Viscoelastic stability of pre-cured resin-composite CAD/CAM structures

Water absorption in artificial composites: Curse or blessing?

OBJECTIVES

This study evaluated the impact of mutable water uptake on the durability of mechanical properties and the long-term reliability of artificial composites.

METHODS

Three resin-based CAD/CAM restorative materials (CRMs) were investigated in three-point bending tests to calculate flexural strength (FS), modulus of elasticity (ME), modulus of resilience (MR), modulus of toughness (MT), and elastic recovery (ER). All specimens (n = 180) were stored under the same conditions and tested in four subsets (n = 15 per material) that were respectively withdrawn after repeated thermocycling (5000 cycles; 5-55 °C, H2O) and repetitive drying (7 d; 37 °C, air). For every specimen, weight differences were determined per storage condition. Likewise, loss tangent data were separately recorded via dynamic mechanical analysis to reliably assess damping characteristics.

RESULTS

Repeated thermocycling always induced weight increase and a concurrent significant loss in all mechanical properties except for MT and ER of a polymethylmethacrylate-based CRM. Drying consistently provoked weight loss and raised mechanical properties to initial values. Weight increase, however, enhanced loss tangent values and accordingly distinct damping characteristics, whereas weight decrease markedly lowered damping properties.

SIGNIFICANCE

Water uptake repeatedly induced a decrease in common mechanical properties but concurrently increased damping behavior. Invertible equilibrium processes were found with no evidence for permanent material degradation.

Combining a CAD-CAM composite resin palatal wall with a direct composite resin layering technique for the restoration of a large Class IV fracture: A clinical report

This clinical report presents combining a computer-aided design and computer-aided manufacturing (CAD-CAM) composite resin palatal wall with a direct composite resin layering technique for the esthetic and functional restoration of a large Class IV fracture of a maxillary central incisor to achieve optimal esthetic and functional outcomes.

Evaluation of repair bond strength of a dental CAD/CAM resin composite after surface treatment with two Er,Cr:YSGG laser protocols following artificial aging

The aim of the present study was to evaluate the impact of two Er,Cr:YSGG laser surface treatments on the repair bond strength of a dental CAD/CAM resin composite (Brilliant Crios) after artificial aging. Twenty-four resin-based CAD/CAM blocks were cut and 48 rectangular slabs (3 x 12 x 14 mm) were prepared. Preliminary SEM observations indicated the most favorable laser settings regarding surface modification of the tested restorative material. The CAD/CAM specimens were then divided into 4 groups (n=12) based on their surface pretreatment: no treatment, air abraded with 50-μm Al2O3 particles, and laser irradiated with two different protocols using Er,Cr:YSGG laser with average power 3.5 and 4.5 W, pulse repetition rate 35 and 50 Hz, and pulse energy 100 and 90 mJ, respectively. After surface treatments each group followed a bonding protocol with silane and a flowable resin composite was used to prepare 48 microrods. Half of the microrods of each group were subjected on shear bond strength (SBS) test (chisel-shaped blade, load cell of 500 N, crosshead speed of 1 mm/min) after 24 h, while the other half underwent artificial aging (15,000 cycles, 5-55 °C) and then SBS test. The debonded specimens were examined under an optical microscope to determine the failure mode. All specimens were also evaluated using SEM to assess the surface topography after the treatments. The results showed that SBS significantly decreased after thermocycling in all the experimental groups (p<0.05). Control group presented much lower SBS values than the other groups after both 24 h and thermocycling (p<0.05). The highest values of SBS exhibited air-abrasion group (p<0.05), followed by the two laser groups, which did not differ to each other (p>0.05). The results of the current study indicated that Er,Cr:YSGG laser irradiation can be an alternative treatment for repairing the tested resin-based CAD/CAM restorative material.

Effect of tooth brushing simulation on the surface properties of various resin-matrix computer-aided design/computer-aided manufacturing ceramics

PURPOSE

The purpose was to investigate the alterations in surface properties of different resin-matrix CAD/CAM ceramics following tooth brushing simulation (TBS) and compare them with a direct resin composite and a glass ceramic CAD/CAM material.

