Flexural strength, fracture toughness, three-body wear, and Martens parameters of pressable lithium-X-silicate ceramics

Effect of "fast"-crystallization and simultaneous glazing on physicochemical properties of lithium-disilicate CAD/CAM ceramic

OBJECTIVE

Evaluate the impact of a "fast" crystallization and simultaneous-glazing on the physicochemical properties of lithium-disilicate CAD/CAM-ceramic.

METHODS

Lithium-disilicate bars and crowns (IPS e.max CAD, Ivoclar-Vivadent) were divided into four groups (n = 30): WG/F (WG=with glaze/F=fast crystallization), NG/F (NG=no glaze), WG/C (C=conventional crystallization), and NG/C. A liquid/powder glaze system was used (IPS Ivocolor®, Ivoclar-Vivadent). Specimens were crystallized (Programat P310, Ivoclar-Vivadent) using the P161 program for C (approx. 20-25 min), and P165 for F (approx. 14-16 min). Bars (n = 30) underwent three-point bending tests (flexural strength-FS in MPa and modulus of elasticity-E in GPa) using a universal testing machine. Crowns were analyzed via scanning electron microscopy (SEM) after selective etching, and to Raman, FTIR-ATR, and X-ray diffraction (XRD) spectroscopies to assess chemical composition.

RESULTS

For FS, both factors/interaction were statistically significant. C (427.48±42.41 MPa) showed significantly higher values than F (409.82±38.82 MPa). WG (398.32±29.80 MPa) exhibited significantly lower FS than NG (438.21±41.77 MPa). For E data, both factors/interaction were significant. NG (90.28±14.71 GPa) displayed higher E than WG (83.07±5.69 GPa), while C (90.08±12.98 GPa) exhibited higher E than F (83.46±9.40 GPa). NG/C showed the best results for both variables. F groups showed (SEM) porous surfaces and crack-like marks on crystals. FTIR, Raman and XRD spectra confirmed the typical composition of a lithium-disilicate glass ceramic, and some attenuated signals and structural variations (XRD) in WG.

CONCLUSIONS

"Fast" crystallization and simultaneous-glazing produced weaker/less-rigid structures with irregular crystals and glassy phases. Simultaneous glazing may have hindered proper thermal distribution during crystallization.

SIGNIFICANCE

"Fast" crystallization and simultaneous glazing with non-recommended systems, can adversely affect the final properties of lithium disilicate restorations.

Impact of varnishing, coating, and polishing on the chemical and mechanical properties of a 3D printed resin and two veneering composite resins

STATEMENT OF PROBLEM

Three-dimensional (3D) printing enables the fast fabrication of definitive fixed dental prostheses (FDPs). However, data on the effects of surface treatments on their chemical and mechanical properties are lacking.

PURPOSE

The purpose of this in vitro study was to examine the influence of different surface treatments on a 3D printed resin in comparison with 2 veneering composite resins.

MATERIAL AND METHODS

A total of 288 specimens were manufactured from a 3D printed resin (VarseoSmile Crownplus) or veneering composite resins (GRADIA PLUS; VITA VM LC flow). Surfaces underwent varnishing, coating, polishing or remain untreated. Conversion rate (DC), surface roughness (SR), Martens parameter, flexural strength (FS), and 3-body wear (3BW) were determined (n=12). Statistical analysis was performed using Mann-Whitney-U, Kruskal-Wallis, and Spearman correlation tests (α=.05).

RESULTS

After polishing, the 3D printed resin showed higher DC, SR, and 3BW but lower Martens parameters compared with veneering composite resins (P<.007). After goat hair brushing, the 3D printed resin showed lower FS than VITA-VCR (P=.043). For the 3D printed resin, goat hair brushing or GC-Varnish reduced SR, while VITA-Varnish showed the lowest 3BW (P<.045). For both veneering composite resins, goat hair brushing led to low SR and 3BW and high EIT and FS (P<.043). Silicone polishing led to low EIT of the 3D printed resin and low EIT and FS of GC-VCR (P<.009). Coating resulted in a lower EIT than the untreated surface and higher 3BW than GC-Varnish (P<.030).

