Monolithic CAD/CAM laminate veneers: Reliability and failure modes

Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) Fabricated Laminate Veneers in Aesthetic Rehabilitation: A Case Report

Porcelain laminate veneers are a popular cosmetic dentistry treatment for correcting discoloured, worn, misaligned, gapped, chipped, or crooked teeth. The restorative material utilized in the indirect method can be processed using CAD/CAM (computer-aided design and computer-aided manufacturing) technology or conventional technique, which is highly sensitive. Due to its multiple benefits, digital technology is growing quickly and has opened up a lot of new opportunities for dental practitioners. These days, CAD/CAM is a helpful technique that enables the creation of monolithic restorations for ceramic materials, which is most recently utilized in the field of ceramic veneers as well as digital impression capturing and digital designing as part of treatment planning. This case study details the methodical process of creating laminate veneers for a patient who wants to enhance the look of their anterior teeth utilizing both traditional and CAD/CAM technology.

Load-bearing capacity of 3D-printed incisor partial-coverage crowns made from zirconia and composite

PURPOSE

This study investigated the fracture resistance of 0.5-mm-thick restorations for minimally invasive therapy. Anterior partial-coverage crowns composed of three-dimensional (3D)-printed 3-mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP; Lithacon 3Y210, Lithoz) and 3D-printed composite (Varseo Smile Crown plus, Bego) were compared with a control group made from milled 3Y-TZP (Cercon ht, DentsplySirona).

METHODS

Three groups each with 27 restorations were produced. For milled 3Y-TZP partial-coverage crowns, drill compensation was needed so the milling bur could access the inner surface at the incisal edge. Restoration fit was verified by cross-sectioning 12 specimens in each group. The remaining 15 restorations were sandblasted (Al2O3, 0.1 MPa) and adhesively cemented (Panavia SA, Kuraray) onto CoCr teeth. Static load-to-failure tests were performed. The load was induced on the incisal edge. The forces needed to fracture the specimens were analyzed using the Welch analysis of variance and post hoc Dunnet-T3 tests. The Weibull parameters were also calculated.

RESULTS

Drill compensation increased cement thickness at the loading area by 200 µm in milled 3Y-TZP restorations compared with the 3D-printed partial-coverage crowns. Fracture resistance was the highest in 3D-printed 3Y-TZP restorations (1570±661N) followed by milled 3Y-TZP (886±164N) and 3D-printed composite partial-coverage crowns (570±233 N). Milled 3Y-TZP was associated with a substantially higher Weibull modulus (m=6) than the 3D-printed materials (m=2), suggesting greater reliability.

CONCLUSIONS

Fracture resistance increased with tighter fit, demonstrating the benefit of the geometric freedom associated with 3D-printing. Future research should focus on making 3D-printed 3Y-TZP more reliable to increase its safety in clinical use.

Effect of Optical Properties of Lithium Disilicate Glass Ceramics and Light-Curing Protocols on the Curing Performance of Resin Cement

This study aimed to investigate the effects of optical properties of lithium disilicate glass ceramics and the light-curing protocols (LCP) on the curing performance of light-cured resin cement. Lithium disilicate glass-ceramics with different optical properties were sectioned to produce ceramic specimens of 0.8 mm thickness. Irradiance through the ceramic specimens was measured by a radiometer. Light transmittance of ceramics was assessed using a UV/Vis spectrophotometer. The light-cured resin cement was injected into a Teflon mold and ceramics with different optical properties were placed on it, cured under different LCPs, and the degree of conversion (DC) and Vickers microhardness of the resin cement were separately measured by Micro-ATR/FTIR spectrometry and the microhardness tester. The shade (p < 0.001) and transparency (p < 0.001) of ceramics affect the irradiance of the light-curing unit. The transparency (p < 0.001) of the ceramic and light-curing protocols (p < 0.001) affect the DC and microhardness of resin cements. When the thickness of the ceramic is 0.8 mm, the light transmittance of the ceramic and the curing performance of the resin cement increase with the increase of the transparency of the ceramic. An appropriate increase in irradiance and exposure time can optimize the curing performance of resin cement. These factors should be taken into account by the clinician when designing the bonding solution for porcelain veneers.

