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Moreira PM, Carvalho GLM, de Castro Albuquerque R, André CB. Effect of hydrofluoric acid and self-etch ceramic primers on the flexural strength and fatigue resistance of glass ceramics: A systematic review and meta-analysis of in vitro studies. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:198-210. [PMID: 39027733 PMCID: PMC11254839 DOI: 10.1016/j.jdsr.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 05/06/2024] [Accepted: 06/04/2024] [Indexed: 07/20/2024] Open
Abstract
This systematic review evaluated the effect of different hydrofluoric acid (HF) etching regimens and a self-etch ceramic primer (SECP) on the flexural strength (FS) and fatigue failure load (FFL) of glass-ceramic materials.The identification of relevant studies was conducted by two authors in five databases: PubMED, Scopus, Web Of Science, LILACS and Virtual Health Library (BVS) until July 2022 with no year limit. The analysis was conducted in RevMan 5.4.1 Software (Cochrane Collaboration) using Random effect model at 5 %. The risk of bias of the included studies were assessed. From the 5349 articles identified, 34 were included for quantitative analysis. Meta-analysis showed that for predominantly glassy ceramics, etching with HF 5 % had no significant impact on FS, however, HF acid etching with concentrations greater than 5 % negatively impacted FS. For lithium disilicate glass-ceramics (LDGC) HF acid etching, negatively influenced FS, while increasing the FFL. HF etching negatively affected FS of hybrid ceramics. The self-etch ceramic primer and HF acid etching showed a similar impact on FFL and FS. This meta-analysis indicates that the impact of SECP and HF acid etching on the mechanical behavior of glass ceramics is material-dependent.
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Affiliation(s)
- Paulo Matias Moreira
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Rodrigo de Castro Albuquerque
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Carolina Bosso André
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Cantelli V, Meirelles MT, Della Bona A. Fatigue methods for evaluating translucent dental zirconia. J Dent 2024; 148:105242. [PMID: 39009334 DOI: 10.1016/j.jdent.2024.105242] [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: 06/09/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024] Open
Abstract
OBJECTIVE To investigate fatigue methods for the evaluation of translucent zirconia and to associate in vitro failures with clinically reported ones. DATA Studies published in English that used fatigue tests on dental translucent zirconia. SOURCES Two databases (MEDLINE/PubMed and Scopus) were electronically searched without any restriction on year of publication. STUDY SELECTION A total of 4555 studies were identified. After removal of duplicates (78) and irrelevant articles (4316) that did not meet the inclusion criteria, 161 articles were considered eligible based on their titles and abstracts. These articles were fully read, leading to the inclusion of 41 studies in the review. RESULTS The most widely used fatigue method for evaluation of translucent zirconia was step-stress (18 articles), followed by staircase (seven articles), and step-wise (two articles). Most studies had been conducted in a wet environment with the use of a stainless steel piston to apply load to cemented structures on a dentin-like substrate. Most fracture analyses indicated the fracture originated on the cementation or contact surface where the load was applied. Moreover, studies that utilized anatomical structures (dental crowns) reported fractures starting at the cervical margin of the crowns. CONCLUSION Most studies used the step-stress method. Only three studies reported failures similar to those found in clinical trials that used translucent zirconia restorations. CLINICAL SIGNIFICANCE The study findings can assist on correlating clinical failures to the ones observed in vitro.
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Affiliation(s)
- Viviane Cantelli
- Post-graduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Marcelo Tapparo Meirelles
- Graduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Alvaro Della Bona
- Post-graduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil.
