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Eggmann F, Orta AL, Abdulmajeed A, Att W, Beuer F, Bergler M, Blatz MB, Brief J, Castro VE, Cooper LF, Han S, Ortiz MA, Paravina RD, Pizzi P, Tholey MJ, Conejo J. Interdisciplinary Delphi study by PROSEC North America: Recommendations on single indirect restorations made from ceramic and nonmetallic biomaterials for posterior teeth. J ESTHET RESTOR DENT 2024. [PMID: 39093128 DOI: 10.1111/jerd.13289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/05/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE This article puts forward consensus recommendations from PROSEC North America regarding single indirect restorations made from ceramic and nonmetallic biomaterials in posterior teeth. OVERVIEW The consensus process involved a multidisciplinary panel and three consensus workshops. A systematic literature review was conducted across five databases to gather evidence. The recommendations, informed by findings from systematic reviews and formulated based on a two-phase e-Delphi survey, emphasize a comprehensive treatment strategy that includes noninvasive measures alongside restorative interventions for managing dental caries and tooth wear. The recommendations advocate for selecting between direct and indirect restorations on a case-by-case basis, favoring inlays and onlays over crowns to align with minimally invasive dentistry principles. The recommendations highlight the critical role of selecting restorative biomaterials based on clinical performance, esthetic properties, and adherence to manufacturer guidelines. They emphasize the importance of precision in restorative procedures, including tooth preparation, impression taking, contamination control, and luting. Regular follow-up and maintenance tailored to individual patient needs are crucial for the longevity of ceramic and nonmetallic restorations. CONCLUSIONS These PROSEC recommendations provide a framework for dental practitioners to deliver high-quality restorative care, advocating for personalized treatment planning and minimally invasive approaches to optimize oral health outcomes. CLINICAL SIGNIFICANCE The PROSEC North America recommendations highlight the importance of minimally invasive techniques in posterior tooth restorations using ceramic and non-metallic biomaterials. These principles prioritize tooth structure conservation and personalized treatment planning, essential for enhancing clinical outcomes and long-term oral health.
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Affiliation(s)
- Florin Eggmann
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Amelia L Orta
- Department of Advanced Oral Sciences and Therapeutics, Division of Prosthodontics, University of Maryland School of Dentistry, University of Maryland, Baltimore, Maryland, USA
- Department of Restorative Sciences, Advanced Education in Prosthodontics, The Dental College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Awab Abdulmajeed
- Department of General Practice and Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Wael Att
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Michael Bergler
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Markus B Blatz
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jakob Brief
- PROSEC gGmbH, Bad Säckingen, Germany
- VITA Zahnfabrik, Bad Säckingen, Germany
| | | | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sean Han
- Master's Arch, Phoenix, Arizona, USA
| | - Miguel A Ortiz
- Department of Restorative Dentistry, University of Illinois College of Dentistry, Chicago, Illinois, USA
| | - Rade D Paravina
- Department of Restorative Dentistry and Prosthodontics, John M. Powers, PhD, Center for Biomaterials and Biomimetics, The University of Texas School of Dentistry at Houston, Houston, Texas, USA
| | - Peter Pizzi
- Pizzi Dental Studio, Staten Island, New York, USA
| | - Michael J Tholey
- PROSEC gGmbH, Bad Säckingen, Germany
- VITA Zahnfabrik, Bad Säckingen, Germany
| | - Julián Conejo
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Alsulimani OA, Alhaddad AJ, AlSaggaf AU, Altassan M, Alghamdi M, Abuzinadah SH, Hajjaj MS, Marghalani AA. Comparative Invitro Testing of the Tensile Bond Strength Under Artificial Aging Between Different Lithium Disilicate Ceramics to Composite Substrate: A Novel Methodology. Cureus 2024; 16:e66163. [PMID: 39233935 PMCID: PMC11372504 DOI: 10.7759/cureus.66163] [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] [Accepted: 08/04/2024] [Indexed: 09/06/2024] Open
Abstract
Objective The purpose of this study is to compare the tensile bond strength values to composite substrate pre- and post-aging between IPS E.max CAD and Initial LiSi. Methods The study utilized four blocks of IPS E.max CAD LT/B1 C14 (Ivoclar Vivadent, Liechtenstein, Germany) (referred to as E) and four blocks of Initial LiSi LT/B1 (GC, Tokyo, Japan) (referred to as L). These blocks were milled to produce 76 ceramic bars measuring 2 mm × 2 mm × 10 mm (E = 38, L = 38/n = 19). After acid etching with hydrofluoric acid (BISCO, Schaumburg, IL, USA) and silane application (BIS-SILANE, BISCO), the specimens were embedded in putty (Express STD, 3M, Decatur, AL, USA) to create a mold for the resin cement (RelyX U200, 3M). Subsequently, one group of each brand underwent mechanical tensile testing (E0 and L0), while the other groups were subject to tensile testing after artificial aging involving 500 thermal cycles between 5 and 55°C (E5 and L5). The mean tensile strength for each group (E0, E5, L0, and L5) was determined using the Brown-Forsythe one-way ANOVA and Tamhane's post hoc tests. Results Initial LiSi showed a superior pre-aging mean (11.7 MPa). However, both materials had identical post-aging means (7.6 MPa). There were no statistically significant differences, except between the dependent Initial LiSi groups (L0-L5). Most failure modes were mixed (cohesive cement and adhesive). There were no cohesive failures on the cement side except in three specimens of Initial LiSi post-aging. Conclusion The tested conditions have shown that Initial Lisi exhibited the highest pre-aging mean; however, it exhibited inferior bond stability under aging conditions compared to IPS E.max CAD. Analyzing the microstructure before and after aging may provide insights into the greater decrease in bond strength observed in the Initial LiSi specimens.
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Affiliation(s)
- Osamah A Alsulimani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Abdulrahaman J Alhaddad
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Arwa U AlSaggaf
- Department of Oral and Maxillofacial Surgery, College of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | - Mosa Altassan
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Mazen Alghamdi
- Department of General Dentistry, Seven Stars Clinic, Jeddah, SAU
| | - Samar H Abuzinadah
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Maher S Hajjaj
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Amin A Marghalani
- Department of Oral and Maxillofacial Surgery, College of Dental Medicine, Umm Al-Qura University, Makkah, SAU
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Sarıyer S, Subaşı MG. Surface treatment, liquid, and aging effects on color and surface properties of monolithic ceramics. J Adv Prosthodont 2024; 16:174-188. [PMID: 38957290 PMCID: PMC11215038 DOI: 10.4047/jap.2024.16.3.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 05/25/2024] [Accepted: 06/09/2024] [Indexed: 07/04/2024] Open
Abstract
PURPOSE The purpose of this study was to investigate the effects of surface treatments, liquids, and aging on color, translucency, and surface properties of monolithic ceramics. MATERIALS AND METHODS Lithium disilicate (LDS) and zirconia-reinforced lithium silicate (ZLS) ceramics (n = 135 each) were cut and divided into three groups [crystallization+glaze (single stage), crystallization-glaze (two stages), and crystallization-polish (two stages)]. One sample from each group was examined using scanning electron microscopy (SEM). Remaining samples were divided into four subgroups (distilled water, coffee, grape juice, and smoothie) (n = 11 each), stored for 12 d in the respective liquids, and thermally aged. One sample from each subgroup was analyzed using SEM. The color, gloss, and roughness values of the samples were analyzed after surface treatment (initial) and storage under different liquids+aging conditions. The initial data and both the aged data and data change values were analyzed using robust two- and three-way analyses of variance. RESULTS The glazed groups exhibited smoother surfaces. Ceramic type and ceramic-surface treatment interactions affected the initial translucency parameter (TP) (P < .001) and the initial and aged roughness values (P ≤ .001). Surface treatment type affected the color change (P < .001), and ceramic type affected the aged TP values (P < .001). Type of ceramic, surface treatment, and their interactions affected both the initial and aged gloss (P ≤ .001) and TP change values (P ≤ .015). Surface treatment type and ceramic-surface treatment interactions affected the gloss change values (P ≤ .001). CONCLUSION Although both ceramics and all surface treatments are clinically applicable, crystallization-glaze is recommended. When gloss and smoothness are important or when translucency is important, ZLS or LDS may be preferred, respectively.
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Affiliation(s)
- Sertaç Sarıyer
- Department of Prosthodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kütahya, Turkey
| | - Meryem Gülce Subaşı
- Department of Prosthodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kütahya, Turkey
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Soares PM, Dal Piva AMDO, Pereira GKR, Valandro LF, Rippe MP, Feilzer AJ, Kleverlaan CJ, Tribst JPM. Effect of brushing simulation on the wear behavior of repaired CAD-CAM restorations. Int Dent J 2024:S0020-6539(24)00066-2. [PMID: 38461097 DOI: 10.1016/j.identj.2024.02.012] [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: 10/31/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 03/11/2024] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the influence of multidirectional brushing on the surface roughness, morphology, and bonding interface of resin-repaired CAD-CAM ceramic and composite restorations. MATERIALS AND METHODS Twelve (N = 12) blocks (4 mm × 4 mm × 2 mm for parallel axis; 5 mm × 4 mm × 2 mm for perpendicular axis) of lithium disilicate glass-ceramic (IPS e.max CAD, Ivoclar AG) and CAD-CAM resin composite (Tetric CAD, Ivoclar AG) were obtained and repaired with direct resin composite (Clearfil AP-X, Kuraray). An abrasive slurry was prepared and the brushing was performed according to each restorative material and axis of brushing (n = 6; perpendicular to repair interface and parallel to repair interface) during 3,650 cycles (240 strokes per minute) to simulate 3 years of brushing. The surface roughness (Ra) and the profile variation for each material (restoration and direct repair resin composite) were measured at the baseline condition and after brushing, and the mean roughness and presence of steps at the repair interface were evaluated through factorial analysis of Variance (ANOVA). Scanning Electron Microscopy (SEM) images were taken to evaluate the surface topography of the repaired materials after brushing. RESULTS The mean roughness of the repaired CAD-CAM restorations was affected by the brushing (P < .05), mainly when evaluating the repair material and the interface (P < .05), while the restorative CAD-CAM materials presented more stable values. The profile evaluation showed higher steps at the interface when repairing lithium disilicate than for CAD-CAM resin composite. CONCLUSION Repaired CAD-CAM restorations were susceptible to wear after brushing simulation. The surface roughness of the direct resin composite was the most affected leading to step development at the interface, particularly in the repaired lithium disilicate samples. Cinical maintenance recalls and polishing protocols must be considered to enhance the longevity of such restorations.
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Affiliation(s)
- Pablo Machado Soares
- Division of Prosthodontics-Biomaterials, Center for Development of Advanced Materials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands
| | - Gabriel Kalil Rocha Pereira
- Division of Prosthodontics-Biomaterials, Center for Development of Advanced Materials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Luiz Felipe Valandro
- Division of Prosthodontics-Biomaterials, Center for Development of Advanced Materials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Marilia Pivetta Rippe
- Division of Prosthodontics-Biomaterials, Center for Development of Advanced Materials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Albert J Feilzer
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands; Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands.
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Yousry M, Hammad I, Halawani ME, Aboushelib M. Translucency of recent zirconia materials and material-related variables affecting their translucency: a systematic review and meta-analysis. BMC Oral Health 2024; 24:309. [PMID: 38443872 PMCID: PMC10913643 DOI: 10.1186/s12903-024-04070-7] [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: 01/13/2024] [Accepted: 02/25/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Recent forms of translucent zirconia material have been developed, offering a wide range of options and varieties for enhancing aesthetics, making it a preferred choice in the field of prosthetic dentistry. However, there is insufficient understanding regarding the recent types of zirconia materials and their optical behavior. Understanding the variables that influence the translucency of zirconia and identifying strategies to enhance its esthetics are crucial. PURPOSE The current systemic review highlights a comprehensive understanding of different zirconia generations in relation to their optical characteristics and evaluates material-related variables affecting their translucency. METHODS The present review studied in-vitro studies that evaluated the optical characteristics of different yttria content of yttria stabilized materials. The topics explored were: (1) the different zirconia material generations and their optical behavior; (2) material-related factors that affect their translucency. The research was restricted to online publication in the English language from July 1, 2010, to July 31, 2023, using PubMed, Scopus, and Science Direct resources. The search key terms and their combinations were "zirconia," "translucent zirconia," "cubic zirconia," "highly translucent zirconia," "yttria partially stabilized zirconia," "monolithic zirconia," "translucency," "optical properties," and "light transmission." RESULTS The data obtained from fifty-three studies addressed the optical characteristics of various zirconia generations. They reported that changing yttria content had a significant impact on translucency. Different kinds of zirconia ceramics of the same generation have varying translucencies. Achieving optimum aesthetics with monolithic zirconia is challenging due to factors related to material aspects such as the presence of additives, point defects, microstructure, thickness, phase distribution, and sintering conditions. CONCLUSIONS Newly developed monolithic dental zirconia ceramics have improved aesthetics and translucency. However, additional research is necessary to evaluate their performance and long-term durability. TRIAL REGISTRATION This systematic review was registered in PROSPERO, under number CRD42023474482.
