). RESULTS Two-way ANOVA revealed that the abutment design (F = 28.44, P = 1.52 × 10- 8<0.001) and the crown materials (F = 4.37, P = 0.043 < 0.05) had a significant effect on the fracture resistance of implant crown restoration. The Lava Ultimate-2 mm group showed the highest fracture resistance of 2222.74 ± 320.36 N, and the Vita Enamic-3 mm group showed the lowest fracture resistance of 1204.96 ± 130.50 N. Most of the 1 and 2 mm groups had partial crown fractures that could be repaired directly with resin, while the 3 mm group had longitudinal fracture of the crown, and the crowns were detached from the abutments. CONCLUSION Based on the in vitro data of this study, the fracture resistance of the 2 mm thick resin-matrix ceramic crown design was higher than that of the 1 and 3 mm groups. The 2 mm thick resin-matrix ceramic crown and personalized abutment are an option to replace zirconia for implant crown restoration.
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Affiliation(s)
- Jie Lin
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China
- Department of Crown and Bridge, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, 102-8159, Tokyo, Japan
- School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, 102-8159, Tokyo, Japan
| | - Pingping Cai
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China
| | - Yingying Zhuo
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China
| | - Ling Lin
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China
| | - Zhiqiang Zheng
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China.
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Influence of thermo-mechanical aging on fracture resistance and wear of digitally standardized chairside computer-aided-designed/computer-assisted-manufactured restorations. J Dent 2023; 130:104450. [PMID: 36773741 DOI: 10.1016/j.jdent.2023.104450] [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: 07/03/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVES To investigate the influence of thermal cycling and mechanical loading (TCML) aging on fracture resistance and wear behavior of various chairside computer-aided-designed/computer-assisted-manufactured (CAD/CAM) premolar crowns cemented on standardized tooth abutments. METHODS Eighty chairside CAD/CAM crowns were prepared using lithium disilicate (IPS e.max CAD; EM), zirconia-infiltrated lithium silicate (Celtra Duo; CD), polymer-infiltrated ceramic network (Vita Enamic; VE), and resin nanoceramics (Cerasmart; CS) (n = 20). The specimens were divided into two groups (n = 10). In one group, they were subjected to TCML: thermocycling (6000 cycles in distilled water at 5-55 °C) and mechanical loading (50 N for 1.2 × 106 cycles), while in control group they were stored in distilled water (37 °C for 24 h). The fracture load, height loss, and volume wear of the crowns were measured after TCML. Fractography was performed on fractured specimens. Data were analyzed using analysis of variance and multiple comparison tests (α=0.05). RESULTS The mean fracture loads of EM and CD were significantly higher than those of EC and CS (p<0.05). There was no significant change in the fracture load of any CAD/CAM crowns after TCML (p>0.05). CS exhibited a significantly higher volume wear than the other materials investigated. The wear tracts of all TCML crowns acted as failure origins during the fracture test. CONCLUSIONS The fracture resistance of glass-ceramic CAD/CAM crowns was significantly higher than that of resin composite crowns. A 5-year TCML aging did not affect the fracture resistance of CAD/CAM crowns investigated. However, TCML treatment produces a larger wear track in CS than in other materials. CLINICAL SIGNIFICANCE Appropriate chairside CAD/CAM restorative material should be selected for successful clinical practice after considering the fracture and wear resistance of the crowns.
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Sousa-Santos S, Silva AS, Sousa-Santos P, Vale T, Mendes JM. The Influence of Saliva pH on the Fracture Resistance of Two Types of Implant-Supported Bis-Acrylic Resin Provisional Crowns-An In Vitro Study. J Funct Biomater 2023; 14:jfb14020062. [PMID: 36826861 PMCID: PMC9965934 DOI: 10.3390/jfb14020062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/25/2023] Open
Abstract
Temporary restorations play a fundamental role in oral rehabilitation. A properly adapted implant-supported provisional restoration implies better esthetics, contouring and architectural modeling of the upper peri-implant tissue. This study aimed to evaluate the influence of oral pH on the fracture resistance of implant-supported provisional restorations made with two brands of bis-acrylic resin (LuxaCrown® and Protemp™ 4) and to compare the fracture resistance of these two materials. Twenty crowns (ten manufactured using each brand) served as a control, and another forty crowns (twenty of each brand) were aged using artificial saliva with pHs of 4 or 7, for 7 days at 37 °C, in an attempt to simulate the behavior of these materials inside the oral cavity. Subsequently, all crowns were subjected to the application of a force at a constant speed, in a universal testing machine, until fracture was achieved. The LuxaCrown® brand showed greater resistance to fracture than the Protemp™ 4 brand. Salivary pH did not influence the fracture resistance of provisional LuxaCrown® crowns but did influence the fracture resistance of provisional Protemp™ 4 crowns.
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Affiliation(s)
- Sofia Sousa-Santos
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
| | - António Sérgio Silva
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
- Correspondence:
| | - Primavera Sousa-Santos
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
| | - Teresa Vale
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
| | - José Manuel Mendes
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
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Güleç C, Sarıkaya I. The influence of aging on the fracture load of milled monolithic crowns. BMC Oral Health 2022; 22:516. [PMCID: PMC9675227 DOI: 10.1186/s12903-022-02529-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: 02/15/2022] [Accepted: 10/24/2022] [Indexed: 11/21/2022] Open
Abstract
Background This in-vitro study was conducted to assess the effect of aging on the fracture load of molar crowns fabricated with monolithic CAD/CAM materials. Methods The crown restorations were produced from Cerasmart, Vita Enamic, and IPS e.max CAD blocks. Aging was applied to the 10 samples each of monolithic CAD/CAM materials (n = 10). Dual-axis chewing simulator (50 N, 1.1 Hz, lateral movement: 1 mm, mouth opening: 2 mm, 1,200,000 cycles) and thermocycling (± 5–55 °C, 6000 cycles) were applied as an aging procedure. 10 samples each of monolithic CAD/CAM materials without aging (n = 10) were considered the control group. 6 tested groups were obtained. Then, all samples were evaluated in a universal testing machine to determine the fracture loading values’. Results There was not a statistically significant difference between the fracture load values before and after aging for all samples of Cerasmart, Vita Enamic, and IPS e.max CAD (p > 0.005). In a comparison of the monolithic materials together, a statistically significant difference was found between the fracture load values of IPS e.max CAD and Vita Enamic crowns before aging (p = 0.02). Also, Vita Enamic crowns (1978,71 ± 364,05 N) were found different from the IPS e.max CAD (p = 0.005) and Cerasmart crowns (p = 0.041) after aging. Conclusions Dynamic aging with 1.200.000 cycles was found to have no effect to fracture loading on milled Cerasmart, Vita Enamic, and IPS e.max CAD monolithic crowns.
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Affiliation(s)
- Ceyda Güleç
- grid.411550.40000 0001 0689 906XDepartment of Prosthodontics, Faculty of Dentistry, Tokat Gaziosmanpasa University, Ali Şevki Erek Campus, 60100 Tokat, Turkey
| | - Işıl Sarıkaya
- grid.411550.40000 0001 0689 906XDepartment of Prosthodontics, Faculty of Dentistry, Tokat Gaziosmanpasa University, Ali Şevki Erek Campus, 60100 Tokat, Turkey
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Donmez MB, Okutan Y. Marginal gap and fracture resistance of implant-supported 3D-printed definitive composite crowns: An in vitro study. J Dent 2022; 124:104216. [PMID: 35803388 DOI: 10.1016/j.jdent.2022.104216] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/20/2022] [Accepted: 07/04/2022] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To compare the marginal gap and fracture resistance of implant-supported 3-dimensional (3D) printed definitive composite crowns with those fabricated by using 3 different millable materials. MATERIAL AND METHODS A prefabricated abutment was digitized by using a laboratory scanner (E4 Lab Scanner) and a complete-coverage maxillary first premolar crown was designed (Dental Designer). Forty crowns were fabricated either by 3D printing (Saremco Print Crowntec, SP) or milling (Brilliant Crios, BC; Vita Enamic, VE; Cerasmart 270, CS) (n = 10). Baseline marginal gap values were evaluated by measuring 60 predetermined points on an abutment (15 points for each side) with a stereomicroscope at ×40 magnification. Marginal gap values were reevaluated after adhesive cementation. Load-to-fracture test was performed by using a universal testing machine. Two-way analysis of variance (ANOVA) was used to evaluate the effect of material type and cementation on marginal gap values. While Tukey HSD tests were used to compare the materials' marginal gap values before and after cementation, the effect of cementation on marginal gap values within each material was analyzed by using paired samples t-tests. Fracture resistance data were analyzed by using 1-way ANOVA (α=0.05). RESULTS Material type and cementation significantly affected marginal gap values (P < .001). Regardless of cementation, SP had the lowest marginal gap values (P < .001), while the differences among milled crowns were nonsignificant (P ≥ .14). Cementation significantly increased the marginal gap values (P < .001). Material type did not affect fracture resistance values (F = 1.589, P = .209). CONCLUSION Implant-supported 3D-printed composite crowns showed higher marginal adaptation compared with the milled crowns before and after cementation. In addition, all crowns endured similar forces before fracture.