Color Changes Associated with Sandblasting, Hydrofluoric Acid Etching, and Er:YAG Laser Irradiation of Milled Feldspathic Porcelain Laminate Veneers

OBJECTIVES

To evaluate color changes in milled feldspathic porcelain laminate veneers following hydrofluoric acid etching (HFA), sandblasting (SB), or Er:YAG laser irradiation (LI).

METHODS AND MATERIALS

Disc-shaped specimens (thickness=1 mm, diameter=8 mm) were milled from feldspathic porcelain blocks (n=40). Glazed specimens were randomly assigned to four subgroups (n=10 each) according to surface treatment: negative control, HFA, SB, and LI. A layer of translucent, light-cured resin cement (thickness=0.1 mm) was then applied following silanization. The color was characterized by the L*, a*, and b* uniform color space (CIE) using a reflection spectrophotometer. CIEDE2000 (ΔE00) was calculated to determine the color difference between each surface treatment and negative control groups. Data were statistically analyzed using analysis of variance (ANOVA), Kruskal-Wallis, and Dunn-Bonferroni post hoc tests.

RESULTS

There were no significant differences in CIEL* and CIEb* coordinates between negative control and all surface treatment groups (p≥0.108). The SB group demonstrated significantly lower mean CIEa* (higher greenish hue) compared to other groups (p≤0.003). HFA exhibited significantly higher CIEa* (closer to red) when compared to LI (p=0.039). LI induced the smallest overall color change compared to negative control (ΔE00=1.43 [1.07]). However, the differences in ΔE00 values were not statistically significant (p=0.648).

CONCLUSIONS

The tested surface treatments did not affect the lightness or the yellowness of the 1-mm-thick milled feldspathic porcelain veneers. However, sandblasting resulted in a significant increase in the greenish hue. The Er:YAG laser resulted in the closest ΔE00 (1.43) to the 50:50% perceptibility threshold (ΔE00=1.2).

Comparison of Wear Resistance of Prefabricated Composite Veneers Versus Ceramic and Enamel

PURPOSE

To measure surface roughness before and after wear-tests of two different prefabricated composite veneers and compare them to ceramic veneers and human dental enamel.

MATERIALS AND METHODS

Roughness (Ra-values) of two prefabricated composite veneers (Visalys Veneer Chairside (VIS) and Componeer (COM)) were compared to lithium disilicate Veneers (e.max CAD) and dental enamel (DENT) in vitro. In total n = 45 specimens per material and enamel samples were used for wear-tests. Wear-out tests were conducted by abrasion tests with a toothbrush simulator (22,000 strokes/ 100 g load; approximately equal to two years of cleansing) and erosion tests were carried out using citric acid (pH 1.57). Ra- and Sa-values were detected by white light interferometer before and after wear-tests. Data were analyzed with ANOVA followed by Games-Howell post hoc test and t-test (α = 0.05).

RESULTS

At baseline the lowest Ra- and Sa-values were found in VIS (Ra: 0.01 µm; Sa: 0.04 µm) while DENT revealed significantly higher surface roughness (Ra: 0.11 µm, p < 0.05; Sa: 0.30, p = 0.186). COM had significantly higher Ra-values (Ra: 0.10 µm; Sa: 0.22 µm) after abrasion, while e.max CAD was most resistant to the treatments (Ra: 0.01 µm, p < 0.05; Sa: 0.05 µm, p < 0.05). Compared to DENT all veneers were significantly less affected by citric acid (p < 0.001).

CONCLUSIONS

Prefabricated composite veneers have demonstrated less wear after abrasion and erosion tests compared to DENT, nevertheless, they revealed more wear compared to e.max CAD.