Effect of acidic agents on the wear behavior of a polymer infiltrated ceramic network (PICN) material

Aging processes in dental thermoplastics - Thermoanalytical investigations and effects on Vickers as well as Martens hardness

OBJECTIVE

The influence of various aging protocols, representing and accelerating influences present in the dental context, on possible changes in the microstructure and mechanical properties of thermoplastics was investigated. In order to minimize the complexity of the systems, first pure polymers and then later the equivalent dental polymeric materials were analyzed.

MATERIALS AND METHODS

Pure polymers (Poly(methyl methacrylate) - PMMA, Polyoxymethylene homopolymer - POM-H, Polyether ether ketone - PEEK, Nylon 12 - PA12, Polypropylene - PP) were analyzed before as well as after applying different aging protocols relevant to the oral environment (ethanol, thermocycling, alkaline and acidic setting) by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). The thermoanalytical parameters used were glass transition temperature (Tg), melting peak and crystallization peak temperature (Tpm, Tpc) and decomposition behavior. In a second step selected commercially available dental products (Telio CAD - PMMAD, Zirlux Acetal - POMD, Juvora Natural Dental Disc - PEEKD) aged by the protocol that previously showed strong effects were examined and additionally tested for changes in their Vickers and Martens hardness by Mann-Whitney-U test.

RESULTS

The combinations of pure polymers and viable aging protocols analyzed within this study were identified via TGA or DSC as PA12 & thermocycling, POM-H & denture cleanser/lactic acid/ethanol, PP & lactic acid. The dental polymeric materials PMMAD and POMD due to aging in lactic acid showed slight but significantly (p < 0.01) reduced Vickers and partly Martens hardness. PEEK showed the greatest material resistance within this study.

Effects of erosion and abrasion on resin-matrix ceramic CAD/CAM materials: An in vitro investigation

The aim of the study was to evaluate the effects of erosion and abrasion on resin-matrix ceramic CAD/CAM materials [CERASMART (GC); VITA ENAMIC (VITA Zahnfabrik); Lava Ultimate (3 M)] in comparison to feldspar ceramic (VITABLOCS Mark II, VITA Zahnfabrik) and resin composite materials (ceram.x universal, Dentsply Sirona). Daily brushing and acid exposure were simulated using a brushing apparatus and a solution of 0.5 vol% citric acid. Microhardness, surface roughness, and substance loss were measured at baseline and after simulation of 1 and 3 years of function. All materials showed a decrease in microhardness after 3 years and an increase in surface roughness (Ra) after 1 and 3 years. The Ra increase was statistically significantly lower for the resin-matrix ceramics than for feldspar ceramic and similar to composite material. After 3 years, only feldspar ceramic showed no significant substance loss. In conclusion, resin-matrix ceramics demonstrate reduced roughening compared to feldspar ceramics, potentially improving restoration longevity by preventing plaque buildup, but differences in abrasion resistance suggest the need for further material-specific research. Future research should aim to replicate clinical conditions closely and to transition to in vivo trials.

Comparative study on the impact-sliding wear behaviour of CAD/CAM resin-ceramic materials and tooth enamel

OBJECTIVES

To compare the impact-sliding wear of different CAD/CAM resin-ceramic materials and tooth enamel, and explore the corresponding wear damage mechanism.

METHODS

Human tooth enamel (EN), Vita ENAMIC (Vita, VE), Lava Ultimate (3 M, LU), and GC CERASMART (GC, CS) were used in this study. The hardness, elastic modulus, and roughness values of the samples were measured. Further, impact-sliding wear tests were performed in a ball-on-flat configuration with spherical zirconia antagonists and the coefficients of friction (CoF) were recorded simultaneously. Additionally, a white light interferometer was used to determine the volume losses and scanning electron microscopy was used to observe the wear morphology of the wear scars and the damage feature in the vertical sections to clarify the damage mechanism during the impact-sliding wear test.