CONCLUSIONS

The 3D printed resin showed higher DC, SR, 3BW and lower HM, EIT, and FS values than the veneering composite resins. Polishing with a goat hair brush can be recommended for all tested materials. For the 3D printed resin, varnishing presents a promising alternative with regard to SR and 3BW. Silicone polishing and coating cannot be recommended.

Hybrid ceramic repair strength, surface roughness, and bond failure, using methylene blue-activated low-level laser therapy, Carbon dioxide, and Ti: Al2O3 laser

AIMS

To evaluate the impact of various pretreatment regimes (LLLT, Ti-sapphire laser, CO2, and HFA-S) on hybrid ceramics, specifically focusing on their ability to enhance repair strength and minimize surface roughness (Ra).

MATERIAL AND METHODS

Discs were made from hybrid ceramics and after disinfection were randomly divided into four groups based on different surface conditioning techniques. Each group consisted of 15 discs, resulting in a total sample size of 60. dics in group 1 was surface treated with Low-level laser therapy (LLLT) using methylene blue (MB), Discs in group 2 with Ti-sapphire laser, Discs in group 3 with CO2 laser, and discs in group 4 with HFA-S. Five samples from each group were assessed for Ra. The remaining 10 samples from each group underwent repair using a porcelain repair kit in adherence to the planned instructions. The bond strength of each sample in all groups was measured using a universal testing machine. Following the bond strength testing, the specimens from all study groups were analyzed to determine the mode of failure. To evaluate the data, a two-way analysis of variance (ANOVA) was used, followed by post hoc multiple comparisons.

RESULTS

The highest repair bond strength was observed in group 4 hybrid ceramics pretreated with HFA-S (19.05±0.79 MPa). The lowest repair bond scores were observed in group 1 hybrid ceramics preconditioned with LLLT in the presence of Photosensitizer (13.41±0.36 MPa). The highest Ra scores were exhibited in group 2 surface treated with Ti-sapphire laser (0.0515±0.16 µm) and the lowest Ra scores were observed in Group 4 HFA-S (0.0311±0.79 µm). Predominant bond failure among different investigated groups was cohesive.

CONCLUSION

The current gold standard for hybrid ceramic conditioning is the use of hydrofluoric acid (HFA) combined with a silane coupling agent. Low-level laser therapy with methylene blue photosensitizer is not recommended for the treatment of hybrid ceramics.

Effect of crystal orientation on flexural strength of pressable lithium disilicate glass-ceramics

This study examined the crystal orientation of four kinds of pressable lithium disilicate glass-ceramics and evaluated the effect of crystal orientation on flexural strength. Bar-shaped (24 mm in length, 1.2 mm in thickness, 4.0 mm in width), disk-shaped (12 mm in diameter, 0.5 mm in thickness), and crown-shaped (maxillary first molar) specimens were prepared according to the manufacturer's instructions. Three-point and biaxial flexural strengths were measured for bar- and disk-shaped specimens. Microstructure analysis was performed using X-ray diffractometry and scanning electron microscopy. Three-point flexural strength was improved by parallel crystal orientation along the longitudinal direction of the bar-shaped specimen. There was no relationship between two-dimensional crystal orientation and biaxial flexural strength. The results of this study assumed that biaxial flexural strength was improved by the crystal orientation in the cross-sectional direction. Pressed restorations are expected to possess higher strength than milled restorations due to their crystal orientation.

Fracture resistance of pressed ZLS crowns versus pressed LD crowns under thermo-mechanical cycling

The aim of this study was conducted to assess the fracture resistance of zirconia reinforced lithium silicate all ceramic material "Celtra Press" compared to lithium disilicate one "IPS e-max Press" under simulated oral conditions. Fourteen ceramic crowns were fabricated on epoxy dies which were duplicated from stainless steel master die and divided into two equal groups (n=7) according to the material of construction; Group A: Crowns fabricated with IPS e-max Press material and Group B: Crowns fabricated with Celtra Press material. The crowns were then cemented onto their corresponding dies with a self-adhesive resin cement and subjected to thermocycling and cyclic loading. Then they were loaded to fractur in a universal testing machine. The results were tabulated and statistically analyzed using Kolmogorov-Smirnov and Shapiro-Wilk tests. Student t-test used to compare mean values. The significance level was set at P ≤ 0.05 and 95% Confidence interval. Statistical analysis was performed using Graph Pad Instat (Graph Pad, Inc.) software for windows. The mean ± SD values of fracture resistance were recorded for lithium Disilicate group (1706.01 ±154.32 N) meanwhile the mean ± SD value recorded with celtra group were (1550.67±196.71 N). Zirconia reinforced lithium silicate ceramic crowns produced comparable fracture resistance values to lithium disilicate ceramic crowns and both tested materials are within the clinically acceptable values in the posterior area.

