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Aydin N, Uslu Kavrama F, Kocak EF. Effect of thickness on the translucency of machinable and printable ceramic-glass polymer materials. J Dent 2024; 147:105129. [PMID: 38878814 DOI: 10.1016/j.jdent.2024.105129] [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: 11/27/2023] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVES To assess the translucency of machinable and printable ceramic-glass polymer materials with different thicknesses. METHODS Five ceramic-glass polymer materials were tested: one 3D-printable material, Permanent Crown resin (3D), two machinable materials available at low translucency (LT) and high translucency (HT) levels, VITA Enamic (VE) HT/LT, and Cerasmart 270 (CS) HT/LT. A total of 100 specimens were produced across 10 subgroups (n = 10) with thicknesses of 1 mm and 1.5 mm. The colour coordinates of the specimens were measured against black and white backgrounds using a spectrophotometer. Translucency was quantified using the Relative Translucency Parameter (RTP), calculated via the CIEDE2000 formula. A two-way ANOVA followed by post-hoc tests with Bonferroni correction (α = 0.05) was used for statistical analysis. RESULTS The RTP for both thicknesses were ranked as follows: CSHT > VEHT > CSLT > 3D > VELT. The RTP of the 3D was lower than that of the HT machinable materials (CSHT and VEHT) for both thicknesses (p < 0.05). No significant difference was observed between the RTP of 3D and CSLT at 1.5 mm (p = 1.000); however, at 1 mm, the RTP of the 3D was lower than that of the CSLT (p < 0.05). Notably, the 3D showed the least translucency difference with a 0.5 mm increase in thickness. CONCLUSIONS Printable ceramic-glass polymer materials demonstrated lower translucency than HT machinable ceramic-glass polymer materials. Both the thickness and type significantly influenced the translucency of the LT machinable counterparts compared to the printable ceramic-glass polymer material. CLINICAL SIGNIFICANCE Printable ceramic-glass polymer resins may be a suitable option for minimally invasive procedures, especially when attempting to mask undesirable-coloured abutments. When selecting HT machinable ceramic-glass polymers, clinicians should pay greater attention to the abutment colour and thickness of the restorative material.
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Affiliation(s)
- Nazli Aydin
- Cukurova University, Faculty of Dentistry, Department of Prosthodontics, Adana, Turkey; The Abdi Sutcu Vocational School of Health Services, Cukurova University, Balcali, Adana, Turkey.
| | | | - Elif Figen Kocak
- Dokuz Eylul University, Faculty of Dentistry, Department of Prosthodontics, Izmir, Turkey
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Abdulmajeed A, Sulaiman TA, Suliman AA, Abdulmajeed AA, Närhi TO. Surface roughness and optical characteristics evaluations after chairside adjustment of different zirconia types. J ESTHET RESTOR DENT 2024; 36:1075-1080. [PMID: 38716797 DOI: 10.1111/jerd.13246] [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: 02/29/2024] [Revised: 04/18/2024] [Accepted: 04/26/2024] [Indexed: 06/14/2024]
Abstract
STATEMENT OF PROBLEM Limited evidence is available for the effect of chairside adjustment using rotary cutting instruments on the surface roughness and optical properties of different zirconia types. PURPOSE To evaluate the effect of simulated adjustments on surface roughness and optical properties of different zirconia types. MATERIALS AND METHODS Three Partially Stabilized Zirconia (PSZ) types based on mole percent yttria (Y) concentration from the same manufacturer (Katana; Kuraray) were used: 3Y-PSZ, 4Y-PSZ, and 5Y-PSZ. Thirty disk-shaped specimens (Ø14 × 1.2 mm) from different zirconia types (N = 90) were prepared. Specimens were either left without adjustment (NA), adjusted with Dialite ZR finishing and polishing system (Brasseler) (APol), or adjusted with course diamond instruments only (ADia). The specimens were distributed into 9 groups (n = 10): Group 3Y-PSZ/NA, Group 3Y-PSZ/APol, Group 3Y-PSZ/ADia, Group 4Y-PSZ/NA, Group 4Y-PSZ/APol, Group 4Y-PSZ/ADia, Group 5Y-PSZ/NA, Group 5Y-PSZ/APol, and Group 5Y-PSZ/ADia. The surface roughness of specimen was analyzed using an Atomic Force Microscope (AFM) (Bruker's Dimension Icon, Bruker) and Root Means Square (RMS) were recorded (nm). Surface Gloss (SG), Translucency Parameter (TP), and Contrast Ratio (CR) values of all groups were recorded using an integrating sphere spectrophotometer. Statistical analysis was performed using analysis of variance (ANOVA) and Tukey's multiple comparison tests for pairwise comparisons at p < 0.05 and 95% confidence interval. RESULTS APol had no effect on the surface roughness (p = 0.88) while ADia had a significant negative effect (p < 0.05) despite the type of zirconia. Out of the three testes optical properties, only SG was negatively affected by ADia for all types of zirconia (p < 0.05). The two adjustment types did not affect the TP of all the tested zirconia (p = 0.91). The CR was not affected by the tested adjustments for all zirconia types (p = 0.726). CONCLUSION Proper zirconia adjustment following a sequence of burs and polishers can maintain acceptable roughness and optical properties. Adjustment of zirconia with rough diamond can lead to deleterious effects and should be avoided. CLINICAL SIGNIFICANCE Chairside adjustment of zirconia could lead to rougher surface and unpredictable changes of surface gloss. Therefore, zirconia adjustment should be minimized to the greatest extent possible and a proper protocol should be followed if had to be done.
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Affiliation(s)
- Awab Abdulmajeed
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of General Practice and Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Taiseer A Sulaiman
- Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Abdulhaq A Suliman
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE
| | - Aous A Abdulmajeed
- Department of General Practice and Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Timo O Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
- Wellbeing Service County Southwest Finland, Helsinki, Finland
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Abounassif FM, Alfaraj A, Gadah T, Yang CC, Chu TMG, Lin WS. Color stability of precolored and extrinsically colored monolithic multilayered polychromatic zirconia: Effects of surface finishing and aging. J Prosthodont 2024. [PMID: 38923252 DOI: 10.1111/jopr.13875] [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: 01/06/2024] [Accepted: 05/13/2024] [Indexed: 06/28/2024] Open
Abstract
PURPOSE To explore the impact of zirconia types, coloring methods, and surface finishing on the color stability of monolithic multilayered polychromatic zirconia after artificial aging, including thermocycling and simulated toothbrushing. MATERIALS AND METHODS Eighty square-shaped zirconia samples were divided into 2 types (M3Y-TZP and M6Y-PSZ), further categorized based on coloring methods (precolored and extrinsically colored) and surface finishing techniques (mechanical polishing or glazing). The color stability was assessed using the CIEDE2000 formula. Artificial aging was simulated via thermocycling and toothbrushing. All samples were analyzed with a spectrophotometer to determine the post-aging color changes (ΔE00). The ΔE00 were interpreted and classified using the 50:50% perceptibility threshold (PT) and the 50:50% acceptability threshold (AT). Comparisons between groups for ΔE00 differences were performed using three-way ANOVA, with pairwise comparisons facilitated by Fisher's protected least significant difference test, α = 0.05. RESULTS The study results indicated significant impacts of zirconia type, coloring method, and surface finishing on color stability. The M6Y groups experienced significantly greater color changes (6.61 ± 1.63) compared to the M3Y groups (3.40 ± 2.24), p < 0.0001. For both types of zirconia, extrinsically colored samples exhibited significantly higher ΔE00 when mechanically polished (p = 0.004). However, surface finishing had no significant effect on ΔE00 in precolored samples of either zirconia material (p = 1.000). The evaluation and categorization of ΔE00 variations indicated that nearly all color changes in the M6Y groups, regardless of being precolored, extrinsically colored, polished, or glazed, were deemed extremely unacceptable (Grade 1). In contrast, the M3Y groups showed more acceptable results, with the majority of color changes classified as moderately unacceptable (Grade 3). CONCLUSIONS The color stability of multilayered polychromatic zirconia is influenced by the type of material, extrinsic coloring, and the chosen surface treatment post-artificial aging. The translucent 6Y-PSZ exhibited lower color stability, especially with only mechanical polishing. For the fabrication of M3Y-TZP and 6Y-PSZ monolithic multilayered polychromatic zirconia restorations, extrinsic coloring should be paired with glazing to maintain color stability. Conversely, in the absence of extrinsic coloring, both glazing and mechanical polishing are effective in preserving color stability.