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Golriz N, Hosseinabadi N. Additive manufacturing of ceria and yttria incorporated toughened monolithic zirconia dental ceramic crowns: In vitro simulated aging behavior. J Prosthet Dent 2024:S0022-3913(24)00415-3. [PMID: 38981804 DOI: 10.1016/j.prosdent.2024.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 07/11/2024]
Abstract
STATEMENT OF PROBLEM The comprehensive characterization of additively manufactured zirconia-based dental prostheses can promote widespread clinical application. However, simulated in vitro analysis of the aging behavior is lacking. PURPOSE The purpose of this in vitro study was to assess the simulated in vitro durability of monolithic transformation toughened additively manufactured zirconia-based restorations with different compositions to predict the clinical reliability depending on their ceramic composition. MATERIAL AND METHODS Crowns were 3-dimensionally (3D) printed by using a combination of custom-made stereolithography and a laser polymerized digital light processing process with high solid content slurries with suitable photo-interactive polymers. The main characteristics tested for mechanical behavior (structural reliability and flexural strength) were overall toughness and fatigue limits. Combinations of chemical compositions including yttria and ceria additives and processing conditions including pressing and sintering temperatures were applied to transform custom stereolithography and digitally light activated polymerized green parts to high strength and toughened ceramic crowns. The fluctuations in strength and toughness of as-sintered parts before and after physical thermocycling, physiochemical hydrothermal aging, and mechanical mastication simulation were studied via statistical methods (ANOVA) to indicate variable dependencies (α=.05). RESULTS Near theoretical density as high as 99.1%, minimum surface porosity as low as 0.25%, medium translucency, and high contrasts were achieved. The high original hardness near 19 GPa, a toughness of 6 to 7 MPa.m1/2, and 1300 MPa flexural strength with 95% confidence interval in as-sintered specimens satisfied the requirements for crowns. The simultaneously yttria and ceria stabilized systems should be able to resist low-temperature degradation aging with decreases as small as 2% in flexural strength and near 25% in fatigue fracture limits. The structure and process dependency of the mechanical properties of flexural strength (P<.020), hardness (P<.030), and modulus of elasticity (P<.020) were statistically significant while the toughness showed significant dependency (P ≤.001). CONCLUSIONS The 3D printed posterior crowns with enhanced mechanical properties and augmented simulated in vitro durability can be manufactured by adding tetragonal phase stabilizer oxides (ceria and yttria) to zirconia-based ingredients. The combination of both oxide stabilizers in the additive manufacturing of crowns is a significant approach to improving clinical performance, enhanced toughness, and fatigue limit before and after physicomechanical, mechanochemical, and thermocyclic aging analysis.
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Affiliation(s)
- Naghmeh Golriz
- Restorative Dentistry Specialist, Private practice, Shiraz, Iran
| | - Navid Hosseinabadi
- Assistant Professor, Materials Science and Engineering, Department of Materials and Metallurgical Engineering, Abadeh Higher Education Center, Shiraz University, Shiraz, Iran.
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Lenz U, Santos RB, Griggs JA, Estrela C, Bueno MDR, Porto OCL, Della Bona A. Longevity of different abutments placed on narrow diameter implants: Assessment of structural damage and loosening. Dent Mater 2024:S0109-5641(24)00133-7. [PMID: 38876825 DOI: 10.1016/j.dental.2024.06.003] [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: 12/27/2023] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES To evaluate structural damage and loosening of abutments placed on narrow diameter implants after cyclic fatigue. METHODS Sixty Morse taper narrow diameter implants (Neodent, Brazil) received two types of abutments (1PA- one-piece abutment or 2PA- two-piece abutment), which were randomly divided into 3 fatigue experiments (n = 10). The implants were placed into a customized supporting holder and a software-assisted digital torque wrench secured the manufacturer recommended torque for each abutment. Cone beam computed tomography (CBCT) scans were acquired, before and after fatigue, and post-processed (software e-Vol DX) to assess damage and abutment displacement. The boundary fatigue method was adapted to use 2 × 106 cycles, 2 Hz of frequency and constant peak load of 80 N (first experiment) that varied according to the failure rate of previous specimens (second and third experiments). Failure was evaluated using CBCT scans and removal torque values. Data were used to estimate long-term torque degradation, probability of failure and Weibull modulus (software ALTA PRO9). RESULTS All 2PA specimens became loosen independently of the applied fatigue load, and structural bending was observed in 14 abutments. Eight 1PA got loosen during the fatigue experiment. The Weibull analysis showed a lower modulus (m = 1.0; 0.7, 1.4) for 1PA than for 2PA (m = 2.6; 2, 3.4) resulting in longer predicted lifetimes and slower torque degradation for 1PA than for 2PA specimens. SIGNIFICANCE 1PA showed greater long-term survival probability than 2PA. Predicting the lifetime and mechanical behavior of implant-abutment systems are useful information to clinicians during the decision-making process of oral rehabilitations.