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Affiliation(s)
- Mahinour Yousry
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ihab Hammad
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed El Halawani
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Moustafa Aboushelib
- Department of Dental Materials Science, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Periferakis A, Periferakis AT, Troumpata L, Dragosloveanu S, Timofticiuc IA, Georgatos-Garcia S, Scheau AE, Periferakis K, Caruntu A, Badarau IA, Scheau C, Caruntu C. Use of Biomaterials in 3D Printing as a Solution to Microbial Infections in Arthroplasty and Osseous Reconstruction. Biomimetics (Basel) 2024; 9:154. [PMID: 38534839 DOI: 10.3390/biomimetics9030154] [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: 01/26/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
The incidence of microbial infections in orthopedic prosthetic surgeries is a perennial problem that increases morbidity and mortality, representing one of the major complications of such medical interventions. The emergence of novel technologies, especially 3D printing, represents a promising avenue of development for reducing the risk of such eventualities. There are already a host of biomaterials, suitable for 3D printing, that are being tested for antimicrobial properties when they are coated with bioactive compounds, such as antibiotics, or combined with hydrogels with antimicrobial and antioxidant properties, such as chitosan and metal nanoparticles, among others. The materials discussed in the context of this paper comprise beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), hydroxyapatite, lithium disilicate glass, polyetheretherketone (PEEK), poly(propylene fumarate) (PPF), poly(trimethylene carbonate) (PTMC), and zirconia. While the recent research results are promising, further development is required to address the increasing antibiotic resistance exhibited by several common pathogens, the potential for fungal infections, and the potential toxicity of some metal nanoparticles. Other solutions, like the incorporation of phytochemicals, should also be explored. Incorporating artificial intelligence (AI) in the development of certain orthopedic implants and the potential use of AI against bacterial infections might represent viable solutions to these problems. Finally, there are some legal considerations associated with the use of biomaterials and the widespread use of 3D printing, which must be taken into account.
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Affiliation(s)
- Argyrios Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Aristodemos-Theodoros Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Lamprini Troumpata
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Serban Dragosloveanu
- Department of Orthopaedics and Traumatology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Orthopaedics, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Iosif-Aliodor Timofticiuc
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Spyrangelos Georgatos-Garcia
- Tilburg Institute for Law, Technology, and Society (TILT), Tilburg University, 5037 DE Tilburg, The Netherlands
- Corvers Greece IKE, 15124 Athens, Greece
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Konstantinos Periferakis
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Pan-Hellenic Organization of Educational Programs (P.O.E.P.), 17236 Athens, Greece
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Ioana Anca Badarau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
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Hawthan M, Larsson C, Chrcanovic BR. Survival of fixed prosthetic restorations on vital and nonvital teeth: A systematic review. J Prosthodont 2024; 33:110-122. [PMID: 37455556 DOI: 10.1111/jopr.13735] [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: 09/09/2022] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
PURPOSE To evaluate the survival rate of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs), taking into consideration the potential influence of tooth-vitality, presence and type of post, and type of prosthetic restoration material. MATERIALS AND METHODS In October 2022, two authors independently conducted a search in PubMed, Web of Science, and Scopus electronic databases as well as a hand search to identify clinical human studies on full-coverage SCs and FDPs supported by vital and/or non-vital abutments and/or a combination of both, with a minimum observation period of 24 months. RESULTS Out of 4198 studies identified through the database search and 22 through hand searching, 26 studies fulfilled the inclusion criteria and were included in the analysis of the present systematic review. Included studies scored six points and more according to Newcastle-Ottawa Scale (NOS). The highest estimated 5-year survival rate was observed for (metal-ceramic and all-ceramic) SCs on vital teeth (98.3%; 95% CI [98.1, 98.6%]) and all ceramic SCs on non-vital teeth with fiber post (95.0%; 95% CI [94.5-95.4%]). Metal-ceramic SCs on vital teeth (97.1%; 95% CI [95.6-98.7%]) showed a statistically significant higher estimated 5-year survival rate compared to metal-ceramic SCs with cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001), fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001) and without post (85.7%; 95% CI [80.7, 90.6%], P < 0.032). All-ceramic SCs with fiber post had a statistically significant higher estimated 5-year survival rate (95.0%; 95% CI [94.5-95.4%]) compared to metal-ceramic SCs on non-vital teeth with fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001). SCs (all-ceramic and metal-ceramic) with fiber post had a statistically significantly higher estimated 5-year survival rate of (92.7%; 95% CI [92.4-92.9%]) than SCs made of metal-ceramic and retained by cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001). For FDPs, the 5-year survival rate was significantly higher for FDPs on vital abutments (84.9%; 95% CI [75.9, 93.9%]) compared to FDPs retained by non-vital abutment/s (81.3%; 95% CI [80.3, 82.2%], P = 0.049) irrespective to presence, type of post, and FDPs material. The results are limited by the limited number of studies and the presence of uncontrolled confounding clinical variables. CONCLUSIONS Within the limitations of the study, tooth vitality is suggested to contribute positively to the survival of SCs and FDPs.
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Affiliation(s)
- Mohammed Hawthan
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Bruno R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Michaud PL, Dort H. Do onlays and crowns offer similar outcomes to posterior teeth with mesial-occlusal-distal preparations? A systematic review. J ESTHET RESTOR DENT 2024; 36:295-302. [PMID: 37497796 DOI: 10.1111/jerd.13114] [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: 01/25/2023] [Revised: 05/22/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Teeth prepared for mesial-occlusal-distal (MOD) restorations have a significant risk of cusp fracture. Crowns and onlays can provide cusp coverage to reinforce posterior teeth at risk. Onlays are often more conservative of tooth structure which may be an advantage for teeth with large MOD preparations. It remains uncertain how onlays and crowns compare for posterior teeth with MOD tooth structure loss. The purpose of this systematic review was to compare the resistance to fracture, success rate, survival rate, and failure rate of teeth with MOD preparations restored with onlays or crowns. MATERIALS AND METHODS An electronic search queried Medline (PubMed), Embase (Ovid), Scopus, the Cochrane Library, and grey literature (OpenGrey) from database inception through April 29, 2023. RESULTS After eliminating duplicates and irrelevant records, 32 manuscripts were assessed. Only three publications met the criteria for inclusion. Most exclusions were due to poor reporting of restorative design and the amount of tooth structure remaining, or due to combining various restorative designs. Due to the limited sample size and high heterogeneity, no meta-analysis was conducted. One study observed a better outcome for onlays and two observed no difference. All three studies reported the mode of failure for crowns as more catastrophic whereas teeth with onlays could be salvaged. CONCLUSIONS Onlays may be an advantageous alternative to crowns for teeth with MOD preparations, but the level of evidence is insufficient to draw meaningful conclusions. CLINICAL SIGNIFICANCE Current evidence is insufficient to determine whether onlays or crowns are providing a different outcome when used to restore posterior teeth with MOD tooth structure loss. However, the fracture of teeth with MOD tooth structure loss restored with onlays appears to be less catastrophic than when restored with crowns.
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Affiliation(s)
- Pierre-Luc Michaud
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hillary Dort
- Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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AlHelal AA. Biomechanical behavior of all-ceramic endocrowns fabricated using CAD/CAM: A systematic review. J Prosthodont Res 2024; 68:50-62. [PMID: 37286503 DOI: 10.2186/jpr.jpr_d_22_00296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE This study performed a systematic review to assess the biomechanical behavior of all-ceramic endowcrowns fabricated using computer-aided design and computer-aided manufacturing (CAD/CAM) for the restoration of endodontically treated teeth. STUDY SELECTION Three electronic databases (PubMed, Web of Science, and Scopus) were searched by operators specializing in health sciences databases searches to answer the following focused question based on the Population, Intervention, Comparison, Outcome (PICO) format: "Whether all-ceramic CAD/CAM endocrowns (Intervention) used to restore human endodontically treated teeth (Population) exhibit superior fracture resistance (Outcome) compared to non-CAD/CAM all-ceramic or non-ceramic endocrowns (Comparison)." The methodological quality assessment was performed using previously conducted systematic reviews of in vitro studies. The outcomes were expressed as the mean ± the standard deviation (SD). RESULTS Seventeen in vitro studies were included. The materials used in these studies were lithium disilicate glass-ceramic, polymer-infiltrated ceramic, zirconia-reinforced lithium silicate glass-ceramic, resin/hybrid nanoceramics, zirconia-reinforced lithium silicate ceramics, and feldspathic ceramic. The fracture resistance of endocrowns using different ceramics varied as follows: (i) IPS e.max CAD (2863.62 ± 51.47 N), (ii) Vita Enamic (1952 ± 378 N), (iii) Vita Suprinity (1859 ± 588 N), (iv) Cerasmart (1981 ± 169.5 N), (v) LAVA Ultimate (2484 ± 464 N), (vi) Celtra Duo (1618.30 ± 585.00 N), and (vii) Cerec Blocs (236.29 ± 32.12 N). CONCLUSIONS CAD/CAM all-ceramic endocrowns can withstand occlusal forces in the posterior region. All-ceramic endocrowns improve the fracture strength of endodontically treated teeth. Lithium disilicate crowns were commonly and successfully used in the included studies. More in vitro investigations that implement uniformity in material and measurement approaches are required to strengthen the evidence currently available in the literature regarding the durability of all-ceramic endocrowns.
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Affiliation(s)
- Abdulaziz A AlHelal
- Department of Prosthetic Dental Sciences, King Saud University, College of Dentistry, Riyadh, Saudi Arabia
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10
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Caixeta MT, de Oliveira D, Isquierdo de Souza F, Rocha EP. Efficacy of two polishing systems in reestablishing the surface smoothness of posterior monolithic lithium disilicate restorations: One-year results of a split-mouth randomized controlled clinical trial. J Prosthet Dent 2024; 131:25-33. [PMID: 35272843 DOI: 10.1016/j.prosdent.2022.01.008] [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: 03/21/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Selecting the optimal polishing procedure to reestablish surface smoothness after occlusal adjustment is essential for the long-term success of glass-ceramic restorations. While in vitro studies have shown different effective polishing protocols, clinical trials are lacking. PURPOSE The purpose of this split-mouth controlled clinical trial was to evaluate the effectiveness of 2 polishing systems in reestablishing the surface smoothness of posterior monolithic lithium disilicate ceramic restorations. MATERIAL AND METHODS Ninety-six restorations that required occlusal adjustment after bonding were randomized into 2 groups: Forty-eight restorations were polished by using the Exa Cerapol polishing kit, and the other 48 restorations were polished by using the Shofu polishing kit. The restorations were replicated with epoxy resin at 3 study times-after bonding (t1), after occlusal adjustment (t2), and after polishing (t3)-for quantitative roughness analysis (Ra). Representative specimens from each group were qualitatively analyzed by using a confocal laser microscope. Clinical analyses were performed after the polishing procedure and at 30, 180, and 365 days after the polishing procedure by following the United States Public Health Service (USPHS) criteria. ANOVA and the Tukey multiple comparisons parametric tests were computed (α=.05). The Kaplan-Meier test was used to analyze the survival rate of restorations. RESULTS No statistically significant difference was found between the Exa Cerapol and Shofu groups (P=.086). A statistically significant difference was found between study times t1 and t2 and between t2 and t3 (both P<.001) in both experimental groups. No statistically significant difference was found between study times t1 and t3 (P=.181) in either experimental group. For the clinical criterion "integrity of restorations," all the elements analyzed indicated an alfa grade at all study times. The survival rate of the restorations was 100%. CONCLUSIONS Both polishing kits were effective in reestablishing the surface smoothness of restorations after occlusal adjustment.