Flexural strengths, failure load, and hardness of glass-ceramics for dental applications

STATEMENT OF PROBLEM

Glass-ceramics are often selected for use in dental restorations based upon advertised flexural strengths obtained from standardized tests on prefabricated specimens (bars and disks); these may not accurately reflect their performance in dental applications.

PURPOSE

The purpose of this in vitro study was to determine and compare 4-point flexural strength, biaxial flexural strength, hardness, and crown failure loads for 3 commercially available glass-ceramics.

MATERIAL AND METHODS

Specimens were pressed and prepared from 3 brands of glass-ceramics: Celtra (CEL), IPS e.max (EMA), and Lisi (LIS). Rectangular bars, circular disks, and fully contoured crowns were created (n=15 specimens per glass-ceramic, 45 specimens per geometry, totaling 135 specimens). Disks were tested for biaxial flexural strength by using a piston-on-3-ball (POB) test, while bars were tested for 4-point flexural strength by using 4-point bending (4PB) and Vickers hardness (VH) tests. Crown failure loads were assessed in "crunch-the-crown" (CTC) tests. The results were analyzed by using general linear modeling, the Pearson correlation coefficient, and Weibull analysis.

RESULTS

The general linear modeling revealed significant differences (P<.05) in the failure load for crown specimens (EMA>LIS>CEL), the 4-point flexural strength (EMA>LIS>CEL), and the biaxial flexural strength (EMA>LIS=CEL). The disk specimens had higher flexural strengths than the bar specimens for CEL and EMA materials. LIS had a higher Weibull modulus than EMA and CEL for bar and crown specimens. CEL had a higher Weibull modulus than LIS and EMA for disk specimens. There was no correlation among the VH (R²=0.86 and P=.24), biaxial flexural strength (R²=0.84 and P=.26), and crown failure load. However, there was a high correlation between the failure load (crown specimens) and 4-point flexural strength (bar specimens) (R²=0.99 and P=.03).

CONCLUSIONS

The 4-point flexural strength correlated significantly with crown failure load.

Microstructural considerations for novel lithium disilicate glass ceramics: A review

OBJECTIVE

To review the ultrastructural characteristics of novel lithium disilicate based glass ceramics (LDC), how their manufacturing process influences their structure and their clinical use.

OVERVIEW

Lithium disilicate based glass ceramic has been successfully used for indirect restorations ranging from partial tooth coverage up to tooth replacement for over 20 years. It combines esthetic and mechanical properties, unlike any other indirect material which makes it an indispensable part of esthetic and restorative dentistry. Recently, novel LDCs have been introduced to the market. Parameters for their use and their microstructure are still not been widely known. This article will review these materials and highlight with high-resolution scanning electron microscopic images their structural aspects and their resulting clinical relevance.

CONCLUSION

Restorations made from LDCs are reliable and can be predictably used only when proper guidelines and protocols during manufacturing and clinical use are followed. For novel LDCs manufacturing and long-term bonding protocols still must be established. Moreover, novel LDCs machinable blocks should be crystallized or heat-treated after milling for superior performance.

CLINICAL SIGNIFICANCE

With more and newer etchable LDC materials entering the market, clinicians and technicians need to be aware of the differences in manufacturing and the resulting microstructure to ensure a successful treatment outcome that will last.

Posterior minimally invasive full-veneers: Effect of ceramic thicknesses, bonding substrate, and preparation designs on failure-load and -mode after fatigue

OBJECTIVE

To evaluate the effect of ceramic thicknesses, bonding surface (enamel vs. dentin), and preparation design (box vs. no box) on the fatigue survival and failure load of minimally invasive full-veneer restorations.