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Affiliation(s)
- Feras M Abounassif
- Dental Department, Al Imam Abdulrahman Bin Faisal Hospital, National Guard Health Affairs, Dammam, Saudi Arabia
| | - Amal Alfaraj
- Department of Prosthodontics, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Thuraya Gadah
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Chao-Chieh Yang
- Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Tien-Min G Chu
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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Yang F, Zhang L, Yang M, Chen J, Xing W. The effect of deviations in sintering temperature on the translucency and color of multi-layered zirconia. BMC Oral Health 2024; 24:471. [PMID: 38637799 PMCID: PMC11027308 DOI: 10.1186/s12903-024-04243-4] [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: 01/16/2024] [Accepted: 04/09/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECT This study aimed to investigate the changes in the translucency and color of four different multi-layered zirconia materials when the sintering temperature were inaccurate. MATERIALS AND METHODS Two hundred zirconia samples (11 × 11 × 1.0 mm) of four multi-layered zirconia, Upcera TT-GT (UG), Upcera TT-ML (UM), Cercon xt ML (CX), and Lava Esthetic (LE), were divided into five subgroups according to the sintering temperature: L1 (5% lower temperature), L2 (2.5% lower temperature), R (recommended sintering temperature), H2 (2.5% higher temperature), H1 (5% higher temperature). After sintering, color coordinates were measured. Then the translucency parameter (TP) values, and the color differences (between the inaccurate sintering temperature and the recommended temperature) of each zirconia specimen were calculated. Statistical analysis was performed by using three-way ANOVA tests, the one-way ANOVA, and Tukey's post hoc test. RESULTS Three-way ANOVA results showed that material type, sintering temperature, specimen section, and their interactions significantly influenced the TP values (except for the interactions of specimen section and sintering temperature) (P < .05). TP values of zirconia specimens were significantly different in the inaccurate sintering temperatures (P < .05), except for the cervical and body sections of UG group (P > .05). Compared with recommended sintering temperature, higher sintering temperature caused higher TP values for CX, but lower for LE. Three-way ANOVA results showed that material type, sintering temperature, and their interactions significantly influenced the ∆E00 values (P < .05). There were no significant differences in ∆E00 values of UM and CX groups at different inaccurate sintering temperatures, and were clinical imperception (except for UM-L1) (∆E00 < 1.25). ∆E00 values of all zirconia specimens showed clinically acceptable (∆E00 < 2.23). CONCLUSION The deviations in sintering temperature significantly influenced the translucency and color of tested multi-layered zirconia. The trends of translucency in the multi-layered zirconia depended on material type and the color changes of all zirconia materials were clinically acceptable at inaccurate sintering temperatures.
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Affiliation(s)
- Fan Yang
- Graduate School of Dalian Medical University, Dalian, China
| | - Luyao Zhang
- Graduate School of Dalian Medical University, Dalian, China
| | - Minghui Yang
- Dental Technology Center, Dalian Stomatological Hospital, Dalian, China
| | - Jianfeng Chen
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wenzhong Xing
- Department of Prosthodontics, Dalian Stomatological Hospital, Dalian, Liaoning, 116021, PR China.
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Stevens CD, Renné WG, Vág J. Translucency of chairside monolithic zirconias using different sintering ovens: An in vitro investigation. J Dent 2024; 142:104839. [PMID: 38216029 DOI: 10.1016/j.jdent.2024.104839] [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: 11/30/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE To evaluate the translucency of several monolithic zirconias (MZ) processed in various sintering ovens designed for single-visit, chairside use. METHODS Discs (n = 40) from zirconia blocks were fabricated for each MZ at manufacturer-recommended minimal thicknesses, as provided in each material's instructions for use: IPS e.max ZirCAD LT (ZLT); CEREC Zirconia+ (CZ+); 3M Chairside (3M); KATANA Zirconia (KT). Groups (n = 10) were sintered following manufacturer instructions for each oven: CEREC SpeedFire, Ivoclar CS4, Ivoclar CS6, and Ivoclar S2 (laboratory furnace control). Specimens were highly polished on one side and glazed on the other. Each side was measured with a spectrophotometer against white and black backgrounds to determine translucency parameter (TP) and contrast ratio (CR) values. Results for TP and CR for each material and oven combination were compared with a linear mixed model. Oven precision was evaluated using the Kruskall-Wallis test. RESULTS Glazed specimens were more translucent than polished ones (p < 0.001). ZLT and CZ+ were more translucent than 3M and KT regardless of the sintering oven (p < 0.01). Several oven/material combinations reached or exceeded the S2 oven TP: CS4 with CZ+ and 3M; CS6 with ZLT and KT (p < 0.01). SpeedFire was significantly less precise (p < 0.05) and produced lower TP values for ZLT, CZ+, and KT (p < 0.01). Results for TP and CR were highly correlated. CONCLUSIONS MZ surface finish, material thickness, and oven used all had a significant effect on translucency. Some chairside-oriented solutions produced results with translucency equal to conventionally processed zirconia. CLINICAL SIGNIFICANCE The translucency of a ceramic restoration is an important factor in determining its esthetics. Clinicians desiring the most esthetic outcomes with monolithic zirconia should be aware of the significant effects that surface finishing, material thickness, and the sintering oven used can have on restoration translucency.
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Affiliation(s)
| | | | - János Vág
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary.
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Çakır Kılınç NN, Yıldız P. Do mouthwashes affect the optical properties of resin cement? BMC Oral Health 2024; 24:275. [PMID: 38403580 PMCID: PMC10894495 DOI: 10.1186/s12903-024-04044-9] [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: 08/06/2023] [Accepted: 02/17/2024] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the effect of mouthwashes on the optical properties of resin cement. MATERIALS AND METHODS One hundred and 60 resin cement discs (6x2mm) were produced from 4 different brands of resin cement (Panavia V5, Estecem II, RelyX Veneer, NX3) with the help of a Teflon mould. The discs were divided into 4 subgroups, 1 of which served as the control group, to be immersed in mouthwashes after measuring the initial L, a, and b values on white and black backgrounds. Colour measurements were repeated after the 1st and 7th days. The collected data were used to calculate the ∆E00 value to measure colour stability, the translucency parameter (TP00), and the contrast ratio parameter (CR) to compare translucency change. Data were statistically analysed using mixed-design analysis of ANOVA and the Bonferroni-Dunn test. Repeated measures ANOVA was used for dependent results (α = 0.05). RESULTS On the ∆E00, TP00, and CR parameters; the joint effect of resin groups, mouthwash groups, and measurement times were found to be statistically significant. The ∆E00 (colour difference) parameter; the joint effect of resin groups, mouthwash groups, and measurement times was found to be statistically significant. The TP00; the joint effect of resin groups, mouthwash groups, and measurement times were found to be statistically significant. The CR parameter; the joint effect of resin groups, mouthwash groups, and measurement times was found to be statistically significant. In the Estecem II (Tokuyama) group, the means of Listerine Cool Mint (Johnson & Johnson) was above acceptable limits in both time periods. In the Panavia V5 (Kuraray Noritake) group, the color change was above acceptable limits in all time periods and in all mouthwash groups. Among the resin materials used, Estecem II (Tokuyama) shows the most color change. Listerine Cool Mint (Johnson & Johnson) caused more color change than other mouthwashes at all times. CONCLUSIONS Within the limitations of this study; the colour stability and translucency value of resin cement depend on both the resin cement content and the mouthwash. Long-term use of mouthwash may adversely affect the optical properties of the resin cement. CLINICAL RELEVANCE Clinicians should take into account the fact that mouthwash use and the composition of the resin cement employed will have an impact on the colour of laminate veneers.
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Affiliation(s)
| | - Pınar Yıldız
- Nimet Bayraktar Oral and Dental Health Center, Kayseri, Turkey.
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Liu H, Inokoshi M, Xu K, Tonprasong W, Minakuchi S, Van Meerbeek B, Vleugels J, Zhang F. Does speed-sintering affect the optical and mechanical properties of yttria-stabilized zirconia? A systematic review and meta-analysis of in-vitro studies. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:312-328. [PMID: 37705876 PMCID: PMC10495607 DOI: 10.1016/j.jdsr.2023.08.007] [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: 11/09/2022] [Revised: 08/02/2023] [Accepted: 08/22/2023] [Indexed: 09/15/2023] Open
Abstract
Zirconia restorations are increasingly popular in dental treatment. Yttria-stabilized zirconia (YSZ) needs to be sintered for clinical applications and novel speed-sintering protocols are being developed for chairside treatments. Whether the properties of speed-sintered YSZ meet clinical requirements, however, remains unclear. Therefore, we conducted a systematic review and meta-analysis on the influence of speed-sintering on the optical and mechanical properties of dental YSZ according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A literature search was conducted using PubMed, Embase, and Web of Science databases for relevant articles published between January 1, 2010 and February 28, 2022 in English, Chinese, or Japanese. After full-text evaluation and quality assessment, 26 articles were selected. Meta-analysis revealed that speed-sintering does not significantly affect the CIEDE2000-based translucency parameter, contrast ratio, three-point flexural strength, biaxial flexural strength, or fracture toughness of YSZ (p < 0.01) compared to conventional sintering. However, the CIELab-based translucency parameter of conventionally sintered YSZ is higher than that of speed-sintered YSZ. The descriptive analysis indicated that speed-sintering does not affect the hardness of YSZ compared to that of conventionally sintered YSZ. The results indicate that speed-sintering is suitable for preparing YSZ for dental restorations.
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Affiliation(s)
- Hengyi Liu
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Masanao Inokoshi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Kaiqi Xu
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Watcharapong Tonprasong
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 blok a, B-3000 Leuven, Belgium
| | - Jef Vleugels
- KU Leuven (University of Leuven), Department of Materials Engineering, Kasteelpark Arenberg 44, BE-3001 Leuven, Belgium
| | - Fei Zhang
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 blok a, B-3000 Leuven, Belgium
- KU Leuven (University of Leuven), Department of Materials Engineering, Kasteelpark Arenberg 44, BE-3001 Leuven, Belgium
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Zhu J, Xu Y, Li M, Huang C. Instrumental and visual evaluation of the color adjustment potential of a recently introduced single‑shade composite resin versus multishade composite resins. J Prosthet Dent 2023:S0022-3913(23)00653-4. [PMID: 37919131 DOI: 10.1016/j.prosdent.2023.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023]
Abstract
STATEMENT OF PROBLEM Single-shade composite resins simplify the process of shade selection by providing a narrow range of color but the ability to simulate all shades. However, evidence is limited for the color shifting ability of a newly developed single‑shade composite resin. PURPOSE The purpose of this in vitro study was to evaluate the instrumental color adjustment potential (CAP-I) and visual color adjustment potential (CAP-V) of a recently introduced single-shade composite resin compared with conventional multishade composite resins against different background colors. MATERIAL AND METHODS Four multishade composite resins (Spectrum TPH3, Beautifil II, Clearfil AP-X, and Gradia Direct) and a single-shade composite resin (Charisma Diamond One) were tested. Four base shades (A1, A2, A3, and A3.5) of the same composite resin (Filtek Z350XT) were selected as different background colors. Dual specimens (an outer base material with an inner hole filled with inner test material) and single specimens of all test and base materials were prepared (n=6 per group). Spectral reflectance values were obtained by using a spectroradiometer. The color difference (ΔE00) and relative translucency parameter (RTP) were calculated by using the CIEDE2000 and RTPCIEDE2000 formula. Visual scoring of color matching was performed by independent observers. The CAP-I and CAP-V values were calculated according to ΔE00 and visual scoring. Analysis of variance (ANOVA) was used for statistical analysis (α=.05). RESULTS CAP-I and CAP-V were significantly affected by composite resin type, background color, and their interaction (P<.001). Positive CAP-I and CAP-V values were found for the majority of test materials. Charisma Diamond One exhibited the highest CAP-I value under all background colors, the highest CAP-V value under most background colors, and the significantly highest RTP value (P<.001). CONCLUSIONS The color adjustment potential was dependent on the material type and background color. Charisma Diamond One exhibited the highest color adjustment potential and the most pronounced color shifting ability.
