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Stawarczyk B, Meinen J, Wuersching SN. Two-body wear of novel monolithic lithium-silicate ceramic materials and their corresponding different antagonists. J Dent 2024; 144:104952. [PMID: 38508442 DOI: 10.1016/j.jdent.2024.104952] [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: 02/23/2024] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES Evaluation of the two-body wear of lithium-silicate ceramics against different antagonists compared to a direct resin composite and human teeth. METHODS Initial LiSi Block [LISI], IPS e.max CAD [EMA], and CEREC Tessera [TESE] were investigated and compared with direct resin composite [FILL] and human teeth [tooth]. As antagonists were used: steatite, ceramic, and human enamel. The control group tooth was only tested with enamel antagonist. The combinations underwent thermomechanical aging using a chewing simulator. Material losses were calculated using GOM-analysis software. Kolmogorov-Smirnov test, Kruskal-Wallis H, Mann-Whitney-U-test with Bonferroni correction and Spearman-rho correlation were calculated. A fractographic analysis was performed. RESULTS Within TESE, enamel antagonists led to lower restoration losses than steatite and ceramic antagonists. Within FILL, enamel and steatite antagonists caused lower material losses compared to ceramic antagonists. Against steatite antagonists, LISI showed lowest material losses. Against ceramic antagonists, the use of LISI led to lower material losses compared to FILL. Against tooth antagonists, TESE showed lower material losses than tooth and FILL and LISI lower than FILL. Within LISI, steatite antagonists showed lower material losses on the antagonist than ceramic. Within EMA, steatite antagonists showed higher material losses than ceramic ones. Within ceramic antagonists, LISI restoration material showed lower material losses than FILL and EMA. CONCLUSIONS Regardless of the antagonist material, the material losses of LISI and EMA were comparable. However, the abrasion resistance of LISI tended to be higher than EMA. CLINICAL SIGNIFICANCE LISI is a fully crystallized lithium-silicate ceramic and no longer needs to be processed after milling. In addition, the abrasion resistance is very good, regardless of the antagonist material chosen.
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Affiliation(s)
- Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336 Munich, Germany.
| | - John Meinen
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336 Munich, Germany
| | - Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestraße 70, 80336 Munich, Germany
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Mao Z, Beuer F, Hey J, Schmidt F, Sorensen JA, Prause E. Antagonist enamel tooth wear produced by different dental ceramic systems: A systematic review and network meta-analysis of controlled clinical trials. J Dent 2024; 142:104832. [PMID: 38211687 DOI: 10.1016/j.jdent.2024.104832] [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: 10/30/2023] [Revised: 12/14/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the amount of enamel tooth wear induced by different antagonistic ceramic crown materials in the posterior area within a follow-up period up to 24 months in function. A network meta-analysis was performed to assess the effect of the materials on the mean vertical loss (MVL) of the antagonist enamel tooth surface. DATA Main search terms used in combination: ceramic, dental materials, metal ceramic, tooth wear and dental enamel. SOURCES An electronic search was conducted in PubMed/Medline, Embase, and Cochrane CENTRAL plus hand-searching. STUDY SELECTION Eligibility criteria included clinical studies reporting on MVL on antagonist's tooth up to 24 months following the permanent crown placement. From a total of 5697 articles, 7 studies reporting on 261 crowns for 177 subjects with 3 ceramic materials (Lithium disilicate, metal-ceramic, monolithic zirconia) were included. Among all, metal-ceramic and zirconia caused significantly higher enamel tooth wear on antagonist teeth, representing 82.5 µm [54.4; 110.6]) and 40.1 µm [22.2; 58.0]) more MVL than natural teeth group. In contrast, lithium disilicate showed only 5.0 µm [-48.2; 58.1]) more MVL than occurs on opposing natural teeth. CONCLUSIONS This systematic review demonstrated that prosthodontic ceramic materials produced significantly more antagonist enamel tooth wear than opposing natural enamel tooth wear, and ceramic material type was correlated to the degree of enamel tooth wear. Additional well-conducted, randomized controlled trials with homogeneous specimens are required due to inadequate sample size and number of the clinical studies included in the analyses. CLINICAL SIGNIFICANCE The amount of wear caused by different restorative materials has a high influence on the antagonistic natural teeth and should therefore be evaluated intensively by the dentist.