MATERIALS AND METHODS

Human-premolars (n = 60) were divided into five test groups (n = 12). All teeth received full-veneer preparation with the following occlusal/labial thicknesses: standard: 1.5/0.8 mm; thin: 1.0/0.6 mm; ultrathin 0.5/0.4 mm. Preparations for each ceramic thickness were refined in enamel (E-1.0 and E-0.5) or dentin (D-1.5, D-1.0, and D-0.5). Control groups DB-1.5, EB-1.0, and EB-0.5 received box preparations. Monolithic lithium disilicate restorations (IPS-e.max-Press, Ivoclar Vivadent) were adhesively cemented (Syntac-Classic/Variolink-II, Ivoclar Vivadent) and subjected to cyclic mechanical loading (F = 49 N, 1.2 million cycles) with simultaneous thermocycling (5-55°C). All specimens were exposed to single load-to-failure. Pair-wise differences were calculated by using a linear regression model and Student-Newman-Keuls method (p < 0.05).

RESULTS

All full-veneers of group D-1.5, E-1.0, E-0.5, DB-1.5, EB-1.0, and EB-0.5 survived fatigue. Two full-veneers (D-1.0 and D-0.5) revealed cracks during fatigue, resulting in an overall fatigue survival rate of 98.1%. Mean load-to-failure values (N) were as followed: 1005 (D-1.5); 866 (D-1.0); 816 (D-0.5); 1495 (E-1.0); 1279 (E-0.5); 1129 (DB-1.5); 1087 (EB-1.0); and 833 (EB-0.5). Irrespective of ceramic thicknesses, enamel-based full-veneers resulted in higher failure loads than dentin-based restorations. Box preparation reduced the failure loads of thin and ultrathin enamel-based restorations.

CONCLUSION

All tested monolithic lithium disilicate full-veneer restorations exceeded physiological masticatory forces. Minimally invasive full-veneer restorations with enamel as a bonding surface and a non-retentive preparation design showed superior performance.

CLINICAL SIGNIFICANCE

Enamel-based non-retentive full-veneers made of monolithic lithium disilicate may serve as a reliable and esthetical minimally invasive treatment option for premolars.

A REVIEW OF MECHANICAL BEHAVIOR OF DENTAL CERAMIC RESTORATIONS

Dental ceramics are well known for restoring the function and aesthetic of lost or damaged teeth. Understanding these materials’ mechanical and aesthetic properties can make a suitable choice for those materials. The longevity of dental ceramics depends on several factors, including manufacturing method, clinical process, and the oral cavity’s aqueous environment. Failure mechanisms in restorative ceramics are complex and a combination of several factors. Different microstructures in the crystalline phase will involve the propagation of cracks and eventually the fatigue of ceramic materials. Large grains reduce mechanical performance compared to small grain sizes. Aesthetic materials used for veneering are weaker than the core materials and fail when even subjected to small loads. The soft bonding in the core–veneer interface and possible residual stresses created during the veneering method are drawbacks of these systems. Studies on the mechanical behavior of these materials have grown significantly in recent years and provide helpful information about static and fatigue experimentation and the failure behavior of various materials used in dental crowns.

Investigation of indentation size effect and R-curve behaviour of Li2O-SiO2 and Li2O-2SiO2 glass ceramics

Indentation size effect (ISE) and R-curve behaviour of Li₂O-SiO₂ and Li₂O-2SiO₂ glass ceramics are investigated using micro-indentation and indentation-strength (IS) techniques, respectively. Vickers micro-indentations were applied on both materials at the load of 0.10-19.6 N to determine the load influence on the measured hardness. For the IS-measured fracture toughness, the load ranged from 1.96 to 19.6 N. The hardness decreased with increasing load by 20% and 18% on Li₂O-SiO₂ and Li₂O-2SiO₂ glass ceramics, respectively, indicating the ISE behaviour on both materials. The fracture toughness increased with the load by 27% and 59% on Li₂O-SiO₂ and Li₂O-2SiO₂ glass ceramics, respectively, signifying the R-curve behaviour. The ISE behaviour of both materials was analysed using the Meyer's, Hays-Kendall (HK), proportional specimen resistance (PSR), Nix-Gao (NG), modified PSR (MPSR) and elastic plastic deformation (EPD) models while the R-curve behaviour was analysed by the fractional power law. The Meyer's index of both materials was less than 2, strongly confirming the ISE existence. The HK, PSR and NG models were only suitable to determine intrinsic Vickers hardness for Li₂O-2SiO₂ glass ceramic while the MPSR and EPD models were successful for both materials. The fractional power law gave higher R-curve steepness for Li₂O-2SiO₂ than Li₂O-SiO₂ glass ceramics. Also, material and brittleness indices predicted, respectively, higher quasi-plasticity and better machinability for Li₂O-2SiO₂ than Li₂O-SiO₂ glass ceramics indicating superior performance in the former to the latter. Finally, this study presents a new significant insight into the micro-mechanisms of fracture tolerance behaviour of these glass ceramics which is critical to their functional performance as structural ceramics.

