Effect of toothbrushing on shade and surface roughness of extrinsically stained pressable ceramics

Microshear bond strength of resin cement to glass-ceramics after intaglio surface staining

STATEMENT OF PROBLEM

Applying stains to the intaglio surface of computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic ceramic restorations has been proposed as an option to help mask darkened substrates. However, little is known about the effects of this procedure on the adhesion between the resin cement and the ceramic.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of intaglio surface staining on the microshear bond strength between 2 CAD-CAM ceramics and a resin cement.

MATERIAL AND METHODS

Lithium disilicate (Gmax) and leucite-reinforced (Gpress) ceramic blocks were sectioned, crystalized when indicated, and polished. They received either none, 1, or 2 layers of ceramic stains and a glaze liquid mixture followed by a firing cycle. The surfaces of groups Gmax0, Gmax1, and Gmax2 were etched with 9% hydrofluoric acid etching (HF) for 20 seconds, and those of groups Gpress0 and Gpress1 were etched for 60 seconds. After rinsing and drying, a ceramic primer was applied and air-dried. Resin cement rods (n=24 per group) were built from a silicone mold. Specimens were stored in distilled water for 24 hours before microshear bond testing. Failure mode was observed under a digital microscope. Data were analyzed by using the Kruskal-Wallis and Mann-Whitney nonparametric tests (α=.05).

RESULTS

Intaglio staining negatively affected the microshear bond strength for both ceramics. A significant difference was observed between Gmax1 (3.5 ±1.73 MPa) and Gmax2 (3.7 ±2.1 MPa) when compared with Gmax0 (14.2 ±4.4 MPa) and also between GPress0 (25.7 ±5.1 MPa) and Gpress1 (1.8 ±2.7 MPa). No difference was observed between 1 and 2 stain layers for Gmax. Most failures were adhesive for Gmax0, mixed for Gpress, and cohesive within the stain layer for experimental groups.

CONCLUSIONS

Intaglio surface staining with a stain and glaze mixture caused a significant reduction in bond strength between resin cement and both ceramics tested.

Evaluation of one versus two glaze firings on the color stability and mechanical properties of an extrinsically characterized monolithic CAD-CAM lithium disilicate glass ceramic

PURPOSE

To evaluate the effects of 1 versus 2 glaze firings on the color and mechanical properties of an extrinsically characterized lithium disilicate ceramic after thermal cycling, brushing, or both.

MATERIALS AND METHODS

Eighty specimens were divided into 2 groups: 1 glaze firing (GL1) and 2 glaze firings (GL2). Each group was subdivided into 4 groups (n = 10), according to the experimental conditions: thermal-cycling, brushing, thermal-cycling + brushing, and immersion in distilled water (control). Color variation, surface roughness, and Vickers microhardness were analyzed before each designated experiment and after the simulated periods of 2.5, 5, and 10 years. Three-way mixed ANOVA was used for all outcomes, followed by 1-way ANOVA, repeated measures 1-way ANOVA, Bonferroni post hoc test, and t-test to check for statistical differences (α = 0.05).

RESULTS

Thermal cycling generated greater color changes in the GL1 group at 2.5 and 5 years (p < 0.001; p = 0.013). Brushing generated color changes in GL1 at 5 years (p = 0.003) and in GL2 at 10 years (p = 0.017). Regarding surface roughness, the GL1 group suffered alterations in thermal cycling + brushing at 5 years. In the control group, the GL1 group exhibited higher roughness values than GL2 (p < 0.05). Most of the groups experienced an increase in microhardness at 2.5 years (p < 0.05). In the GL1 group, thermal-cycling increased the microhardness at 5 years (p = 0.006); at 5 and 10 years, the GL1 group had a higher microhardness than the GL2 in thermal-cycling + brushing (p < 0.05).

CONCLUSION

Ceramics with 1 glaze firing showed greater color, roughness, and microhardness changes compared to those submitted to 2 firings.

Effect of staining layer on roughness after progressive wear of monolithic ceramics

PURPOSE

The aim of this study was to evaluate staining layer behavior applied to high-translucency zirconia (YZHT), feldspathic ceramics (FD), and zirconia-reinforced lithium silicate (ZLS) surfaces against different antagonists.

