Influence of preparation design and spacing parameters on the risk of chipping of crowns made with Cerec Bluecam before cementation

Influence of CAD-CAM milling strategies on the outcome of indirect restorations: A scoping review

STATEMENT OF PROBLEM

The influence of computer-aided manufacturing (CAM) parameters and settings on the outcomes of milled indirect restorations is poorly understood.

PURPOSE

The purpose of this scoping review was to summarize the current CAM systems, parameters, and setting changes, and their effects on different outcomes of milled indirect restorations and aspects related to their manufacture.

MATERIAL AND METHODS

The protocol of this review is available online (https://osf.io/x28ps/). Studies that used at least 2 different parameters (CAM units, number of axes, digital spacers, or protocols with different rotatory instruments, grit-sizes, milling speed, or others) for milling indirect restorations were included. A structured search up to July 2023 was performed by 2 independent reviewers for articles written in English in LILACS, MEDLINE via PubMed, EMBASE, Web of Science, and Scopus.

RESULTS

Of 1546 studies identified, 22 were included in the review. Discrepancies were found between the planned and actual measured cement space, with a decreasing linear relationship impacting restoration adaptation at different points. The CEREC MC XL milling machine was the most used system in the included studies, with variations in bur types, milling modes, and number of burs uses affecting internal fit and surface trueness. The results demonstrated the better adaptation of restorations made with 5-axis over 3-axis milling machines. Lithium disilicate and zirconia were the most commonly used materials, and crowns and inlays were popular designs. Marginal and internal adaptation were the primary outcomes assessed using the various techniques.

CONCLUSIONS

The study presented a comprehensive exploration of CAM systems and parameters, and their influence on indirect restorations. The planned cement space was not properly reproduced by the milling. Bur characteristics can affect restoration fit and trueness. The 5-axis units seem to result in better-adapted restorations compared with 3- and 4-axis units.

Biaxial Flexural Strength of High-Translucence Monolithic Ceramics upon Various Thicknesses

Introduction

High-translucence ceramics have been used increasingly. This study evaluated the biaxial flexural strength of different ceramics as a result of varying thicknesses.

Materials and Methods

Circular discs with varied thickness of 0.4, 0.6, 0.8, 1.0, 1.2, 1.4, 1.6, 1.8, and 2.0 mm were prepared from high-translucence yttria-partially stabilized zirconia (HTY-PSZ); Bruxzir^® Anterior (Bc), and zirconia-reinforced lithium silicate (ZLS) including Celtra^® DUO (Cc) and VITA Suprinity^® (Vc) (n = 15 discs/group). Biaxial flexural strength (σ) was evaluated utilizing piston-on-three-balls in a testing machine at a speed of 0.5 mm/min. A scanning electron microscope (SEM) was used to determine the microscopic structure. ANOVA and multiple comparisons were analyzed for significant differences (a = 0.05).

Results

The mean ± sd value of σ (MPa) for thickness 0.4, 0.6, 0.8, 1.0, 1.2, 1.4, 1.6, 1.8, and 2.0 mm was 672.66 ± 107.54, 655.93 ± 93.98, 589.01 ± 63.63, 624.89 ± 87.08, 618.82 ± 83.36, 672.64 ± 84.61, 659.81 ± 122.89, 632.79 ± 92.54, and 657.86 ± 73.17, for Bc; 477.64 ± 88.23, 496.39 ± 86.36, 461.56 ± 57.00, 450.26 ± 86.60, 468.28 ± 83.65, 472.45 ± 53.63, 453.05 ± 72.50, 462.67 ± 47.57, and 535.28 ± 84.33, for Cc; and 500.97 ± 76.36, 506.70 ± 87.76, 557.82 ± 62.78, 543.76 ± 87.29, 507.53 ± 86.09, 502.46 ± 64.75, 557.70 ± 80.91, 527.04 ± 80.78, and 499.88 ± 57.35, for Vc. A significant difference in flexural strength was indicated among groups (p < 0.05). Bc was significantly stronger than Cc and Vc (p < 0.05). Varying thickness did not have a significant influence on strength (p > 0.05). SEM revealed a tight arrangement of crystals for Bc and needle-like crystals diffusing in glass for Vc and Cc.

Conclusion

Flexural strength of ceramics varied among types, but each retained strength equitably with varying thickness. HTY-PSZ was stronger than ZLS, but each was equally strong for thickness in the range of 0.4–2.0 mm.

Influence of Material and Surface Roughness of Resin Composite Cements on Fibroblast Behavior

Clinical Relevance

A well-polished cement surface increases the viability and spreading of gingival fibroblasts. The tested resin composite cements did not reveal any cytotoxic effects.

SUMMARY

Objective: This in vitro study aimed to investigate the effect of cement type and roughness on the viability and cell morphology of human gingival fibroblasts (HGF-1).

Methods and Materials: Discs of three adhesive (Panavia V5 [PV5], Multilink Automix [MLA], RelyX Ultimate [RUL] and three self-adhesive (Panavia SA plus [PSA], SpeedCem plus [SCP], RelyX Unicem [RUN]) resin composite cements were prepared with three different roughnesses using silica paper grit P180, P400, or P2500. The cement specimens were characterized by surface roughness and energy-dispersive X-ray spectroscopic mapping. A viability assay was performed after 24 hours of incubation of HGF-1 cells on cement specimens. Cell morphology was examined with scanning electron microscopy.

Results: The roughness of the specimens did not differ significantly among the different resin composite cements. Mean Ra values for the three surface treatments were 1.62 ± 0.34 μm for P180, 0.79 ± 0.20 μm for P400, and 0.17 ± 0.08 μm for P2500. HGF-1 viability was significantly influenced by the cement material and the specimens’ roughness, with the highest viability for PSA ≥ RUN = MLA ≥ SCP = PV5 &gt; RUL (p&lt;0.05) and for P2500 = P400 &gt; P180 (p&lt;0.001). Cell morphology did not vary among the materials but was affected by the surface roughness.

Conclusion: The composition of resin composite cements significantly affects the cell viability of HGF-1. Smooth resin composite cement surfaces with an Ra of 0.2–0.8 μm accelerate flat cell spreading and formation of filopodia.