Material preferences for tooth-supported 3-unit fixed dental prostheses: A survey of German dentists

STATEMENT OF PROBLEM

Different material options are available for fixed dental prostheses (FDPs), but valid data on the favored materials of German dentists for 3-unit FDPs are lacking. It is unclear whether preferences depend on the individual characteristics of the dentists or their dental practices.

PURPOSE

The purpose of this survey was to identify the preferred material selection of German dentists for the fabrication of tooth-supported 3-unit FDPs depending on the location of the abutment teeth and the individual characteristics of the dentist or the dental practice.

MATERIAL AND METHODS

A survey was developed that included questions on the demographic characteristics (sex, area of expertise, age group, time since graduation, number of inhabitants, and the postal code of the dental practice or dental school) of the participating dentist and their preferred materials for the fabrication of tooth-supported 3-unit FDPs. Three clinical scenarios (anterior maxillary FDP, posterior maxillary FDP, posterior mandibular FDP) were presented. The dentists were allowed to select from predefined options or to give a free answer. For comparisons of characteristic associations, the number of inhabitants was chosen to represent the characteristics of the dental practice, and sex and time since graduation were selected to represent the characteristics of the dentist. Group comparisons were conducted with Chi-square tests (α=.05).

RESULTS

A response of 721 dentists from all parts of Germany was received, and data from 688 dentists were included in the analyses. Ceramic was the most preferred material for the fabrication of 3-unit FDPs independent of the location of the abutment teeth with veneered zirconia as the favored option. Metal-ceramic was ranked second. The time since graduation ≤15 years was associated with a preference of ceramic over metal-ceramic for the anterior restoration (P<.001).

CONCLUSIONS

Most participating dentists selected appropriate restorative materials depending on the individual clinical setting presented in the survey. For the anterior 3-unit FDP, time since graduation was associated with the preference for a restorative material. Some dentists selected lithium-X-silicate ceramics for situations beyond their recommended indication range.

Comparative analysis of flexural strength of abraded and polished porcelain surfaces - an in vitro study

Typically, prosthodontists adjust ceramic restorations glazed surface by grinding prior to insertion. Such alterations of surfaces are necessary for the correction of occlusal interferences. We aimed to evaluate and compare the change in flexural strength of ceramic surfaces after re-glazing and polishing. This study included 40 samples of ceramic blocks that were fabricated and glazed, and then fired in accordance with the manufacturer’s recommendations. The sample was randomly divided into four groups of 10 samples each. The first group was the control group with unaltered glazed samples. The second group was abraded with an extra-fine diamond bur followed by re-glazing, and the other two groups were polished with two commercially available polishing kits after abrading them with an extra-fine diamond bur. The samples were tested for their flexural strength using a universal testing machine. On the application of the F test on the means of all the groups, a value greater than 0.05 was found, which meant that there is no statistically significant difference in flexural strength values between the groups (P-value>0.05). Since the flexural strength values of the polished group were comparable to the other groups, polishing can be used instead of re-glazing for ceramic restorations. This reduces an additional clinical appointment for the patient and saves working time.

Modern CAD/CAM silicate ceramics, their translucency level and impact of hydrothermal aging on translucency, Martens hardness, biaxial flexural strength and their reliability

OBJECTIVES

To investigate the impact of hydrothermal aging on Martens parameter (Martens hardness: HM/elastic indentation modulus: E_IT) and biaxial flexural strength (BFS) of recently available CAD/CAM silicate ceramics.