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Affiliation(s)
- Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Yener Okutan
- Department of Prosthodontics, Aydin Adnan Menderes University Faculty of Dentistry, Aydin, Turkey.
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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.
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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.
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Mechanical Stability of Screw-Retained Monolithic and Bi-layer Posterior Hybrid Abutment Crowns after Thermomechanical Loading: An In Vitro Study. MATERIALS 2021; 14:ma14247539. [PMID: 34947134 PMCID: PMC8706390 DOI: 10.3390/ma14247539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
To evaluate the failure-load and survival-rate of screw-retained monolithic and bi-layered crowns bonded to titanium-bases before and after mouth-motion fatigue, 72 titanium-implants (SICvantage-max, SIC-invent-AG) were restored with three groups (n = 24) of screw-retained CAD/CAM implant-supported-single-crowns (ISSC) bonded to titanium-bases: porcelain-fused-to-metal (PFM-control), porcelain-fused-to-zirconia (PFZ-test) and monolithic LDS (LDS-test). Half of the specimens (n = 12/group) were subjected to fatigue in a chewing-simulator (1.2 million cycles, 198 N, 1.67 Hz, thermocycling 5–55 °C). All samples were exposed to single-load-to-failure without (PFM0, PFZ0, LDS0) or with fatigue (PFM1, PFZ1, LDS1). Comparisons were statistically analyzed with t-tests and regression-models and corrected for multiple-testing using the Student–Neuman–Keuls method. All PFM and LDS crowns survived fatigue exposure, whereas 16.7% of PFZ showed chipping failures. The mean failure-loads (±SD) were: PFM0: 2633 ± 389 N, PFM1: 2349 ± 578 N, PFZ0: 2152 ± 572 N, PFZ1: 1686 ± 691 N, LDS0: 2981 ± 798 N, LDS1: 2722 ± 497 N. Fatigue did not influence load to failure of any group. PFZ ISSC showed significantly lower failure-loads than monolithic-LDS regardless of artificial aging (p < 0.05). PFM ISSC showed significantly higher failure loads after fatigue than PFZ (p = 0.032). All ISSC failed in a range above physiological chewing forces. Premature chipping fractures might occur in PFZ ISSC. Monolithic-LDS ISSC showed high reliability as an all-ceramic material for screw-retained posterior hybrid-abutment-crowns.
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Thermoanalytical Investigations on the Influence of Storage Time in Water of Resin-Based CAD/CAM Materials. Biomedicines 2021; 9:biomedicines9121779. [PMID: 34944594 PMCID: PMC8698771 DOI: 10.3390/biomedicines9121779] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022] Open
Abstract
New resin-based composites and resin-infiltrated ceramics are used to fabricate computer-aided design (CAD) and computer-aided manufacturing (CAM)-based restorations, although little information is available on the long-term performance of these materials. The aim of this investigation was to determine the effects of storage time (24 h, 90 days, 180 days) on the thermophysical properties of resin-based CAD/CAM materials. Thermogravimetric Analysis (TGA), differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA) were used in the study. TGA provided insight into the composition of the resin-based materials and the influence of internal plasticization and water sorption. Resin-based composites showed different decomposition, heat energy and mechanical behavior, which was influenced by storage time in water. Individual materials such as Grandio bloc showed lower influence of water storage while maintaining good mechanical properties.
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Comparison of Fracture Strengths of Three Provisional Prosthodontic CAD/CAM Materials: Laboratory Fatigue Tests. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11209589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Temporary restorations play a fundamental role in oral rehabilitation. They can be used on teeth or implants for a variable period of time during the period prior to rehabilitation with definitive restorations. Temporary or provisional restorations manufactured via CAD/CAM methods are becoming increasingly used in the intermediate phase of the treatment of complex cases. The main objective of this study was to compare the fracture resistance of three materials used in the creation of provisional crowns on implants: polymethyl methacrylate (PMMA), composite resin, and polyether ether ketone (PEEK). Fracture resistance in PMMA (Zirkonzahn Temp Basic® , Gais, South Tyrol, Italy) ranged from 1216.0 N to 1461.2 N, with a mean of 1300.4 N (SD = 97.09). In the composite material (3M Lava Ultimate®, Minnesota, USA), fracture resistance varied between 1343.5 N and 1490.6 N, with a mean of 1425.9 N (SD = 49.03). Lastly, in PEEK (Tecno Med Mineral®, Zirkonzahn®, Gais, South Tyrol, Italy), fracture resistance ranged from 2294.8 N to 2451.7 N, with a mean of 2359.5 (SD = 50.01). The crowns made with the PEEK Tecno Med Mineral® (Zirkonzahn®, Tyrol, Italy) material presented the best fracture resistance, followed by the crowns made with the Lava Ultimate® (3M® ESPE, Minnesota, USA) composite resin material and, finally, those made with the PMMA Temp Basic® (Zirkonzahn®, Tyrol, Italy) material.
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Mechanical Performance of Chairside Ceramic CAD/CAM Restorations and Zirconia Abutments with Different Internal Implant Connections: In Vitro Study and Finite Element Analysis. MATERIALS 2021; 14:ma14175009. [PMID: 34501107 PMCID: PMC8434075 DOI: 10.3390/ma14175009] [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: 07/22/2021] [Revised: 08/14/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022]
Abstract
(computer-aided design-computer-aided manufacturing) CAD/CAM monolithic restorations connected to zirconia abutments manufactured with a chairside workflow are becoming a more common restorative option. However, their mechanical performance is still uncertain. The aim of this study was to evaluate the mechanical behavior of a combination of a zirconia abutment and monolithic all-ceramic zirconia and lithium disilicate crown manufactured with a chairside workflow, connected to titanium implants with two types of internal connection—tube in tube connection and conical connection with platform switching. They were thermally cycled from 5 °C to 55 °C and were subjected to a static and fatigue test following ISO 14801. The fractured specimens from the fatigue test were examined by SEM (scanning electron microscopy). Simulations of the stress distribution over the different parts of the restorative complex during the mechanical tests were evaluated by means of (finite element analysis) FEA. The mechanical performance of the zirconia abutment with an internal conical connection was higher than that of the tube in tube connection. Additionally, the use of disilicate or zirconia all-ceramic chairside CAD/CAM monolithic restorations has similar results in terms of mechanical fracture and fatigue resistance. Stress distribution affects the implant/restoration complex depending on the connection design. Zirconia abutments and monolithic restorations seem to be highly reliable in terms of mechanical resistance.
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Bajunaid SO, Alshiddi I, Alhomaidhi L, Almutairi R, Alolayan S, Habib SR. Comparison of the Fracture Resistance and Fracture Mode of Contemporary Restorative Materials to Overcome the Offset of Mandibular Implant-Supported, Cement-Retained Crowns. MATERIALS 2021; 14:ma14174838. [PMID: 34500928 PMCID: PMC8432696 DOI: 10.3390/ma14174838] [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: 05/24/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022]
Abstract
Background: The purpose was to compare the fracture resistance and the mode of failure of different contemporary restorative materials to restore implant supported, cement-retained mandibular molars. Methods: Two 5 × 10 mm titanium dental implants were mounted in resin blocks and prefabricated titanium and zirconia abutments were connected to each implant. Each implant received forty crowns resembling mandibular first molars. The specimens were divided into four groups (n = 10/group) for each abutment according to the type of material; Group A: porcelain fused to metal crowns; Group B: monolithic zirconia crowns; Group C: zirconia coping with ceramic veneer; Group D: all ceramic lithium disilicate crowns. Specimens were cemented to the abutments, mounted into a universal testing machine, and vertical static load was applied at a speed of 1 mm/min. The test stopped at signs of visual/audible fracture/chipping. Fracture resistance values were analyzed using ANOVA and Tukey’s tests (α ≤ 0.05). The modes of failure were visually observed. Results: A statistically significant difference (p < 0.001) of the fracture resistance values among tested groups was found. The group that showed the highest fracture resistance was Group A for both the titanium and the zirconia abutments (3.029 + 0.248 and 2.59 ± 0.39, respectively) while Group D for both abutments (1.134 + 0.289 and 1.68 ± 0.13) exhibited the least resistance. Conclusions: Fracture resistance and fracture mode varied depending on type of restorative material. For both titanium and zirconia abutments, porcelain fused to metal showed the highest fracture resistance values followed by monolithic zirconia.
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Affiliation(s)
- Salwa Omar Bajunaid
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (I.A.); (S.R.H.)
- Correspondence: ; Tel.: +966-59-002-8784
| | - Ibraheem Alshiddi
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (I.A.); (S.R.H.)
| | - Lamya Alhomaidhi
- King Abdulaziz Medical City-National Guard, Riyadh 14611, Saudi Arabia;
| | | | - Shoq Alolayan
- Sajer Govermental Hospital, Sajer 17658, Saudi Arabia;
| | - Syed Rashid Habib
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (I.A.); (S.R.H.)