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Affiliation(s)
- Jiakang Zhu
- Doctoral candidate, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Yue Xu
- Doctoral candidate, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Mengxun Li
- Lecturer, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Cui Huang
- Professor, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China..
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Adak IO, Aguloglu S, Adak BM, Sari I. Comparison of the translucency parameters and bond strength of 5Y-ZP zirconia, 3-YTZP zirconia, and lithium disilicate. Niger J Clin Pract 2023; 26:1491-1497. [PMID: 37929525 DOI: 10.4103/njcp.njcp_91_23] [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] [Indexed: 11/07/2023]
Abstract
Background E-max is a more aesthetic material than traditional zirconia. In addition, the bond strength of traditional zirconia with adhesive cements is lower. There are not enough studies on how the aesthetic values and bond strength of 5-YZP, the new generation zirconia, compare to e-max and traditional zirconia. Can 5-YZP be an alternative to e-max in terms of aesthetics and bond strength? Aim The aim of the study is to compare the translucency property and bonding ability of 5y-zp zirconias with previous generation zirconias and lithium disilicate. Materials and Methods Two types of zirconia Katana UT and Katana HT for measuring translucency values; and using a type of lithium disilicate IPS e.max CAD LT, three groups were formed (n = 10). Translucency specimens were fabricated (n = 10). Their L*a*b* values were measured against a black-and-white background with a spectrophotometer, and DE00 was calculated. To perform micro-shear tests, a cylinder design was made from zirconia and IPS e.max CAD blocks (n = 20). After the samples were aged by thermal cycle, the micro-shear test was applied to specimens cemented to teeth extracted with two different adhesive cement systems. Results According to the results of one-way analysis of variance, a statistically significant difference was found between the translucency parameter (TP) values of the groups. According to Tukey's honestly significant difference (HSD) multiple comparisons, the values of the three groups are statistically different from each other. Although IPS e.max CAD group has the highest TP values, the Katana HT group has the lowest values. Conclusion 5Y-PZ has a TP intermediate to those of 3Y-TZP and lithium disilicate. Long-term bond strength of 3Y-TZP and 5Y-ZP were similar to those of lithium disilicate. To be an alternative to glass ceramics in the anterior region, translucency and bond strength values need to be improved.
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Affiliation(s)
- I Ozkan Adak
- Department of Prosthetic Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - S Aguloglu
- Department of Prosthetic Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - B M Adak
- Deparment of Oral and Maxillofacial Surgery, Izmir Katip Celebi University, Izmir, Turkey
| | - I Sari
- Department of Prosthetic Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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Souza LFB, Soares PM, Ribeiro VF, Scotti N, Kleverlaan CJ, Bacchi A, Pereira GKR. Influence of coloring techniques on the surface characteristics and color stability of a monolithic zirconia ceramic. J Prosthet Dent 2023; 130:392.e1-392.e9. [PMID: 37516645 DOI: 10.1016/j.prosdent.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/31/2023]
Abstract
STATEMENT OF PROBLEM The color of monolithic zirconia restorations is obtained by presintering or postsintering coloring techniques. However, studies on the differences in surface characteristics and their influence on color stability are lacking. PURPOSE The purpose of this in vitro study was to evaluate the influence of shading and staining techniques for a zirconia ceramic on the surface characteristics and colorimetric parameters (color difference, translucency, and whiteness index) after exposure to coffee or red wine and then polishing. MATERIAL AND METHODS Ceramic disks (N=30; Ø10×1mm) were allocated into 3 groups: preshaded-shaded by the manufacturer (IPS e.max ZirCAD MT, shade A2); manually shaded-unshaded zirconia (IPS e.max ZirCAD MT, bleaching shade-BL) colored by the brushing technique, before sintering; stained-unshaded zirconia (IPS e.max ZirCAD MT BL) colored by the staining technique, after sintering. Spectrophotometric color assessments ensured the same initial perceived color (Vita Classical A2) for specimens included in the study (∆E00<1.77 acceptability threshold). Surface characteristics were assessed by scanning electron microscopy and atomic force microscopy. The specimens were immersed in coffee (n=5) or red wine (n=5) for 12 and 24 days and subsequently polished. The data were statistically and descriptively analyzed for color differences (∆E00), translucency parameters (TP00), and whiteness indexes for dentistry (WID), considering acceptability and perceptibility thresholds. RESULTS The shaded groups found an irregular ceramic surface with uniformly sized zirconia crystals. The stained group found a glass-covered smoother surface. Significant alterations in color parameters (∆E00, TP00, WID) were observed with immersion in pigmenting beverages (P<.001) both after 12 days, and after 24 days. The shaded specimens had greater color alterations after immersion but benefited from the polishing procedure, which reduced color differences below an acceptable threshold in comparison with the baseline. Stained specimens had lower color alterations after immersion, but the polishing protocol was detrimental as it whitened the ceramic by subsurface exposure. CONCLUSIONS The coloring technique influences the surface characteristics of zirconia ceramic and also the color parameters after exposure to colored beverages and polishing.
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Affiliation(s)
- Luiza Freitas Brum Souza
- Postgraduate Program in Oral Sciences (Prosthodontics Units), Faculty of Odontology, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Pablo Machado Soares
- Postgraduate Program in Oral Sciences (Prosthodontics Units), Faculty of Odontology, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Vinícius Fogliato Ribeiro
- Undergraduate student, Department of Restorative Dentistry, Postgraduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, Noord-Holland, the Netherlands
| | - Ataís Bacchi
- Postgraduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, CE, Brazil
| | - Gabriel Kalil Rocha Pereira
- Undergraduate student, Department of Restorative Dentistry, Postgraduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
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11
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Emam M, Metwally MF. Effect of coping materials zirconia or polyetheretherketone with different techniques of fabrication on vertical marginal gap and fracture resistance of posterior crowns with composite veneering. BMC Oral Health 2023; 23:546. [PMID: 37559037 PMCID: PMC10413631 DOI: 10.1186/s12903-023-03247-w] [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: 04/27/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Insufficient research has been conducted in the literature assessing the performance of zirconia and polyetheretherketone (PEEK) crowns in relation to the essential requirements of successful restorations, such as fracture resistance or margin adaptation. The purpose of this study was to evaluate the effect of the coping materials zirconia or PEEK with different fabrication techniques on the vertical marginal gap and fracture resistance of posterior crowns with composite veneering. METHODS Ceramic copings (n = 18) restoring mandibular first molar were fabricated from zirconia (Zircon.x, Presidentdental, Germany), milled PEEK (PEEK CAD) (breCAM.BioHPP, Bredent, Germany) and pressed PEEK (PEEK Press) (BioHPP Granules, Bredent, Germany) six specimens each (n = 6). The copings were veneered with high impact polymer composite (HIPC) material (breCAM.HIPC, Bredent, Germany). The vertical marginal gap was captured under a magnification of 40X. Five equidistant marks on each surface of the die distinguished the points of measurement for a total of 20 readings per sample. The analysis was completed using an image analysis system (ImageJ 1.53t, National Institute of Health, USA). The specimens were loaded to failure at a crosshead speed of 1 mm/min and the load at failure was recorded to measure the fracture resistance. RESULTS The marginal gap was analyzed using one-way ANOVA followed by Tukey's post hoc test. Fracture resistance was analyzed using Welch one-way ANOVA followed by the Games-Howell post hoc test. Marginal gap values showed a significant difference between the tested groups, with zirconia having significantly lower gap values (48.67 ± 11.98 µm) than both the PEEK CAD (108.00 ± 20.08 µm) and Press groups (108.00 ± 25.10 µm) (p < 0.001). However, the results of fracture resistance showed no significant difference (p = 0.06) with 1687.47 ± 253.29 N, 2156.82 ± 407.64 N, 2436.72 ± 725.93 N for zirconia, PEEK CAD, and Press, respectively. The significance level was p < 0.05. CONCLUSIONS Zirconia framework crowns have a smaller vertical marginal gap than milled and pressed PEEK crowns. Crowns fabricated from zirconia, PEEK CAD, or PEEK Press frameworks and veneered with composite resin have comparable fracture resistance lower than the maximum biting force in the posterior region. CLINICAL RELEVANCE Posterior crowns with zirconia frameworks are preferred over milled and pressed PEEK frameworks regarding margin adaptation, although all can safely survive the maximum occlusal forces without fracture.