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Affiliation(s)
- Mariana Tassinari Caixeta
- Graduate student, Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Danila de Oliveira
- Doctoral student, Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
| | - Fernando Isquierdo de Souza
- Assistant Professor, Department of Prosthodontics, State University of Northern Paraná (UENP), Jacarezinho, Paraná, Brazil
| | - Eduardo Passos Rocha
- Assistant Professor, Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Frasnelli GD, Leoni GB, Cassani R, Faria ACL, Gomes EA, Moris ICM. Effect of different ceramic systems on antagonist dental structure by microtomographic analysis. Dent Mater 2024; 40:118-123. [PMID: 37940499 DOI: 10.1016/j.dental.2023.10.021] [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: 01/12/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES This study aims to identify the two-dimensional and three-dimensional analyses and evaluate the loss of tooth structure in the tooth's different constituent elements and the ceramic antagonist's surface. METHODS In this study, three groups (n = 10) represented by different ceramic systems (lithium disilicate [GDis], lithium silicate reinforced with zirconia [GSil], and monolithic zirconia [GZir]) were evaluated. Each group obtained ten ceramic blocks and submitted them to the sintering/crystallization process. To carry out the wear test, healthy mandibular premolars were used as the specimens and the ceramic blocks as antagonists. The premolars were submitted to two-dimensional and three-dimensional analyses using a computerized microtomography (µTC) before and after the wear test. The wear test was performed with 30 N and 300,000 cycles load, with occlusion, laterality, and disocclusion movements. RESULTS The statistical analysis comparing the loss of two-dimensional tooth structure showed a statistically significant difference among all groups (p < 0.05). Statistical analysis comparing the percentage of loss of three-dimensional tooth structure showed a statistically significant difference between groups GDis and GSil and between groups GDis and GZir. However, when comparing GSil with GZir, no statistically significant difference was found. The qualitative analysis of the teeth showed that GDis showed considerable enamel loss and dentin exposure, GSil showed enamel wear with flattening the cusp without dentin exposure, and GZir showed minimal enamel wear without dentin exposure. In the qualitative analysis of ceramic antagonists, more significant wear of the ceramic material for GDis was observed, followed by the GSil and GZir groups, respectively. SIGNIFICANCE The use of the lithium disilicate should be cautious, restricting it to areas with lower masticatory forces. Areas of higher masticatory forces showed a large amount of antagonist wear, with dentin involvement. This can lead to dentinal hypersensitivity, risk of compromising patients' occlusion, by harming group disocclusion guides, causing pain and temporomandibular disorders.
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Affiliation(s)
| | | | - Raquel Cassani
- School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil
| | | | - Erica Alves Gomes
- School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil
| | - Izabela C M Moris
- School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil.
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Jurado CA, Lee D, Ramirez P, Cortes-Treviño DA, Tsujimoto A. Fracture Resistance of Chairside CAD/CAM Lithium Disilicate-reinforced Ceramic Occlusal Veneers With and Without Margin and Full Coverage Crowns. Oper Dent 2024; 49:84-90. [PMID: 38058016 DOI: 10.2341/23-043-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The aim of this investigation was to compare the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate-reinforced ceramic occlusal veneers with and without margin and traditional full coverage premolar crowns. METHODS AND MATERIALS A total of 60 chairside CAD/CAM lithium disilicate-reinforced ceramic (Amber Mill, Hass Bio) restorations were designed and fabricated with a chairside CAD/CAM system (CEREC Dentsply Sirona). The restorations were divided into three groups (n=20): 1) occlusal veneer with 1.0-mm uniform occlusal thickness and with chamfer margin; 2) occlusal veneer with 1.0-mm uniform occlusal thickness and without margin; and 3) full coverage crown with uniform occlusal thickness and gingival margin. Occlusal veneers and crowns were cemented with dual cured resin luting cement (Multilink, Ivoclar Vivadent) to printed resin dies, load cycled (5 million load cycles at 1 Hz with 275 N force), and then loaded until fracture. Load at break (LB) and peak load (PL) until fracture were recorded. Scanning electron microscope images of the tested restorations on the abutments were obtained. RESULTS Fracture strengths were different depending on the design of the restoration. There was no significant difference in fracture strength between the two types of occlusal veneer (LB: 1132.45 N; PL: 1143.30 N for veneers with margin; LB: 1149.25 N; PL: 1219.05 N for veneers without margin). Full coverage crowns showed the lowest fracture resistance (LB: 936.26 N, PL: 976.42 N), which was significantly lower than both designs of occlusal veneer. CONCLUSIONS The fracture resistance of the CAD/CAM lithium disilicate-reinforced ceramic restorations was influenced by the design. Occlusal veneers with and without margin displayed higher fracture resistance than traditional crowns.
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Affiliation(s)
- C A Jurado
- Carlos Alberto Jurado, DDS, MS, clinical associate professor, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - D Lee
- Damian Lee, DDS, MS, associate professor and chair, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - P Ramirez
- Paulette Ramirez, BS, dental student, Texas Tech University Health Sciences Center El Paso, Woody L. Hunt School of Dental Medicine, El Paso, TX, USA
| | - D A Cortes-Treviño
- Daniel Alberto Cortes-Treviño, DDS, MS, private practice, Dallas, TX, USA
| | - A Tsujimoto
- *Akimasa Tsujimoto, DDS, PhD, professor and chair, Department of Operative Dentistry, Aichi Gakuin University School of Dentistry, Nagoya, Aichi, Japan; adjunct associate professor, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA; visiting associate professor, Department of General Dentistry, Creighton University School of Dentistry, Omaha, NE, USA
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Timofticiuc IA, Călinescu O, Iftime A, Dragosloveanu S, Caruntu A, Scheau AE, Badarau IA, Didilescu AC, Caruntu C, Scheau C. Biomaterials Adapted to Vat Photopolymerization in 3D Printing: Characteristics and Medical Applications. J Funct Biomater 2023; 15:7. [PMID: 38248674 PMCID: PMC10816811 DOI: 10.3390/jfb15010007] [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: 11/15/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Along with the rapid and extensive advancements in the 3D printing field, a diverse range of uses for 3D printing have appeared in the spectrum of medical applications. Vat photopolymerization (VPP) stands out as one of the most extensively researched methods of 3D printing, with its main advantages being a high printing speed and the ability to produce high-resolution structures. A major challenge in using VPP 3D-printed materials in medicine is the general incompatibility of standard VPP resin mixtures with the requirements of biocompatibility and biofunctionality. Instead of developing completely new materials, an alternate approach to solving this problem involves adapting existing biomaterials. These materials are incompatible with VPP 3D printing in their pure form but can be adapted to the VPP chemistry and general process through the use of innovative mixtures and the addition of specific pre- and post-printing steps. This review's primary objective is to highlight biofunctional and biocompatible materials that have been adapted to VPP. We present and compare the suitability of these adapted materials to different medical applications and propose other biomaterials that could be further adapted to the VPP 3D printing process in order to fulfill patient-specific medical requirements.
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Affiliation(s)
- Iosif-Aliodor Timofticiuc
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Octavian Călinescu
- Department of Biophysics, The “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Adrian Iftime
- Department of Biophysics, The “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Serban Dragosloveanu
- Department of Orthopaedics and Traumatology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Orthopaedics, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Ioana Anca Badarau
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Andreea Cristiana Didilescu
- Department of Embryology, Faculty of Dentistry, The “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
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Manziuc M, Kui A, Chisnoiu A, Labuneț A, Negucioiu M, Ispas A, Buduru S. Zirconia-Reinforced Lithium Silicate Ceramic in Digital Dentistry: A Comprehensive Literature Review of Our Current Understanding. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2135. [PMID: 38138238 PMCID: PMC10744576 DOI: 10.3390/medicina59122135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 11/26/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Abstract
Zirconia-reinforced lithium silicate (ZLS) ceramic is a new innovative dental material with unique a chemical composition that is designed to combine harmoniously with the appropriate optical properties of lithium disilicate and the enhanced mechanical strength of zirconia. A thorough understanding of ZLS materials is essential for both clinicians and dental technicians. At present, the mechanical behavior and optical properties of the ZLS ceramic system have not been extensively researched, and there is still a lack of consensus regarding the fabrication process and clinical behavior of ZLS all-ceramic restorations. The aim of the present study was to present a selection of comprehensive information concerning zirconia-reinforced lithium silicate ceramics and their optical and mechanical properties, as well as to assess data regarding cementation procedures and clinical outcomes for ZLS all-ceramic restorations. Three electronic databases (PubMed, Web of Science, and the Cochrane Library) were used for the research by two independent reviewers. The search was limited to articles published in the English language, as well as clinical and in vitro studies of color and studies on mechanical behavior and the cementation procedures of ZLS restorations. The exclusion criteria comprised abstracts, questionnaire-based studies, case reports, literature reviews, and studies that were not available in English. Zirconia-reinforced lithium-silicate-based ceramic presents a unique and complex microstructure that increases mechanical resistance but decreases aesthetic appearance, especially its translucency, due to tetragonal zirconia content. A material's thickness, the color of the underlying tooth structure, and the resin cement shade are important factors that influence the final shade and aesthetic appearance of ZLS restorations. Mechanical properties, which are defined by the fracture toughness, flexural strength, elastic modulus, and hardness of ZLS ceramic are higher compared to feldspathic, lithium disilicate, and hybrid ceramics, as well as resin nanoceramics; however, they are lower than translucent or high-translucency zirconia. Acid etching, sandblasting, and laser etching represent the most used methods to prepare the ZLS restoration surfaces for proper bonding procedures.
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Affiliation(s)
| | - Andreea Kui
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (M.M.); (S.B.)
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Ramzy NA, Azer AS, Khamis MM. Evaluation of the marginal adaptation and debonding strength of two types of CAD-CAM implant-supported cement-retained crowns. BMC Oral Health 2023; 23:967. [PMID: 38053146 PMCID: PMC10696722 DOI: 10.1186/s12903-023-03711-7] [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: 08/13/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND In-vitro data from a clinically well-known lithium disilicate ceramic reference was used to assess the expected performance of resin-based materials in implant dentistry. The purpose of the study was to compare the bond strength and marginal adaptation of nano-ceramic hybrid composite crowns cemented to stock cement-retained abutments to lithium disilicate crowns. METHODS Twenty abutment analogs were embedded into auto-polymerizing acrylic resin blocks. The blocks were divided into 2 groups according to the restorative crown material. The 2 groups were divided as follows: Resin nano-ceramic group and lithium disilicate group. Abutment analogs in both groups were scanned using a laboratory scanner, and the restorations were designed, manufactured, and cemented with resin cement over the corresponding group. All samples were tested for marginal adaptation and bond strength after storage for 24 hours at 37 °C in 100% humidity. Data were collected, tabulated, and statistically analysed using the appropriate tests. Normality was checked using Shapiro Wilk test and Q-Q plots. Data were normally distributed. Variables were presented using mean, 95% Confidence Interval (CI) and standard deviation in addition to median and Inter Quartile Range (IQR). Differences between groups regarding debonding forces was assessed using independent t test. Two Way ANOVA was performed to assess the effect of material and bonding on marginal gap. All tests were two tailed and p value was set at < 0.05. RESULTS Marginal gap and debonding force values were significantly different according to the type of material used (P < .05). Resin nano-ceramic crowns presented lower marginal gap values before (20.80 ± 8.87 μm) and after (52.11 ± 22.92 μm) bonding than lithium disilicate crowns. The debonding force value for resin nano-ceramic crowns (284.30 ± 26.44 N) was significantly higher than that for lithium disilicate crowns (253.30 ± 33.26 N). Adhesive failure mode was detected in all the specimens in both groups. CONCLUSIONS The type of material used for implant-supported cement-retained crowns had a statistically significant effect on marginal adaptation and bond strength. Resin nano-ceramic implant-supported cement-retained crowns had better marginal adaptation and higher bond strength than those manufactured using lithium disilicate.
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Affiliation(s)
- Nada Ahmed Ramzy
- Faculty of Dentistry, Alexandria University, Alexandria, 8, Abbas Alhalawany Street Ibrahemia, Egypt.
| | - Amir Shoukry Azer
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Moataz Khamis
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Bataineh K, Al Janaideh M. Fatigue behavior of three thin CAD/CAM all-ceramic crown materials. Int Biomech 2023; 10:1-8. [PMID: 38205926 PMCID: PMC10786422 DOI: 10.1080/23335432.2024.2303121] [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: 03/23/2020] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
The purpose of this study was to study the effect of crown thickness on the fatigue life of CAD/CAM ceramic materials. CAD/CAM ceramic materials for the crown were virtually designed with three thickness designs of (a) ultra-thin occlusal crown average 0.7 mm thick (group A), (b) thin occlusal crown 1.1 mm average thick (group B), (c) thick occlusal crown 1.5 mm thick. The materials are: zirconia Cercon ZC and IPS e.max CAD (LD). Finite Element Analysis (FEA) simulations were carried out to estimate the fatigue lives of restorative materials. The lives for groups B and C under fatigue load were not significantly different from each other for Zirconia. The predicted lives for group A zirconia crowns, under fatigue load 50 N, 100 N, 120 N is 24 years, 4.3 years, 1.9 years, respectively. Results for crowns made of LD can be summarized as follows: under load 50 N, all groups have survived longer than 5 respectively, while under the load of 100 N, only group C survived longer than 5 years. 0.7 mm thick full contour Zirconia crowns possessed adequate endurance strength to survive under physiologic conditions. On the other hand, the crown made of LD should have at least 1.5 mm thickness to survive longer than 5 years.