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Donmez MB, Diken Turksayar AA, Olcay EO, Sahmali SM. Fracture Resistance of Single-Unit Implant-Supported Crowns: Effects of Prosthetic Design and Restorative Material. J Prosthodont 2021; 31:348-355. [PMID: 34383979 DOI: 10.1111/jopr.13415] [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] [Accepted: 08/10/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the fracture resistance and fracture patterns of single implant-supported crowns with different prosthetic designs and materials. MATERIALS AND METHODS One hundred and forty-four identical crowns were fabricated from zirconia-reinforced lithium silicate (ZLS), leucite-based (LGC), and lithium disilicate (LDS) glass-ceramics, reinforced composite (RC), translucent zirconia (ZR), and ceramic-reinforced polyetheretherketone (P). These crowns were divided into 3 subgroups according to restoration design: cementable crowns on a prefabricated titanium abutment, cement-retained crown on a zirconia-titanium base abutment, and screw-cement crown (n = 8). After adhesive cementation, restorations were subjected to thermal-cycling and loaded until fracture. The fracture patterns were evaluated under a stereomicroscope. Statistical analysis was performed by using 2-way ANOVA/Bonferroni multiple comparison post hoc test (α = 0.05). RESULTS For each prosthetic design, ZR presented the highest fracture resistance (p ≤ 0.005). Other than the differences with ZLS and RC for screw-cement crowns (p > 0.05) and RC for crowns on zirconia-titanium base abutments (p > 0.05), LGC showed the lowest fracture resistance. P endured higher loads than LDS (p < 0.001), except for the crowns on zirconia-titanium base abutments (p > 0.05). Cementable crowns presented the highest fracture resistance (p < 0.001), other than LGC and LDS. The differences between LGC crowns (p > 0.05) or LDS crowns on prefabricated titanium and zirconia-titanium abutments were nonsignificant (p = 0.133). Fragmented crown fracture was predominant in most of the restorations. Screw and abutment fractures were observed in ZR screw-cement crowns, and all P crowns were separated from the abutments. CONCLUSIONS Restorative material and restoration design affect the fracture resistance and fracture pattern of implant-supported single-unit restorations. Clinicians may restore single-unit implants in premolar sites with the materials and prosthetic designs tested in the present study.
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Affiliation(s)
- Mustafa Borga Donmez
- Biruni University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | | | - Emin Orkun Olcay
- Biruni University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | - Sevil Meral Sahmali
- Biruni University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
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Johansson C, Håkansson A, Papia E. Bond strength between titanium and polymer-based materials adhesively cemented. Biomater Investig Dent 2021; 8:79-86. [PMID: 34212155 PMCID: PMC8218681 DOI: 10.1080/26415275.2021.1937182] [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] [Indexed: 11/11/2022] Open
Abstract
The aim was to evaluate the bond strength between titanium and polymer-based materials for prosthetic restorations, cemented with different adhesive cement systems. Eight groups with 13 specimens in each group were included. Each specimen consisted of two parts: a cylinder of titanium resembling a titanium base, and a cylinder of one of two polymer-based materials Micro Filled Hybrid (MFH) or Telio CAD and cemented with one of four adhesive cement systems, namely Multilink Hybrid Abutment, Panavia V5, RelyX Ultimate and G-Cem LinkAce. The titanium was sandblasted with 50 µm Al2O3 and treated according to each cement manufacturer's recommendations. The polymer-based materials were pre-treated according to the manufacturer's instructions including sandblasting for MFH. After cementation, the groups were water stored for one day before thermocycling: 5000 cycles in 5–55 °C. A shear bond strength test was performed (crosshead speed 0.5 mm/min) and data was analysed with one-way ANOVA, Tukey's test. Telio CAD cemented with Panavia V5 and G-Cem LinkAce showed significantly lower bond strength compared to all other groups, due to spontaneous debonding. The highest numerical bond strength was found in the group of MFH cemented with RelyX Ultimate or with G-Cem LinkAce. Generally, the Telio CAD groups showed lower bond strength values than the MFH groups. The conclusions are that pre-treatment methods and choice of cement system are of importance for polymer-based materials for prosthetic restorations. The bond strength is adequate for provisional cementation irrespective of cement system when pre-treating by sandblasting, but cement dependent without sandblasting.
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Affiliation(s)
- Camilla Johansson
- Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Aleksandra Håkansson
- Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Evaggelia Papia
- Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Optical behaviors, surface treatment, adhesion, and clinical indications of zirconia-reinforced lithium silicate (ZLS): A narrative review. J Dent 2021; 112:103722. [PMID: 34118284 DOI: 10.1016/j.jdent.2021.103722] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The present narrative review was focused on the optical properties, surface treatment, adhesion, and clinical indications of zirconia-reinforced lithium silicate ceramics (ZLS) for Computer-aided design / Computer-aided manufacturing (CAD/CAM) technologies. DATA/SOURCES A literature search was performed by 3 calibrated independent researchers on PubMed, Scopus, Embase, Google Scholar, Dynamed, and Open Grey. The criteria for inclusion were: 1) papers addressing at least one of the following variables about ZLS: optical properties, surface treatment, adhesion, and clinical indications; 2) in vitro, in silico, or in vivo studies; 3) case reports; 4) systematic reviews. The exclusion criteria were: 1) animal studies; 2) non-dental studies; 3) studies only focusing on ZLS used in the heat-pressed process. STUDY SELECTION 98 records among in vitro studies and case reports were included. CONCLUSIONS Despite the promising microstructure characteristics of ZLS, increased translucency compared to lithium disilicate ceramics (LS2) was not proven, but acceptable color changes and stability were reported. Mechanical polishing was the most effective method to reduce surface roughness. Moreover, machinability and handling of ZLS resulted harder than LS2. Conventional acid etching procedures seemed effective in conditioning ZLS surface, but no protocol has been established yet. Besides, silane-coupling and dual-curing resin cements were recommended. CLINICAL SIGNIFICANCE ZLSs can be used for anterior and posterior fixed single-unit CAD/CAM restorations onto both natural teeth and implants, but do not seem to represent a viable treatment option for endocrowns onto posterior teeth or fixed dental prostheses.
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Comparison of Mechanical Properties of Chairside CAD/CAM Restorations Fabricated Using a Standardization Method. MATERIALS 2021; 14:ma14113115. [PMID: 34204092 PMCID: PMC8200951 DOI: 10.3390/ma14113115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/18/2022]
Abstract
The aim of this in vitro study was to investigate the fracture resistance, fracture failure pattern, and fractography of four types of chairside computer-aided design/computer-aided manufacturing (CAD/CAM) restoration materials in teeth and titanium abutments fabricated using a standardization method. An artificial mandibular left first premolar prepared for all-ceramic crown restoration was scanned. Forty extracted mandibular molars and cylindrical titanium specimens were milled into a standardized shape. A total of eighty CAD/CAM restoration blocks were milled into a crown and twenty pieces of each lithium disilicate (LS), polymer-infiltrated-ceramic-network (PICN), resin nano ceramic (RNC), and zirconia-reinforced lithium silicate (ZLS) materials were used. Crowns were bonded to abutments, and all specimens underwent thermal cycling treatment for 10,000 cycles. Fracture resistance was measured using a universal testing machine and fracture failure patterns were analyzed using optical microscopy and scanning electron microscopy. Statistical differences were analyzed using appropriate ANOVA, Tukey HSD post hoc tests, and independent sample t-tests (α = 0.05). The results indicated that, in both teeth abutments and titanium abutments, the fracture resistances showed significantly the highest values in LS and the second highest in ZLS (p < 0.05). The fracture resistances based on teeth abutments and titanium abutments were significantly different in all the CAD/CAM restoration materials (p < 0.05). There are statistically significant correlations between the types of materials and the types of abutments (p < 0.05). Each of the different materials showed different fracture failure patterns, and there was no noticeable difference in fractographic analysis. Lithium disilicates and zirconia-reinforced lithium silicates exhibited statistically high fracture resistance, indicating their suitability as restoration materials for natural teeth or implant abutments. There were no distinct differences in the fracture pattern based on the restoration and abutment materials showed that the fracture initiated at the groove where the ball indenter was toughed and propagated toward the axial wall.
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Spitznagel FA, Bonfante EA, Vollmer F, Gierthmuehlen PC. Failure Load of Monolithic Lithium Disilicate Implant-Supported Single Crowns Bonded to Ti-base Abutments versus to Customized Ceramic Abutments after Fatigue. J Prosthodont 2021; 31:136-146. [PMID: 33870577 DOI: 10.1111/jopr.13369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This laboratory study analyzed the influence of retention mode (screw- vs cement retained) and fatigue application on the failure load of monolithic lithium-disilicate (LDS) implant-supported single crowns (ISSC). MATERIAL AND METHODS A total of 72 samples of monolithic LDS (*Ivoclar Vivadent) ISSC were divided into three groups (n = 24) according to their type of retention mode: Group Ti-CAD: Titanium base (SICvantage CAD/CAM Abutment red (SIC invent AG), screw-retained milled monolithic LDS (IPS e.max CAD*); Group Ti-P: Titanium base (SICvantage CAD/CAM Abutment red), screw-retained pressed monolithic LDS (IPS e.max Press*) and Group Ti-Cust: Titanium base with cemented press LDS (IPS e.max Press*) crown on a LDS (IPS e.max Press*) custom abutment. A mandibular first molar implant-supported single crown model was investigated (Titanium implant: SICvantage-max, SIC invent AG, diameter: 4.2 mm, length: 11.5 mm). Half of each group (n = 12) were exposed to fatigue with cyclic mechanical loading (F = 198 N, 1.2 million cycles) and simultaneous thermocycling (5-55°C). Single load to failure testing was performed, before (Subgroups Ti-CAD, Ti-P, and Ti-Cust) and after (Subgroups Ti-CAD-F, Ti-P-F, and Ti-Cust-F) fatigue. Weibull distribution was used to determine the characteristic strength and Weibull modulus differences between groups. Probability of survival at 900N load was calculated. RESULTS No samples failed during fatigue. Characteristic strength values were as follow: Ti-CAD: 3259.5N, Ti-CAD-F: 2926N, Ti-P: 2763N, Ti-P-F: 2841N, Ti-Cust: 2789N, Ti-Cust-F: 2194N. Whereas no difference was observed between pressed or milled monolithic crowns cemented to Ti-base, regardless of loading condition, fatigue decreased the characteristic strength of crowns cemented to custom abutments. Probability of survival at 900 N was not significantly different between groups. CONCLUSIONS Screw-retained pressed or milled monolithic LDS ISSC, cemented directly to Ti-base abutments or LDS crowns cemented to custom ceramic abutments resist physiological chewing forces after simulated 5-year aging in the artificial mouth and presented equally high probability of survival. However, a significant decrease in load to failure was observed in LDS crowns cemented to custom ceramic abutments after fatigue. Prospective clinical trials are needed to confirm the results of this laboratory investigation.