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Affiliation(s)
- Marwa Emam
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Organization of African Unity St, El-Qobba Bridge, Al Waili, 11566, Cairo, Egypt.
| | - Mohamed F Metwally
- Department of Crown and Bridge, Faculty of Dental Medicine, AL Azhar University, Cairo, Egypt
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12
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The mechanical properties, tribological behaviors and color stability of a feldspar nanoceramics strengthening extrinsic stain for high-translucent zirconia. J Mech Behav Biomed Mater 2023; 140:105698. [PMID: 36753850 DOI: 10.1016/j.jmbbm.2023.105698] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
The present work is aimed to explore the mechanical properties, tribological behaviors and color stability of nanoceramics and microceramics strengthened extrinsic stain coatings (NS and MS) upon high-translucent zirconia (TZ). The Na-rich feldspar ceramics component, microstructure and particle size of NS and MS were verified. The mechanical properties including elastic modulus and hardness of NS were enhanced compared to MS. Reciprocating wear tests under a ball-on-plate configuration manifested that the reduced coefficient of friction, wear depth and wear volume loss of NS was evaluated after 1 × 10 4 cycles and the wear scar morphology of NS characterized by microcracks while MS featured more delamination and wear debris. Post toothbrushing simulation revealed that the color stability of extrinsic stain coatings was elevated with the addition of feldspar nanoceramics. The feldspar nanoceramics strengthening extrinsic stain exhibited enhanced elastic modulus, hardness, wear resistance and color stability, especially for TZ.
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13
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Ruiz-López J, Espinar C, Lucena C, de la Cruz Cardona J, Pulgar R, Pérez MM. Effect of thickness on color and translucency of a multi-color polymer-infiltrated ceramic-network material. J ESTHET RESTOR DENT 2023; 35:381-389. [PMID: 36533557 DOI: 10.1111/jerd.12952] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the effect of thickness on color and translucency of a multi-color polymer-infiltrated ceramic-network (PICN) material. METHODS Specimens of 0.5, 1.0, 1.5 mm thicknesses were obtained by sectioning VITA ENAMIC® multiColor (E-MC) High Translucent CAD-CAM blocks (1M1-HT, 1M2-HT, 2M2-HT, 3M2-HT, and 4M2-HT). Spectral reflectance and color coordinates were measured on white and black backgrounds using a spectroradiometer, CIE D65 illuminant and CIE 45°/0° geometry. CIEDE2000 color and translucency differences (ΔE00 and ΔTP00 ) between thicknesses and adjacent layers were evaluated using their respective 50:50% perceptibility and acceptability thresholds (PT00 and AT00 ). RESULTS In general, ΔE00 between thicknesses for all shades and layers were above AT00 in general. Chroma decreased from cervical to incisal layers with statistically significant differences (p < 0.05), and ΔE00 between sequential layers were above PT00 , for all shades and thicknesses. TP00 decreased from 0.5 to 1.5 mm and increased from cervical to incisal layers for all shades with statically significant translucency differences (p < 0.05). In general, for all thicknesses, TPT00 < ΔTP00 < TAT00 for sequential layers. CONCLUSIONS The gradient in color and translucency of E-MC PICN material was influenced by the thickness of the CAD-CAM block. In addition, color and TP transition values between the layers depends on the thickness and shade. CLINICAL SIGNIFICANCE The effect of thickness must be taken into account by dental technicians and dentists when CAD-CAM multicolor PICN materials are used.
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Affiliation(s)
- Javier Ruiz-López
- Department of Optics, Faculty of Science, University of Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Cristina Espinar
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Stomatology, Faculty of Dentistry, Colegio Máximo, University of Granada, Spain
| | - Cristina Lucena
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Stomatology, Faculty of Dentistry, Colegio Máximo, University of Granada, Spain
| | - Juan de la Cruz Cardona
- Department of Optics, Faculty of Science, University of Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Rosa Pulgar
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Stomatology, Faculty of Dentistry, Colegio Máximo, University of Granada, Spain
| | - María M Pérez
- Department of Optics, Faculty of Science, University of Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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14
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Lee WF, Takahashi H, Iwasaki N, Peng PW. Effect of thickness of externally characterized stains on optical properties of high-translucency zirconia. Clin Oral Investig 2023; 27:165-171. [PMID: 36125622 DOI: 10.1007/s00784-022-04704-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/29/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES There is insufficient information about the effects of the thickness of externally characterized stains or glazes on CIELAB color parameters and the translucency parameter (TP) of 5 mol% yttria partially stabilized zirconia (5Y-PSZ). The present study evaluated the effect of a thickness reduction of the externally characterized or glazed layer on its CIE2000 color parameters and TP00 of 5Y-PSZ. MATERIALS AND METHODS Twenty-eight specimens were sectioned from 5Y-PSZ blanks. Three brands of powdered stains (namely VI, SH, and IV) and a glaze (GL) were used to extrinsically stain the specimen surfaces (n = 7 per group). After measuring the final thickness and color, specimens of each group were carefully ground and finally polished. The reduced thickness was carefully controlled in decrements of 0.02 mm on the characterized stains or glazed layers at each reduction cycle until the surface of the un-stained zirconia was exposed. The CIELAB color parameters of specimens were measured using a spectrophotometer. Subsequently, differences in lightness (∆L'), chroma (∆C'), and hue (∆H'), and TP00 values and color differences (ΔE00) were calculated using the CIEDE2000 formula to determine differences between the specimen and the un-stained zirconia at each reduction cycle. A paired-samples t-test, two-way mixed-design analysis of variance, and Pearson correlation coefficient were used to analyze the data (α = 0.05). RESULTS There were no significant differences in lightness, chroma, hue, or TP00 values before or after glazing or after each reduction cycle of the glazed layer. Mean ΔE00 values ranged between 20.94 and 33.55 after applying the externally characterized stains. With a decreased thickness of the characterized stain layer, there were observed that significant decreases in ∆L', ∆H', ∆C', and ΔE00, and significant increases in TP00. CONCLUSIONS Increasing the thickness of externally characterized stains decreased the lightness and caused the alternation of chroma and hue, whereas these phenomena were not observed in the glazed group. There was a slight change of CIE2000 color parameters and TP00 when the thickness of the characterized layer exceeded 0.06 mm. CLINICAL RELEVANCE The application and thickness of externally characterized stains can sensitively affect CIE2000 color parameters and translucency of 5Y-PSZ.
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Affiliation(s)
- Wei-Fang Lee
- School of Dental Technology, Taipei Medical University, Taipei, 11031, Taiwan
| | - Hidekazu Takahashi
- School of Oral Health Engineering, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, 113-8549, Japan
| | - Naohiko Iwasaki
- School of Oral Health Engineering, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, 113-8549, Japan
| | - Pei-Wen Peng
- School of Dental Technology, Taipei Medical University, Taipei, 11031, Taiwan.
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15
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Albayrak H, Eraslan R, Aydinlioglu Ö. Effect of sintering procedures on optical properties, chemical composition, and grain size of monolithic zirconia ceramic at different thicknesses after hydrothermal aging: An in vitro study. J Indian Prosthodont Soc 2023; 23:57-64. [PMID: 36588376 PMCID: PMC10088447 DOI: 10.4103/jips.jips_345_22] [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: 07/15/2022] [Revised: 10/09/2022] [Accepted: 11/21/2022] [Indexed: 12/29/2022] Open
Abstract
Aim The purpose of the present study was to examine the optical properties, chemical composition, and grain size (GS) of monolithic zirconia (MZ) ceramic at different thicknesses sintered using different procedures after hydrothermal aging. Settings and Design An in vitro study. Materials and Methods Forty MZ discs (0.5-mm thickness [Group-0.5] and 1-mm thickness [Group-1]; 12 mm diameter) were milled and divided according to standard (Group-ST) and speed (Group-SP) sintering procedures. All specimens were hydrothermally aged at 134°C after sintering. Translucency (TP), opalescence (OP), and fluorescence (ΔEabFNx01-FL) parameters were calculated using the color coordinates (LFNx01, aFNx01, bFNx01, respectively) of the discs. The chemical composition and the GS of the specimens were characterized using X-ray fluorescence spectroscopy and a scanning electron microscopy, respectively. Statistical Analysis Used TPs and ΔEabFNx01-FLs were analyzed using independent samples t-tests and Mann-Whitney U-tests while a two-way analysis of variance (ANOVA) was used for OPs. Results Group-1 showed significantly lower TP than Group-0.5 (P < 0.001) but a significantly higher OP (P = 0.014). Group-SP showed significantly higher OP (P = 0.00003) and ΔEabFNx01-FL (P = 0.0026) values than Group-ST without considering the thickness. Group-SP (0.29 ± 0.119 μm) had a smaller GS than Group-ST (0.306 ± 0.142 μm). Compared to Group-ST, Group-SP had a lower percentage of Y2O3 and a higher percentage of Al2O3. Conclusion The effect of the sintering procedure on TP and OP of MZ was not perceived by the naked eye. The speed sintering procedure may increase Δ EFNx01ab-FL of MZ to higher values than natural teeth when compared with standard sintering. The speed sintering may cause minor changes in GS and the chemical composition of MZ.