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Affiliation(s)
- Khaled Bataineh
- Department of Mechanical Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Al Janaideh
- Department of Mechanical Engineering, Jordan University of Science and Technology, Irbid, Jordan
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Lindner S, Frasheri I, Hickel R, Crispin A, Kessler A. Retrospective clinical study on the performance and aesthetic outcome of pressed lithium disilicate restorations in posterior teeth up to 8.3 years. Clin Oral Investig 2023; 27:7383-7393. [PMID: 37870592 PMCID: PMC10713824 DOI: 10.1007/s00784-023-05328-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES Evaluation of cumulative survival and complication rate of monolithic lithium disilicate inlays and partial crowns performed by supervised undergraduate students up to 8.3 years of clinical service. MATERIALS AND METHODS In this retrospective clinical study 143 lithium disilicate posterior restorations (IPS e.max Press) were examined according to the FDI criteria. A standardised questionnaire was used to determine patient satisfaction. The aesthetic outcome was evaluated by dentists and dental technicians using intraoral photographs. Data were descriptively analysed. Cumulative survival and success rates were calculated using Kaplan-Meier estimation. RESULTS The cumulative survival rate of lithium disilicate restorations was 97.5% after a mean service time of 5.9 years and 95.0% after 8.3 years. The cumulative success rate decreased from 94.4% after 5.9 years to 30.7% after 8.3 years. Repairs were required for 7 restorations (4.9%), and 5 (3.5%) were classified as failures. The results of the questionnaire indicate a high level of patient satisfaction. The subjective aesthetics were assessed more critically by dental technicians compared to dentists. CONCLUSION Lithium disilicate posterior restorations survived successfully up to 8.3 years when carried out by undergraduate students. CLINICAL RELEVANCE Pressed lithium disilicate glass ceramic inlays and partial crowns are reliable treatment options in posterior teeth.
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Affiliation(s)
- Stefanie Lindner
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-Universität München, Goethestr 70, 80336, Munich, Germany.
| | - Iris Frasheri
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-Universität München, Goethestr 70, 80336, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-Universität München, Goethestr 70, 80336, Munich, Germany
| | - Alexander Crispin
- Department of Medical Informatics, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Marchioninistr 15, 81377, Munich, Germany
| | - Andreas Kessler
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-Universität München, Goethestr 70, 80336, Munich, Germany
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Jurado CA, Afrashtehfar KI, Hyer J, Alhotan A. Effect of sintering on the translucency of CAD-CAM lithium disilicate restorations: A comparative in vitro study. J Prosthodont 2023; 32:861-866. [PMID: 36609993 DOI: 10.1111/jopr.13644] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The available independent data on the translucency of novel pre and fully sintered chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate are limited. This comparative in vitro study evaluated the translucency degree of pre and fully sintered chairside CAD-CAM lithium disilicate crowns after optional, required, and additional firing processes. MATERIALS AND METHODS One hundred and five maxillary left central incisor crowns manufactured by three different CAD-CAM lithium disilicate brands shade A1 were assigned into seven groups as follows (n = 15): (1) Straumann n!ce without sintering; (2) Straumann n!ce with one additional sintering process; (3) Straumann n!ce with two additional sintering processes; (4) Amber Mill with one sintering process; (5) Amber Mill with two sintering processes; (6) IPS e.max CAD with one sintering process; and (7) IPS e.max CAD with two sintering processes. The translucency of all crowns was evaluated with a color imaging spectrophotometer. All statistical analyses were performed using statistical software. A standard level of significance was set at α < 0.05. RESULTS All the milled crowns presented different degrees of translucency, and additional sintering processes altered it. IPS e.max CAD with two (4.33 ± 0.26) and one (4.01 ± 0.15) sintering processes displayed the highest translucency, whereas Straumann n!ce with no sintering process provided the lowest value (2.82 ± 0.16). CONCLUSIONS The translucency of chairside lithium disilicate single-unit full-coverage restorations manufactured with subtractive technology was significantly influenced by the brand and the number of sintering processes. The traditional presintered IPS e.max CAD and the fully crystallized glass-ceramic Straumann n!ce considerably increased the translucency after one additional firing process, whereas Amber Mill decreased its translucency.
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Affiliation(s)
- Carlos A Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Kelvin I Afrashtehfar
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, UAE
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jared Hyer
- A.T. Still University Arizona School of Dentistry and Oral Health, Mesa, Arizona, USA
| | - Abdulaziz Alhotan
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Nilsson G, Ellner S, Arnebrant L, Brudin L, Larsson C. Loss of pulp vitality correlated with the duration of the interim restoration and the experience of the dentist: A retrospective study. J Prosthet Dent 2023; 130:833-839. [PMID: 35105459 DOI: 10.1016/j.prosdent.2021.11.029] [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: 04/28/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022]
Abstract
STATEMENT OF PROBLEM The second most common biological complication in fixed prosthodontics is loss of pulp vitality, which may lead to restoration loss. While reasons for loss of pulp vitality are unclear, 2 potential contributing factors, duration of the interim restoration and operator experience, have not been fully investigated. PURPOSE The purpose of this retrospective study was to investigate whether the duration of the interim restoration or the experience of the dentist was correlated with loss of pulp vitality. MATERIAL AND METHODS Fixed prosthetic restorations placed between 2005 and 2012 were retrospectively analyzed. Abutment teeth supporting single-unti or multiunit restorations were evaluated regarding loss of pulp vitality. The Mann-Whitney U test and simple logistic regression were used, with α=.05 for the subsequent multiple logistic regression. The experience of dental professionals was defined by the number of treatments performed and coupled with failure rate by using an analysis of variance. RESULTS One hundred seventy-four dentists made 15 879 restorations, of which 1136 failed during the observation period, a failure rate of 7.2%. Two hundred fifty restorations were randomly selected from the failed restorations, and a corresponding 250 restorations were randomly selected from nonfailed restorations for the control group. Increased duration with interim replacement was linked to a higher risk of loss of pulp vitality (P<.001). Failure rate in the dentist group varied from 0% to 100%. No significant differences in failure rate were found among dentists who did few restorations and those who performed larger numbers of restorations. CONCLUSIONS The results of the present study suggest that operator experience does not affect failure rate. However, extended time with an interim restoration was a contributing factor to the loss of pulp vitality.
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Affiliation(s)
- Göran Nilsson
- Senior consultant, Specialist in prosthetic Dentistry, Department of Prosthetic Dentistry Specialist clinic, Kalmar County Public Dental Service, Kalmar, Sweden.
| | - Stefan Ellner
- Senior consultant, Specialist in prosthetic Dentistry, Department of Prosthetic Dentistry Specialist clinic, Kalmar County Public Dental Service, Kalmar, Sweden
| | - Liselott Arnebrant
- Professor emerita, Department of Prosthodontics, Faculty of Odontology, Malmö, Sweden
| | - Lars Brudin
- Adjunct, Department of Clinical Physiology, Kalmar County and Department of Medical and Health Sciences, Linköping University, Kalmar, Sweden
| | - Christel Larsson
- Associate Professor, Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Yousry MA, Hammad IA, El Halawani MT, Aboushelib MN. Effect of sintering time on microstructure and optical properties of yttria-partially stabilized monolithic zirconia. Dent Mater 2023; 39:1169-1179. [PMID: 37845165 DOI: 10.1016/j.dental.2023.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/12/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To evaluate the impact of speed sintering on the microstructure and optical properties of 3 and 5 mol% yttria-partially stabilized monolithic zirconias. METHODS 120 plate-shaped zirconia specimens (10x10x 0.4 mm) were prepared from three commercial 5 mol% yttria-partially stabilized zirconia blocks (5Y-PSZs); Katana UTML (Kuraray Noritake), Cercon xtML (Dentsply Sirona), and Zolid FX white (Amann Girrbach), and two commercial 3 mol% yttria-partially stabilized zirconia blocks (3Y-PSZs); Lava Plus (3 M ESPE) and InCoris (Sirona, GmbH). Specimens were either conventional sintered (CS) using a 7-hour program or speed sintered (SS) using a quick 90-minute program. The microstructure was inspected with a scanning electron microscope (SEM), and phase fractions were detected using x-ray diffraction analysis (XRD). Translucency (TP00), and contrast ratio (CR) were obtained using a spectrophotometer (VITA Easyshade V). Color difference (ΔE00) between both sintering processes was calculated with the CIEDE2000 formula. ΔE00 up to 1.8 was set as the acceptability threshold. Data were analyzed using two-way ANOVA, Krusakll-Wallis, and Mann-Whitney U tests. (n = 12, α = .05). RESULTS Grain size was significantly decreased after SS for all tested materials (P < .0001). The average grain sizes of 5Y-PSZs were significantly larger than those of 3Y-PSZs. The atomic structure, microstructure, and transparency of CS and SS were all affected by the amount of yttria, the size of the crystals, and tetragonality. SS significantly reduced TP00 (F = 7135.95, P < 0.0001) and increased CR (F = 453.21, P < 0.0001). The CS Katana presented the highest TP00 and lowest CR value. ΔE00 between the CS and SS groups were clinically acceptable except for Lava, which had values above the set threshold (1.89). SIGNIFICANCE SS altered the grain size and internal structure of the tested materials, which was reflected in translucency.
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Affiliation(s)
- Mahinour A Yousry
- Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ihab A Hammad
- Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed T El Halawani
- Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Moustafa N Aboushelib
- Department of Dental Materials Science, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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21
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Jurado CA, Amarillas-Gastelum C, Tonin BSH, Nielson G, Afrashtehfar KI, Fischer NG. Traditional versus conservative endodontic access impact on fracture resistance of chairside CAD-CAM lithium disilicate anterior crowns: An in vitro study. J Prosthodont 2023; 32:728-734. [PMID: 36471494 DOI: 10.1111/jopr.13625] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/04/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate the effect of traditional and conservative endodontic access hole preparation on fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate maxillary right central incisor crowns. MATERIALS AND METHODS Fifty-seven milled lithium disilicate maxillary right central incisor crowns were designed and fabricated with a chairside CAD-CAM system (Planmeca Romexis, Planmeca). The abutment preparation had a 1.0 mm incisal reduction and 1.0 mm chamfer finish. The restorations were bonded with resin cement to printed resin dies (n = 19 per group) and were treated and divided into three groups, (1) no endodontic access, (2) traditional triangular endodontic access, and (3) conservative ovoidal endodontic access. The endodontic access of the crowns was sealed with flowable resin composite. Restorations were subjected to 10,000 cycles of thermal cycling between 5° and 55°C. Then, restorations were loaded and exposed to compressive loading force, and the crack initiation (CI) and complete fracture (CF) were recorded. SEM micrographs of broken specimens on the printed dies were captured. ANOVA test and Bonferroni's correction were used for statistical comparison. RESULTS The fracture resistance among the three groups varied. Crowns with no endodontic access displayed significantly (p < 0.001) higher resistance [CI: 1025 (121) N; CF 1134 (127) N], followed by crowns with conservative ovoidal endodontic access [CI: 924 (60) N; CF: 1000 (72) N. Crowns with traditional triangular endodontic access showed the significantly (p < 0.001) lowest fracture resistance [CI: 635 (82) N; CF: 709 (75) N]. CONCLUSION The fracture resistance of chairside CAD-CAM lithium disilicate maxillary anterior crowns is influenced by the type of endodontic access provided. Conservative ovoidal endodontic access provides crowns with higher fracture resistance than traditional triangular endodontic access. Crowns with no endodontic access provided the highest resistance than other types of endodontic access.