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Affiliation(s)
- Zhen Mao
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6 14197, Berlin, Germany.
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6 14197, Berlin, Germany
| | - Jeremias Hey
- Department of Prosthodontics, School of Dental Medicine, Martin-Luther-University, Halle, Germany
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6 14197, Berlin, Germany
| | - John A Sorensen
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, USA
| | - Elisabeth Prause
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6 14197, Berlin, Germany
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Hoffmann M, Mayinger F, Stawarczyk B. Influence of different surface finishing procedures of strength-gradient multilayered zirconia crowns on two-body wear and fracture load: Lithium silicate or leucite glazing versus polishing? J Mech Behav Biomed Mater 2024; 150:106307. [PMID: 38071838 DOI: 10.1016/j.jmbbm.2023.106307] [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: 10/01/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES To examine the influence of different finishing procedures on the surface roughness, wear resistance and fracture load of strength-gradient multilayered zirconia. MATERIALS AND METHODS Zirconia crowns (Multilayer 3D pro; n = 96) were manufactured and treated with a lithium-silicate- (LISI_S), leucite-based glaze spray (LEU_S), leucite-based glaze mass (LEU_M) or polished (POL). Natural molars (CG; n = 24) acted as a control. Roughness was determined on flat glazed specimens (n = 28). Two-body wear was examined by digitalizing and matching the occlusal surface before and after thermo-mechanical aging (6,000 thermal and 1,200,000 chewing cycles). The groups were split to measure fracture load initially and after aging. Kolmogorov-Smirnov, Spearman correlation, Kruskal-Wallis-H, Levene's test, one-way ANOVA with Scheffé post-hoc and Weibull modulus were computed. RESULTS POL presented the lowest and LEU_S the highest roughness. Following POL, no ceramic loss was observed. LISI_S, LEU_S and LEU_M showed lower ceramic wear than the CG. The lowest wear of the antagonist was observed for the CG. LISI_S showed a lower antagonistic wear than LEU_S, LEU_M and POL. LISI_S, LEU_S, LEU_M and POL showed higher fracture load values and Weibull moduli than the CG. Artificial aging did not impact the fracture load or Weibull moduli. SIGNIFICANCE With glazed groups showing height losses closer to the CG, glazing should be preferred to polishing when approximating the wear behavior of a natural dentition. Finishing of monolithic zirconia by glazing with a lithium silicate-based spray is recommended to preserve the antagonists. All examined zirconia crowns presented sufficient mechanical properties to withstand masticatory forces, even after prolonged aging.
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Affiliation(s)
- Moritz Hoffmann
- Department of Prosthetic Dentistry, Dental School, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany.
| | - Felicitas Mayinger
- Department of Prosthetic Dentistry, Dental School, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, Dental School, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany
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PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties. Polymers (Basel) 2023; 15:polym15020386. [PMID: 36679266 PMCID: PMC9864167 DOI: 10.3390/polym15020386] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023] Open
Abstract
Polyetheretherketone (PEEK) is a thermoplastic material widely used in engineering applications due to its good biomechanical properties and high temperature stability. Compared to traditional metal and ceramic dental materials, PEEK dental implants exhibit less stress shielding, thus better matching the mechanical properties of bone. As a promising medical material, PEEK can be used as implant abutments, removable and fixed prostheses, and maxillofacial prostheses. It can be blended with materials such as fibers and ceramics to improve its mechanical strength for better clinical dental applications. Compared to conventional pressed and CAD/CAM milling fabrication, 3D-printed PEEK exhibits excellent flexural and tensile strength and parameters such as printing temperature and speed can affect its mechanical properties. However, the bioinert nature of PEEK can make adhesive bonding difficult. The bond strength can be improved by roughening or introducing functional groups on the PEEK surface by sandblasting, acid etching, plasma treatment, laser treatment, and adhesive systems. This paper provides a comprehensive overview of the research progress on the mechanical properties of PEEK for dental applications in the context of specific applications, composites, and their preparation processes. In addition, the research on the adhesive properties of PEEK over the past few years is highlighted. Thus, this review aims to build a conceptual and practical toolkit for the study of the mechanical and adhesive properties of PEEK materials. More importantly, it provides a rationale and a general new basis for the application of PEEK in the dental field.