RESULTS

EN exhibited the highest elastic modulus and CoF, followed by VE, LU, and CS. The hardness and roughness of EN and VE were similar and were higher than those of LU and CS. Throughout the wear tests, VE exhibited the highest volume loss, whereas CS exhibited the lowest. The wear damage characteristics of VE were similar to those of EN, displaying brittle fractures of inorganic substances and plastic deformation of organic substances in the impact part, exhibiting plough marks in the sliding parts. In the case of LU and CS, the entire wear areas displayed plastic deformation of the resin matrix, exfoliation of the filler particles, and plough marks.

SIGNIFICANCE

Enamel and polymer-infiltrated ceramic network materials exhibit similar wear damage modes. Additionally, the high-density nanocomposite resin material is the most resistant to impact-sliding wear from a tribological perspective.

Effect of roughness and acidic medium on wear behavior of dental resin composite

Background

The aim of the study was to investigate whether the citric acid and rough surface have a synergistic effect leading to severe wear behavior of resin composite.

Materials and methods

Disk-shaped (Ø15 × 1.5 mm) specimens of resin composite (n = 12) with different initial roughness were prepared. Reciprocating ball-on-flat wear tests were performed under distilled water and citric acid (pH = 5.5) respectively. The coefficient of friction (COF), wear volume loss, and duration of the running-in period were quantified to assess the wear performance. And the values were analyzed with one-way ANOVA (α = 0.05). Regression analysis was applied to examine the influence of Ra values and mediums on the wear data. The wear morphology was analyzed by scanning electron microscopy and a 3D profilometer.

Results

The average COF was higher in distilled water than in citric acid but was independent of the surface roughness. For the composite, the volume loss of worn area and running-in period increased with surface roughness when tested under distilled water. However, these increasing trends were not found in citric acid. All specimens exhibited mild wear behavior with low COF and less superficial abrasion in acidic medium.

Conclusions

The effect of initial roughness on wear behavior depends on the medium. In distilled water, resin composites with high initial roughness exhibit a longer running-in time, which eventually leads to a significant increase in material loss. The adverse effects of high roughness can be alleviated by the lubrication of citric acid, which can maintain a mild wear behavior regardless of initial surface roughness.

Effects of Streptococcus mutans and their metabolites on the wear behavior of dental restorative materials

The wear behavior of dental restorative materials is highly related to the biolubricating medium in the oral environment. Bacteria, along with their metabolic products, are essential substances in the oral cavity and have not been studied as a potential factor affecting lubrication performance during mastication. In this study, the effects of the Streptococcus mutans bacterial cells and their metabolites were investigated on the wear behavior of resin composites, polymer-infiltrated ceramic networks and zirconium-lithium silicate glass-ceramics. A reciprocating friction test and quantitative analysis of the wear morphology were utilized to determine the coefficient of friction (COF) and wear resistance of the test materials. The results showed that the bacterial metabolite medium significantly reduces the COF and wear rate of the three restorative materials and provide better protection against superficial abrasion. When tested under lactic acid medium, a key acid production in bacterial metabolites, similar wear reduction results were observed in the three materials, which confirmed that lactic acid should be accountable for the excellent lubricating property of bacterial metabolites. Furthermore, the resin composite with lower wettability exhibited a more significant wear reduction than the other two materials when lubricating with a bacterial metabolite medium. These findings provide novel insights into the biological basis of lubrication mechanisms in the oral cavity under high-loading and low-velocity conditions.

Effect of Erosive Agents on Surface Characteristics of Nano-Fluorapatite Ceramic: An In-Vitro Study