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Affiliation(s)
- Carlos A Jurado
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, Texas
| | | | - Bruna Santos Honório Tonin
- Department of Dental Materials and Prosthetics, University of Sao Paulo School of Dentistry of Ribeirao Preto, Ribeirao Preto, Brazil
| | - Gentry Nielson
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, Texas
| | - Kelvin I Afrashtehfar
- Clinical Sciences Department, Ajman University Dental College, Ajman City, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland
| | - Nicholas G Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, Minnesota
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22
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Zahran M, Abo El-Farag S, Soltan H, Attia A. Fracture load of ultrathin occlusal veneers: Effect of thickness and surface conditioning. J Mech Behav Biomed Mater 2023; 145:106030. [PMID: 37473575 DOI: 10.1016/j.jmbbm.2023.106030] [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: 06/02/2023] [Revised: 07/12/2023] [Accepted: 07/15/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE This in-vitro study is planned to analyze the effect of different thicknesses of ceramic occlusal veneers and different surface treatments on fracture resistance. MATERIALS AND METHODS A total of 48 sound mandibular molars are anatomically prepared from the occlusal surface with two different thicknesses (1.0 and 0.5 mm). CAD/CAM zirconia-reinforced glass ceramic blocks (Vita Suprinity) are used for fabricating occlusal veneers. The teeth are randomly divided into two primary groups A and B (n=24) according to occlusal veneer thickness. Each group is subdivided according to surface conditioning into three equal subgroups (n=8)-subgroup HF: etching with hydrofluoric acid and ceramic primer application; subgroup APF: etching with acidulated phosphate fluoride and ceramic primer application; subgroup EP: conditioning with etch and prime only. Dual-cure adhesive resin cement (Multilink Automix) is utilized to adhesively bond the veneers. All specimens are subjected to 240,000 cycles of dynamic load aging prior to the fracture resistance test. The fracture resistance is measured in Newton (N). The Failure mode patterns are analyzed and categorized using a scanning electron microscope (SEM). The results are analyzed using a two-way ANOVA with Bonferroni's Post-Hoc test, followed by a one-way ANOVA for each factor. That is in addition to one-way ANOVA for surface treatment under each thickness, each followed by Bonferroni's Post-Hoc test. Then, a T-test is used to compare the two thicknesses under each surface treatment. All tests are set at 0.05 significance level. RESULTS The two-way ANOVA test revealed that restoration thickness and surface treatment both significantly affect the fracture resistance values (p<0.05). The highest fracture resistance mean (2672±216N) is obtained from HF at 1.0 mm thickness, while the lowest mean (2104±299N) is obtained from APF at 0.5 mm thickness. CONCLUSION All test groups, regardless of thickness, demonstrated fracture resistance values that exceeded both normal and parafunctional bite forces. The veneers that bonded after hydrofluoric acid etching followed by ceramic primer application showed more favourable fracture patterns.
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Affiliation(s)
- Maged Zahran
- Department of Fixed Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt.
| | - Shaimaa Abo El-Farag
- Department of Fixed Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt.
| | - Hassan Soltan
- Production and Mechanical Design Engineering Department, Faculty of Engineering, Mansoura University, Mansoura 35516, Egypt.
| | - Ahmed Attia
- Department of Fixed Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt.
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23
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Alevizakos V, Mosch R, von See C. Influence of Multiple Used Implant Drills on Their Cutting Performance and Fracture Resistance. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5271. [PMID: 37569975 PMCID: PMC10420324 DOI: 10.3390/ma16155271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
This study aimed to analyze the influence of multiple uses of zirconia implant drills on their cutting performance and bending strength. The hypothesis was that drill usage and sterilization cycles would not affect drilling time or flexural strength. Sixty zirconia twist drills from Z-Systems were used to drill in the angulus mandibulae region of fresh porcine jaws. The drills were divided into four groups based on the cycle count, and the drilling time was measured. Bending strength tests were conducted using a universal testing machine, and statistical analysis was performed using ANOVA tests. The results showed that drilling times followed a normal distribution, and significant differences were observed in drilling times between group 1 and the other groups for the pilot drill. However, no significant differences were found for ø3.75 mm and ø4.25 mm drills, and drilling times also varied significantly among different drill diameters, regardless of the cycle count. Flexural strength did not significantly differ among drill diameters or sterilization cycles. Overall, using and sterilizing zirconia implant drills had no significant impact on drilling time or flexural strength. Nevertheless, drilling times did vary depending on the diameter of the drill. These findings provide valuable insights into the performance and durability of zirconia implant drills, contributing to the optimization of dental implant procedures.
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Affiliation(s)
- Vasilios Alevizakos
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Danube Private University, Steiner Landstrasse 124, 3500 Krems an der Donau, Austria; (R.M.); (C.v.S.)
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24
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Abd Alraheam I, Al-Asmar A, Hasan N, Asoleihat F, Alkayed A. Clinical evaluation of cemented and adhesively resin-bonded monolithic and partially layered zirconia and lithium disilicate crowns. Saudi Dent J 2023; 35:508-514. [PMID: 37520593 PMCID: PMC10373076 DOI: 10.1016/j.sdentj.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose Zirconia and lithium disilicate crowns are very popular dental restorations. The cement type and layering technique used can profoundly affect the clinical performance of these crowns.This retrospective study is designed to investigate the success rate of cemented and adhesively bonded monolithic and partially layered zirconia and lithium disilicate crowns placed in faculty practice settings. Materials and Methods Patients who had received zirconia or lithium disilicate crowns at the faculty practice were invited for clinical examination. The examiner used the modified United States Public Health Service (MUSPHS) evaluation criteria to evaluate the crowns. The crowns were either glass ionomer cemented zirconia (GIC-Zr), resin-bonded zirconia (Adh-Zr), or resin-bonded lithium disilicate (Adh-LD). The crowns were also divided into monolithic and layered groups. Inferential analysis was used to examine the differences through bivariate analysis using t-testing and one-way ANOVA. Results Thirty-five patients, with a combined total of 218 single crowns, agreed to participate in the study. No statistically significant differences in the quality outcome variables considered were found between the groups, except for marginal adaptation, where Adh-Zr achieved significantly higher scores compared to GIC-Zr and Adh-LD. Layered zirconia and lithium disilicate crowns have significantly higher quality outcomes in terms of anatomic form, marginal adaptation, and color match compared to monolithic zirconia and lithium disilicate crowns. Conclusions Conventionally cemented zirconia and adhesively bonded zirconia and lithium disilicate crowns are reliable treatment options with high short-term success rates. Clinical studies with longer follow-up times are needed to investigate their long-term success rates.
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Affiliation(s)
- Islam Abd Alraheam
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Aya Al-Asmar
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Noor Hasan
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Firas Asoleihat
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Awni Alkayed
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
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25
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Al-Dulaijan YA, Aljubran HM, Alrayes NM, Aldulaijan HA, AlSharief M, Aljofi FE, Ibrahim MS. Clinical outcomes of single full-coverage lithium disilicate restorations: A systematic review. Saudi Dent J 2023; 35:403-422. [PMID: 37520610 PMCID: PMC10373088 DOI: 10.1016/j.sdentj.2023.05.012] [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: 01/04/2023] [Revised: 05/07/2023] [Accepted: 05/16/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Lithium disilicate glass-ceramic (LDC) restorations exhibit microorganism infiltration, recurrent caries, pulpal lesions, periodontal inflammation, and cement exposure to the oral environment over time. All these factors lead to restoration failure. This systematic review aimed to investigate the clinical outcomes of LDC full-coverage crowns (FCC) in permanent teeth compared with those of other full-coverage restoration materials. Materials & Methods Search strategies were developed for four databases: Web of Science, OVID, PubMed, and Scopus. Data extraction and quality appraisals were performed by two independent reviewers. Data on the presence of caries, post-operative sensitivity, and periodontal changes were extracted from the included clinical studies. In addition to the outcome measures, data on the sample size, study groups, method of restoration fabrication, type of impression, and type of abutment were recorded. Results We retrieved 3989 records for the title and abstract screening. Of these, 19 clinical studies met the inclusion criteria. The overall quality of the included studies indicates a low risk of bias. Most studies reported no pulpal involvement, recurrent caries, or post-operative sensitivity and presented a favorable periodontal response after the cementation of LDC-FCC during different follow-up periods. Conclusion Based on the endodontic and periodontic clinical responses of natural tooth abutments and their supporting periodontium, LDC-FCC can be considered a clinically successful restorative option.
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Affiliation(s)
- Yousif A. Al-Dulaijan
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Hussain M. Aljubran
- College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Nabras M. Alrayes
- College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Hajer A. Aldulaijan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mishali AlSharief
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Faisal E. Aljofi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Maria S. Ibrahim
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Adabo GL, Longhini D, Baldochi MR, Bergamo ETP, Bonfante EA. Reliability and lifetime of lithium disilicate, 3Y-TZP, and 5Y-TZP zirconia crowns with different occlusal thicknesses. Clin Oral Investig 2023:10.1007/s00784-023-05001-6. [PMID: 37022529 DOI: 10.1007/s00784-023-05001-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVES To assess the probability of survival of crowns made with a 3Y-TZP, a 5Y-TZP, and a lithium disilicate. MATERIALS AND METHODS CAD-CAM premolar crowns with occlusal thicknesses of 1.0 mm or 1.5 mm and cemented on a metal dye. Step-stress accelerated life testing (SSALT) was performed to access the use level probability Weibull curves and reliability were calculated for the completion of a mission of 100,000 cycles at 300 to 1200 N. RESULTS All ceramics showed a high probability of survival (87-99%) at 300 N, irrespective of thickness. 3Y-TZP shows no significant decrease in the probability of survival up to 1200 N (83-96%). Lithium disilicate presented lower reliability than zirconia under the 600 N mission. 5Y-TZP showed lower reliability than 3Y-TZP at 1200 N. There was no significant difference in the Weibull modulus (3.23-7.12). 3Y-TZP had the highest characteristic strength (2483-2972 N), followed by 5Y-TZP (1512-1547 N) and lithium disilicate (971-1154 N). CONCLUSION Zirconia ceramics have a high probability of survival (up to 900 N-load), while lithium disilicate survives up to 300 N load only, irrespective of the thickness (1.0 mm or 1.5 mm). CLINICAL RELEVANCE The probability of survival of posterior crowns made with zirconia ceramics resists extreme loads while glass ceramics resist normal chewing loads. In addition, crowns with thinner occlusal face showed sufficient mechanical behavior.
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Grants
- 2016/09640-0, 2012/19078-7, 2021/06730-7, EMU 2016/18818-8, 2019/08693-1 Fundação de Amparo à Pesquisa do Estado de São Paulo
- 2016/09640-0, 2012/19078-7, 2021/06730-7, EMU 2016/18818-8, 2019/08693-1 Fundação de Amparo à Pesquisa do Estado de São Paulo
- 2016/09640-0, 2012/19078-7, 2021/06730-7, EMU 2016/18818-8, 2019/08693-1 Fundação de Amparo à Pesquisa do Estado de São Paulo
- Finance Code 001 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Finance Code 001 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- 307255/2021-2 Conselho Nacional de Desenvolvimento Científico e Tecnológico
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Affiliation(s)
- Gelson Luis Adabo
- School of Dentistry, Sao Paulo State University (Unesp), Araraquara, Sao Paulo, Brazil.
| | - Diogo Longhini
- School of Dentistry, Sao Paulo State University (Unesp), Araraquara, Sao Paulo, Brazil
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27
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Hassall D. The use of the monolithic ceramic and direct monolithic composite in the aesthetic rehabilitation of tooth wear. Br Dent J 2023; 234:406-412. [PMID: 36964362 DOI: 10.1038/s41415-023-5621-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 03/26/2023]
Abstract
Traditional cold layering composite techniques can have limitations in the aesthetic rehabilitation of advanced tooth wear, with potentially high maintenance/failure rates and compromised aesthetics. This article explores advances in materials and clinical techniques involving monolithic ceramics and direct monolithic composites. These restorations satisfy the most aesthetically demanding patient, providing good to excellent aesthetics and long-term predictability.
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Affiliation(s)
- Dominic Hassall
- Specialist in Restorative, Prosthodontic, Periodontal and Endodontic Dentistry, Dominic Hassall Training Institute, 91 Lode Lane, Solihull, B91 2HH, UK.
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28
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Edelhoff D, Erdelt KJ, Stawarczyk B, Liebermann A. Pressable lithium disilicate ceramic versus CAD/CAM resin composite restorations in patients with moderate to severe tooth wear: Clinical observations up to 13 years. J ESTHET RESTOR DENT 2023; 35:116-128. [PMID: 35919964 DOI: 10.1111/jerd.12947] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report the long-term clinical survival and failure rates of single-tooth restorations made of pressable lithium disilicate ceramics (LS2 ) and CAD/CAM resin composite (RC) by two separate clinical observations. MATERIALS AND METHODS Twenty-one patients (12 female, nine male) were treated with 436 minimally invasive single-tooth restorations made of 274 pressed LS2 (n = 12; posterior: monolithic IPS e.max Press; anterior: IPS e.max Ceram veneered, Ivoclar) or 162 milled from RC (n = 9; monolithic exp. CAD/CAM resin composite, Ivoclar). The mean age of patients was 44.1 ± 9.3 years and the mean observation time was 86.2 ± 13.5 months (7.7 ± 1.1 years), with 8.5 ± 2.7 years for LS2 and 6.7 ± 0.5 years for RC. All restorations were observed for technical/biological failures using the modified criteria of the United States Public Health Service (USPHS). Collected data were analyzed using Kaplan-Meier survival analysis and log-rank test (α < 0.025). RESULTS The 274 LS2 restorations showed a survival of 100% and a total failure rate of 5.5%. The 162 RC restorations showed a survival of 100% and a total failure rate of 25.3%. RC restorations exhibited more material fractures (p = 0.020) and higher discoloration rates (p < 0.001). CONCLUSIONS Pressed LS2 single-tooth restorations showed lower long-term failure rates than restorations made of RC. CLINICAL SIGNIFICANCE Despite the limitations of the clinical observations, single-tooth restorations of both materials can be recommended for permanent use in patients with severe tooth wear.