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Mayinger F, Buser R, Laier M, Schönhoff LM, Kelch M, Hampe R, Stawarczyk B. Impact of the material and sintering protocol, layer thickness, and thermomechanical aging on the two-body wear and fracture load of 4Y-TZP crowns. Clin Oral Investig 2022; 26:6617-6628. [PMID: 35840737 DOI: 10.1007/s00784-022-04616-5] [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: 03/03/2022] [Accepted: 07/04/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of this study is to investigate the influence of the material and corresponding sintering protocol, layer thickness, and aging on the two-body wear (2BW) and fracture load (FL) of 4Y-TZP crowns. MATERIALS AND METHODS Multi-layer 4Y-TZP crowns in three thicknesses (0.5 mm/1.0 mm/1.5 mm) were sintered by high-speed (Zolid RS) or conventional (Zolid Gen-X) sintering. 2BW of ceramic and enamel antagonist after aging (1,200,000 mechanical-, 6000 thermal-cycles) was determined by 3D-scanning before and after aging and subsequent matching to determine volume and height loss (6 subgroups, n = 16/subgroup). FL was examined initially and after aging (12 subgroups, n = 16/subgroup). Fractographic analyses were performed using light-microscope imaging. Global univariate analysis of variance, one-way ANOVA, linear regression, Spearman's correlation, Kolgomorov-Smirnov, Mann-Whitney U, and t test were computed (alpha = 0.05). Weibull moduli were determined. Fracture types were analyzed using Ciba Geigy table. RESULTS Material/sintering protocol did not influence 2BW (crowns: p = 0.908, antagonists: p = 0.059). High-speed sintered Zolid RS presented similar (p = 0.325-0.633) or reduced (p < 0.001-0.047) FL as Zolid Gen-X. Both 4Y-TZPs showed an increased FL with an increasing thickness (0.5(797.3-1429 N) < 1.0(2087-2634 N) < 1.5(2683-3715 N)mm; p < 0.001). For most groups, aging negatively impacted FL (p < 0.001-0.002). Five 0.5 mm specimens fractured, four showed cracks during and after aging. CONCLUSIONS High-speed sintered crowns with a minimum thickness of 1.0 mm showed sufficient mechanical properties to withstand masticatory forces, even after a simulated aging period of 5 years. CLINICAL RELEVANCE Despite the manufacturer indicating a thickness of 0.5 mm to be suitable for single crowns, a minimum thickness of 1.0 mm should be used to ensure long-term satisfactory results.
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Affiliation(s)
- Felicitas Mayinger
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany.
| | - Ramona Buser
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany.,Department of Reconstructive Dentistry and Gerodontology, University of Bern, Freiburgstrasse 7, 3007, Bern, Switzerland
| | - Maximilian Laier
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Lisa Marie Schönhoff
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Matthias Kelch
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Rüdiger Hampe
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
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Wang B, Huang M, Dang P, Xie J, Zhang X, Yan X. PEEK in Fixed Dental Prostheses: Application and Adhesion Improvement. Polymers (Basel) 2022; 14:polym14122323. [PMID: 35745900 PMCID: PMC9228596 DOI: 10.3390/polym14122323] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/27/2023] Open
Abstract
Polyetheretherketone (PEEK) has been widely applied in fixed dental prostheses, comprising crowns, fixed partial dentures, and post-and-core. PEEK’s excellent mechanical properties facilitate better stress distribution than conventional materials, protecting the abutment teeth. However, the stiffness of PEEK is not sufficient, which can be improved via fiber reinforcement. PEEK is biocompatible. It is nonmutagenic, noncytotoxic, and nonallergenic. However, the chemical stability of PEEK is a double-edged sword. On the one hand, PEEK is nondegradable and intraoral corrosion is minimized. On the other hand, the inert surface makes adhesive bonding difficult. Numerous strategies for improving the adhesive properties of PEEK have been explored, including acid etching, plasma treatment, airborne particle abrasion, laser treatment, and adhesive systems.