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Affiliation(s)
- Ulysses Lenz
- Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Renan Brandenburg Santos
- Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Jason Alan Griggs
- Department of Biomedical Materials Science, University of Mississippi Medical Center, MS, USA
| | - Carlos Estrela
- School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | | | - Alvaro Della Bona
- Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil.
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Weber KR, Meneghetti DE, Benetti P, Della Bona A, Griggs JA, Borba M. Influence of piston material on the fatigue behavior of a glass-ceramic. J Prosthet Dent 2023; 129:931-937. [PMID: 34482967 PMCID: PMC8888770 DOI: 10.1016/j.prosdent.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 11/15/2022]
Abstract
STATEMENT OF PROBLEM The lack of standardization regarding the loading piston material used in fatigue tests could limit the interpretation of study findings. PURPOSE The purpose of this in vitro study was to evaluate the effect of the piston material on the fatigue behavior of a lithium disilicate glass-ceramic. MATERIAL AND METHODS Plate-shaped, 1.2-mm-thick, lithium disilicate glass-ceramic specimens were cemented onto a dentin analog substrate with resin cement. The specimens were divided into 4 groups according to the piston material used in the fatigue test (n=30): metal, glass fiber-reinforced epoxy resin, ceramic, and human tooth. The fatigue test was performed in a mechanical cycling machine by using the boundary technique at 2 Hz in distilled water at 37 °C. The fatigue data were analyzed by using the Weibull distribution and a lifetime-inverse power law relationship. Failures were evaluated with fractography and transillumination. RESULTS The Weibull modulus (β) was similar among groups. The exponent of crack growth (n) was significantly greater for glass fiber-reinforced epoxy resin and tooth groups than for metal and ceramic; therefore, the probability of failure (Pf) of glass-ceramic specimens loaded by resin and tooth pistons depended more on load amplitude. Specimens tested with tooth showed the highest value of K (characteristic lifetime), which is an indication of greater survival. Radial crack was the only failure mode observed for all experimental groups. CONCLUSIONS The piston material influenced the fatigue survival of the lithium disilicate glass-ceramic. The glass fiber-reinforced epoxy resin piston closely simulated the fatigue behavior induced by the human tooth on the evaluated glass-ceramic.
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Affiliation(s)
- Katia R Weber
- PhD student, Post-Graduation Program in Dentistry, Dental School, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Daniel E Meneghetti
- Predoctoral student, Dental School, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Paula Benetti
- Professor, Post-Graduation Program in Dentistry, Dental School, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Alvaro Della Bona
- Professor, Post-Graduation Program in Dentistry, Dental School, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Jason A Griggs
- Professor, Department of Biomedical Materials Science, University of Mississippi Medical Center, Jackson, Miss
| | - Márcia Borba
- Professor, Post-Graduation Program in Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil.
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Lana TMDSD, Weber KR, Medeiros JA, Goedel F, Benetti P, Borba M. Fatigue-life and stress distribution of a glass-ceramic under different loading conditions. Braz Dent J 2023; 34:80-88. [PMID: 36888848 PMCID: PMC10027096 DOI: 10.1590/0103-6440202305129] [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: 07/04/2022] [Accepted: 11/17/2022] [Indexed: 03/08/2023] Open
Abstract
This study aimed to evaluate the effect of different loading conditions on the mechanical behavior and stress distribution of a leucite-reinforced glass-ceramic. Plate-shaped ceramic specimens were obtained from leucite-reinforced glass-ceramic (1.5 × 8.4 × 8.3 mm) and adhesively cemented to a dentin analog substrate. Monotonic and cyclic contact fatigue tests were performed to simulate sphere-to-flat contact, using a 6 mm diameter spherical piston; and flat-to-flat contact, using a 3 mm diameter flat piston. For the monotonic test (n=20), a gradual compressive load (0.5 mm/min) was applied to the specimen using a universal testing machine. Failure load data were analyzed with Weibull statistics. The cyclic contact fatigue test was performed using protocols (load and a number of cycles) defined by the boundary technique (n=30). Fatigue data were analyzed using an inverse power law relationship and Weibull-lifetime distribution. The stress distribution was investigated using Finite Element Analysis (FEA). The monotonic and the fatigue Weibull modulus were similar among the two contact conditions. In fatigue, the slow crack growth exponent was greater for sphere-to-flat contact, which indicates that the load level had a greater effect on the specimen's probability of failure. In conclusion, FEA showed different stress distribution for the tested loading conditions. The stress distribution and probability of fatigue failure of specimens tested in sphere-to-flat contact showed greater dependency to load level.