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Affiliation(s)
- Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Kurt-Jürgen Erdelt
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Anja Liebermann
- Polyclinic of Prosthetic Dentistry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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29
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Yoo SK, Jo YH, Yeo ISL, Yoon HI, Lee JH, Ahn JS, Han JS. Analysis of surface characteristics of (Y, Nb)-TZP after finishing and polishing. J Adv Prosthodont 2022; 14:335-345. [PMID: 36685792 PMCID: PMC9832147 DOI: 10.4047/jap.2022.14.6.335] [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: 08/09/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 12/28/2022] Open
Abstract
PURPOSE This in vitro study aimed to evaluate the surface characteristics of a full veneer crown fabricated chairside (CS) from a (Y, Nb)-TZP zirconia block in response to conventional zirconia grinding and polishing. MATERIALS AND METHODS Zirconia crowns (n = 40) were first prepared and divided into two groups of materials: Labside (LS) and CS, after which each specimen went through a five-step grinding and polishing procedure. Following each surface treatment, surface characteristics were analyzed using confocal laser microscopy (CLSM), average surface roughness (Ra) values were processed from the profile data through Gaussian filtering, and X-ray diffraction pattern analysis was performed to evaluate the monoclinic (M) phase content. Then, a representative specimen was selected for field-emission scanning electron microscopy (FE-SEM), followed by a final analysis of the roughness and X-ray diffraction of the specimens using the independent t-test and repeated measures analysis of variance (RM-ANOVA). RESULTS In every group, polishing significantly reduced the Ra values (P < .001). There was no significant difference in Ra between the polished state CS and LS. Furthermore, CLSM and FE-SEM investigations revealed that even though grain exposure was visible in CS specimens throughout the as-delivered and ground states, the exposure was reduced after polishing. Moreover, while no phase transformation was visible in the LS, phase transformation was visible in CS after every surface treatment, with the M phase content of the CS group showing a significant reduction after polishing (P < .001). CONCLUSION Within the limits of this study, clinically acceptable level of surface finishing of (Y, Nb)-TZP can be achieved after conventional zirconia polishing sequence.
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Affiliation(s)
- Seong-keun Yoo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ye-Hyeon Jo
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jae-Hyun Lee
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jin-Soo Ahn
- Department of Dental Biomaterials Science and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jung-Suk Han
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Jodha KS, Kaur N, Salazar Marocho SM, Mecholsky JJ, Lirette ST, Duan Y, Griggs JA. Relationship between fracture toughness and fractal dimensional increment in two types of dental glass-ceramics with different fracture surface roughness. Dent Mater 2022; 38:1977-1988. [PMID: 36414435 PMCID: PMC9888424 DOI: 10.1016/j.dental.2022.11.011] [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: 07/25/2022] [Revised: 11/06/2022] [Accepted: 11/11/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Previous studies have reported the fractal dimensional increment of glass-ceramic fracture surfaces. The objective of this study was to determine the relationship between fracture toughness and fractal dimensional increment of two dental glass-ceramics with different volume fraction of crystals and different fracture surface roughness. METHODS Bar-shaped specimens were prepared from lithium disilicate (LDS) and nanofluorapatite (NFA) glass-ceramics. One face of each specimen was indented using a Knoop diamond at 25 N (LDS) or 10 N (NFA) followed by loading in 4-point, or 3-point flexure, respectively, until failure. Fracture toughness (Kc) was calculated using the surface crack in flexure (SCF) technique (ASTM C1421). Epoxy replicas of the fracture surfaces were scanned using the atomic force microscope (AFM) followed by noise filtering. The FRACTALS software was used to determine the fractal dimensional increment (D*) by the Minkowski cover algorithm. RESULTS Median (25%, 75% quartiles) fracture toughness of LDS bars were 1.62 (1.59, 1.69) MPa m1/2 and NFA bars were 0.68 (0.66, 0.74) MPa m1/2, respectively. The median fractal dimension (D) value (25%, 75% quartiles) before noise filtering were 2.16 (2.15, 2.17) and after noise filtering were 2.14 (2.14, 2.15) for LDS and before noise filtering were 2.29 (2.21, 2.38) and after noise filtering were 2.17 (2.17, 2.18) for NFA. Median (25%, 75% quartiles) surface roughness (Ra) before noise filtering were 139 (119, 188) nm and after noise filtering were 137 (118, 187) nm for LDS and before noise filtering were 7 (6, 15) nm and after noise filtering were 7 (6, 15) nm for NFA. SIGNIFICANCE Noise filtering successfully eliminated noise from the material with smooth fracture surfaces (NFA), decreasing the measured fractal dimension. The NFA data fit a Kc vs. D*1/2 statistical model for fused silica previously tested using a similar technique. The equation relating fracture toughness to the fractal dimension was modified, accounting for the toughening mechanisms. Fractal analysis with noise filtering can be used to estimate the fracture toughness of dental glass-ceramics that do not exhibit crack bridging.
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Affiliation(s)
- Kartikeya S Jodha
- Department of Biomedical Materials Science, University of Mississippi Medical Center, MS, USA
| | - Navleen Kaur
- Department of Biomedical Materials Science, University of Mississippi Medical Center, MS, USA
| | | | - John J Mecholsky
- Department of Materials Science and Engineering, Herbert Wertheim College of Engineering, University of Florida, USA
| | - Seth T Lirette
- Department of Data Science, University of Mississippi Medical Center, MS, USA
| | - Yuanyuan Duan
- Department of Biomedical Materials Science, University of Mississippi Medical Center, MS, USA
| | - Jason A Griggs
- Department of Biomedical Materials Science, University of Mississippi Medical Center, MS, USA.
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Benli M, Turkyilmaz I, Martinez JL, Schwartz S. Clinical performance of lithium disilicate and zirconia CAD/CAM crowns using digital impressions: A systematic review. Prim Dent J 2022; 11:71-76. [PMID: 36533368 DOI: 10.1177/20501684221132941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The purpose of this systematic review was to compare the clinical performance of lithium disilicate (LDS) and zirconia (Z) single crowns manufactured by computer-aided design/computer-aided manufacturing (CAD/CAM) systems using intraoral optical scanners (IOS). MATERIALS AND METHODS An electronic search for articles published between January 2012 and January 2022 in the English language was performed with the Medline/Pubmed database under the guidelines of Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA). The specific search terms used were "zirconia", "lithium disilicate", "CAD/CAM", "intraoral optical scanner", and "survival". RESULTS The initial electronic search resulted in 278 articles. Most of the resulting articles were excluded, six clinical studies addressing the clinical outcomes of Z and LDS crowns fitted the inclusion criteria and were selected for review. Of these six studies, three were randomised controlled trials, two were retrospective studies, and one was a prospective study. To quantify the clinical performance of the crowns several parameters were recorded, including fractures, endodontic complications, periodontal complications, technical complications, aesthetic complications, and biological complications. It was noted that the most common technical complication of Z and LDS crowns was chipping at a rate of 1.4% and 5% respectively. Regarding Z crowns, aesthetic concerns were the most frequently observed complication. CONCLUSION The outcomes of this systematic review indicate that Z and LDS crowns display a similar incidence of periodontal and endodontic complications when compared to metal-ceramic crowns, suggesting that these all-ceramic materials are viable alternatives. The incidence of chipping was higher in LDS crowns compared to other materials, while Z crowns were inferior in terms of aesthetics.
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Affiliation(s)
- Merve Benli
- Researcher, University of Pittsburgh, School of Dental Medicine, Department of Oral Biology, Pittsburgh, USA; Assistant Professor, Istanbul University, School of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | - Ilser Turkyilmaz
- Professor, New York University College of Dentistry, Department of Prosthodontics, New York, USA
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Three-year clinical evaluation of zirconia and zirconia-reinforced lithium silicate crowns with minimally invasive vertical preparation technique. Clin Oral Investig 2022; 27:1577-1588. [PMID: 36383297 PMCID: PMC10102102 DOI: 10.1007/s00784-022-04779-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/06/2022] [Indexed: 11/17/2022]
Abstract
Abstract
Objectives
Large part of the tooth is required to be removed during crown preparation. A minimally invasive method for preparing single crowns is required to increase the durability of teeth. The aim of this study was to evaluate the clinical performance of two ceramic systems fabricated with minimally invasive vertical preparation.
Materials and methods
Forty endodontically treated maxillary premolars were prepared with vertical preparation and received temporary crowns for a period of 21 days. Twenty zirconia-reinforced lithium silicate (Celtra Duo HT, Dentsply Sirona, Germany) and 20 monolithic high translucency zirconia (Katana HT, Kuarary Noritake, Japan) crowns were fabricated by CAD/CAM and cemented with dual-polymerizing luting resin. The crowns were evaluated clinically and radiographically for 36 months following modified FDI criteria. Statistical analysis was conducted with t Student test (Cochran Q).
Results
Over the follow-up period, there was no need to replace any of the study’s crowns. The overall survival rate of the 40 crowns was 100% according to the Kaplan–Meier survival method. The clinical quality of all crowns and the patient’s satisfaction were high. No caries was detected and no adverse soft tissue reactions around the crowns were observed. Periodontal probing depth was reported to be increased at mesial and distal sites more than the facial one in the 36-month follow-up with no statistically significant difference between both materials (P = 0.186).
Conclusions
Zirconia and zirconia-reinforced lithium silicate could be used as a material for restoration of teeth prepared with vertical preparation technique. Both ceramic materials achieved good esthetic results, promotes healthy and stable soft tissues with no mechanical complications after 3 years of clinical evaluation.
Clinical relevance
Monolithic high translucency zirconia and zirconia-reinforced lithium silicate ceramics can be used for the restorations of minimal invasive vertical preparation in premolar area with 0.5 mm margin thickness.
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da Silva SEG, de Araújo GM, Souza KB, Moura DMD, Aurélio IL, May LG, Vila-Nova TEL, Zhang Y, de Assunção E Souza RO. Biaxial flexure strength and physicochemical characterization of a CAD/CAM lithium disilicate ceramic: effect of etching time, silane, and adhesive applications. Clin Oral Investig 2022; 26:6753-6763. [PMID: 35980474 PMCID: PMC9902029 DOI: 10.1007/s00784-022-04635-2] [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: 03/07/2022] [Accepted: 07/12/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To evaluate the effect of different acid etching time and bonding agent (silane and/or adhesive system) on biaxial flexural strength and physico-chemical properties of a lithium disilicate ceramic. MATERIAL AND METHODS One hundred twenty ceramic discs were made and divided into 8 groups (n = 15) according to factors "etching time" (20 and 120 s) with hydrofluoric acid (HF) and "bonding agent" (C, no bonding agent; S, silane, A, adhesive; and SA, silane + adhesive). After surface treatment, a resin cement layer was applied to the surface and all specimens were subjected to biaxial flexural strength (BFS) test with treated surfaces loaded in tension (1 mm/min). The Weibull analyses and complementary analyses were also performed. Statistical analysis was done with 2-way ANOVA and the Tukey test (α = 0.05). RESULTS ANOVA revealed that the factors "etching time" (p = 0.0003) and "bonding agent" (p = 0.007) were statistically significant. In the overall analysis, the HF120S group (272.02 ± 35.30A MPa) presented significantly higher BFS than that of HF120C (218.45 ± 17.15CD MPa) and HF20S (228.40 ± 37.83BCDMPa). On the other hand, the HF20A group (208.92 ± 31.16D MPa) had significantly lower BFS than HF120S (272.02 ± 35.30A), HF120A (254.42 ± 26.87ABC) and HF120SA (259.30 ± 36.55AB) groups (Tukey). The Weibull modulus (m) of all groups was significantly different from each other (p = 0.000). CONCLUSIONS Regardless of etching time, the application of silane alone is sufficient to increase the flexural strength of glass ceramic, eliminating the need for the application of adhesive systems. Moreover, if only silane or adhesive is applied, 120-s HF application should increase the flexural resistance of the lithium disilicate ceramic. CLINICAL SIGNIFICANCE Applications of adhesive systems after silanization can be suppressed from the surface treatment protocol of glass ceramics, since it does not improve their mechanical strength.