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Affiliation(s)
- Biyao Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Minghao Huang
- Liaoning Provincial Key Laboratory of Oral Diseases, Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China;
| | - Pengrui Dang
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Jiahui Xie
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Xinwen Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China;
- Correspondence: (X.Z.); (X.Y.); Tel.: +86-024-31927731 (X.Z.); +86-024-31927715 (X.Y.)
| | - Xu Yan
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
- Correspondence: (X.Z.); (X.Y.); Tel.: +86-024-31927731 (X.Z.); +86-024-31927715 (X.Y.)
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Micovic Soldatovic D, Liebermann A, Huth KC, Stawarczyk B. Fracture load of different veneered and implant-supported 4-UNIT cantilever PEEK fixed dental prostheses. J Mech Behav Biomed Mater 2022; 129:105173. [DOI: 10.1016/j.jmbbm.2022.105173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/16/2022]
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Kelch M, Stawarczyk B, Mayinger F. Chemical and mechanical properties of dual-polymerizing core build-up materials. Clin Oral Investig 2022; 26:4885-4896. [PMID: 35344103 PMCID: PMC9276564 DOI: 10.1007/s00784-022-04455-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/10/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the chemical (degree of conversion (DC)) and mechanical properties (Martens hardness (HM), elastic indentation modulus (EIT), and biaxial flexural strength (BFS)) of four dual-polymerizing resin composite core build-up materials after light- and self-polymerization. MATERIALS AND METHODS Round specimens with a diameter of 12 mm and a thickness of 1.5 mm were manufactured from CLEARFIL DC CORE PLUS (CLE; Kuraray), core·X flow (COR; Dentsply Sirona), MultiCore Flow (MUL; Ivoclar Vivadent), and Rebilda DC (REB; VOCO) (N = 96, n = 24/material). Half of the specimens were light-polymerized (Elipar DeepCure-S, 3 M), while the other half cured by self-polymerization (n = 12/group). Immediately after fabrication, the DC, HM, EIT, and BFS were determined. Data was analyzed using Kolmogorov-Smirnov, Mann-Whitney U, and Kruskal-Wallis tests, Spearman's correlation, and Weibull statistics (p < 0.05). RESULTS Light-polymerization either led to similar EIT (MUL; p = 0.119) and BFS (MUL and REB; p = 0.094-0.326) values or higher DC, HM, EIT, and BFS results (all other groups; p < 0.001-0.009). When compared with the other materials, COR showed a high DC (p < 0.001) and HM (p < 0.001) after self-polymerization and the highest BFS (p = 0.020) and Weibull modulus after light-polymerization. Positive correlations between all four tested parameters (R = 0.527-0.963, p < 0.001) were found. CONCLUSIONS For the tested resin composite core build-up materials, light-polymerization led to similar or superior values for the degree of conversion, Martens hardness, elastic indentation modulus, and biaxial flexural strength than observed after self-polymerization. Among the tested materials, COR should represent the resin composite core build-up material of choice due to its high chemical (degree of conversion) and mechanical (Martens hardness, elastic indentation modulus, and biaxial flexural strength) properties and its high reliability after light-polymerization. The examined chemical and mechanical properties showed a positive correlation. CLINICAL RELEVANCE The chemical and mechanical performance of dual-polymerizing resin composite core build-up materials is significantly affected by the chosen polymerization mode.
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Affiliation(s)
- Matthias Kelch
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany.
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Felicitas Mayinger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
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