METHODS

220 specimens (diameter: 12 mm, thickness: 0.95 mm) were fabricated from six CAD/CAM ceramics in two translucency levels (LT/HT): (a) two lithium disilicate (Amber Mill, ABM; IPS e.max CAD, IEM), (b) one lithium metasilicate (Cetra Duo, CEL), (c) one lithium alumina silicate (n!ce, NIC), and (d) two leucite ceramics (Initial LRF Block, LRF; IPS Empress CAD, IPR). HM/E_IT and BFS were measured initially and after hydrothermal aging (134 °C/0.2 MPa/100 h) in an autoclave. The Kolmogorov-Smirnov-test, t-test, one-way ANOVA with post-hoc Scheffé test, Kruskal-Wallis-test, Mann-Whitney-U-test with Bonferroni correction and Weibull statistics were performed (α = 0.05).

RESULTS

CEL and IEM showed the highest and the leucite ceramics the lowest Martens parameter. Within HT, ABM and NIC were in same initial HM value range with CEL and IEM. ABM and NIC showed lower initial E_IT values than CEL and IEM, however higher than IPR. The lowest aged values were analyzed for ABM. After aging, Martens parameter decreased for LRF, ABM, and CEL. IEM showed the initial highest BFS, followed by ABM. NIC and LRF showed the lowest BFS. IEM and ABM presented the highest aged BFS. Hydrothermal aging increased BFS values for LRF (HT), IPR, CEL (HT), and NIC (HT) compared to the initial values. CAD/CAM leucite ceramics showed higher Weibull modul values compared to lithium silicate ceramics.

SIGNIFICANCE

The well-considered selection of ceramics in relation to the areas of indication has the highest influence on the long-term stability of restorations: CAD/CAM lithium disilicate ceramics presented the highest and leucite ceramics the lowest mechanical properties, whereas the reliability was better for leucite than for lithium silicate ceramics.

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.

Effects of thermal and mechanical cycling on the mechanical strength and surface properties of dental CAD-CAM restorative materials

STATEMENT OF PROBLEM

The properties of dental computer-aided design and computer-aided manufacturing (CAD-CAM) materials vary. Studies regarding the effects of aging on the properties of these materials are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the changes in the mechanical and surface properties of different CAD-CAM materials after thermocycling and mechanical loading.

MATERIAL AND METHODS

In total, 150 bar-shaped specimens (17.0×4.0×2.0 mm) were prepared from feldspathic glass-ceramic (VM; Vitablocs Mark II), lithium disilicate glass-ceramic (EX; IPS e.max CAD), zirconia-reinforced lithium silicate glass-ceramic (CD; Celtra Duo), polymer-infiltrated ceramic network (VE; Vita Enamic), and resin-nanoceramic (CS; Cerasmart). Each type was divided into 2 groups (n=15; each). One group was subjected to thermocycling in distilled water at 5 °C to 55 °C for 6000 cycles and 50 N mechanical loading for 1.2×10⁶ cycles. The other group was stored in 37 °C water for 24 hours. Nanoindentation hardness, Young modulus, and 3-point flexural strength were measured for the analyses of the mechanical properties. Surface roughness, surface microstructure, and elemental composition were measured to analyze the surface characteristics. Statistical analyses were performed with 1-way ANOVA with the Tukey HSD post hoc test, independent samples t test, Kruskal-Wallis test with Bonferroni post hoc test, Mann-Whitney U test, and 2-way ANOVA (α=.05).

RESULTS

Before and after aging, CS exhibited the lowest hardness (1.20 to 1.04 GPa) and Young modulus (13.76 to 13.48 GPa) values (P<.05). EX exhibited the highest flexural strengths (393.43 to 391.86 MPa), and VM exhibited the lowest (109.98 to 112.73 MPa) values (P<.05). CS exhibited the highest surface roughness (S_a and S_q; 10.60 to 28.82, 14.21 to 38.27 nm) values (P<.05). After aging, the hardness and Young modulus of VM, EX, and VE decreased significantly (P<.001). No significant difference was observed in the flexural strengths of the CAD-CAM materials (P>.05). Significant increases were observed in the surface roughness of all the materials (P<.05), with altered microstructures. Except for the flexural strength, the mechanical properties and surface characteristics of the CAD-CAM materials were significantly affected by the material type after aging.