METHODS AND MATERIALS

Monolithic ceramic discs (n = 120) (ø 12 mm; thickness, 1.2 mm; ISO 6872) were obtained, 30 from YZHT and FD, and 60 from ZLS CAD/CAM blocks (staining layer applied before or after the crystallization procedure). The specimens were divided into 12 subgroups (n = 10) according to the antagonists: steatite, polymer-infiltrated ceramic, or zirconia. Mechanical cycling (1.5 × 104  cycles; 15 N; horizontal displacement, 6 mm; 1.7 Hz) and flexural strength tests (1 mm/min-1000 kg cell) were performed. The differences between final and initial roughnesses (Ra, Rz, and Rsm), the mass loss, and the flexural strength data were individually analyzed by two-way ANOVA and Tukey's test (α = 0.05).

RESULTS

The roughnesses of all ceramics did not present a statistically significant difference before wear simulation: Ra (p = 0.3348), Rz (p = 0.5590), and Rsm (p = 0.5330). After the wear simulation, the Ra parameter was not affected by an interaction between ceramic and antagonist (p = 0.595). The Rz and Rsm parameters were affected only by the antagonist pistons (both, p = 0.000). The ceramics used in this study showed statistically significant differences in mass loss after the wear test (p < 0.0001). The additional firing (2 steps) of the ZLS2 led to a higher lost mass quantity.

CONCLUSION

All ceramics presented similar initial roughnesses and similar roughnesses after the wear simulation. The zirconia antagonist showed better performance against ceramics with high crystalline content.

CLINICAL SIGNIFICANCE

It is clear that restorative materials must be carefully selected by dental practitioners according to indications, properties, and antagonists. The steatite antagonist, that is, an enamel analog, showed better performance against vitreous ceramics, while the zirconia antagonist showed better performance against ceramics with high crystalline content. Wear affects the surface roughnesses of the ceramics. Additional firing for the staining of the zirconia-reinforced lithium silicate ceramic led to a greater loss of mass.

Penetration and durability of CPP-ACP paste and sodium fluoride varnish as desensitizing agents: An in vitro comparison

Background

This study aimed to investigate and compare the penetration and durability of two dentin desensitizers, sodium fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, using electron microscopy.

Methods

The study was performed on 60 dentin specimens prepared from extracted human premolars. After applying 17% EDTA to remove the smear layer, the specimens were divided into two groups. MI Paste and Bi-fluoride varnish were applied to the specimens. Microscopic images of 20 samples were obtained immediately. Twenty other samples were accessed after 15 days, and the other 20 were accessed after 30 days of toothbrushing and thermal cycling. Both surface and longitudinal cross-sectional images (after sample fracture) were studied. Data were analyzed with two-way ANOVA and Mann-Whitney U test at a significance level of P<0.05.

Results

The mean depth of material penetration was significantly time-dependent and fluctuated in both groups. There was a significant difference between the mean level of plugs between 0, 15, and 30 days (P<0.001). Penetration increased with time for the MI Paste group, while in the Bi-fluoride group, the increase was significant at 15 and 30 days than immediately after application. The mean thickness of the plugs was significantly different at the three time periods, and MI Paste showed a sudden decrease in plug thickness after 15 days.

Conclusion

Immediately after application, Bi-fluoride occluded dentinal tubules more effectively, and its durability after abrasion and thermal fatigue were higher than MI Paste.

The Toothbrushing Effects on Surface Properties and Color Stability of CAD/CAM and Pressable Ceramic Fixed Restorations-An In Vitro Study