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Affiliation(s)
- Haydar Albayrak
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ravza Eraslan
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ömer Aydinlioglu
- Department of Textile Engineering, Erciyes University, Kayseri, Turkey
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16
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Elkhishen EA, Al-Zordk W, Hassouna M, Elsherbini A, Sakrana AA. Effect of ceramic and resin cement type on color stability and translucency of ceramic laminate veneers for diastema closure: an in vitro study. Sci Rep 2022; 12:22082. [PMID: 36543821 PMCID: PMC9772217 DOI: 10.1038/s41598-022-26581-5] [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: 06/10/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
To investigate the effect of resin cements on the color stability and translucency of ceramic laminate veneers used for diastema closure. Sixty resin abutments were prepared for ceramic laminate veneers and divided into six groups according to the ceramic type (lithium disilicate, zirconia-reinforced lithium silicate, and translucent zirconia) and the cement type (Variolink Esthetic LC and RelyX Veneer). Color coordinates and translucency were analyzed after cementation and after soaking in the coffee solution. Differences in color and translucency were estimated, and results were statistically assessed (α = 0.05). Ceramic materials showed a significant impact on color changes after soaking in coffee within Variolink Esthetic groups. Translucent zirconia showed the highest color change, followed by zirconia reinforced lithium silicate and lithium disilicate. Ceramic materials showed a significant impact among the RelyX Veneer groups. A significant interaction in color changes was found between ceramic types and cement types after cementation, and after soaking in coffee was found. All groups showed a clinically acceptable difference in translucency parameters after soaking in coffee. The resin cement affects the color and translucency of ceramic laminate veneers used for diastema closure, and ceramic laminate veneers bonded with Variolink Esthetic LC resin cement are more translucent, while ceramic laminate veneers bonded with RelyX Veneer resin are more resistant to coffee staining. The lithium disilicate laminate veneer is more resistant to coffee staining than zirconia reinforced lithium silicate and translucent zirconia laminate veneers used for diastema closure.
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Affiliation(s)
- Eman Adel Elkhishen
- grid.10251.370000000103426662Department of Fixed Prosthodontics, Mansoura University, Faculty of Dentistry, Mansoura, Egypt
| | - Walid Al-Zordk
- grid.10251.370000000103426662Department of Fixed Prosthodontics, Mansoura University, Faculty of Dentistry, Mansoura, Egypt ,Department of Fixed Prosthodontics, Horus University, Faculty of Dentistry, New Damietta, Egypt
| | - Mahy Hassouna
- grid.10251.370000000103426662Department of Fixed Prosthodontics, Mansoura University, Faculty of Dentistry, Mansoura, Egypt
| | - Ahmed Elsherbini
- grid.26999.3d0000 0001 2151 536XDepartment of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo, Tokyo, Japan
| | - Amal Abdelsamad Sakrana
- grid.10251.370000000103426662Department of Fixed Prosthodontics, Mansoura University, Faculty of Dentistry, Mansoura, Egypt ,Department of Fixed Prosthodontics, Horus University, Faculty of Dentistry, New Damietta, Egypt
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da Silva AO, Fiorin L, Faria ACL, Ribeiro RF, Rodrigues RCS. Translucency and mechanical behavior of partially stabilized monolithic zirconia after staining, finishing procedures and artificial aging. Sci Rep 2022; 12:16094. [PMID: 36167885 PMCID: PMC9515067 DOI: 10.1038/s41598-022-20120-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
Partially stabilized zirconia (5Y-PSZ) has been widely used to manufacture indirect monolithic restorations, and the effect of finishing procedures on the optical and mechanical properties of these materials are still unclear. The purpose of this study was to evaluate the effect of staining, polishing and glazing on surface roughness, crystalline phase content, microhardness, fracture toughness, dynamic elastic modulus, three-point flexural strength, strain distribution, color (∆E00/∆L/∆a/∆b), and translucency before and after artificial accelerated aging (water spray and ultraviolet) of 5Y-PSZ. Bar-shaped and rectangle-shaped specimens of the 5Y-PSZ were prepared and divided into six groups, according to finishing procedure: GC (control), GS (staining), GG (glazing), GSG (staining and glazing), GP (polishing), GSP (staining and polishing). There was a significant difference between groups for surface roughness (p < 0.05), dynamic elastic modulus (p = 0.007), microhardness (p = < 0.05), ∆E00 (p = 0.010), and ∆a (p = 0.008). GC presented higher cubic phase content, and the stained groups (GS, GSG and GSP) presented higher monoclinic content. The different finishing procedures affected roughness, dynamic elastic modulus, microhardness, and color of 5Y-PSZ; polishing being the finish that provides minors changes to the 5Y- PSZ. Accelerated artificial aging caused color change, regardless of finishing procedure used.
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Affiliation(s)
- Allan Oliveira da Silva
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Lívia Fiorin
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Adriana Claudia Lapria Faria
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Ricardo Faria Ribeiro
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Renata Cristina Silveira Rodrigues
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil.
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18
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Altan B, Cinar S. Effect of Repeated Firings and Thickness on Optical Properties of Variable Preshaded and Shaded Novel Translucent Zirconia Blocks. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8572782. [PMID: 36017380 PMCID: PMC9398792 DOI: 10.1155/2022/8572782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/05/2022] [Indexed: 11/18/2022]
Abstract
Objective The purpose of this study was to examine the optical properties of translucent zirconia with different thickness during multiple firings. Materials and Methods Three different types of translucent zirconia (Vita YZ HT (HT), Vita YZ ST (ST), Vita YZ XT (XT)) with thickness of 0.5, 1, and 1.5 mm were used in the study. 180 disk-shaped specimens (n = 10) were prepared from preshaded and nonshaded blocks. The coloring liquid (A2, Vita Shade Liquid) was applied with a synthetic nylon brush in the nonshaded group. Then, the specimens were then subjected to 1, 3, and 5 firing times. After consecutive firings, color differences (ΔE) and translucency parameter (TP) were measured. Statistical analysis was carried out by using repeated measure ANOVA followed by Tukey test. Results ANOVA analysis reveals that TP and ΔE were significantly affected by the repeated firings. The highest TP was seen in 0.5 mm XT specimen. For all specimens, TP decreases from 1st to 3rd firing cycles, despite TP increases from 3rd to 5th firing cycles. Although there is a significant change in TP values in 0.5 mm thickness, there is no significant change between firing cycles for 1 and 1.5 mm thickness specimens. The highest ΔE value was observed for shaded specimens between 1st and 5th firings. ΔE values were not significantly different between 1 and 3 firings. Conclusions Changes in thickness and repeated firings of zirconia specimens affected final color and translucency of zirconia specimens. HT blocks are more affected by consecutive firings than ST and XT blocks. ΔE increased as the thicknesses decreased for both types of translucent zirconia specimens tested.
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Affiliation(s)
- Bike Altan
- Department of Prosthodontics, Faculty of Dentistry, University of Health Sciences, Uskudar, Istanbul, Turkey
| | - Sevki Cinar
- Department of Prosthodontics, Faculty of Dentistry, University of Health Sciences, Uskudar, Istanbul, Turkey
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Hsu WC, Peng TY, Kang CM, Chao FY, Yu JH, Chen SF. Evaluating the Effect of Different Polymer and Composite Abutments on the Color Accuracy of Multilayer Pre-Colored Zirconia Polycrystal Dental Prosthesis. Polymers (Basel) 2022; 14:polym14122325. [PMID: 35745899 PMCID: PMC9229389 DOI: 10.3390/polym14122325] [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: 05/11/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 12/25/2022] Open
Abstract
With increasing aesthetic awareness and emphasis on time costs in today’s society, monolithic multilayer precolored zirconia ceramics (M-Zr) facilitate aesthetic restorations in a convenient and straightforward manner without the need for veneering porcelain to modify the color. However, the effect of abutment materials on the final color of M-Zr remains unclear. Herein, we placed Vita A1 Shade M-Zr on six different abutment materials, zirconia (Y-TZP), 3D printed composite resin (CR), dental model resin (MR), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), and cobalt−chromium alloy (Co−Cr), to evaluate their effect on the color accuracy of M-Zr. The color attributes (L*, a*, and b*) were measured using a dental spectrophotometer. The translucency parameter (TP), contrast ratio, color difference (ΔE) between each background substrate and the Vita A1 Shade Guide, and chroma values (C) were calculated to evaluate the color accuracy of M-Zr. A statistical analysis was performed using one-way analysis of variance and post hoc Tukey’s HSD tests (α = 0.05). The experimental results indicate that the TP values and contrast ratio of the M-Zr samples were 14.85 and 0.83, respectively. Co−Cr had the highest ΔE (6.08) and lowest C value (7.52); PEKK had the lowest ΔE (2.60), and PEEK had the highest C value (12.23) (p < 0.05). Notably, the ΔE values of CR (3.13), PEEK (2.86), and PEKK were within clinical indicators (ΔE < 3.7). Based on these results, it can be concluded that the abutment material has a significant effect on the final color of the M-Zr, and PEEK or PEKK resulted in good color accuracy. When choosing the dental MR, traditional zirconia, or metals as abutment materials, colored or opaque cement might be required to eliminate color distortion and achieve desirable optical properties.
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Affiliation(s)
- Wen-Chieh Hsu
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan;
| | - Tzu-Yu Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan;
| | | | - Fan-Yi Chao
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO 80045, USA;
| | - Jian-Hong Yu
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan;
- Correspondence: (J.-H.Y.); (S.-F.C.); Tel.: +886-4-2205-3366 (ext. 2309) (S.-F.C.)
| | - Su-Feng Chen
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan;
- Correspondence: (J.-H.Y.); (S.-F.C.); Tel.: +886-4-2205-3366 (ext. 2309) (S.-F.C.)