CONCLUSIONS

Before and after aging, resin-nanoceramic exhibited the lowest hardness and Young modulus, and the highest surface roughness. Lithium disilicate glass-ceramic exhibited the highest flexural strength and feldspathic glass-ceramic exhibited the lowest value. After aging, increased surface roughness and microstructure alterations were observed. Significant interactions between aging process and material type were found for the mechanical properties and surface characteristics except for the flexural strength.

Comparison of mechanical properties of different reinforced glass-ceramics

STATEMENT OF PROBLEM

Data concerning the mechanical properties of the newly developed lithium disilicate ceramic HS10PC are lacking.

PURPOSE

The purpose of this in vitro study was to investigate the flexural strength (FS), Martens hardness (HM), indentation modulus (E_IT), fracture load (FL), and wear resistance (WR) of HS10PC compared with those of the established glass-ceramics IPS e.max Press and IPS Empress Esthetic.

MATERIAL AND METHODS

Four pressable glass-ceramics were examined: HS10PC (estetic ceram ag), IPS e.max Press low translucency (LT) and high translucency (HT; Ivoclar Vivadent AG), and IPS Empress Esthetic (ES; Ivoclar Vivadent AG). For each material, a total of 85 specimens were fabricated. Specimens were subdivided into 4 groups for FS (n=30), HM, E_IT (n=10), and FL measurement according to the Voss test after artificial aging in an autoclave (n=15), artificial aging in a mastication simulator (n=15), and no artificial aging (n=15). In addition, WR (n=10) was measured after 240 000, 600 000, and 1 200 000 masticatory cycles. Data were statistically analyzed using the global univariate ANOVA, the Scheffé post hoc and paired t tests, and Weibull distribution (α=.05).

RESULTS

HT showed the highest FS, while ES presented the lowest FS of all groups (P<.001). ES showed lower values for HM (P<.001), E_IT (P<.001), and FL for specimens treated in an autoclave and mastication simulator (P<.001) compared with all other groups. An increase in the wear of the ceramic and enamel antagonist between 240 000 and 1 200 000 masticatory cycles was observed for all groups (P<.001). After 1 200 000 masticatory cycles, HS10PC presented less wear of the ceramic than the other 3 materials (P=.003).

CONCLUSIONS

The newly developed lithium disilicate ceramic HS10PC showed comparable results with the established IPS e.max Press for FS, HM, E_IT, FL, and WR. Lithium disilicate ceramics presented higher mechanical results than the leucite-reinforced ES, with all the ceramics showing similar results for the WR of the enamel antagonist.

Material selection for tooth-supported single crowns-a survey among dentists in Germany

Objectives

This study aimed to survey dentists in Germany to identify their favored materials for the fabrication of tooth-supported single crowns (SCs) depending on the location of the abutment teeth and the preparation margin.

Materials and methods

The survey included questions regarding demographic characteristics of dentists/their dental practice and preferred restorative materials for the fabrication of SCs for abutment teeth 16, 11, 34, and 36 with either supra- or subgingival preparation margins.

Results

Between August 2019 and February 2020, 721 dentists participated in the survey; responses from 33 dentists were excluded from data analysis because the dentists did not work in Germany or provided less than one fixed dental prosthesis/month. Dentists favored ceramic materials independent of the location of the abutment tooth and preparation margin (56.6–92.2%). CAD/CAM resin composites or full metals were preferred by only a few participants. A significantly higher proportion of dentists recommended porcelain fused to metal for subgingival preparation margins than for supragingival margins (p < 0.001). Characteristics of dentists/dental practices influenced a single scenario (11 subgingival) that was dependent on the dentist’s time since graduation. When asked to specify the ceramic materials, numerous participants wrote a free response (5.7–7.8%) or did not answer (0.7–4.8%).

Conclusions

Dentists in Germany selected restorative materials for SCs depending on the clinical scenario. Since numerous dentists did not specify the ceramic materials, postgraduate information and education might help to extend expertise.

Clinical relevance

The results of this survey provide insight into the favored materials of dentists for the fabrication of tooth-supported SCs.