Erosive beverages cause dissolution of natural teeth and intra-oral restorations, resulting in surface characteristic changes, particularly roughness and degradation. The purpose of this study was to evaluate the surface roughness and topography of a dental ceramic following immersion in locally available erosive solutions. A total of 160 disc specimens of a nano-fluorapatite type ceramic (12 mm diameter and 2 mm thickness) were fabricated and equally distributed into two groups (n = 80) and then evenly distributed among the following five testing groups (n = 16): lemon juice, citrate buffer solution, 4% acetic acid, soft cola drink, and distilled water which served as a control. The surface roughness (Ra) and topography were evaluated using a profilometer and scanning electron microscope at baseline, 24 h, 96 h, and 168 h respectively. Data were analyzed using ANOVA and Tukey’s multiple comparisons (p ≤ 0.05). Surface changes were observed upon exposure to all acidic beverages except distilled water. Amongst all immersion media, 4% acetic acid produced the most severe surface roughness across all time periods (i.e., baseline, 24 h, 96 h, and 168 h). A statistically significant difference in the surface roughness values between all immersion media and across all four time intervals was observed. Erosive agents had a negative effect on the surface roughness and topography of the tested ceramic. The surface roughness increased with increased storage time intervals.

Wear of Polymer-Infiltrated Ceramic Network Materials against Enamel

Polymer-infiltrated ceramic network materials (PICNs) have high mechanical compatibility with human enamel. However, the wear properties of PICN against natural human enamel have not yet been clarified. We investigated the in vitro two-body wear behaviors of PICNs and an enamel antagonist. Two PICNs were used: Experimental PICN (EXP) prepared via the infiltration of methacrylate-based resin into the porous silica ceramic network and commercial Vita Enamic (ENA). Two commercial dental ceramics, lithium disilicate glass (LDS) and zirconia (ZIR), were also characterized, and their wear performance was compared to PICNs. The samples were subjected to Vickers hardness tests and two-body wear tests that involve the samples being cyclically impacted by enamel antagonists underwater at 37 °C. The results reveal that the Vickers hardness of EXP (301 ± 36) was closest to that of enamel (317 ± 17). The volumetric wear losses of EXP and ENA were similar to those of LDS but higher than that of zirconia. The volumetric wear loss of the enamel antagonist impacted against EXP was moderate among the examined samples. These results suggest that EXP has wear behavior similar to that of enamel. Therefore, PICNs are mechanically comparable to enamel in terms of hardness and wear and are excellent tooth-restoration materials.

Wear resistance of crowns made from different CAM/CAD materials

OBJECTIVES

The aim of this laboratory study was to evaluate the wear resistance of crowns made from current computer-aided design and computer-aided manufacture (CAD/CAM) materials. In addition, the abrasion of the steatite antagonist against these materials was compared.

METHODS

Identically shaped crowns of lithium disilicate, zirconia-reinforced lithium disilicate and a polymer-infiltrated ceramic network (PICN) were fabricated with an occlusal thickness of 1.5mm and a lateral wall thickness of 1.2mm (n=8). The crowns were cemented with a dual-polymerizing luting resin on composite resin dies. Using spherical steatite antagonists, all specimens were loaded with 49N for 1,200,000 cycles in a mastication simulator with additional thermocycling. After 120,000, 240,000, 480,000, 960,000, and 1,200,000 cycles, precision impressions were made and investigated with a laser scanning microscope. The vertical and volume substance loss was measured. Additionally, the substance loss of the antagonists was evaluated after 1,200,000 loading cycles.

RESULTS

No significant difference (p>0.05) was found in the median volume loss of the test materials after 1,200,000 cycles (lithium disilicate: 0.405mm³, PICN: 0.362mm³, zirconia-reinforced lithium disilicate: 0.340mm³). The vertical substance loss of PICN (157μm) was significantly lower (p≤0.05) than that of lithium disilicate (201μm) and zirconia reinforced lithium disilicate (191μm). However, the substance loss of steatite against zirconia-reinforced lithium disilicate (0.191mm³) was significantly lower (p≤0.05) than against lithium disilicate (0.296mm³) and PICN (0.531mm³).

SIGNIFICANCE

All three CAD/CAM materials showed wear resistance that seems appropriate for clinical application. Also, the abrasion of the antagonist looks promising.