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Masking Ability of Monolithic and Layered Zirconia Crowns on Discolored Substrates. MATERIALS 2022; 15:ma15062233. [PMID: 35329684 PMCID: PMC8949301 DOI: 10.3390/ma15062233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/04/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022]
Abstract
There is scarce information on the colorimetric behavior of monolithic and layered zirconia crowns in combination with various abutment colors. This study evaluated the masking ability on discolored substrates of monolithic and layered zirconia crowns. Anterior crowns were fabricated using 3Y-TZP zirconia and layering ceramic and divided into three groups: monolithic (ML), bi-layer (BL), and tri-layer (TL). The crowns were placed over eleven substrates (ND1-ND9, zirconia, metal), and CIE L*, a*, b*, C*, and h° color coordinates were measured in the cervical, middle, and incisal areas with a spectrophotometer. Masking ability was calculated using the color difference formula, and values were interpreted according to the perceptibility and acceptability thresholds. Data were analyzed statistically (α = 0.001). The L* coordinate was not significantly different between BL and TL crowns, regardless of the measurement area or substrate (p ≥ 0.001). In the middle area, the L* coordinate of the ML group was statistically different from the BL and TL groups only for zirconia and metal substrates, while in the incisal area, only for ND7 and metal substrates. The a* coordinate was significantly different between the ML and layered crowns for all measurement areas and substrates (except zirconia). The b* and C* coordinates differed significantly between the groups only in the cervical area (p < 0.001). The ML crown had better masking ability than the BL and TL crowns. However, the color differences for ML crowns were below the acceptability threshold for ND2, ND3, and ND7 substrates in the cervical and middle areas and below perceptibility threshold only for the incisal area. The lowest masking ability of the crowns was found for ND9 and metal substrates in all measurement areas.
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Corcodel N, Herpel C, Rammelsberg P, Rion K, Seceleanu I. Effect of grinding on the optical properties of monolithic zirconia. J ESTHET RESTOR DENT 2022; 34:942-950. [PMID: 35274430 DOI: 10.1111/jerd.12898] [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: 12/19/2021] [Revised: 02/14/2022] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this study was to analyze the color infiltration in monolithic zirconia after grinding, which plays an essential role in the color stability of restorations after occlusal adjustment. METHODS One hundred and eight white zirconia plates (36 Dentsply Sirona-Cercon high translucency [C], 36 Zirkonzahn-Prettau [P], 36 Zirkonzahn-Prettau anterior [Pa]) were stained by infiltration with target colors Vita A2, A3.5, and A4. In a standardized experimental setup, all plates were grinded in nine successive steps (from baseline to 500 μm), and color was measured with a spectroradiometer at each grinding step. Color differences ΔE00 between initial color and after each grinding step were calculated. The data was analyzed using regression, Kruskal-Wallis test, inverse prediction, and simultaneous 95%-confidence intervals. RESULTS Grinding had a significant effect on color stability across all zirconia types and target colors (p < 0.001). At each cut level and target color, ΔE00 means for groups C, P, and Pa were statistically different (p < 0.05). Among the three zirconia types, Pa had the lowest ΔE00 mean score for cut levels 20-100 μm for A2 and between 50 and 300 μm for A3.5 and A4. For all other cut levels, differences between Pa and P were not significant (α = 0.05). C had the largest mean ΔE00 except for A4 until 100 μm, where it was second best. CONCLUSION Zirconia type had a significant effect on the color infiltration depth across all target colors. Pa showed the best color stability until 150 μm material reduction, whereas C presented significantly less color stability than the other two zirconia materials. CLINICAL SIGNIFICANCE Color stability is important for minimizing the risk of restoration failure due to unacceptable color changes after grinding. Pa is less susceptible to color change and has an additional buffer of 60 μm until exceeding the color acceptability threshold. When higher flexural strength is needed, P is to be preferred.
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Affiliation(s)
- Nicoleta Corcodel
- Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Christopher Herpel
- Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Germany
| | - Kevin Rion
- Department of Mathematics, Bridgewater State University, Bridgewater, Massachusetts, USA
| | - Irina Seceleanu
- Department of Mathematics, Bridgewater State University, Bridgewater, Massachusetts, USA
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Effect of surface treatment and surface region on the color stainability of a cemented high-translucency monolithic zirconia ceramic after coffee thermocycling. J Prosthet Dent 2022; 127:767.e1-767.e7. [DOI: 10.1016/j.prosdent.2022.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/21/2022]
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Zhang CN, Zhu Y, Zhang YJ, Jiang YH. Clinical esthetic comparison between monolithic high-translucency multilayer zirconia and traditional veneered zirconia for single implant restoration in maxillary esthetic areas: Prosthetic and patient-centered outcomes. J Dent Sci 2022; 17:1151-1159. [PMID: 35784115 PMCID: PMC9236935 DOI: 10.1016/j.jds.2022.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/14/2022] [Indexed: 11/19/2022] Open
Abstract
Background/purpose Clinical esthetic evidence for the performance of monolithic high-translucency multilayer zirconia is lacking. The aim of this study was to compare monolithic high-translucency multilayer zirconia with traditional veneered zirconia in clinical situation. Material and methods A total of 30 participants who were provided with both monolithic zirconia crowns (Group 1) and traditional veneered crowns (Group 2) for single implant restoration in maxillary esthetic areas were enrolled. Patients' subjective outcome (Visual Analog Scale, VAS) were recorded. Photos were taken and then evaluated by 9 evaluators with Pink and White Esthetic Score (WES). Wilcoxon signed rank test was used for comparison between Group 1 and Group 2 in VAS, WES and five variables in WES. Kendall's coefficient of concordance test was used to calculate inter-rater reliability of WES variables. Spearman correlation was used to analyze association between patients' outcome and evaluators' scores. Results There was no significant difference in patients' subjective outcome between monolithic zirconia and traditional veneered crowns: overall VAS were 9.0 (8.0–9.0) and 9.0 (8.5–9.5), respectively (P > 0.05). However, in professional view, significant difference between Group 1 and Group 2 in WES was observed: 7.5 (6.0–8.0) and 8.0 (6.5–8.5), respectively (P < 0.05). Kendall's test showed, among WES variables, translucency demonstrated the highest agreement. Professionally reported evaluations did not correlate with patient-reported outcomes (Spearman correlation were 0.246 and 0.224 for Group 1 and Group 2, respectively). Conclusion Within the limitation of this study, it can be concluded that monolithic high-translucency multilayer zirconia restoration might be a treatment modality.
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Affiliation(s)
- Chu-Nan Zhang
- Department of Implant Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yu Zhu
- Department of Implant Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yi-Jie Zhang
- Department of Implant Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yin-Hua Jiang
- Department of Oral and Maxillofacial Implantology, Lishui People’s Hospital, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Corresponding author. Department of Oral and Maxillofacial Implantology, Lishui People's Hospital, The Sixth Affiliated Hospital of Wenzhou Medical University, No. 15 Dazhong Road, Lishui, 323000, China. Fax: +86 0578 2187120.
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Effects of thickness of different types of high-translucency monolithic multilayer precolored zirconia on color accuracy: An in vitro study. J Prosthet Dent 2021; 126:587.e1-587.e8. [PMID: 34446291 DOI: 10.1016/j.prosdent.2021.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM High-translucency monolithic multilayer precolored zirconia provides acceptable esthetics and eliminates chipping of the veneering porcelain. However, the color is not always consistent with the standard Vita shade guide, and the color saturation may vary with the thickness of the zirconia. PURPOSE The purpose of this in vitro study was to characterize the effect of thickness on the color accuracy of high-translucency monolithic multilayer precolored zirconia. MATERIAL AND METHODS Plate-shaped (20×20 mm) Vita A2 shade high-translucency monolithic multilayer precolored zirconia specimens of 3 types (SHT Multilayer, AT Multilayer, and 3D Multilayer) in 4 thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were fabricated (N=120, n=10). A spectrophotometer was used to measure the color attributes (CIELab) against gray or A2 substrates to evaluate the color accuracy based on differences in color (ΔE) (versus the Vita shade guide) and chroma. Statistical analysis was performed by using the Pearson correlation, 2-way ANOVA, and post hoc Scheffé test (α=.05). RESULTS Against gray substrates, thickness was significantly positively correlated with all color attributes. Against A2 substrates, L∗ values increased with an increase in thickness; however, a∗, b∗, and chroma values remained stable. Zirconia with a thickness of 1.0 mm exhibited the lowest ΔE, regardless of the type, except for AT Multilayer against A2 substrates, where the lowest ΔE was achieved at 0.5 mm. At thicknesses ≥1.0 mm, the ΔE between the 2 substrates was imperceivable. CONCLUSIONS Thickness affected the color accuracy of different high-translucency monolithic multilayer precolored zirconia types. It appears that the optimal thickness in terms of color accuracy is 1.0 mm. These results could be used as a reference for the selection and preparation of abutments in clinical applications.
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Manziuc MM, Gasparik C, Burde AV, Dudea D. Color and masking properties of translucent monolithic zirconia before and after glazing. J Prosthodont Res 2021; 65:303-310. [PMID: 33116028 DOI: 10.2186/jpr.jpr_d_20_00039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose 1. to assess the ability of four brands of translucent monolithic zirconia with different thicknesses to mask discolored substrates; 2. to assess the influence of glazing upon their color coordinates and masking properties.Methods Sixty samples of shade A1 (0.8, 1.5, and 2.0 mm thickness) from: ZirCAD/MT, Katana/HT, Vita YZ/HT, Cercon/HT were fabricated and glazed using a standardized laboratory procedure. CIE L*a*b* parameters were recorded on composite substrates, (IPS Natural Die Material Kit) (ND1=reference; ND2, ND3, ND4, ND5=test backgrounds), before and after glazing. The color changes of zirconia samples induced by glazing were analyzed. Masking properties was calculated as the color difference between CIE L*a*b* parameters of the samples placed on reference and test substrates with CIEDE2000(1:1:1) formula. The effect of material, thickness, substrate, and glazing on the color of monolithic zirconia was analyzed with ANOVA test and the multiple comparisons were analyzed with Tukey HSD tests (α=0.05).Results After glazing, lightness L* significantly increased, while chromatic coordinates a* and b* decreased (p<0.05). Significant differences in the masking properties of the four materials (p<0.001) were found, with IPS e.max ZirCAD/MT having the lowest masking effect (p<0.001). Thickness, substrate and glazing had a significant effect on the color masking properties of monolithic zirconia (p<0.001).Conclusions Masking properties of translucent zirconia were significantly influenced by the materials, the thickness and the color of the substrate; moreover, glazing improved the masking ability for all zirconia samples.