MATERIALS AND METHODS

Four resin-based CAD/CAM restoratives (Brilliant Crios-BR, Lava™ Ultimate-LV, Grandio Blocs-GR and Shofu Block HC-SH), a leucite-reinforced glass ceramic (IPS Empress® CAD-EC) and a resin composite (Filtek™ Z250-FZ) for direct restorations were tested. In particular, surface loss, hardness, roughness and morphology were investigated utilizing confocal microscopy, scanning electron microscopy and nanoindentation tester. TBS was conducted for 4 × 15 min on the surface of the samples and then the changes in their surface properties were evaluated.

RESULTS

After TBS, all the experimental groups exhibited surface loss to different extent. FZ and BR presented the highest surface loss, while EC and GR the lowest (p < 0.05). Regarding surface roughness, all the tested materials exhibited increase after TBS (p < 0.05), except LV (p = 0.099). EC presented the lowest Sa values, while FZ and BR the highest (p < 0.05). Changes in surface morphology were in compliance with the results of surface roughness and also surface hardness was correlated with surface loss.

CONCLUSIONS

The tested resin-matrix CAD/CAM ceramic restorative materials showed a competent behavior against abrasive forces applied during TBS. Surface loss and roughness changes were material dependent and superior compared to a resin composite for direct restorations, while in comparison with a leucite-reinforced glass ceramic exhibited inferior properties.

CLINICAL SIGNIFICANCE

Tooth brushing affected differently the surface of the tested restorative materials. However, the abrasive wear that was induced was negligible. Clinical studies are necessary to ascertain if there is clinical significance of these surface alterations that may demand repair of such restorations.

The effect of water storage on nanoindentation creep of various CAD-CAM composite blocks

BACKGROUND

To study the effect of water storage (3 months) on the creep deformation of various CAD-CAM composite structures at the nanoscale and compare it to that at the macroscale.

METHODS

Seven CAD-CAM blocks were investigated: five resin-composite blocks (RCB), one polymer-infiltrated ceramic network (PICN) block, and one ceramic-filled polyetheretherketone (PEEK) block. Specimens of each material (n = 6) were separated into two groups (n = 3) according to their storage conditions (24 h dry storage at 23˚C and 3 months storage in 37˚C distilled water). Nano-indentation creep measurements were undertaken (creep depth measured in µm) using a nanoindenter (Nanovea) equipped with Berkovich three-sided pyramidal diamond tip. The machine was set for the chosen parameters: a load of 20 gf, a pause of 20 s, and the material type. Thirty indentations on 3 samples were made for each material for each test. Data were analysed using two-way ANOVA followed by one-way ANOVA and Bonferroni post hoc tests and independent t-test (< 0.05) for comparisons between the materials.

RESULTS

The nanoindentation creep depth after 24 h storage ranged from 0.09 to 0.33 μm and increased after 3 months storage in distilled water to between 0.28 and 3.46 μm. There was a statistically significant difference in nanoindentation creep behaviour between the two storage conditions for each investigated material (independent t-test) and between all materials (Bonferroni post hoc). There was a non-significant negative correlation between nanoindentation creep (µm) and filler weight% at 24 h dry storage but a significant correlation at 3 months of water storage. A further non-significant positive correlation between nanoindentation creep (µm) and bulk compressive creep (%) was found.

CONCLUSION

The PICN material showed superior dimensional stability in terms of nanoindentation creep depth in both storage conditions. Other composite blocks showed comparable performance at 24 h dry condition, but an increased nanoindentation creep upon water storage.