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Affiliation(s)
| | - Kátia Raquel Weber
- Graduate Program in Dentistry, Dental School, University of Passo Fundo(UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Juliana Arisi Medeiros
- Graduate Program in Dentistry, Dental School, University of Passo Fundo(UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Fábio Goedel
- Engineering School, University of Passo Fundo(UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Paula Benetti
- Graduate Program in Dentistry, Dental School, University of Passo Fundo(UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Márcia Borba
- Graduate Program in Dentistry, Dental School, University of Passo Fundo(UPF), Passo Fundo, Rio Grande do Sul, Brazil
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Ottoni R, Marocho SMS, Griggs JA, Borba M. CAD/CAM versus 3D-printing/pressed lithium disilicate monolithic crowns: adaptation and fatigue behavior. J Dent 2022; 123:104181. [DOI: 10.1016/j.jdent.2022.104181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/13/2022] [Accepted: 06/06/2022] [Indexed: 10/18/2022] Open
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Velho HC, Dapieve KS, Valandro LF, Pereira GKR, Venturini AB. Cyclic fatigue tests on non-anatomic specimens of dental ceramic materials: A scoping review. J Mech Behav Biomed Mater 2021; 126:104985. [PMID: 34861521 DOI: 10.1016/j.jmbbm.2021.104985] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 11/16/2022]
Abstract
The aim of the present scoping review was to identify and discuss the methods, testing parameters, and characteristics used to induce cyclic fatigue on non-anatomic dental ceramic specimens. In vitro studies written in English which evaluated commercially-available non-anatomic dental ceramic specimens subjected to mechanical cyclic fatigue were selected. The search was performed in the PubMed, Scopus and Web of Science databases. The initial search yielded 1,636 articles, of which 81 were included. Based on the collected data, most of the included studies evaluated dental ceramic specimens cemented to supporting substrate (n= 42; 51.9%); used step-stress (n= 35; 42.2%) accelerated fatigue test, loading frequencies above 10 Hz (n= 31, 35.6%), stainless steel (n = 28, 32.6%) load applicator with spherical shaped tip 40 mm diameter (n= 25, 30.9%); applied only axial loads (n= 77, 95.1%); and considered a wet testing environment (n= 65, 78.3%). The definition of test geometry, method, and testing parameters must be cautiously considered according to the study objective and the scenario that is simulated. Accelerated fatigue tests, load frequencies up to 20 Hz, a 40 mm stainless steel spherical load applicator and a wet testing environment are the major common defined parameters presented in the existing literature. More studies exploring the influence of such factors on fatigue mechanism are necessary.