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Affiliation(s)
- Manuela Maria Manziuc
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristina Gasparik
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Victor Burde
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Dudea
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Patient Satisfaction with Implant-Supported Monolithic and Partially Veneered Zirconia Restorations. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6692939. [PMID: 33628810 PMCID: PMC7884129 DOI: 10.1155/2021/6692939] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/03/2021] [Accepted: 01/30/2021] [Indexed: 12/22/2022]
Abstract
The digital workflow and the application of Computer-Aided Manufacturing (CAM) to prosthodontics present the clinician with the possibility of adopting new materials that confer several advantages. Especially in the case of zirconia, these innovations have profoundly changed daily practice. This paper compares the satisfaction and perception of patients who received implant-supported single crowns (SC) and fixed partial dentures (FPD) made from zirconia, either monolithic or partially veneered, after 3 years of follow-up; the success and survival rate of these restorations were also measured. Forty patients, who had been previously treated with implant-supported SC or FPD, either monolithic or partially veneered, and submitted to a yearly maintenance program, were recalled 3 years after their treatment and requested to complete an 8-question questionnaire regarding their perceptions of the treatment. Any mechanical or biological complication that had occurred from the time of delivery was also recorded. Patients that experienced ≥1 complication were less likely to be prone to repeat the treatment. The 3-year success rate was 92.6% for monolithic restoration and 92.3% for partially veneered restoration, while the survival rate was 100% for both restorations. The 3-year follow-up found that monolithic and partially veneered zirconia restorations are both well-accepted treatment options, and patients preferred the veneered restorations (0.76, p < 0.05) from an aesthetic point of view. According to our results, monolithic and veneered zirconia restorations are both reliable treatment options and are both equally accepted by patients.
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Xia H, Xiong F. Clinical threshold of the translucency parameter of maxillary central incisors. Dent Mater J 2020; 40:547-551. [PMID: 33361662 DOI: 10.4012/dmj.2020-137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this in vivo study is to describe the clinical threshold and relative factors associated with the translucency of maxillary central incisors. Bilateral maxillary central incisors were measured in 106 individuals using a digital colorimeter against black and white backings. The translucency parameters (TP) of incisors and the difference in TP (ΔTP) between the left and right maxillary central incisors of the same individual was calculated. The mean TP value of the maxillary incisors was 8.22. There was a significant effect of age on the translucency of the maxillary central incisors (p<0.05). The TP of females was higher than that of males (p<0.05). The absolute mean value of ΔTP was 1.33. The ΔTP of the two maxillary central incisors in the same individual can be used as a reference for the threshold value of translucency.
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Affiliation(s)
- Hui Xia
- Department of Maxillofacial Surgery, State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Fang Xiong
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
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Al-Zordk W, Saker S. Impact of sintering procedure and clinical adjustment on color stability and translucency of translucent zirconia. J Prosthet Dent 2020; 124:788.e1-788.e9. [DOI: 10.1016/j.prosdent.2020.05.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 10/23/2022]
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Saker S, Özcan M. Effect of surface finishing and polishing procedures on color properties and translucency of monolithic zirconia restorations at varying thickness. J ESTHET RESTOR DENT 2020; 33:953-963. [PMID: 33188586 DOI: 10.1111/jerd.12681] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/12/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to assess the impact of monolithic zirconia thickness on its color properties after different surface finishing and polishing procedures, and following aging in coffee solution. MATERIALS AND METHODS Two types of monolithic zirconia brands [Prettau Anterior (PA) and DD Cubex2 (DDC)] with three different thicknesses: 0.5, 1, and 1.5, and 10 mm diameter were tested. The color properties were evaluated after various surface finishing procedures (glazing, adjusting with burs + glaze, polishing, adjusting with burs + polishing) and after 5,000 cycles in a coffee solution were evaluated. The differences in color (ΔE) and translucency, were calculated and statistically analyzed by three-way ANOVA and pairwise comparison (α = 0.05). RESULTS The brand, material thickness, and surface finishing protocol before and after coffee thermocycling had significant effect on color variations (p < 0.001). For translucency, 3-way ANOVA revealed a significant interaction between the material thickness and surface finishing protocol following aging in coffee solution (p < 0.001), however no significant interaction was observed following the surface finishing protocols (p = 0.247). CONCLUSIONS The optical properties of monolithic zirconia ceramics can be influenced by the material brand, material thickness and the procedure of surface finishing and polishing. CLINICAL SIGNIFICANCE Clinicians should take into consideration the potential change of the color properties of monolithic zirconia restorations following both contouring and occlusal adjustment procedures and coffee intake.
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Affiliation(s)
- Samah Saker
- Department of Fixed Prosthodontics, Mansoura University, Mansoura, Egypt
| | - Mutlu Özcan
- Division of Dental Biomaterials, Center for Dental and Oral Medicine, Clinic for Reconstructive Dentistry, University of Zürich, Zürich, Switzerland
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Valizadeh S, Mahmoudi Nahavandi A, Daryadar M, Özcan M, Hashemikamangar SS. The effect of ceramic thickness on opalescence. Clin Exp Dent Res 2020; 6:693-699. [PMID: 32902165 PMCID: PMC7745071 DOI: 10.1002/cre2.325] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives Creating a tooth‐like appearance by use of dental ceramics is still a challenge. Opalescence is a unique property of dental enamel, attempted to be mimicked by dental restorative materials. This study aimed to assess the effect of ceramic thickness on opalescence. Materials and methods Twenty‐four discs were fabricated of feldspathic ceramic, IPS e.max, zirconia and Enamic ceramics with 10 mm diameter and 0.5 and 1 mm thicknesses (n = 12). The opalescence of ceramic specimens was calculated by measuring the difference in yellow‐blue axis (CIE ∆b*) and red‐green axis (CIE ∆a*) between the transmitted and reflected spectra. One‐way ANOVA was applied to compare the opalescence of different ceramic specimens with variable thicknesses at .05 level of significance. Results The opalescence of feldspathic, IPS e.max, zirconia and Enamic ceramic specimens with 0.5 mm thickness was 1.06 ± 0.15, 3.39 ± 0.15, 1.98 ± 0.15 and 1.44 ± 0.15, respectively. By increasing the thickness to 1 mm, the opalescence of feldspathic, IPS e.max, zirconia and Enamic ceramics changed to 1.12 ± 0.15, 1.47 ± 0.15, 3.85 ± 0.15 and 2.00 ± 0.15, respectively. In all groups except for IPS e.max, the mean opalescence of 1‐mm‐thick specimens was higher than that of 0.5‐mm‐thick specimens. Conclusion Type and thickness of ceramic affect its opalescence. The opalescence of all ceramic specimens tested in this study with 0.5 and 1 mm thicknesses was lower than that of the enamel.
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Affiliation(s)
- Sara Valizadeh
- Dental Research Center, Dentistry Research Institute, Restorative Dentistry Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mahmoudi Nahavandi
- Color Imaging and Color Image Processing Department, Institute for Color Science and Technology (ICST), Tehran, Iran
| | - Marzieh Daryadar
- Restorative Dentist, Tehran University of Medical Sciences, Tehran, Iran
| | - Mutlu Özcan
- Division of Dental Biomaterials, Center for Dental and Oral Medicine, Clinic for Reconstructive Dentistry, University of Zürich, Zurich, Switzerland
| | - Sedighe Sadat Hashemikamangar
- Dental Research Center, Dentistry Research Institute, Department of Operative Dentistry, Dental School, Tehran University of Medical Sciences, Tehran, Iran
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Sulaiman TA, Rodgers B, Suliman AA, Johnston WM. Color and translucency stability of contemporary resin‐based restorative materials. J ESTHET RESTOR DENT 2020; 33:899-905. [DOI: 10.1111/jerd.12640] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Taiseer A. Sulaiman
- Division of Comprehensive Oral Health University of North Carolina, Adams School of Dentistry Chapel Hill North Carolina USA
| | - Brandon Rodgers
- Division of Comprehensive Oral Health University of North Carolina, Adams School of Dentistry Chapel Hill North Carolina USA
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Kang CM, Peng TY, Shimoe S. Color accuracy of different types of monolithic multilayer precolored zirconia ceramics. J Prosthet Dent 2020; 124:789.e1-789.e7. [PMID: 32778469 DOI: 10.1016/j.prosdent.2020.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM The use of monolithic multilayer precolored zirconia facilitates the production of esthetic restorations in a convenient and straightforward manner. However, the accuracy of the final color is not clear. PURPOSE The purpose of this in vitro study was to determine the color accuracy of different types of monolithic multilayer precolored zirconia ceramics of varying thicknesses. MATERIAL AND METHODS Eighty cubical A2-shade monolithic multilayer precolored zirconia ceramic specimens (15×15 mm) of 2 different thicknesses (1.0 mm and 1.5 mm) and 4 zirconia brands (UPCERA EXPLORE [UPEX], KATANA Zirconia STML [STML], Enamel ZR Multi-5 [EZM5], and Aidite 3D Pro Zir [A3DM]) were fabricated and divided into 8 groups (n=10). The Commission Internationale de l'Eclairage (CIELab) values were measured against 3 different backing substrates (gray, transparent, and A2) by using a spectrophotometer. The color difference (ΔE) between the backing substrates of each group and the Vita A2 Shade Guide, translucency parameter (TP), and chroma (C) values were calculated to evaluate the accuracy of the final color. Statistical analysis was performed by using ANOVA and the post hoc Tukey HSD tests (α=.05). RESULTS The ΔE values for UPEX and STML exceeded the clinically acceptable thresholds for gray and transparent backing substrates (ΔE>3.7) and were higher than those for the A2 backing substrate. A3DM showed less ΔE from the shade guide for all the backing substrates (P<.05), and the corresponding ΔE values were within the clinically acceptable threshold (ΔE<3.7). The TP value was inversely proportional, and the C value was proportional to thickness. For the zirconia ceramics with identical thicknesses, UPEX and STML exhibited the highest TP values, and A3DM showed the lowest C value (P<.05). CONCLUSIONS At a specific thickness, color accuracy was mainly affected by the type of monolithic multilayer precolored zirconia ceramic, and the high transparency of ceramics will cause color differences.