Application of the Small Punch Creep-Recovery Test (SPCRT) for the Estimation of Large-Amplitude Viscoelastic Properties of Polymers

The Small Punch Creep-Recovery Test (SPCRT) is a novel miniature test used to estimate the viscoelastic properties of polymers and biomaterials. The current investigation related to the SPCRT is limited to Finite Element Method (FEM) simulations and experimental tests on PVC. The aim of this investigation was focused on: (i) extending the experimental tests to other polymers with dissimilar viscoelastic properties; (ii) deepening the influence of non-linear viscoelastic properties in the estimation capabilities of the SPCRT; and (iii) developing a numerical methodology to estimate and take into account the viscoelastic recovery produced during the unloading step of compressive creep-recovery tests (CCRT) and SPCRTs. The experimental tests (CCRTs and SPCRTs) were done on polyethylene PE 500, polyoxymethylene POM C, nylon PA 6, and polytetrafluoroethylene (PTFE), with a range of creep loads, in the case of CCRTs, in the whole elastic regime and the surroundings of the yield strength of each material. The experimental results confirmed that the SPCRT was an accurate and reliable testing method for linear viscoelastic polymers. For a non-linear viscoelastic behavior, SPCRT estimated the viscoelastic properties obtained from CCRTs for creep loads near the yield strength of the polymer, which corresponded with large-amplitude viscoelastic properties in dynamic creep testing. In order to consider the viscoelastic recovery generated in the unloading step of CCRTs and SPCRTs, a Maxwell-Wiechert model with two branches was used, simulating the different steps of the experimental tests, and solving numerically the differential equation of the Maxwell-Wiechert model with the Runge-Kutta-Fehlberg (RKF) numerical method. The coefficients of the elements of the Maxwell-Wiechert model were estimated approaching the straining curve of the recovery step of the simulation with the same curve registered on each experimental test. Experimental CCRTs with different unloading times demonstrated that the use of this procedure derived in no influence of the unloading step time in the viscoelastic properties estimation.

Thermoanalytical Investigations on the Influence of Storage Time in Water of Resin-Based CAD/CAM Materials

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.

Characterisation of the Filler Fraction in CAD/CAM Resin-Based Composites

The performance of dental resin-based composites (RBCs) heavily depends on the characteristic properties of the individual filler fraction. As specific information regarding the properties of the filler fraction is often missing, the current study aims to characterize the filler fractions of several contemporary computer-aided design/computer-aided manufacturing (CAD/CAM) RBCs from a material science point of view. The filler fractions of seven commercially available CAD/CAM RBCs featuring different translucency variants were analysed using Scanning Electron Microscopy (SEM) with Energy Dispersive X-ray Spectroscopy (EDS), Micro-X-ray Computed Tomography (µXCT), Thermogravimetric Analysis (TG) and X-ray Diffractometry (XRD). All CAD/CAM RBCs investigated included midifill hybrid type filler fractions, and the size of the individual particles was clearly larger than the individual specifications of the manufacturer. The fillers in Shofu Block HC featured a sphericity of ≈0.8, while it was <0.7 in all other RBCs. All RBCs featured only X-ray amorphous phases. However, in Lava Ultimate, zircon crystals with low crystallinity were detected. In some CAD/CAM RBCs, inhomogeneities (X-ray opaque fillers or pores) with a size <80 µm were identified, but the effects were minor in relation to the total volume (<0.01 vol.%). The characteristic parameters of the filler fraction in RBCs are essential for the interpretation of the individual material's mechanical and optical properties.

New method to differentiate surface damping behavior and stress absorption capacities of common CAD/CAM restorative materials

OBJECTIVES

To assess energy dissipation capacities and surface damping abilities of different CAD/CAM restorative materials (CRMs) to characterize stress resistance during load peaks.

METHODS

Using instrumented indentation testing (IIT), Martens hardness (HM) together with its elastic (η_IT) and plastic index (η_ITdis) and Leeb hardness (HLD) together with its deduced energy dissipation (HLD_dis) were determined for eight ceramic, eight composite, and four polymer-based materials as well as three metals. The results were compared to those of bovine enamel. Ten indentations per material were performed at room temperature (23 ± 1 °C) on two separate specimens (12.0 × 12.0 × 3.5 mm³) after water storage (24 h; 37.0 ± 1.0 °C). Hardness parameters were recorded, and data were analyzed with one-way MANOVA (Games-Howell post hoc tests, α = 0.05). Correlations between different parameters were tested (Pearson, α = 0.05).