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Affiliation(s)
- F A Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - E A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - F Vollmer
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.,Private Practice, Tettnang, Germany
| | - P C Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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Zarone F, Ruggiero G, Leone R, Breschi L, Leuci S, Sorrentino R. Zirconia-reinforced lithium silicate (ZLS) mechanical and biological properties: A literature review. J Dent 2021; 109:103661. [PMID: 33864886 DOI: 10.1016/j.jdent.2021.103661] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES This paper aimed to provide a literature review of the mechanical and biological properties of zirconia-reinforced lithium silicate glass-ceramics (ZLS) in Computer-aided design / Computer-aided manufacturing (CAD/CAM) systems. DATA/SOURCES An extensive search of the literature for papers related to ZLS was made on the databases of PubMed/Medline, Scopus, Embase, Google Scholar, Dynamed, and Open Grey. The papers were selected by 3 independent calibrated reviewers. STUDY SELECTION The search strategy produced 937 records. After the removal of duplicates and the exclusion of papers that did not meet the inclusion criteria, 71 papers were included. CONCLUSIONS After reviewing the included records, it was found that two types of ZLS (Vita Suprinity PC; Vita Zahnfabrik and Celtra Duo; Dentsply Sirona) are nowadays available on the market for CAD/CAM systems, similar in their chemical composition, microstructure, and biological-mechanical properties. ZLS is reported to be a biocompatible material, whose fracture resistance can withstand physiological chewing loads. The firing process influences the improvements of strength and fatigue failure load, with a volumetric shrinkage. To date, ZLS can be considered a viable alternative to other glass-ceramics for fixed single restorations. CLINICAL SIGNIFICANCE . As to biocompatibility and mechanical properties of ZLS, data are still scarce, often controversial and limited to short-term observational periods. These promising ceramics require further in vitro/in vivo studies to accurately define mechanical and biological properties, mainly in the long-term performance of restorations produced with such materials.
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Affiliation(s)
- Fernando Zarone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Prosthodontics and Digital Dentistry, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Gennaro Ruggiero
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Prosthodontics and Digital Dentistry, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Renato Leone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Prosthodontics and Digital Dentistry, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Alma Mater Studiorum, Via San Vitale 59, 40125, Bologna, Italy.
| | - Stefania Leuci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, School of Medicine, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Roberto Sorrentino
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Prosthodontics and Digital Dentistry, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
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Pitta J, Hjerppe J, Burkhardt F, Fehmer V, Mojon P, Sailer I. Mechanical stability and technical outcomes of monolithic CAD/CAM fabricated abutment-crowns supported by titanium bases: An in vitro study. Clin Oral Implants Res 2020; 32:222-232. [PMID: 33258267 DOI: 10.1111/clr.13693] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 11/08/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate mechanical stability (survival and complication rates) and bending moments of different all-ceramic monolithic restorations bonded to titanium bases (hybrid abutment-crowns) or to customized titanium abutments compared to porcelain-fused-to-metal crowns (PFM) after thermo-mechanical aging. MATERIAL AND METHODS Sixty conical connection implants (4.3 mm-diameter) were divided in five groups (n = 12): PFM using gold abutment (GAbut-PFM), lithium disilicate crown bonded to customized titanium abutment (TAbut+LDS), lithium disilicate abutment-crown bonded to titanium base (TiBase+LDS), zirconia abutment-crown bonded to titanium base (TiBase+ZR), polymer-infiltrated ceramic-network (PICN) abutment-crown bonded to titanium base (TiBase+PICN). Simultaneous thermocycling (5°-55°C) and chewing simulation (1,200,000-cycles, 49 N, 1.67 Hz) were applied. Catastrophic and non-catastrophic events were evaluated under light microscope, and survival and complication rates were calculated. Specimens that survived aging were loaded until failure and bending moments were calculated. RESULTS Survival rates after aging were 100% (TAbut+LDS, TiBase+LDS), 91.7% (GA-PFM), 66.7% (TiBase+ZR) and 58.3% (TiBase+PICN) and differed among the groups (p = .006). Non-catastrophic events as screw loosening (GA-PFM) and loss of retention or micro-/macro-movement (TiBase groups) were observed. Complication rates varied among the groups (p < .001). TiBase+PICN had lower bending moment than all the other groups (p < .001). CONCLUSIONS Hybrid abutment-crowns made of lithium disilicate can be an alternative to PFM-based restorations, although concerns regarding the bonded interface between the titanium base and abutment-crown can be raised. PICN and zirconia may not be recommended due to its inferior mechanical and bonding outcomes, respectively. Titanium customized abutment with bonded lithium disilicate crown appears to be the most stable combination.
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Affiliation(s)
- João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Jenni Hjerppe
- Departments of Oral and Maxillofacial Diseases, Helsinki University Hospital (HUH), Helsinki, Finland.,Department of Prosthodontics and Stomatognathic physiology, University of Turku, Turku, Finland
| | - Felix Burkhardt
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Vincent Fehmer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Philippe Mojon
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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Khamis MM, Zakaria NH. Effect of screw access channel on the fracture rate of lithium disilicate cement-retained implant-supported posterior crowns. J Prosthet Dent 2020; 127:618-625. [PMID: 33309213 DOI: 10.1016/j.prosdent.2020.08.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Whether the presence of a screw access channel on the occlusal surface of a lithium disilicate cement-retained single tooth implant restoration reduces its fracture rate is unclear. PURPOSE The purpose of this randomized controlled clinical trial was to compare the fracture rate of lithium disilicate cement-retained posterior single tooth implant restorations with or without screw access channels. The study also evaluated whether the crown dimensions and location of the occlusal screw access channel would affect the fracture rate. MATERIAL AND METHODS A split-mouth study was conducted where 40 participants having 2 implants placed to restore single missing posterior teeth with crowns were enrolled. Implants were randomly allocated into a conventional crown group or a screw access group, receiving cement-retained restorations fabricated from lithium disilicate glass-ceramic with and without an occlusal screw access channel. Crown dimensions were recorded in millimeters from the designing software. Follow-up evaluations were made at 3, 6, and 12 months by observing visible cracks or fractures of the crowns. The Kolmogorov-Smirnov test of normality was used. Comparisons were carried out by using the Student and Welch t tests (α=.05). RESULTS After a 12-month follow-up period, no crowns fractured or revealed visible cracks, resulting in a 100% success rate. No statistically significant differences were found between the conventional crown group and screw access channel group in all crown dimensions (P>.05). CONCLUSIONS The presence of an occlusal screw access channel did not affect the short-term fracture rate of lithium disilicate cement-retained single implant-supported posterior crowns. The amount of axial cantilever, occlusal ceramic thickness, and location of the screw access channel on the occlusal surface of the restoration have no effect on its fracture rate.
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Affiliation(s)
- Mohamed Moataz Khamis
- Professor and Chairman, Prosthodontic Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Niveen Hazem Zakaria
- Demonstrator of Fixed Prosthodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Giner S, Bartolomé JF, Gomez-Cogolludo P, Castellote C, Pradíes G. Fatigue fracture resistance of titanium and chairside CAD-CAM zirconia implant abutments supporting zirconia crowns: An in vitro comparative and finite element analysis study. J Prosthet Dent 2020; 125:503.e1-503.e9. [PMID: 33243472 DOI: 10.1016/j.prosdent.2020.09.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Zirconia abutments with a titanium base are promising candidates to substitute for titanium abutments based on clinical studies reporting good short-term survival rates. However, information on the long-term performance of zirconia abutments supporting ceramic crowns is scarce. PURPOSE This in vitro comparative and finite element analysis study compared the fatigue life performance of ceramic computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic restorations and zirconia abutments fabricated with a chairside workflow connected to a titanium interface versus titanium abutments. MATERIAL AND METHODS Twenty-two internal connection implants were divided into 2 groups, one with a zirconia abutment and monolithic ceramic zirconia crown (ZZ) and the other with a titanium abutment and zirconia crown (TiZ). They were subjected to a fatigue test to determine the fatigue limit and fatigue performance of each group as per International Organization for Standardization (ISO) 14801. Microstructural analysis of the fracture surfaces was conducted by using a scanning electron microscope (SEM). Simulations of the in vitro study were also conducted by means of finite element analysis (FEA) to assess the stress distribution over the different parts of the restoration. RESULTS The fatigue limit was 250 N for the TiZ group and 325 N for the ZZ group. In both groups, the screw was the part most susceptible to fatigue and was where the failure initiated. In the zirconia abutment models, the stress on the screw was reduced. CONCLUSIONS Chairside CAD-CAM zirconia abutments with a titanium base supporting zirconia crowns had higher fatigue fracture resistance compared with that of titanium abutments.