Pressable ceramic restorations have been introduced and investigated, and found comparable to CAD/CAM ceramic in terms of mechanical properties; however, the effect of toothbrushing on the pressable ceramic has not been thoroughly investigated. The objective of the current study was to assess the effect of artificial toothbrushing simulation on the surface roughness, microhardness, and color stability of different ceramic materials. Three lithium disilicate-based ceramics (IPS Emax CAD [EC], IPS Emax Press [EP]; (Ivoclar Vivadent AG), and LiSi Press [LP] (GC Corp, Tokyo, Japan)) were examined. For each ceramic material, eight bar-shaped specimens were prepared and subjected to 10,000 brushing cycles. Surface roughness, microhardness, and color stability (∆E) were measured before and after brushing. Scanning electron microscopy (SEM) was used for surface profile analysis. The results were analyzed using one-way ANOVA, Tukey's post hoc test, and paired sample t-test α = 0.05. The findings revealed a non-significant decrease in the surface roughness of EC, EP, and LP groups (p > 0.05), and both LP and EP have the lowest surface roughness values (0.64 ± 0.13, 0.64 ± 0.08 µm) after brushing, respectively. Toothbrushing showed a decrease in the microhardness of the three groups: EC and LP, p < 0.001; EP, p = 0.012). EP showed the lowest hardness value after brushing (862.45 ± 273.83). No significant changes (∆E) were observed in all groups (p > 0.05); however, the EC group was found to be considerably affected by color changes, in comparison to the EC and LP groups. Toothbrushing had no effect on surface roughness and color stability of all tested materials, but it decreased the microhardness. Material type, surface treatments, and glazing of ceramic materials contributed to the surface changes in the ceramic materials, necessitating further investigations in terms of the toothbrushing effect with different glazing as variables.

The mechanical properties, tribological behaviors and color stability of a feldspar nanoceramics strengthening extrinsic stain for high-translucent zirconia

The present work is aimed to explore the mechanical properties, tribological behaviors and color stability of nanoceramics and microceramics strengthened extrinsic stain coatings (NS and MS) upon high-translucent zirconia (TZ). The Na-rich feldspar ceramics component, microstructure and particle size of NS and MS were verified. The mechanical properties including elastic modulus and hardness of NS were enhanced compared to MS. Reciprocating wear tests under a ball-on-plate configuration manifested that the reduced coefficient of friction, wear depth and wear volume loss of NS was evaluated after 1 × 10 ⁴ cycles and the wear scar morphology of NS characterized by microcracks while MS featured more delamination and wear debris. Post toothbrushing simulation revealed that the color stability of extrinsic stain coatings was elevated with the addition of feldspar nanoceramics. The feldspar nanoceramics strengthening extrinsic stain exhibited enhanced elastic modulus, hardness, wear resistance and color stability, especially for TZ.

Influences of Different CAD/CAM Ceramic Compositions and Thicknesses on the Mechanical Properties of Ceramic Restorations: An In Vitro Study

The aim of this study was to assess the influences of different CAD/CAM ceramic compositions and thicknesses on the surface roughness and hardness of ceramic restorations. Four different ceramics were used in the current study: lithium disilicate (LD), leucite reinforced (LE), advanced lithium disilicate (ALD), and zirconia-reinforced lithium silicate (ZLS). Each group included 30 specimens subdivided into three different ceramic thicknesses (0.5, 1 and 1.5 mm thicknesses). The microhardness was measured for all the specimens using a microhardness testing machine, while the surface roughness was measured using a non-contact optical profilometer at three intervals (before toothbrushing and after toothbrushing, with and without toothpaste). Three-way and two-way ANOVA were used to determine the factors influencing the surface roughness and microhardness. There was a significant difference in the surface roughness between the studied groups for all the thicknesses. The findings showed that ALD had the lowest surface roughness, while ZLS showed the highest surface roughness. Moreover, ALD, followed by ZLS, had the highest hardness, while LD and LE had the lowest hardness values. Regarding the thicknesses, both the 0.5 and 1 mm ceramic thicknesses showed a significantly lower surface roughness than the 1.5 mm thickness, while the 1.5 mm thickness showed a significantly higher microhardness than the 0.5 mm thickness. The surface roughness and hardness were significantly affected by the ceramic composition and type of filler. It is recommended to use 1.5 mm-thick ceramic materials for the fabrication of definitive full-coverage ceramic restorations, while veneers require 0.5 mm-thick materials. ALD is a promising CAD/CAM material that can be used for the fabrication of restorations with a proper strength in both anterior and posterior regions.

Effect of thickness of externally characterized stains on optical properties of high-translucency zirconia

OBJECTIVES

There is insufficient information about the effects of the thickness of externally characterized stains or glazes on CIELAB color parameters and the translucency parameter (TP) of 5 mol% yttria partially stabilized zirconia (5Y-PSZ). The present study evaluated the effect of a thickness reduction of the externally characterized or glazed layer on its CIE2000 color parameters and TP₀₀ of 5Y-PSZ.