Erosion of CAD/CAM restorative materials and human enamel: An in vitro study

This in vitro study used the same frequency and duration of acid contact as a previous in situ/in vivo study to evaluate the effect of erosion on CAD/CAM restorative materials and human enamel and to compare the effects of in vitro and in situ/in vivo acid challenges on CAD/CAM restorative materials and human enamel. The CAD/CAM restorative materials (IPS e.max CAD, Lava Ultimate, and PMMA block) and human enamel were eroded by immersion in 150 ml of cola drink for 14 days (4 × 5 min/day). The surface microhardness and surface roughness of the specimens were measured at baseline (T1), day 7 (T2), and day 14 (T3). The substance losses were measured at T2 and T3. The data were statistically analyzed using repeated measures ANOVA and Bonferroni's test (α = 0.05). Erosion significantly decreased the surface microhardness of the CAD/CAM restorative materials and human enamel (all P < 0.001). The overall percentage of surface microhardness loss (%SMH_l) of the PMMA block and enamel due to in vitro erosion was significantly higher than that due to in situ/in vivo erosion (P = 0.02 and P < 0.001, respectively). Consistent with in situ/in vivo erosion, the surface roughness and profile of the tested restorative materials remained unchanged after in vitro erosion. A significant increase in the surface roughness and substance loss was observed for enamel after in vitro erosion (all P < 0.001). The overall substance loss of enamel due to in vitro erosion was significantly higher than that due to in situ/in vivo erosion (P < 0.001). In conclusion, erosion decreased the surface microhardness of the CAD/CAM restorative materials and human enamel. Moreover, erosion negatively influenced the substance loss and surface roughness of human enamel. For the substance loss of enamel and %SMH_l of PMMA block and enamel, the in vitro erosive effects were approximately 1-2 times greater than the in situ/in vivo effects. However, for the surface roughness and profile of the CAD/CAM restorative materials, no significant difference was found between in vitro and in situ/in vivo erosion.

Repolishing in situ eroded CAD/CAM restorative materials and human enamel

This study aimed to evaluate the effects of repolishing on the surface microhardness (SMH), color change (ΔE), and translucency parameter (TP) of previously in situ eroded computer-aided design/computer-aided manufacturing (CAD/CAM) restorative materials and human enamel. Each of 8 volunteers wore an intraoral appliance containing 3 CAD/CAM restorative material specimens (IPS e.max CAD lithium disilicate ceramic, Lava Ultimate hybrid ceramic, and poly (methyl methacrylate) (PMMA) block) and 1 human enamel specimen. The specimens were subjected to in situ erosion cycles by rinsing with a cola drink (4 × 5 min/day) for 14 days. After erosion, the specimens were polished with a silicone polishing system (Ceramister, Shofu Inc, Kyoto, Japan). The SMH and color of the specimens were determined at baseline (T1), after erosion (T2), and after repolishing (T3). The ΔE and TP values of the specimens were further calculated. The data were statistically analyzed using repeated-measures analysis of variance (ANOVA) and Bonferroni's test (α = 0.05). After erosion, a decrease in the SMH of the restorative materials and enamel was observed (all P < 0.001), and a decrease in the TP of the enamel was observed (P = 0.016). The ΔE values of the enamel (ΔE = 7.32) and Lava Ultimate (ΔE = 3.19) exceeded the clinically unacceptable threshold after erosion. After repolishing, the SMH of the restorative materials and enamel at T3 was significantly higher than that at T2 (all P < 0.001). No significant difference was found in the TP and ΔE values of the restorative materials and enamel between T2 and T3. In conclusion, erosion negatively affected the surface properties and appearance of the CAD/CAM restorative materials and human enamel. Repolishing contributed to restoring the compromised SMH of the eroded restorative materials and enamel to a certain extent. However, repolishing did not restore the color of the eroded restorative materials and enamel.