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Affiliation(s)
- Sergio Giner
- Researcher, Department of Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - José F Bartolomé
- Researcher, Instituto de Ciencia de Materiales de Madrid (ICMM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain.
| | - Pablo Gomez-Cogolludo
- Associate Professor, Department of Buccofacial Prostheses, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Carlos Castellote
- Professor, Department of Industrial and Aerospace Engineering, Faculty of Engineering, University Europea of Madrid, Madrid, Spain
| | - Guillermo Pradíes
- Professor and Head, Department of Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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31
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The influence of the restorative material on the mechanical behavior of screw-retained hybrid-abutment-crowns. J Mech Behav Biomed Mater 2020; 111:103988. [DOI: 10.1016/j.jmbbm.2020.103988] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/07/2020] [Accepted: 07/11/2020] [Indexed: 11/18/2022]
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32
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In vitro performance and fracture resistance of interim conventional or CAD-CAM implant-supported screw- or cement-retained anterior fixed partial dentures. J Prosthet Dent 2020; 126:575-580. [PMID: 32962835 DOI: 10.1016/j.prosdent.2020.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Interim restorations represent an essential clinical treatment step; however, limited information is available concerning the performance of computer-aided design and computer-aided manufacturing (CAD-CAM) interim materials. PURPOSE The purpose of this in vitro study was to evaluate the performance and fracture load of resin anterior implant-supported interim fixed partial dentures (IFPDs). MATERIAL AND METHODS Identical anterior resin IFPDs (maxillary central incisor to canine; n=16 per material) were milled from polymethylmethacrylate (PMMA) or di-methacrylate (DMA) systems with different filler content. The IFPD groups were split to simulate a chairside (cemented implant-supported prosthesis) or laboratory procedure (screw-retained implant-supported prosthesis). A cartridge DMA material served as a control. After interim cementation, combined thermocycling and mechanical loading (TCML) was performed on all restorations to approximate a maximum of 2.5 years of clinical function. Behavior during TCML and fracture force was determined, and failures were analyzed. The data were statistically investigated (Kolmogorov-Smirnov test, 1-way-ANOVA; post hoc Bonferroni, Kaplan-Meier survival, α=.05). RESULTS Drop out during TCML varied between no failures and complete failure during loading. For most systems, failure occurred between 120 000 and 600 000 mechanical loading cycles. For IFPDs without a screw channel fracture, values varied between 644 ±263 N and 987 ±101 N. Those with a screw channel fracture failed between 493 ±89 N and 951 ±248 N. Individual IFPDs had significantly higher mean fracture loads (P<.002), but the mean fracture values between IFPDs with and without a screw channel were not significantly different (P>.137). Failures were characterized by fracture of the connector (n=53) followed by mixed failures (n=22) or fractures at the abutment (n=21). CONCLUSIONS These interim materials are sufficiently fracture resistant for the fabrication of implant-supported anterior IFPDs and are expected to survive between 6 months and 2 years before failure. The stability of IFPDs depended on the type of material but not on the restoration design (with or without a screw channel).
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Zacher J, Bauer R, Hanie Krifka S, Rosentritt M. In vitro performance and fracture resistance of pressed or CAD/CAM milled ceramic implant-supported screw-retained or cemented anterior FDPs. J Prosthodont Res 2020; 65:208-212. [PMID: 32938865 DOI: 10.2186/jpr.jpor_2019_403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study investigated the in-vitro performance of anterior implant-supported fixed dental prostheses (FDP). The effect of ceramics, fabrication, finalization and the presence of a screw-channel wa s investigated. METHODS Identical anterior ceramic FDPs (tooth 11-13; n=80) were milled (Lithiumdisilicate (LiSiCAD, emaxCAD, Ivoclar-Vivadent), Lithiumaluminiumsilicate (LiAlSi, experimental material) or pressed (Lithiumdisilicate (LiSiPress, emaxPress, Ivoclar-Vivadent), Lithiumsilicate (ZLS, CeltraPress, Dentsply Sirona). FDP-groups (n=8 per material and group) simulated a cemented or screw-retained approach. After cementation or screwing on titanium abutments, thermal cycling and mechanical loading (TCML) was performed on all restorations to mimic 5-year clinical performance. Performance and fracture force were determined and failures were analyzed. STATISTICS (Kolmogorov-Smirnov-test, one-way-ANOVA; post-hoc-Bonferroni, multivariate-regression, α=0.05). RESULTS All FDPs survived TCML without aging, cracks, fractures or chipping. For FDPs without screw channel fracture values varied between with 839.8±112.3N (LiAlSi glazed) and 1485.9±232.6N (LiSiCAD). With screw channel, fracture results varied between 701.4±220.1N (LiALSi glazed) and 1516.3±253.7N (LiSipress). The type of material had a significant influence on the fracture results (LiSi>ZLS>LiAlSi; p≤0.012). Fabrication and finalization had no influence on the results. A screw channel did not significantly (p≥0.135) reduce the fracture force of the FDPs. Type of failure was mostly characterized by a fracture of the connector (LiSi, LiAlSi) or the abutment (ZLS, LiAlSi). CONCLUSIONS FDPs survived TCML without failures indicating that the in vitro performance was not influenced by the tested parameters. Composition of ceramic material has significant influence on the fracture resistance of implant supported LiSi based FDPs. Screw channel, fabrication or finalization did not weaken the FDPs.
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Affiliation(s)
- Julian Zacher
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg
| | - Robert Bauer
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg
| | - Step Hanie Krifka
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg
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Evaluation of bond strength of resin cement to Er:YAG laser-etched enamel and dentin after cementation of ceramic discs. Lasers Med Sci 2020; 36:447-454. [PMID: 32696424 DOI: 10.1007/s10103-020-03103-1] [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: 04/07/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to investigate the shear bond strength (SBS) of ceramic discs luted to differently etched enamel and dentin surfaces. Occlusal surfaces of 64 carious-free human molars and vestibule surfaces of 64 first maxillary incisors were ground to get flat superficial dentin and flattened enamel respectively. After generating 4 groups according to the surface etching method (37% orthophosphoric acid, Er:YAG laser-contact handpiece/scanning handpiece (1 or 2 times of scanning)), ceramic discs were luted to the surfaces with adhesive resin cement (Variolink N, Vivadent Ets., Schaan/Liechtenstein). After etching and cementation, thermocycling of 5000 cycles (Sd Mechatronık Gmbh, Feldkirchen-Westerham, Germany) and SBS test (Servopulser EHFFD1; Shimadzu, Kyoto, Japan) were performed respectively. The surface morphologies of 2 specimens, etched enamel and dentin, prepared for each group were examined with SEM analysis. Failure modes were determined under a USB digital microscope. Data were analyzed with one-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). SBS values in dentin surfaces showed statistically significant differences (p < 0.05) among tested groups. The highest SBS among dentin groups was determined in the group which had 2 times etching by Er:YAG laser (11.42 MPa) by a scanning handpiece. No statistical differences were observed in the other dentin or enamel groups. Laser etching seems to be a viable alternative to acid etching on both enamel and dentin surfaces while double etching of dentin with a scanning handpiece can improve the adhesion.
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Fracture Resistance of Zirconia-Reinforced Lithium Silicate Ceramic Crowns Cemented with Conventional or Adhesive Systems: An In Vitro Study. MATERIALS 2020; 13:ma13092012. [PMID: 32344894 PMCID: PMC7254201 DOI: 10.3390/ma13092012] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/11/2020] [Accepted: 04/23/2020] [Indexed: 12/15/2022]
Abstract
In recent years, Zirconia-reinforced Lithium Silicate ceramic (ZLS), combining lithium-silicate and zirconia features, has shown to have excellent mechanical and aesthetic characteristics. Thus, the aim of this study was to compare the fracture strength of ZLS single crowns cemented with two different cementation techniques. Twenty crowns were realised and cemented on teeth replicas achieved from an extracted premolar human tooth. The samples were divided into two groups of 10 specimens each, Glass-ionomeric cement (GIC) group and Self-Adhesive Resin Cement (ARC) group. The mechanical test was performed using a universal testing machine. The specimens were then evaluated with a scanning electron microscope (SEM) to identify for all crowns and related abutments the pattern of fracture after the breaking point. The data obtained were statistically analysed. The mean fracture toughness values and standard deviations (±SD) were 2227 ± 382 N and 3712 ± 319 N respectively for GIC and ARC groups. In fact, t-test showed a statistically significant difference between the two groups (p < 0.001). Moreover, the SEM results demonstrated portions of abutments still attached to the crown fragments in the ARC group, whilst these were not present in the GIC group. Within the limitations of this study, these results suggest the use of adhesive cementation for ZLS crowns, which significantly increase the compressive strength of ZLS restorations compared to GIC.