RESULTS

Independently determined HLD_dis, and η_ITdis values substantiated different energy dissipation characteristics of CRM, whereby a strong correlation was observed for the two datasets (r = 0.956, p = 0.011). Ceramics had the significantly lowest values (p < 0.001) while both parameters revealed the highest surface damping effects for metals (p < 0.001), followed in both cases by bovine enamel. Energy dissipation of polymer and composite CRM was in between ceramics and bovine enamel (p < 0.001), whereas only for HLD_dis did both show no significant difference (p > 0.05).

SIGNIFICANCE

Promising new HLD_dis and η_ITdis data allow a reliable differentiation of energy dissipation and surface damping capacities of CRMs. Previously published rankings of edge chipping and loss tangent results were perfectly reproduced, especially by HLD_dis.

Validation of a Simple HPLC-UV Method for the Determination of Monomers Released from Dental Resin Composites in Artificial Saliva

Bisphenol-A (BPA), bisphenol A glycerolate dimethacrylate (Bis-GMA), triethylene glycol dimethacrylate (TEGDMA), and urethane dimethacrylate (UDMA) are organic monomers that can be released from dental composites into the oral cavity. Over specific concentrations, they can act as endocrine disruptors or cause toxic effects. The purpose of this work is to develop and validate an analytical method to determine BPA, Bis-GMA, TEGDMA, and UDMA monomers released from synthetic dental resins in artificial saliva. The method was validated before its application to new hybrid ceramic materials used in computer-aided design and computer-aided manufacturing (CAD/CAM) restorations to determine the release of monomers in various time intervals (e.g., 24 h, and 7, 14, 30, and 60 days), both in methanolic solutions, as well as in artificial saliva. Chromatographic analysis was performed isocratically on a Perfect Sil Target ODS-3 analytical column (250 mm × 4.6 mm, 5 µm) with CH₃CN/H₂O, 58/42% v/v as mobile phase within 23 min. The developed method was validated in terms of selectivity, linearity, accuracy, and precision.

The bulk compressive creep and recovery behavior of human dentine and resin-based dental materials

OBJECTIVE

To evaluate and compare the viscoelastic properties of dentine and resin-based dental materials by bulk compressive test and the Burgers model.

MATERIALS AND METHODS

Sound dentine, three resin composites as well as a resin-based cement were prepared into cylindrical specimens (n = 8). A bulk compressive creep test was applied with a constant load of 300 N (23.9 MPa) for 2 h, followed by another 2 h recovery. The maximum strain, creep stain, percentage of recovery and permanent set was measured using a linear variable displacement transducer. The viscoelastic properties were characterized via the Burgers model, and the instantaneous elastic, viscous as well as elastic delayed deformation were separated from the total strain. Data were analysed via ANOVA (or Welch's Test) and Tukey (or Games-Howell Test) with a significance level of 0.05.

RESULTS

Sound dentine presented the lowest maximum strain, creep strain, permanent set and the highest percentage of recovery, followed by 3 resin composites with comparable parameters, while the cement showed a significantly higher maximum strain, permanent set and lower percentage of recovery (p < 0.001). The Burgers model presented acceptable fits for characterization viscoelastic processes of both dentine and resin-based dental materials. Viscous and elastic delayed strain of dentine was significantly lower than those for tested materials (p < 0.001) with the highest instantaneous elastic strain percentage. Similar viscous and delayed strain was found among the 4 resin-based materials (p > 0.05).

SIGNIFICANCE

Sound dentine exhibited superior creep stability compared to resin-based dental materials. The viscous deformation in sound dentine could be ignored when loading parallel to dentine tubules.

Fracture force of CAD/CAM resin composite crowns after in vitro aging

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.