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Affiliation(s)
- Helder Callegaro Velho
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
| | - Kiara Serafini Dapieve
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
| | - Andressa Borin Venturini
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
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Simião da Rocha L, Della Bona A, Deprá Pretto M, Corazza PH, Borba M, Benetti P. Assessment of the survival and success rates of lithium disilicate crowns after different surface finishing procedures: An in vitro study. J Prosthet Dent 2021:S0022-3913(21)00457-1. [PMID: 34598771 DOI: 10.1016/j.prosdent.2021.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Evidence is limited for the impact of clinical adjustments and polishing on the longevity of glazed lithium disilicate restorations. PURPOSE The purpose of this in vitro study was to evaluate the influence of surface finishing on the survival and success rates of lithium disilicate restorations based on fatigue resistance and failure mode. MATERIAL AND METHODS Lithium disilicate (IPS e.max CAD) maxillary premolar crowns (N=54) were cemented on a dentin analog. The restorations were divided into 3 groups: overglaze (OG), abrasion (GA), and abrasion and polishing (AP). The crowns were submitted to cyclic fatigue in 37 oC water at 100 N and 2 Hz in 2 lifetimes. The load was applied to the occlusal surface by using anatomic pistons to simulate a clinical tripod occlusal contact. After cycling, the crowns were examined for failure (cracking, chipping, or catastrophic fractures) under optical and scanning electron microscopy. Cracking was considered either a structural failure (success analysis) or a survival (clinical criteria - survival analysis). Data were analyzed by using the log rank Kaplan-Meier and Holm-Sidak tests (α=.05). RESULTS Surface finishing had no influence on the structural integrity of lithium disilicate, with similar success rates (P=.720). The calculated survival rate was higher for AP than that for other groups (P=.028). Cracking was found for GA and AP crowns, mostly initiating from the external surface. Chipping occurred in all experimental groups, and AP crowns did not show catastrophic failures. CONCLUSIONS Although surface treatments had no influence on the success of lithium disilicate, polishing showed a positive effect on the survival rate of the crowns based on the clinical implications of cracking (no need for replacement).
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Affiliation(s)
- Larissa Simião da Rocha
- PhD student, Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Alvaro Della Bona
- Research Associate Professor, Post-graduate Program in Dentistry, School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Mauren Deprá Pretto
- Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Pedro Henrique Corazza
- Research Associate Professor, Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Marcia Borba
- Research Associate Professor, Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Paula Benetti
- Research Associate Professor, Postgraduate Program in Dentistry, School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil.
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Optical behaviors, surface treatment, adhesion, and clinical indications of zirconia-reinforced lithium silicate (ZLS): A narrative review. J Dent 2021; 112:103722. [PMID: 34118284 DOI: 10.1016/j.jdent.2021.103722] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The present narrative review was focused on the optical properties, surface treatment, adhesion, and clinical indications of zirconia-reinforced lithium silicate ceramics (ZLS) for Computer-aided design / Computer-aided manufacturing (CAD/CAM) technologies. DATA/SOURCES A literature search was performed by 3 calibrated independent researchers on PubMed, Scopus, Embase, Google Scholar, Dynamed, and Open Grey. The criteria for inclusion were: 1) papers addressing at least one of the following variables about ZLS: optical properties, surface treatment, adhesion, and clinical indications; 2) in vitro, in silico, or in vivo studies; 3) case reports; 4) systematic reviews. The exclusion criteria were: 1) animal studies; 2) non-dental studies; 3) studies only focusing on ZLS used in the heat-pressed process. STUDY SELECTION 98 records among in vitro studies and case reports were included. CONCLUSIONS Despite the promising microstructure characteristics of ZLS, increased translucency compared to lithium disilicate ceramics (LS2) was not proven, but acceptable color changes and stability were reported. Mechanical polishing was the most effective method to reduce surface roughness. Moreover, machinability and handling of ZLS resulted harder than LS2. Conventional acid etching procedures seemed effective in conditioning ZLS surface, but no protocol has been established yet. Besides, silane-coupling and dual-curing resin cements were recommended. CLINICAL SIGNIFICANCE ZLSs can be used for anterior and posterior fixed single-unit CAD/CAM restorations onto both natural teeth and implants, but do not seem to represent a viable treatment option for endocrowns onto posterior teeth or fixed dental prostheses.