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Ceramic Materials and Technologies Applied to Digital Works in Implant-Supported Restorative Dentistry. MATERIALS 2020; 13:ma13081964. [PMID: 32331379 PMCID: PMC7216107 DOI: 10.3390/ma13081964] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 12/17/2022]
Abstract
Computer-aided design and manufacturing technology has been closely associated with implant-supported restoration. The digital system employed for prosthodontic restorations comprises data acquisition, processing, and manufacturing using subtractive or additive methods. As digital implantology has developed, optical scanning, computer-based digital algorithms, fabricating techniques, and numerical control skills have all rapidly improved in terms of their accuracy, which has resulted in the development of new ceramic materials with advanced esthetics and durability for clinical application. This study reviews the application of digital technology in implant-supported dental restoration and explores two globally utilized ceramic restorative materials: Yttria-stabilized tetragonal zirconia polycrystalline and lithium disilicate glass ceramics.
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Nawafleh N, Bibars AR, Al Twal E, Öchsner A. Influence of Antagonist Material on Fatigue and Fracture Resistance of Zirconia Crowns. Eur J Dent 2020; 14:200-205. [PMID: 32311751 PMCID: PMC7274834 DOI: 10.1055/s-0040-1708228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective
This study investigates the influence of the most commonly used indenter materials on fatigue survival and fracture resistance of zirconia crowns.
Materials and Methods
A total of 40 zirconia crowns were prepared using computer-aided design (CAD)/computer-aided manufacturing (CAM) technology: 30 crowns were divided into three experimental groups of 10 specimens and the last 10 specimens acted as the control group. The experimental groups were subjected to chewing simulation with simultaneous thermocycling. Three indenter materials (steatite ceramic, stainless steel, and tungsten carbide) with identical diameter were used to load the specimens. All crowns were then subjected to single load to fracture test in universal testing machine. Load was applied vertically with a crosshead speed of 1 mm/min until failure, and fracture load was recorded.
Statistical Analysis
Normal distribution of data was confirmed using the Shapiro–Wilk test. Descriptive statistics including means and standard deviations were determined for all groups. Differences between groups were tested using Dunnett’s test and paired sample
t
-test.
Results
Chewing simulation for 1.2 million cycles resulted in 100% survival. The highest mean fracture load was recorded for the control group and the lowest one was for the group fatigued with stainless steel indenter. Chewing simulation statistically significantly (
p
< 0.05) reduced the mean fracture load of the crowns fatigued with stainless steel and steatite ceramic indenter. However, the mean fracture load for the crowns fatigued with tungsten carbide was not significantly different from that of the control group.
Conclusion
Steatite ceramic and stainless steel indenters produced close results and significantly reduced fracture load of zirconia crowns. However, tungsten carbide indenter caused nonsignificant reduction in the fracture load of zirconia crowns.
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Affiliation(s)
- Noor Nawafleh
- Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel Raheem Bibars
- Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Elina Al Twal
- Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Andreas Öchsner
- Faculty of Mechanical Engineering, Esslingen University of Applied Sciences, Esslingen, Germany.,Faculty of Engineering and Built Environment, University of Newcastle, Newcastle, Australia
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Joos M, Sailer I, Filippi A, Mukaddam K, Rosentritt M, Kühl S. Stability of screw-retention in two-piece zirconia implants: An in vitro study. Clin Oral Implants Res 2020; 31:607-614. [PMID: 32181927 DOI: 10.1111/clr.13597] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare the stability of a screw-retained connection in a novel two-piece zirconia implant to a conventional titanium-based connection in an in vitro chewing simulation including artificial ageing. MATERIAL AND METHODS Incisor (I) and molar (M) shaped monolithic zirconia crowns were screw-retained on either two-piece zirconia (test) or two-piece titanium (control) implants resulting in 4 groups of 8 samples (titanium implants with incisor-shaped crowns (T-I), titanium implants with molar-shaped crowns (T-M), zirconia implants with incisor-shaped crowns (Z-I) and zirconia implants with molar-shaped crowns (Z-M). These were subjected to artificial ageing by thermal cycling (TC: 2 × 3000 × 5°C/55°C cycles of 2 min) and mechanical loading (ML: 1.2 × 106 cycles of 50 N, f = 1 Hz). Surviving samples additionally underwent a fracture force test. Kaplan-Meier plots were drawn, and two-way ANOVA was calculated taking anatomical localisation and material variables as factors. RESULTS The mean corresponding survival times were lower for T-M (0.86 × 106 ± 0.31 × 106 cycles) and Z-I (0.84 × 106 ± 0.21 × 106 cycles) compared to T-I (1.14 × 106 ± 0.10 × 106 cycles) and Z-M (1.20 × 106 ± 0.10 × 106 cycles). In one-way ANOVAs for survival time dependent on either location or material, no statistically significant differences could be found (location: p = .31; material: p = .62) in one-way ANOVAs. The interaction of location and material showed significant differences (F = 21.3, p < .001). CONCLUSION The connection of the tested screw-retained zirconia crowns in two-piece zirconia implants is comparable to standard titanium implants in the specific in vitro testing.
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Affiliation(s)
- Marc Joos
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), Basel, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Occlusion, University of Geneva, Geneva, Switzerland
| | - Andreas Filippi
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), Basel, Switzerland
| | - Khaled Mukaddam
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), Basel, Switzerland
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, University Medical Center Regensburg, Regensburg, Germany
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), Basel, Switzerland
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Zacher J, Bauer R, Strasser T, Rosentritt M. Laboratory performance and fracture resistance of CAD/CAM implant-supported tooth-coloured anterior FDPs. J Dent 2020; 96:103326. [PMID: 32201200 DOI: 10.1016/j.jdent.2020.103326] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/05/2020] [Accepted: 03/18/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES This study investigated the in-vitro performance and fracture force of anterior implant-supported tooth-coloured fixed dental prosthesis (FDPs). Different material types with varying flexural strength and modulus of elasticity were compared with screw-retained or bonded application. MATERIALS AND METHODS Identical anterior FDPs (tooth 11-13; n = 80) from materials (flexural strength 240-1150 MPa, modulus 7.6-210 GPa; 1x lithiumdisilicate ceramic, 2x zirconia (4Y-TZP, 5Y-FSZ), 3x resin-based composites (with different flexural strength and modulus)) were milled. FDPs were grouped into chairside (bonded) and labside (screw-retained) procedure. To simulate a 5-year clinical application, thermal cycling with mechanical loading (TCML) was accomplished. TCML-performance and fracture force were evaluated and failure patterns were analysed. Data were statistically investigated (Kolmogorov-Smirnov-test, one-way-ANOVA; post-hoc-Bonferroni, α = 0.05). RESULTS TCML did not lead to any cracks, fractures or chipping on all tested FDPs. Fracture values varied between 1208.9 ± 354.6 N (experimental resin-based composite) and 2094.3 ± 293.4 N (4Y-TZP) for FDPs without screw channel. With screw channel the results ranged between 1297.9 ± 268.3 N (5Y-FSZ) and 2129.3 ± 321.7 N (4Y-TZP). The influence of the screw channel was not significant for all materials (p ≥ 0.218). Modulus of elasticity and flexural strength had influence on the fracture force only in the individual material groups. Fractures at the connector were predominant for ceramic and zirconia. Resin-based composites primarily showed radial fractures in abutment region or mixed failure types. FDPs with/without screw-channel showed comparable types of failure. CONCLUSIONS TCML did not lead to drop-outs or failures for all FDPs. Individual materials showed no different in-vitro performance, but varying fracture force after TCML. Independent from material, screw channels did not weaken the FDPs. All tested systems showed sufficient properties for an anterior implant application.
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Affiliation(s)
- Julian Zacher
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany.
| | - Robert Bauer
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Thomas Strasser
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
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Rosentritt M, Krifka S, Strasser T, Preis V. Fracture force of CAD/CAM resin composite crowns after in vitro aging. Clin Oral Investig 2019; 24:2395-2401. [PMID: 31712983 DOI: 10.1007/s00784-019-03099-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 09/26/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this in vitro study was to investigate the influence of material, preparation, and pre-treatment on the aging and fracture force of CAD/CAM resin composite molar crowns. MATERIALS AND METHODS CAD/CAM molar crowns (n = 80) were milled from four resin composites (Block HC, Shofu; Lava Ultimate, 3 M; Grandio Blocs, Voco; and Tetric CAD, Ivoclar Vivadent, with/without sandblasting). Extracted human teeth were prepared with optimal preparation (height 6-8 mm, angle 6-8°) or worst-case preparation (height 3.5-4 mm, angle 10-15°). Both groups were prepared with a 1-mm deep cervical circular shoulder. Crowns were adhesively bonded after corresponding tooth treatment required for the individual adhesive systems (Table 1). Specimens were aged for 90 days in water storage (37 °C) and subsequently subjected to thermal cycling and mechanical loading (TCML 3000 × 5 °C/3000 × 55 °C, 2 min each cycle, H20 distilled; 1.2 × 106 cycles à 50 N, 1.6 Hz). De-bonding and fracture force was determined. STATISTICS one-way-ANOVA; post hoc Bonferroni, α = 0.05. RESULTS Four crowns of Lava Ultimate with worst-case preparation de-bonded during TCML. Individual crowns without sandblasting treatment (3x Tetric CAD with optimal preparation; 1x Tetric CAD with worst-case preparation) de-bonded during water storage. One crown of Grandio Blocs with optimal preparation showed a small chipping during TCML. All other crowns survived TCML and water storage without failure. Fracture forces differed between 1272 ± 211 N (Lava Ultimate) and 3061 ± 521 N (Tetric CAD). All Grandio Blocs and Tetric CAD crowns revealed significantly (p ≤ 0.023) higher fracture forces than Block HC or Lava Ultimate crowns. No significantly different (p > 0.05) fracture forces were found between optimal or worst-case preparation/fit groups. CONCLUSIONS De-bonding during water storage and TCML was dependent on material and crown pre-treatment. Therefore, surface roughening seems strongly required. Fracture forces were not influenced by preparation but by the type of material. CLINICAL RELEVANCE Clinical success and de-bonding of CAD/CAM resin composite crowns is strongly influenced by the type of material and its pre-treatment.