MATERIALS AND METHODS

Twenty-eight specimens were sectioned from 5Y-PSZ blanks. Three brands of powdered stains (namely VI, SH, and IV) and a glaze (GL) were used to extrinsically stain the specimen surfaces (n = 7 per group). After measuring the final thickness and color, specimens of each group were carefully ground and finally polished. The reduced thickness was carefully controlled in decrements of 0.02 mm on the characterized stains or glazed layers at each reduction cycle until the surface of the un-stained zirconia was exposed. The CIELAB color parameters of specimens were measured using a spectrophotometer. Subsequently, differences in lightness (∆L'), chroma (∆C'), and hue (∆H'), and TP₀₀ values and color differences (ΔE₀₀) were calculated using the CIEDE2000 formula to determine differences between the specimen and the un-stained zirconia at each reduction cycle. A paired-samples t-test, two-way mixed-design analysis of variance, and Pearson correlation coefficient were used to analyze the data (α = 0.05).

RESULTS

There were no significant differences in lightness, chroma, hue, or TP₀₀ values before or after glazing or after each reduction cycle of the glazed layer. Mean ΔE₀₀ values ranged between 20.94 and 33.55 after applying the externally characterized stains. With a decreased thickness of the characterized stain layer, there were observed that significant decreases in ∆L', ∆H', ∆C', and ΔE₀₀, and significant increases in TP₀₀.

CONCLUSIONS

Increasing the thickness of externally characterized stains decreased the lightness and caused the alternation of chroma and hue, whereas these phenomena were not observed in the glazed group. There was a slight change of CIE2000 color parameters and TP₀₀ when the thickness of the characterized layer exceeded 0.06 mm.

CLINICAL RELEVANCE

The application and thickness of externally characterized stains can sensitively affect CIE2000 color parameters and translucency of 5Y-PSZ.

Effect of Surface-Etching Treatment, Glaze, and the Antagonist on Roughness of a Hybrid Ceramic after Two-Body Wear

Stains and glaze are effective procedures for achieving an aesthetic smoothness on indirect restorations. Thus, the effect of surface-etching treatments previous to the stain layer and the glaze application on the occlusal and antagonist wear of a hybrid ceramic were evaluated against different antagonists. Disc-shaped samples were prepared from polymer-infiltrated ceramic network (PICN) blocks. The specimens were divided into eight groups, according to the surface-etching treatment and glaze application: P (polished specimens); PG (polishing plus glaze); E (hydrofluoric acid etching plus stain); EG (acid etching plus stain plus glaze); A (aluminum oxide sandblasting plus stain); AG (sandblasting plus stain plus glaze); S (self-etching primer plus stain); SG (self-etching primer plus stain plus glaze). Half of the samples were subjected to a wear simulation with a steatite antagonist, and the other half was tested using a PICN antagonist. The test parameters were: 15 N, 1.7 Hz, 6 mm of horizontal sliding, 5000 cycles. The discs and the antagonists' masses were measured before and after the wear tests. The average roughness and spacing defects were evaluated. The etching treatment affected the surface and antagonist mass loss when tested against steatite. AG showed the highest mass loss. This influence was not detected when using the PICN antagonist. The glaze application after staining ensures a smoother surface and avoids antagonist wear.

Vickers micro-hardness study of the effect of fluoride mouthwash on two types of CAD/CAM ceramic materials erosion

BACKGROUND

The aim of this study was to evaluate the protective effects of fluoride mouthwash on the surface micro-hardness of two types of CAD/CAM ceramics after exposure to acidic solutions.

METHODS

40 samples (5 × 5 × 3 mm3) were prepared from two different ceramics: Vitabloc Mark II CAD, and IPS e.max CAD. The samples were randomly divided into 5 groups in each ceramic (n = 8) immersed in different solutions: Gs: saliva: GGA: gastric acid, GAA: acetic acid, GFGA: sodium fluoride + gastric acid, GFAA: sodium fluoride + acetic acid. The microhardness of samples was measured before and after immersion in different solutions by Vickers microhardness tester. By subtracting the microhardness values after and before immersion, the microhardness changes of the samples were obtained. Data were analyzed by Two-way analysis of variance, one-way analysis of variance, and Tukey test (α = 0.05).