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Li X, Wang Q, Qiu X, Zhao B. Effect of different CAD/CAM cutting depths on the post-fatigue load-bearing capacity of novel multilayer zirconia restorations. J Dent 2021; 111:103709. [PMID: 34062215 DOI: 10.1016/j.jdent.2021.103709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/22/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To investigate the post-fatigue load-bearing capacity of restorations milled at various cutting depths in a novel strength- and color-gradient multilayer zirconia CAD/CAM disk. METHODS Identical crowns were divided into 4 groups (n = 25 per group): crowns milled at 3 CAD/CAM cutting depths in multilayer zirconia disks as 3 experiment groups and homogeneous zirconia crowns as a control group. The color differences between various cutting depths were measured. In each group, crowns were tilted at 15° and subjected to fatigue loading for various numbers of cycles (0, 106, 2 × 106, 3 × 106 or 4 × 106, n = 5 per subgroup). All surviving crowns were subsequently submitted to a static fracture test to determine load-bearing capacity. The data were analyzed by ANOVA and Weibull distribution analysis. Failure modes were observed with SEM. RESULTS For a novel multilayer zirconia, a deeper CAD/CAM cutting depth corresponded to a higher load-bearing capacity but a darker color. After 106 cycles of fatigue loading, there was not a significant reduction in fracture load. However, after 4 × 106 cycles, the load-bearing capacity of all crowns decreased significantly by approximately 50%. For multilayer and homogeneous zirconia materials, similar failure mode and Weibull modulus were identified. CONCLUSIONS Restorations can be milled at various CAD/CAM cutting depths in a novel multilayer zirconia disk depending on the durability and esthetic requirements. The load-bearing capacity of multilayer restorations degraded significantly after 4 × 106 cycles of fatigue loading, but not after 106 cycles. CLINICAL SIGNIFICANCE For a novel multilayer zirconia disk, a posterior restoration can be milled from the middle or bottom of the disk to improve its load-bearing capacity. For an anterior restoration, to meet the esthetic requirements, milling the entire thickness of a multilayer disk is recommended.
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Affiliation(s)
- Xuejing Li
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Qiang Wang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
| | - Xiaohai Qiu
- Tianjin Stomatological Hospital, Nankai University, Tianjin, China
| | - Baohong Zhao
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
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Zarone F, Ruggiero G, Leone R, Breschi L, Leuci S, Sorrentino R. Zirconia-reinforced lithium silicate (ZLS) mechanical and biological properties: A literature review. J Dent 2021; 109:103661. [PMID: 33864886 DOI: 10.1016/j.jdent.2021.103661] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES This paper aimed to provide a literature review of the mechanical and biological properties of zirconia-reinforced lithium silicate glass-ceramics (ZLS) in Computer-aided design / Computer-aided manufacturing (CAD/CAM) systems. DATA/SOURCES An extensive search of the literature for papers related to ZLS was made on the databases of PubMed/Medline, Scopus, Embase, Google Scholar, Dynamed, and Open Grey. The papers were selected by 3 independent calibrated reviewers. STUDY SELECTION The search strategy produced 937 records. After the removal of duplicates and the exclusion of papers that did not meet the inclusion criteria, 71 papers were included. CONCLUSIONS After reviewing the included records, it was found that two types of ZLS (Vita Suprinity PC; Vita Zahnfabrik and Celtra Duo; Dentsply Sirona) are nowadays available on the market for CAD/CAM systems, similar in their chemical composition, microstructure, and biological-mechanical properties. ZLS is reported to be a biocompatible material, whose fracture resistance can withstand physiological chewing loads. The firing process influences the improvements of strength and fatigue failure load, with a volumetric shrinkage. To date, ZLS can be considered a viable alternative to other glass-ceramics for fixed single restorations. CLINICAL SIGNIFICANCE . As to biocompatibility and mechanical properties of ZLS, data are still scarce, often controversial and limited to short-term observational periods. These promising ceramics require further in vitro/in vivo studies to accurately define mechanical and biological properties, mainly in the long-term performance of restorations produced with such materials.
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Affiliation(s)
- Fernando Zarone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Prosthodontics and Digital Dentistry, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Gennaro Ruggiero
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Prosthodontics and Digital Dentistry, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Renato Leone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Prosthodontics and Digital Dentistry, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Alma Mater Studiorum, Via San Vitale 59, 40125, Bologna, Italy.
| | - Stefania Leuci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, School of Medicine, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Roberto Sorrentino
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Prosthodontics and Digital Dentistry, University "Federico II" of Naples, Via Pansini 5, 80131, Naples, Italy.
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Alessandretti R, Borba M, Della Bona A. Cyclic contact fatigue resistance of ceramics for monolithic and multilayer dental restorations. Dent Mater 2020; 36:535-541. [DOI: 10.1016/j.dental.2020.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 11/29/2022]
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