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Affiliation(s)
- Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany.
| | - Stefanie Krifka
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Thomas Strasser
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Verena Preis
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
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Rohr N, Balmer M, Müller JA, Märtin S, Fischer J. Chewing simulation of zirconia implant supported restorations. J Prosthodont Res 2019; 63:361-367. [DOI: 10.1016/j.jpor.2019.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/01/2019] [Accepted: 02/13/2019] [Indexed: 11/28/2022]
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Rabel K, Spies BC, Pieralli S, Vach K, Kohal RJ. The clinical performance of all-ceramic implant-supported single crowns: A systematic review and meta-analysis. Clin Oral Implants Res 2019; 29 Suppl 18:196-223. [PMID: 30306684 DOI: 10.1111/clr.13337] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This review aimed at evaluating the survival and technical complication rates of all-ceramic implant-supported single crowns (SC). MATERIAL AND METHODS Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant-supported all-ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5- and 10-year survival and complication estimates. RESULTS Forty-one included studies reported on implant-supported SCs made of veneered and monolithic high-strength oxide ceramics, monolithic, and veneered glass-based ceramics and of a monolithic resin-nano-ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%-96.4%) after 5 years and 94.4% (95% CI: 91.1%-96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%-97.7%) and 96.2% (95% CI: 95.1%-97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%-14.8%)/2.7% (95% CI: 2.1%-3.5%), framework fractures 1.9% (95% CI: 0.7%-4.9%)/1.2% (95% CI: 1%-1.5%), screw loosening 3.6% (95% CI: 1.6%-8.4%)/5.2% (95% CI: 3.6%-7.5%), and decementations with 1.1% (95% CI: 0.4%-2.8%) after 5 years. Some confounding variables influenced the above-mentioned estimates significantly. CONCLUSIONS All-ceramic implant-supported SCs showed-with the exception of a RNC material-high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant-supported all-ceramic SCs.
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Affiliation(s)
- Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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Brandt S, Winter A, Lauer HC, Kollmar F, Portscher-Kim SJ, Romanos GE. IPS e.max for All-Ceramic Restorations: Clinical Survival and Success Rates of Full-Coverage Crowns and Fixed Partial Dentures. MATERIALS 2019; 12:ma12030462. [PMID: 30717358 PMCID: PMC6384731 DOI: 10.3390/ma12030462] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/17/2019] [Accepted: 01/29/2019] [Indexed: 11/16/2022]
Abstract
The IPS e.max system by Ivoclar Vivadent, offering a variety of products and indications, is widely used for all-ceramic restorations. We analyzed the clinical track record of these products in daily clinical practice, associating their restorative survival rate with various parameters to define recommendations for long-term stability. A total of 1058 full-coverage crowns and fixed partial dentures (FPDs) were evaluated retrospectively over up to 66.48 (37.05 ± 18.4) months. All were made of IPS e.max Press, IPS e.max CAD, IPS e.max Ceram or IPS e.max ZirPress and had been delivered by a private dental practice within three years. Uses not recommended by the manufacturer were also deliberately included. The five-year cumulative survival was 94.22% (i.e., 94.69% or 90.58% for glass-ceramic crowns or FDPs and 100% or 90.06% for zirconia-based crowns or FDPs). Significantly superior outcomes emerged for conventional vs. adhesive cementation and for vital vs. non-vital abutment teeth, but not for recommended vs. non-recommended uses. Caution is required in restoring non-vital teeth, but the spectrum of recommended uses should generally be reconsidered and expanded, given our finding of high survival and success rates for IPS e.max ceramics, even for uses not currently recommended by the manufacturer.
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Affiliation(s)
- Silvia Brandt
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany.
| | - Anna Winter
- Department of Prosthodontics, Center for Dentistry, Oral Medicine, Julius Maximilian University, Pleicherwall 2, 97070 Würzburg, Germany.
| | - Hans-Christoph Lauer
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany.
| | - Fritz Kollmar
- Private Practice Dr. Fritz Kollmar, Friedrich-Ebert-Straße 55, 34117 Kassel, Germany.
| | - Soo-Jeong Portscher-Kim
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany.
| | - Georgios E Romanos
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany.
- Germany and Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
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Rosentritt M, Preis V, Behr M, Krifka S. In-vitro performance of CAD/CAM crowns with insufficient preparation design. J Mech Behav Biomed Mater 2019; 90:269-274. [DOI: 10.1016/j.jmbbm.2018.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 11/17/2022]
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Dal Piva AMDO, Tribst JPM, Borges ALS, de Melo RM, Bottino MA. Influence of substrate design for in vitro mechanical testing. J Clin Exp Dent 2019; 11:e119-e125. [PMID: 30805115 PMCID: PMC6383903 DOI: 10.4317/jced.55353] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 01/14/2019] [Indexed: 12/16/2022] Open
Abstract
Background The goal of this study was to evaluate the influence of dental substrate simulator material, and the presence of root and periodontal ligament on the stress distribution in an adhesively-cemented monolithic crown. Material and Methods Five (5) 3D models according to the substrate simulator material and shape were modeled with CAD software for conducting non-linear finite element analysis (FEA): Tooth with and without periodontal ligament - subgroup "pl" (groups Tooth+pl and Tooth-pl), machined tooth in epoxy-resin with and without pulp chamber - subgroup "pc" (ER+pc and ER-pc) and simplified epoxy-resin substrate without pulp chamber and roots (SiER). Next, adhesively-cemented monolithic crowns in zirconia reinforced lithium silicate were modeled over each substrate. The solids were then imported in STEP format to the analysis software and the contact between teeth and cylinder was considered perfectly bonded; whereas, the contacts involving the resin cement were considered as non-separated. The materials were considered isotropic, linearly elastic, and homogeneous. An axial load (600 N) was applied to the occlusal surface and results of maximum principal stress (MPa) on the restoration were required. Results FEA revealed that all evaluated subtracts showed the crown intaglio surface as the most stressed region. The average stress and stress peaks were similar for restorations cemented onto Tooth+pl, Tooth-pl and ER+pc substrates, but, 13% higher in comparison to ER-pc and SiER substrates. Conclusions Simplified substrates can be used to evaluate posterior full crown behavior without periodontal ligaments and roots, since the rigidity of the specimen is taken into account. Key words:Finite element analysis, axial loading, computed assisted numerical analisys, monolithic crowns,methodological study.
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Affiliation(s)
- Amanda-Maria-de Oliveira Dal Piva
- DDs, MSc, PhD Student, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil. CEP 12245-000. Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Gustav Mahlerlaan #3004, 1081 LA Amsterdam, Noord-Holland, The Netherlands
| | - João-Paulo-Mendes Tribst
- DDs, MSc, PhD Student, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil. CEP 12245-000. Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Gustav Mahlerlaan #3004, 1081 LA Amsterdam, Noord-Holland, The Netherlands
| | - Alexandre-Luiz-Souto Borges
- DDs, MSc, PhD, Adjunct Professor, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil. CEP 12245-000
| | - Renata-Marques de Melo
- DDs, MSc, PhD, Researcher III, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil. CEP 12245-000
| | - Marco-Antonio Bottino
- DDs, MSc, PhD, Professor, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil. CEP 12245-000
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Lee C, Yamaguchi S, Ohta K, Imazato S. Mechanical properties of computer-aided design/computer-aided manufacturing resin composites assuming perfect silane coupling using in silico homogenization of cryo-electron microscopy images. J Prosthodont Res 2019; 63:90-94. [DOI: 10.1016/j.jpor.2018.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 11/13/2022]
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Preis V, Hahnel S, Behr M, Rosentritt M. In vitro performance and fracture resistance of novel CAD/CAM ceramic molar crowns loaded on implants and human teeth. J Adv Prosthodont 2018; 10:300-307. [PMID: 30140397 PMCID: PMC6104500 DOI: 10.4047/jap.2018.10.4.300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 03/07/2018] [Accepted: 05/08/2018] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the fatigue and fracture resistance of computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic molar crowns on dental implants and human teeth. MATERIALS AND METHODS Molar crowns (n=48; n=8/group) were fabricated of a lithium-disilicate-strengthened lithium aluminosilicate glass ceramic (N). Surfaces were polished (P) or glazed (G). Crowns were tested on human teeth (T) and implant-abutment analogues (I) simulating a chairside (C, crown bonded to abutment) or labside (L, screw channel) procedure for implant groups. Polished/glazed lithium disilicate (E) crowns (n=16) served as reference. Combined thermal cycling and mechanical loading (TC: 3000×5℃/3000×55℃; ML: 1.2×106 cycles, 50 N) with antagonistic human molars (groups T) and steatite spheres (groups I) was performed under a chewing simulator. TCML crowns were then analyzed for failures (optical microscopy, SEM) and fracture force was determined. Data were statistically analyzed (Kolmogorow-Smirnov, one-way-ANOVA, post-hoc Bonferroni, α=.05). RESULTS All crowns survived TCML and showed small traces of wear. In human teeth groups, fracture forces of N crowns varied between 1214±293 N (NPT) and 1324±498 N (NGT), differing significantly (P≤.003) from the polished reference EPT (2044±302 N). Fracture forces in implant groups varied between 934±154 N (NGI_L) and 1782±153 N (NPI_C), providing higher values for the respective chairside crowns. Differences between polishing and glazing were not significant (P≥.066) between crowns of identical materials and abutment support. CONCLUSION Fracture resistance was influenced by the ceramic material, and partly by the tooth or implant situation and the clinical procedure (chairside/labside). Type of surface finish (polishing/glazing) had no significant influence. Clinical survival of the new glass ceramic may be comparable to lithium disilicate.