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Affiliation(s)
- Sarah Emille Gomes da Silva
- Department of Dentistry, Federal University of Rio Grande Do Norte (UFRN), Av. Salgado FilhoLagoa Nova, Natal, RN, CEP, 178759056-000, Brazil
| | - Gabriela Monteiro de Araújo
- Department of Dentistry, Oral Science, Federal University of Rio Grande Do Norte (UFRN), Av. Salgado FilhoLagoa Nova, Natal, RN. CEP, 178759056-000, Brazil
| | - Karina Barbosa Souza
- Institute of Science and Technology, Univ Estadual Paulista - UNESP, Francisco Jose Longo, Av. Eng, Sao Jose dos Campos, SP, 777, Brazil
| | - Dayanne Monielle Duarte Moura
- Department of Dentistry, State University of Rio Grande Do Norte (UERN), Rua Almino Afonso, 478 - Centro - Mossoró/RN CEP: 59.610-210, Rio, Brazil
| | - Iana Lamadrid Aurélio
- Department of Restorative Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Liliana Gressler May
- Department of Restorative Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | | | - Yu Zhang
- School of Dental Medicine, Department of Preventive and Restorative, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Rodrigo Othávio de Assunção E Souza
- Department of Dentistry, Federal University of Rio Grande Do Norte (UFRN), Av. Salgado FilhoLagoa Nova, Natal, RN, CEP, 178759056-000, Brazil.
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Wang Y, Hui R, Gao L, Ma Y, Wu X, Meng Y, Hao Z. Effect of surface treatments on bond durability of zirconia-reinforced lithium silicate ceramics: An in vitro study. J Prosthet Dent 2022; 128:1350.e1-1350.e10. [DOI: 10.1016/j.prosdent.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/27/2022]
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McGrath CE, Bonsor SJ. Survival of direct resin composite onlays and indirect tooth-coloured adhesive onlays in posterior teeth: a systematic review. Br Dent J 2022:10.1038/s41415-022-4395-3. [PMID: 35725911 DOI: 10.1038/s41415-022-4395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Abstract
Objective To compare the survival of direct resin-composite used as onlays and indirect tooth-coloured adhesive onlays in posterior teeth, along with modes of failure, deterioration and variables affecting survival.Materials and methods PubMed, Embase, The Cochrane Library, Web of Science and Scopus were searched systematically up to 16 October 2020. In total, 3,768 studies were screened, with their results for survival, failure mode, deterioration and variables affecting survival.Results In total, 30 studies were selected. Survival rates in included studies greater than three years in length were 73.1-100%, with a median survival of 92.5% and median follow-up length of 5.1 years. The most prevalent failure mode was fracture, followed by pulpal episodes, debonding and caries. The most prevalent deterioration criteria were loss of marginal integrity and discolouration.Conclusions Survival of direct resin composite onlays and indirect tooth-coloured adhesive onlays in posterior teeth is acceptable (73.1-100%) in the medium-term. There is a need for more studies on direct cusp covering resin composite restorations, zirconia onlays and studies comparing material types. Fracture was the most prevalent failure mode. Restoration margins were the most prevalent area of deterioration.Clinical significance Direct and indirect tooth-coloured adhesive onlays can be a reliable and more conservative way to restore posterior teeth across a range of material options.
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Affiliation(s)
- Colin E McGrath
- Tier 2 Practitioner, DPHC Restorative Managed Clinical Network, Dental Centre Leconfield, HU17 7LX, UK.
| | - Stephen J Bonsor
- Dental Surgeon, The Dental Practice, 21 Rubislaw Terrace, Aberdeen, UK; Online Tutor and Clinical Lecturer, University of Edinburgh, UK; Senior Clinical Lecturer, Institute of Dentistry, University of Aberdeen, UK
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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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ZHOU SHANYU, YOU YUEHUA, HU CHEN, SUN TING, SHAO LONGQUAN. FRACTOGRAPHIC ANALYSIS OF LITHIUM DISILICATE CERAMICS AND MONOLITHIC ZIRCONIA CERAMICS. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422400127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: To compare the fracture mode of lithium disilicate ceramics and zirconia ceramics through a single-load-to-failure test, and reveal the cause of failure through the fractographic analysis of fracture morphology. Methods: Based on the standardized preparations, 10 IPS e.max disilicate ceramic crowns (IPCs) and 10 monolithic zirconia ceramic crowns (MZCs) were designed and fabricated. All the specimens were placed on a universal material testing machine for a single-load-to-failure test. The fracture load was recorded, and two independent sample [Formula: see text]-tests were performed. Additionally, the type of fracture under a stereo-microscope was observed, and the morphological characteristics of the fracture with a scanning electron microscope (SEM) were investigated. Results: The fracture load of the IPC group was [Formula: see text][Formula: see text]N, and that of the MZC group was [Formula: see text][Formula: see text]N, with a statistically significant difference ([Formula: see text], [Formula: see text]). The fracture types of the IPC group and the MZC group were similar, namely, types II and III. The fracture modes of the two groups were all ceramic layer fracture. Through SEM, the origin of the crack on the occlusal surface could be traced back. The crystal fracture of IPC group had a rock sugar-like pattern, and the crystal distribution of MZC group was uniform. Conclusions: Zirconia ceramics have higher fracture load and a denser crystal structure compared to lithium disilicate. Fractographic analysis method could be a better way to analyze the failure mode of single-layer porcelain materials and reveal the origin of fracture.
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Affiliation(s)
- SHANYU ZHOU
- Department of Stomatology, Affiliated Longhua People’s Hospital, Southern Medical University, Shenzhen, Guangdong 518109, P. R. China
| | - YUEHUA YOU
- Department of Stomatology, Affiliated Longhua People’s Hospital, Southern Medical University, Shenzhen, Guangdong 518109, P. R. China
| | - CHEN HU
- Department of Stomatology, Nanfang Hospital, Southern Medical University Guangzhou, Guangdong 510515, P. R. China
| | - TING SUN
- The Affiliated Stomatology Hospital, Foshan University, Foshan, Guangdong 528000, P. R. China
| | - LONGQUAN SHAO
- Department of Stomatology, Nanfang Hospital, Southern Medical University Guangzhou, Guangdong 510515, P. R. China
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Do you know your ceramics? Part 3: lithium disilicate. Br Dent J 2022; 232:147-150. [PMID: 35149803 DOI: 10.1038/s41415-022-3882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/07/2021] [Indexed: 11/08/2022]
Abstract
Lithium disilicate has become very popular and is very commonly used, especially for highly aesthetic cases. It has also proven to be a very durable material and can be used in a variety of clinical situations. It is important as a clinician, technician or ceramist to be able to confidently use this material by appreciating the detail in its construction. The microstructure has a significant impact on the optical and physical properties of this material. Hence, before the prescription of this type of restoration, it is imperative to be knowledgeable in this aspect. This article explores lithium disilicate as a dental ceramic material in detail.
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Hinz S, Bensel T, Bömicke W, Henningsen A, Rudolph J, Boeckler AF. Impact of the Veneering Technique and Framework Material on the Failure Loads of All-Ceramic Computer-Aided Design/Computer-Aided Manufacturing Fixed Partial Dentures. MATERIALS 2022; 15:ma15030756. [PMID: 35160701 PMCID: PMC8836578 DOI: 10.3390/ma15030756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/08/2022] [Accepted: 01/15/2022] [Indexed: 02/04/2023]
Abstract
Objectives: Zirconia (Y-TZP) ceramics are considered as posterior fixed partial denture (FPD) materials; however, their applications are limited due to chipping. The use of monolithic lithium disilicate (LiDi) glass ceramics in posterior FPDs can be advantageous. This in vitro study aims to compare the loads until failure of posterior Y-TZP-FPDs and LiDi-FPDs before and after aging.
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Affiliation(s)
- Sebastian Hinz
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
- Correspondence: (S.H.); (T.B.)
| | - Tobias Bensel
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
- Correspondence: (S.H.); (T.B.)
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany;
| | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Judith Rudolph
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
| | - Arne F. Boeckler
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
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JURADO CA, MOURAD F, TREVINO DACORTES, GOUVEIA DN, HYER J, ELGREATLY A, MAHROUS AM, GARCIA-GODOY F, TSUJIMOTO A. Comparison of full and partial coverage crowns with CAD/CAM leucite reinforced ceramic blocks on fracture resistance and fractographic analysis. Dent Mater J 2022; 41:295-301. [DOI: 10.4012/dmj.2021-253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Carlos A. JURADO
- Texas Tech University Health Sciences Center El Paso, Woody L. Hunt School of Dental Medicine
| | - Firas MOURAD
- Department of Care Planning and Restorative Sciences, University of Mississippi Medical Center School of Dentistry
| | | | - Diogo N. GOUVEIA
- Department of Restorative and Prosthetic Dentistry, Ohio State University College of Dentistry
| | - Jared HYER
- A.T. Still University Arizona School of Dentistry & Oral Health
| | - Amira ELGREATLY
- Department of Operative Dentistry, University of Iowa College of Dentistry
| | - Ahmed M. MAHROUS
- Department of Prosthodontics, University of Iowa College of Dentistry
| | - Franklin GARCIA-GODOY
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center
| | - Akimasa TSUJIMOTO
- Department of Operative Dentistry, University of Iowa College of Dentistry
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Nawafleh N, Elshiyab S, Öchsner A, George R. In Vitro Fatigue and Fracture Load of Monolithic Ceramic Crowns Supported by Hybrid Abutment. Open Dent J 2021. [DOI: 10.2174/1874210602115010664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
This study evaluated the performance of zirconia and lithium disilicate crowns supported by implants or cemented to epoxy resin dies.
Methods:
Eigthy zirconia and lithium disilicate crowns each were prepared and assigned in four groups according to the crown material and supporting structure combinations (implant-supported zirconia, die-supported zirconia, implant-supported lithium disilicate, and die-supported lithium disilicate). Ten crowns in each group acted as control while the rest (n=10) underwent thermocycling and fatigue with 100 N loading force for 1.5 million cycles. Specimens were then loaded to fracture in a universal testing machine. Data were analysed using one-way ANOVA and Tukey multiple comparison test with a 95% level of significance.
Results:
No implants or crown failure occurred during fatigue. The mean fracture load values (control, fatigued) in newton were as follows: (4054, 3344) for implant-supported zirconia, (3783, 3477) for die-supported zirconia, (2506, 2207) for implant-supported lithium disilicate, and (2159, 1806) for die-supported lithium disilicate. Comparing the control with the corresponding fatigued subgroup showed a significantly higher fracture load mean of the control group in all cases. Zirconia showed a significantly higher fracture load mean than lithium disilicate (P=0.001, P<0.001). However, comparing crowns made from the same material according to the supporting structure showed no significant difference (P=0.923, P=0.337).
Conclusion:
Zirconia and lithium disilicate posterior crowns have adequate fatigue and fracture resistance required for posterior crowns. However, when heavy fatigue forces are expected, zirconia material is preferable over lithium disilicate. Zirconia and lithium disilicate implant-supported crowns cemented to hybrid abutments should have satisfactory clinical performance.
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Zhang LX, Hong DW, Zheng M, Yu H. Is the bond strength of zirconia-reinforced lithium silicate lower than that of lithium disilicate? A systematic review and metaanalysis. J Prosthodont Res 2021; 66:530-537. [PMID: 34853237 DOI: 10.2186/jpr.jpr_d_20_00112] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study systematically reviewed the literature to compare the bond strength of resin composites with that of zirconia-reinforced lithium silicate (ZLS) and lithium disilicate (LD). STUDY SELECTION This review was structured based on the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA 2020) statement. This study was registered at the International Prospective Register of Systematic Reviews (CRD42021256900). Studies were searched via PubMed, Web of Science, and Google Scholar databases without language or publication year limits. In vitro studies that evaluated the bond strength of the resin composites to ZLS and LD were included. The risk of bias in all the included articles was evaluated. Statistical analyses were performed using the Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK). RESULTS Of the 90 potentially related articles, the full texts of 16 articles were evaluated after screening. Finally, sevenstudies were included in the qualitative synthesis and meta-analysis. All the studies presented a medium risk of bias. The results showed no significant difference in bond strength between the ZLS and LD groups (P = 0.94, mean difference=0.08, and 95% confidence interval=-1.93 to 2.10). However, a significant difference was found in the subgroup analysis considering different types of aging treatments (P = 0.0008) and different types of bond strength tests (P < 0.00001). CONCLUSION The bond strength of resin composites was found to be similar to that of ZLS and LD, but different aging treatments and bond strength tests exhibited varying effects on the bond strength.