Changes in tribological and antibacterial properties of poly(methyl methacrylate)-based 3D-printed intra-oral appliances by incorporating nanodiamonds

It is essential for 3D-printed intra-oral appliances to be able to withstand the mechanical and microbial insult existent in the harsh environment of the oral cavity. Poly(methyl methacrylate) (PMMA)-based appliances are widely used in dentistry. Hence, the present study aimed to evaluate the role of nanodiamonds (NDs) as fillers to enhance the resistance to friction and wear. Using a solution-based mixing technique, 0.1 wt% ND was incorporated into the PMMA, and specimens were 3D-printed for tribological and bacterial analysis. The control specimens without ND fillers were tested against specimens with both amine-functionalized NDs (A-ND) and pure non-functionalized NDs (ND). The surface hardness test revealed a statistically significant increase in the Vickers micro-hardness (p < 0.001) in the nanocomposite groups. There was a significant reduction in the coefficient of friction (COF) (p < 0.01) in both the ND and A-ND nanocomposites compared to the stainless steel (SS) counter surfaces. However, for titanium (Ti)-based specimens, the COF of the control group was similar to that of A-ND but lower than that of ND. The wear resistance evaluation revealed that both the ND and A-ND groups displayed enhanced resistance to surface loss in comparison to the controls for both SS and Ti counter-surfaces (p < 0.001). Furthermore, both A-ND and ND exhibited significantly enhanced resistance to the formation of Streptococcus mutans biofilms after 48 h (p < 0.01) compared to the control group. Hence, we concluded that the addition of 0.1 wt% ND in the PMMA-based resin for 3D printing resulted in significant improvement in properties such as COF, wear resistance, and resistance to S. mutans, without any notable impact associated with the functionalization of the NDs.

Effect of different pH environments on the durability of bonds between zirconia and Ti-6Al-4V

This study investigated the role played by different pH environments in the deterioration of bonds between Y-TZP and Ti-6Al-4V. One hundred and thirty-five specimens were randomly assigned to one of the following storage media at 37°C: (1) distilled water, pH 6.9, DW; (2) acidic solution, pH 1-2, CS; and (3) alkaline solution, pH 10-11, KS. Shear bond strength (SBS) tests were carried out at the 4-, 14-, and 30-day storage time intervals. The morphology characteristics and elements distribution of the fracture surfaces were analyzed. CS-30 showed the lowest mean SBS and the least amount of residual cement on the Ti-6Al-4V surface after the SBS tests. Bond strength tended to decrease with increasing storage time for the acidic group. Alkaline and neutral media showed little influence on the SBS of Y-TZP to Ti-6Al-4V in 30 days. Acidic environments should be properly avoided to obtain reliable long-term bonding strength between Ti-6Al-4V and Y-TZP.

On the wear behavior and damage mechanism of bonded interface: Ceramic vs resin composite inlays

Advances in adhesive technologies have increased indications for the use of inlays. Decrease in the bonded interface integrity due to wear has been cited as the main cause of its failure. However, this process of interface degradation and the influence of inlay material on damage mechanism appear to be poorly understood. Thus, we aimed to compare the wear behavior and interface damage between ceramic and resin composite inlays bonded to enamel under sliding contact and use the experimental findings to support recommendation of the appropriate inlay material. Bonded interface specimens involving tooth enamel and either ceramic or resin composite inlays were prepared and subjected to reciprocating wear tests up to 5×10⁴ cycles. The wear track profiles and morphologies were characterized after increments of cyclic sliding contact using white light interferometry and scanning electron microscopy, respectively. Optical microscopy was used to evaluate sub-surface cracks and their propagation within the samples. A finite element analysis was used to analyze the stress distributions of the bonded interfaces. Composite inlays showed higher wear depth than the ceramic in the early stage (N ≤ 5×10² cycles), while no significant difference was found at the later stage. For ceramic inlay a greater portion of the contact load was concentrated in the ceramic structure, which facilitated cracks and chipping of the ceramic inlay, with rather minimal damage in the adjacent interface and enamel. In contrast, for the resin composite inlay there was larger stress concentrated in the adjacent enamel, which caused the development of cracks and their propagation to the inner enamel. The restoration material could contribute to the stress distribution and extent of damage within enamel-inlay bonded interfaces. A tough ceramic appears to be more effective at protecting the residual dental tissue.