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Affiliation(s)
- Verena Preis
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Michael Behr
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
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Polishing effects and wear performance of chairside CAD/CAM materials. Clin Oral Investig 2018; 23:725-737. [PMID: 29770877 DOI: 10.1007/s00784-018-2473-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 04/25/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVES To investigate the surface roughness of CAD/CAM materials immediately after milling and after different chairside and labside polishing procedures. A two-body wear test was performed to compare the different wear characteristics of the materials and the corresponding antagonists. MATERIALS AND METHODS Specimens (n = 12 per series) from different CAD/CAM materials (three composites: Lava Ultimate, Cerasmart, BRILLIANT Crios; one hybrid ceramic: VITA Enamic; three ceramics: Celtra Duo, VITA Suprinity, IPS Emax.CAD) were polished according to the manufacturer's instructions. The effect of different polishing procedures was investigated by comparing surface roughness (Ra, Rmax) after labside polishing and after chairside polishing. Wear behavior (mean, volume, and maximum wear) of specimens and antagonists as well as changes in surface roughness were determined in a pin-on-block wear test. Statistical analysis was performed with a one-way analysis of variance (ANOVA)/Bonferroni multiple-comparison post hoc test and a multifactorial ANOVA/Tukey's significant difference post hoc test (α = 0.05). SEM micrographs were used for the qualitative evaluation of surfaces and wear traces. RESULTS After chairside high-gloss polishing, ceramics and composites exhibited Ra values between 0.08 and 0.10 μm and between 0.11 and 0.13 μm, respectively. After labside high-gloss polishing, values varied between 0.02 and 0.09 μm for ceramics and between 0.06 and 0.16 μm for resin composites. No significant differences were found between labside and chairside pre- and high-gloss polishing. For the ceramics, lower mean wear depths (between - 132.2 ± 19.9 and - 137.0 ± 19.0 μm) were identified compared to the resin composites (which exhibited wear depths between - 159.1 ± 19.4 and - 176.3 ± 23.9 μm). For maximum wear depth and volume, a different ranking of the materials was found. Antagonistic wear varied between 12.0 ± 6.4% and 30.6 ± 9.9% and was higher for the ceramic materials and Lava Ultimate. For all materials, a smoothing between 0.20 and 2.70 μm (Ra) was identified after wear simulation. CONCLUSIONS Chairside polishing is as effective as labside polishing, although surfaces were directly adjusted (roughened) only before the chairside polishing. Wear was lowest for ceramics, followed by the resin-infiltrated material and the resin composites. CLINICAL RELEVANCE Polishing after milling or adjustment is essential to guaranteeing optimal clinical performance. Chairside polishing after adjustment leads to comparably smooth surfaces as labside polishing after milling and grinding. Ceramics are expected to exhibit lower wear than resin composites under clinical conditions.
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Schlenz MA, Schmidt A, Rehmann P, Niem T, Wöstmann B. Microleakage of composite crowns luted on CAD/CAM-milled human molars: a new method for standardized in vitro tests. Clin Oral Investig 2018; 23:511-517. [PMID: 29691662 DOI: 10.1007/s00784-018-2460-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/17/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate debonding of full crowns made of CAD/CAM composites, CAD/CAM technology was applied to manufacture standardized test abutments to increase the reproducibility of human teeth used in in vitro studies. MATERIALS AND METHODS A virtual test abutment and the corresponding virtual crown were designed and two STL data sets were generated. Sixty-four human third molars and CAD/CAM blocks were milled using a CNC machine. Crowns of four different composite blocks (Lava Ultimate (LU), Brilliant Crios (BC), Cerasmart (CS), Experimental (EX)) were adhesively bonded with their corresponding luting system (LU: Scotchbond Universal/RelyX Ultimate; BC: One Coat 7 Universal/DuoCem; CS: G-PremioBond/G-Cem LinkForce; EX: Experimental-Bond/Experimental-Luting-Cement). Half of the specimens were chemical-cured (CC) and the others were light-cured (LC). Afterwards, specimens were artificially aged in a chewing simulator (WL-tec, 1 million cycles, 50-500 N, 2 Hz, 37 °C). Finally, a dye penetration test was used to detect debonding. For inspection, the specimens were sliced, and penetration depth was measured with a digital microscope. Data were analyzed with the Mann-Whitney U test. RESULTS No cases of total debonding were observed after cyclic loading. However, the LC specimens showed a significantly lower amount of leakage than the CC ones (p < 0.05). Furthermore, the CC specimens exhibited broad scattering. Only the LC-EX blocks showed no debonding. The CC-CS blocks showed the highest leakage and scattering of all tested specimens. CONCLUSIONS Natural human teeth can be manufactured by CAD/CAM technology in highly standardized test abutments for in vitro testing. For CAD/CAM composites, light curing should be performed. CLINICAL RELEVANCE The success of a restoration depends on the long-term sealing ability of the luting materials, which avoids debonding along with microleakage. For CAD/CAM composites, separate light curing of the adhesive and luting composite is highly recommended.
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Affiliation(s)
- Maximiliane Amelie Schlenz
- Dental Clinic - Department of Prosthodontics, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany.
| | - Alexander Schmidt
- Dental Clinic - Department of Prosthodontics, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany
| | - Peter Rehmann
- Dental Clinic - Department of Prosthodontics, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany
| | - Thomas Niem
- Dental Clinic - Department of Prosthodontics, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany
| | - Bernd Wöstmann
- Dental Clinic - Department of Prosthodontics, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany
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Elshiyab SH, Nawafleh N, Öchsner A, George R. Fracture resistance of implant- supported monolithic crowns cemented to zirconia hybrid-abutments: zirconia-based crowns vs. lithium disilicate crowns. J Adv Prosthodont 2018; 10:65-72. [PMID: 29503716 PMCID: PMC5829289 DOI: 10.4047/jap.2018.10.1.65] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/24/2017] [Accepted: 12/05/2017] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this in vitro study was to investigate the fracture resistance under chewing simulation of implant-supported posterior restorations (crowns cemented to hybrid-abutments) made of different all-ceramic materials. MATERIALS AND METHODS Monolithic zirconia (MZr) and monolithic lithium disilicate (MLD) crowns for mandibular first molar were fabricated using computer-aided design/computer-aided manufacturing technology and then cemented to zirconia hybrid-abutments (Ti-based). Each group was divided into two subgroups (n=10): (A) control group, crowns were subjected to single load to fracture; (B) test group, crowns underwent chewing simulation using multiple loads for 1.2 million cycles at 1.2 Hz with simultaneous thermocycling between 5℃ and 55℃. Data was statistically analyzed with one-way ANOVA and a Post-Hoc test. RESULTS All tested crowns survived chewing simulation resulting in 100% survival rate. However, wear facets were observed on all the crowns at the occlusal contact point. Fracture load of monolithic lithium disilicate crowns was statistically significantly lower than that of monolithic zirconia crowns. Also, fracture load was significantly reduced in both of the all-ceramic materials after exposure to chewing simulation and thermocycling. Crowns of all test groups exhibited cohesive fracture within the monolithic crown structure only, and no abutment fractures or screw loosening were observed. CONCLUSION When supported by implants, monolithic zirconia restorations cemented to hybrid abutments withstand masticatory forces. Also, fatigue loading accompanied by simultaneous thermocycling significantly reduces the strength of both of the all-ceramic materials. Moreover, further research is needed to define potentials, limits, and long-term serviceability of the materials and hybrid abutments.
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Affiliation(s)
- Shareen H Elshiyab
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.,Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Noor Nawafleh
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Andreas Öchsner
- School of Engineering, Griffith University, Gold Coast, Queensland, Australia
| | - Roy George
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
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