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Affiliation(s)
- Li-Xian Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Deng-Wei Hong
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Ming Zheng
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Hao Yu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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An in-vitro comparison of fracture resistance of three CAD/CAM Ceramic materials for fabricating Veneer. Saudi Dent J 2021; 33:745-752. [PMID: 34803329 PMCID: PMC8589618 DOI: 10.1016/j.sdentj.2020.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/15/2020] [Accepted: 03/20/2020] [Indexed: 11/21/2022] Open
Abstract
Aims This research aims to measure and compare the fracture resistance and modes of failure of the following three chemically varied computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic veneering materials: IPS e.max CAD, Vita Enamic, and Shofu HC. Materials and methods Twenty-seven sound human upper premolars were collected and stored in saline at room temperature until the experiment started and were assigned to three groups at random (n = 9). Putty indices were prepared to ensure a standardized butt joint preparation. An InEos X5 scanner was used to scan all the samples, and the resulting data were transferred to a CAD/CAM milling machine for veneer fabrication based on the materials used. Twenty-seven machined ceramic veneers were milled from three different ceramic materials. The cementation process was conducted for each material according to the manufacturer's instructions. To quantify the fracture resistance, all the samples underwent 2000 water cycles in a thermocycler and were then mounted in a universal testing machine at a 90° angle at the occlusal part of the veneer. The modes of failure were determined under a stereomicroscope and grouped into type I, ceramic fracture; type II, combined ceramic and tooth fracture; and type III, root fracture. Results Shofu HC had the highest mean (±standard deviation) fracture resistance (480.8 ± 92.8 N), followed by IPS e.max CAD (415.9 ± 147.2 N) and Vita Enamic (372.3 ± 123.9 N). However, the results of a one-way analysis of variance did not reveal statistically significant differences among the experimental groups (p = 0.194). The different groups exhibited different modes of failure, with ceramic fracture being the most common type of failure. Conclusion All the materials tested in this study exhibited strong fracture resistance values, thereby indicating their use as veneering materials for the upper premolars.
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Lan TH, Chen PH, Fok ASL, Chen YF. Contact fracture test of monolithic hybrid ceramics on different substrates for bruxism. Dent Mater 2021; 38:44-56. [PMID: 34785045 DOI: 10.1016/j.dental.2021.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/26/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine the minimum thickness required for a monolithic hybrid ceramic crown on different substrates (soft vs stiff) used in posterior dentition for bruxism. METHODS 80 polymer-infiltrated ceramic networks Vita Enamic (PICN VE) disc specimens with four different occlusal thicknesses (0.8, 1.2, 1.6 and 2.0 mm), were produced using a computer-aided design/manufacturing system, and cemented on a stiff (zirconia) or soft (polyamide) substrate of 4-mm thickness. The ten specimens, in soft or stiff groups, were subjected to compressive loading by a MTS machine until fracture or maximum load (4500 N) was reached. The unbroken specimens were examined using optical coherence tomography. Eight axisymmetric finite element models and eight 3D models comprising the four different occlusal thicknesses and two substrates under different vertical loads and sliding movements were constructed. The maximum principal stress was selected to evaluate the stress distribution in this study. RESULTS The fracture resistance of the specimens was significantly different between the two substrates (P < 0.001). Fracture resistance was positively associated with specimen thickness (r = 0.597 and 0.896 for the soft and stiff substrate respectively). Specimens on the soft substrate had lower fracture loads, whilst cone cracks were observed in unbroken samples on different soft/stiff substrate prior to final fracture. The finite element analysis confirmed that samples on the stiff substrate had lower maximum principal stress values than those on the soft substrate. For the maximum principal stress not to exceed the flexural strength of PICN VE, a stiff substrate and minimum thickness of 2.0 mm are required for the prostheses. SIGNIFICANCE A minimum 2.0 mm thick, stiff substrate was needed for bruxism as shown by the effect of high/large chewing force on the posterior dentition of monolithic PICN VE crowns.
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Affiliation(s)
- Ting-Hsun Lan
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807377, Taiwan, ROC; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan, ROC.
| | - Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan, ROC.
| | - Alex Siu Lun Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Health Science Tower, 515 Delaware street S.E., Minneapolis, MN 55455, USA.
| | - Yu-Feng Chen
- Division of Oral Surgery, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan, ROC.
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Chairside CAD/CAM Materials: Current Trends of Clinical Uses. BIOLOGY 2021; 10:biology10111170. [PMID: 34827163 PMCID: PMC8614873 DOI: 10.3390/biology10111170] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 12/26/2022]
Abstract
Simple Summary The interest in chairside Computer-aided design/computer-assisted manufacturing (CAD/CAM) restorations has increased the diversity of the restorative material. The promise of accurate, esthetic restorations delivered rapidly to the patient has manly benefits for clinicians in the light of minimally invasive dentistry dictates. New materials have been developed by the industry in order to offer ceramic, composite, and hybrid materials with optimized properties, suitable mechanical and aesthetic features. However, this comes at the expense of making the application more complicated. This article is aimed at providing an overview regarding the main advantages and disadvantages of the CAD/CAM chairside materials. Abstract Restorative materials are experiencing an extensive upgrade thanks to the use of chairside Computer-aided design/computer-assisted manufacturing (CAD/CAM) restorations. Therefore, due to the variety offered in the market, choosing the best material could be puzzling for the practitioner. The clinical outcome of the restoration is influenced mainly by the material and its handling than by the fabrication process (i.e., CAD/CAM). Information on the restorative materials performances can be difficult to gather and compare. The aim of this article is to provide an overview of chairside CAD/CAM materials, their classification, and clinically relevant aspects that enable the reader to select the most appropriate material for predictable success.
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Sellan PLB, Campaner LM, Tribst JPM, Dal Piva AMDO, de Andrade GS, Borges ALS, Bresciani E, Lanzotti A, Ausiello P. Functional or Nonfunctional Cusps Preservation for Molars Restored with Indirect Composite or Glass-Ceramic Onlays: 3D FEA Study. Polymers (Basel) 2021; 13:polym13213831. [PMID: 34771387 PMCID: PMC8587095 DOI: 10.3390/polym13213831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 02/01/2023] Open
Abstract
Evidence regarding the effect of the onlay preparation design for different CAD/CAM restorative materials considering the preservation of cusps is lacking. Molars were 3D-modeled in four preparation designs for onlay restoration: traditional design with functional cusp coverage (TFC), non-retentive design with functional cusp coverage (NFC), traditional design with non-functional cusp coverage (TNFC) and non-retentive design with non-functional cusp coverage (NNFC). The restorations were simulated with two CAD/CAM restorative materials: LD—lithium disilicate (IPS e.max CAD) and RC—resin composite (GrandioBloc). A 100 N axial load was applied to the occlusal surface, simulating the centric contact point. Von Mises (VM) and maximum principal (Pmax) stress were evaluated for restorations, cement layer and dental substrate. The non-retentive preparation design reduced the stress concentration in the tooth structure in comparison to the conventional retentive design. For LD onlays, the stress distribution on the restoration intaglio surface showed that the preparation design, as well as the prepared cusp, influenced the stress magnitude. The non-retentive preparation design provided better load distribution in both restorative materials and more advantageous for molar structure. The resin composite restoration on thenon-functional cusp is recommended when the functional cusp is preserved in order to associate conservative dentistry and low-stress magnitude.
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Affiliation(s)
- Pablo Lenin Benitez Sellan
- School of Dentistry, Universidad Espíritu Santo, Samborondón 092301, Ecuador;
- Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo 12220-690, Brazil; (L.M.C.); (A.L.S.B.); (E.B.)
| | - Larissa Mendes Campaner
- Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo 12220-690, Brazil; (L.M.C.); (A.L.S.B.); (E.B.)
| | - João Paulo Mendes Tribst
- Department of Dental Materials, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (J.P.M.T.); (A.M.d.O.D.P.)
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (J.P.M.T.); (A.M.d.O.D.P.)
| | - Guilherme Schmitt de Andrade
- Department of Dentistry, Center for Biological and Health Sciences, Western Paraná State University (Unioeste), Cascavel 85819-110, Brazil;
| | - Alexandre Luiz Souto Borges
- Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo 12220-690, Brazil; (L.M.C.); (A.L.S.B.); (E.B.)
| | - Eduardo Bresciani
- Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo 12220-690, Brazil; (L.M.C.); (A.L.S.B.); (E.B.)
| | - Antonio Lanzotti
- Fraunhofer JL IDEAS, Department of Industrial Engineering, University of Naples Federico II, 80125 Naples, Italy;
| | - Pietro Ausiello
- School of Dentistry, University of Naples Federico II, 80131 Naples, Italy
- Correspondence:
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Al-Zordk W, Saudi A, Abdelkader A, Taher M, Ghazy M. Fracture Resistance and Failure Mode of Mandibular Molar Restored by Occlusal Veneer: Effect of Material Type and Dental Bonding Surface. MATERIALS 2021; 14:ma14216476. [PMID: 34772003 PMCID: PMC8585144 DOI: 10.3390/ma14216476] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
This study assesses the effect of the material type (lithium disilicate, zirconia, and polymer-infiltrated ceramic) and dental bonding substrates (dentin, dentin with intra-coronal cavity, and dentin with composite filling) on the fracture resistance and failure mode of molars restored by occlusal veneers. Methods: Ninety occlusal veneers, fabricated from either lithium disilicate, zirconia, or polymer-infiltrated ceramic, were adhesively bonded to teeth prepared with either dentin, dentin with intra-coronal cavity, or dentin with composite filling. All specimens were thermally aged (5000 cycles), then load cycled (120,000 cycles). Each specimen was subjected to a compressive load through fracture, then was examined (×20) to identify the fracture type. Data were statistically analyzed. Results: Material type and dental substrate had no significant effect on the fracture resistance of adhesively retained occlusal veneer restorations. For each material, no significant differences were found between veneers bonded to dentin, dentin with intra-coronal cavity, and dentin with composite filling. Additionally, within each bonding substrate, there were no significant differences between lithium disilicate, zirconia, and polymer-infiltrated ceramic veneers. The adhesive failure was recorded mainly with zirconia occlusal veneer restorations. Conclusions: Considering the fracture results, lithium disilicate, zirconia, and polymer-infiltrated ceramic occlusal veneers perform well whatever the type of dental bonding surface. When the dental bonding surface varies, different occlusal veneer materials should be considered. Occlusal veneers bonded to dentin, dentin with composite filling, or dentin with an intra-coronal cavity exhibited a fracture resistance exceeding the average human masticatory forces in the molar area.
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Affiliation(s)
- Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; (A.S.); (A.A.); (M.G.)
- Fixed Prosthodontics Department, Faculty of Dentistry, Horus University, Damietta 34511, Egypt
- Correspondence: ; Tel.: +2-010-0890-6074
| | - Alaa Saudi
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; (A.S.); (A.A.); (M.G.)
| | - Abdelraheem Abdelkader
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; (A.S.); (A.A.); (M.G.)
| | - Mansoura Taher
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt;
| | - Mohamed Ghazy
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; (A.S.); (A.A.); (M.G.)
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Al-Qaysi SH, Saleh ARM, El-Damanhoury HM. Fracture resistance and failure mode of layered translucent zirconia with different crown designs. Dent Mater J 2021; 41:54-59. [PMID: 34483200 DOI: 10.4012/dmj.2021-051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study investigated the impact of different veneering design on the fracture resistance and failure mode of layered translucent zirconia crowns, compared to the full monolithic zirconia crowns. Ninety crowns with different designs were divided into six groups (n=15); one fully contoured monolithic crown (FMC), one fully veneered with porcelain (FVC), or four partially veneered designs. All crowns were thermo-cycled, and then loaded to failure in a universal testing machine. The fracture resistance (N) and fracture modes were assessed. One-way ANOVA was performed followed by Tukey's multiple comparison (α<0.05). Results demonstrated that all the tested partially veneered designs exhibited enhanced fracture resistances and were comparable to that of the full-contour monolithic translucent zirconia crowns.
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Affiliation(s)
- Saif H Al-Qaysi
- Department of Clinical Sciences, College of Dentistry, Ajman University
| | | | - Hatem M El-Damanhoury
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah
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Longevity of Polymer-Infiltrated Ceramic Network and Zirconia-Reinforced Lithium Silicate Restorations: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14175058. [PMID: 34501148 PMCID: PMC8434158 DOI: 10.3390/ma14175058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/22/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to systematically review the existing literature to assess the clinical survival and success of PICN and ZLS indirect restorations as the clinical evidence for them remains lacking. PubMed, SCOPUS, Embase, Cochrane Library, Web of Science, LILACs, and SciElo databases were searched from 1 January 2000 to 1 February 2021. Clinical trials and cohort studies published in English were included while case studies, case series, and in vitro studies were excluded. Results were analyzed qualitatively and a meta-analysis using a random effects model was performed. A strength of recommendation taxonomy (SORT) analysis was conducted and risk of bias (RoB) was assessed using the Newcastle-Ottawa scale and Cochrane RoB tools. An electronic search through the databases yielded 2454 articles, of which 825 remained after duplicate removal. Five studies investigating PICN and four investigating ZLS indirect restorations remained after assessing for eligibility. The overall survival rate of PICN over 1 year was 99.6% and 99.2% over 2 years. The overall survival rate of ZLS over 1 year was 99%. The main mode of failure for both materials was catastrophic fracture. One study had a high RoB, four had a moderate RoB, and four had a low RoB. Both materials demonstrated moderate strength of recommendation at a level 2 evidence for all studies based on SORT analysis. PICN and ZLS show promising short-term clinical performance as full and partial coverage indirect restorations, but longer follow-up studies are required to confirm their long-term performance.
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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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