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Affiliation(s)
- Chien-Ming Kang
- Dental Technician, Huayi Dental Laboratory, Taipei, Taiwan, Republic of China
| | - Tzu-Yu Peng
- Research Assistant, Department of Anatomy and Functional Restorations, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan; Postdoctoral Researcher, School of Dentistry, College of Dentistry, China Medical University, Taichung, Taiwan, Republic of China
| | - Saiji Shimoe
- Associate Professor, Department of Anatomy and Functional Restorations, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
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Papageorgiou-Kyrana K, Fasoula M, Kontonasaki E. Translucency of Monolithic Zirconia after Hydrothermal Aging: A Review of In Vitro Studies. J Prosthodont 2020; 29:489-500. [PMID: 32275345 DOI: 10.1111/jopr.13174] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Recent modifications in composition, structure, and fabrication methods have led to monolithic zirconia ceramics of superior translucency. However, during aging, intrinsic microstructural features, such as grain boundaries and pores, may affect light scattering and consequently the translucency of zirconia. The aim of this study was to systematically review if hydrothermal aging affects the translucency of monolithic zirconia. MATERIALS AND METHODS An electronic search in Medline and Scopus was conducted to identify the effect of hydrothermal aging on the translucency of zirconia. The search was limited to English-language publications and in vitro studies. The following search terms were used alone or in combination: "monolithic zirconia," "full contour zirconia," "Y-TZP zirconia," "tetragonal zirconia," "cubic zirconia," "aging," "hydrothermal aging," "steam autoclave," "translucency," "translucency parameter," and "contrast ratio." From the titles found after searching the electronic databases, only 10 articles met the inclusion criteria and were included in this review. The translucency parameter or total transmittance was used to extract data from the studies. RESULTS Aging reduced the translucency of monolithic zirconia in most of the studies; however, the differences varied according to the brand tested and the microstructure and thickness of the specimens. The thinner specimens presented higher translucency alterations. Although in all studies a change in translucency was recorded, its mean values suggest that the differences are within the acceptability threshold in most cases, independent of the color system used to calculate translucent parameter, so they are clinically undetectable. For longer aging times, beyond the perspective clinical life of the restorations, the change in translucency is higher than the acceptability threshold. CONCLUSIONS There is a controversy regarding how aging affects the translucency of monolithic zirconia ceramics; however, this may not be clinically important, as in most cases, changes (either decrease or increase) in translucency were within the acceptability thresholds.
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Affiliation(s)
| | - Maria Fasoula
- Postgraduate Student, Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleana Kontonasaki
- Associate Professor, Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Öztürk C, Çelik E, Özden AN. Influence of bleaching agents on the color change and translucency of resin matrix ceramics. J ESTHET RESTOR DENT 2020; 32:530-535. [PMID: 32180345 DOI: 10.1111/jerd.12580] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/04/2020] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the color change, translucency, and whiteness index of three different resin matrix ceramics and a resin composite subjected to different bleaching agents. MATERIALS AND METHODS Twenty disc-shaped specimens (A2 shaded) for three different resin matrix ceramic brands (Groups Ena, Ulti, and Cera) (totally 60) were prepared using the CAD/CAM technique and 20 nanofiller composite specimens (Group Comp) (A2 shaded) with the same dimensions were prepared as the control group. The color change (∆E00 ), relative translucency parameter (RTP), and whiteness index (WID ) of the specimens initial and after different bleaching procedures (home-bleaching and office-bleaching) were calculated using ∆E00 , TP00 , and WID formulas. Two-way analysis of variance (ANOVA) and multiple comparison test with Bonferroni correction (α = .05) at the significance level of P < .05 were performed for the comparisons of ∆E00 values. The RTP and WID values were evaluated by using repeated measures ANOVA and multiple-comparison test with Bonferroni corrections (α = .05) at the significance level of P < .05. RESULTS Bleaching procedure and material type were found to be significant regardless of bleaching type for RTP and WID values. Material type has a significant effect on the ∆E00 values. The highest color change values were determined in Group Comp (P < .05). CONCLUSIONS Bleaching procedures significantly affected the RTP values of Groups Ulti and Cera (P < .05). ∆E00 values for the resin matrix ceramics after the bleaching procedures were below the clinically acceptable values, regardless of the bleaching agent. CLINICAL SIGNIFICANCE Optically, materials such as resin matrix ceramics have properties different from not only enamel and dentin but also among themselves. The possible effect of bleaching agents on these materials should be considered carefully while choosing the restorative material.
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Affiliation(s)
- Caner Öztürk
- Department of Prosthodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Antakya, Turkey
| | - Ersan Çelik
- Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Asiye Nehir Özden
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
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Lee JH, Kim SH, Yoon HI, Yeo ISL, Han JS. Colour stability and surface properties of high-translucency restorative materials for digital dentistry after simulated oral rinsing. Eur J Oral Sci 2020; 128:170-180. [PMID: 32032452 DOI: 10.1111/eos.12676] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2019] [Indexed: 12/17/2022]
Abstract
High-translucency restorative materials are commonly used in the restoration of anterior teeth where aesthetics is a critical factor. In this in vitro study, the impact of mouthwash on the colour stability and surface characteristics of high-translucency computer-aided design and computer-aided manufacturing (CAD-CAM) dental restorative materials was evaluated. Two-hundred specimens were fabricated from five high-translucency CAD-CAM materials: a resin nano ceramic; a polymer-infiltrated ceramic network; a feldspathic ceramic; a lithium disilicate glass ceramic; and high-translucency zirconia. Each group of ceramic specimens was then divided into four subgroups: conventional mouthwash (LISTERINE); whitening mouthwash (LISTERINE Healthy White); chlorhexidine gluconate; and distilled water. Oral rinsing was simulated at 100 rpm for 180 h, representing 15 yr of clinical simulation. The specimens were then evaluated for colour, translucency, gloss, roughness, and surface morphology. Two-way ANOVA and linear mixed models were used for intergroup comparisons (α = 0.05). The polymer-infiltrated ceramic network and feldspathic ceramic became brighter, more opaque, less glossy, and rougher after rinsing with the whitening mouthwash. The long-term use of specific mouthwashes can cause deterioration of the optical and surface properties of high-translucency CAD-CAM dental restorations.
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Affiliation(s)
- Jae-Hyun Lee
- Department of Prosthodontics, One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, South Korea
| | - Sung-Hun Kim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Hyung-In Yoon
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - In-Sung L Yeo
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Jung-Suk Han
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
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Lebedenko IY, Dyakonenko EE, Sakhabieva DA, Llaka E. [Translucent zirconia ceramics for fabrication monolithic restorations: review. Part 2]. STOMATOLOGIIA 2020; 99:101-106. [PMID: 33267553 DOI: 10.17116/stomat202099061101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Translucent zirconia ceramics for fabrication monolithic restorations is a ceramic material of latest generation. The objective of this literature review is discussing the ways to increase the transparency of zirconia, novel technologies of its manufacturing (part 1) and laboratory procedures for fabrication translucent zirconia restorations, factors affecting the transparency, optical and physico-mechanical properties of the material, as well as indications for its use (part 2).
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Affiliation(s)
- I Yu Lebedenko
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
- Peoples' Friendship University of Russia, Moscow, Russia
| | - E E Dyakonenko
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - D A Sakhabieva
- Peoples' Friendship University of Russia, Moscow, Russia
| | - E Llaka
- Peoples' Friendship University of Russia, Moscow, Russia
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Mezied M, Alqahtani F. The effect of in vitro aging on the color stability of cubic and tetragonal zirconia materials. SAUDI JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.4103/sjos.sjoralsci_26_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Clinical factors affecting the translucency of monolithic Y-TZP ceramics. Odontology 2019; 108:526-531. [DOI: 10.1007/s10266-019-00446-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
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Manziuc M, Gasparik C, Burde AV, Colosi HA, Negucioiu M, Dudea D. Effect of glazing on translucency, color, and surface roughness of monolithic zirconia materials. J ESTHET RESTOR DENT 2019; 31:478-485. [DOI: 10.1111/jerd.12493] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/11/2019] [Accepted: 05/20/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Manuela‐Maria Manziuc
- Department of Prosthetic Dentistry and Dental MaterialsIuliu Hatieganu University of Medicine and Pharmacy Cluj‐Napoca Romania
| | - Cristina Gasparik
- Department of Prosthetic Dentistry and Dental MaterialsIuliu Hatieganu University of Medicine and Pharmacy Cluj‐Napoca Romania
| | - Alexandru V. Burde
- Department of Prosthetic Dentistry and Dental MaterialsIuliu Hatieganu University of Medicine and Pharmacy Cluj‐Napoca Romania
| | - Horaţiu A. Colosi
- Department of Medical Informatics and BiostatisticsIuliu Hatieganu University of Medicine and Pharmacy Cluj‐Napoca Romania
| | - Marius Negucioiu
- Department of Prosthetic Dentistry and Dental MaterialsIuliu Hatieganu University of Medicine and Pharmacy Cluj‐Napoca Romania
| | - Diana Dudea
- Department of Prosthetic Dentistry and Dental MaterialsIuliu Hatieganu University of Medicine and Pharmacy Cluj‐Napoca Romania
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