RESULTS

Immersion in different solutions reduced the microhardness. Microhardness loss was significantly affected in G FAA and G FGA groups in both types of ceramics (P < 0.05). For Vitabloc Mark II groups, the microhardness loss was significantly higher in GFAA and GFGA compared to IPS e.max CAD P < 0.001).

CONCLUSION

Fluoride mouthwash in conjunction with acidic solutions may adversely affect microhardness of Vitabloc Mark II CAD, and IPS e.max CAD that may consequently compromise the clinical service. Vitabloc Mark II CAD was significantly more affected than IPS e.max CAD.

Effect of Toothpaste on the Surface Roughness of the Resin-Contained CAD/CAM Dental Materials: A Systematic Review

Background: The purpose of this review is to describe the possible effect of toothbrushing on surface roughness of resin-contained CAD/CAM materials. Methods: Systematic literature search for articles published in peer-reviewed journals between January 2000 and February 2020 has been conducted, which evaluated the effect of brushing on surface roughness of resin-contained CAD/CAM dental materials. The research was conducted in Scopus, PubMed/Medline, Web of Science, Embase, and Science Direct using a combination of the following MeSH/Emtree terms: “brushing”, “resin-based”, “dental”, “CAD/CAM”, and “surface roughness”. Results: A total of 249 articles were found in the search during initial screening. Fifty-five articles were selected for the full-text evaluation after the steps of reading of abstract/title and remotion of duplicate. Only six articles fulfilled the inclusion criteria. The Cohen’s Kappa agreement test showed an index of 0.91 for full-text. Discussion: Four of five selected articles identified an increase of surface roughness on resin-contained CAD/CAM materials after toothbrushing. Although all the articles examined used different toothpastes with no homogeneous relative dentine abrasivity (RDA) and cycles of brushing, the findings are about the same. The possible reason is attributable to the compositions of the resin-contained CAD/CAM materials. Conclusions: The surface roughness of most resin-contained CAD/CAM materials was affected by artificial toothbrushing. Correct knowledge of the composition of the dental material and toothpastes is fundamental to avoid an increase of surface roughness on prosthetic rehabilitation.

Effect of toothbrushing on the optical properties and surface roughness of extrinsically stained high-translucency zirconia

OBJECTIVES

The effect of toothbrushing on the color, relative translucency, and surface roughness of extrinsically stained zirconia dental restorations is still unclear. The purpose of the present study was to evaluate the optical properties and surface textures of extrinsically stained or glazed partially stabilized zirconia with 5 mol% yttria (5Y-PSZ) after toothbrushing by determining changes in the color, translucency parameter (TP), and surface roughness.

MATERIALS AND METHODS

Specimens (2 mm thick; n = 50) were sectioned from 5Y-PSZ blanks. Three brands of powdered stains (namely VI, SH, IV) and a glaze (GL) were used to extrinsically stain the specimen surfaces (n = 10 per group). The specimens were subjected to 10,000-50,000 simulated toothbrushing strokes using a toothpaste slurry (Ora2 PREMIUM Stain clear paste). The color parameters were measured before staining or glazing and before and after simulated brushing. The color changes and TP values can be calculated before and after simulated brushing. The surface roughness was also evaluated.

RESULTS

Significant changes were found in the shade and TP values of 5Y-PSZ after extrinsic staining, but no significant changes were found after toothbrushing, irrespective of the staining brand (p > 0.05). The surface roughness of the characterized 5Y-PSZ specimens decreased after toothbrushing, whereas that of the non-characterized 5Y-PSZ group increased.

CONCLUSIONS

Toothbrushing markedly affects the surface roughness of extrinsically stained or glazed 5Y-PSZ specimens, whereas no impacts on the color or translucency were observed.

CLINICAL RELEVANCE

For esthetic reasons, clinicians and dental technicians prefer to apply extrinsic stains to zirconia restorations, which profoundly affects its appearance. The limited influence of toothbrushing on color and translucency of 5Y-PSZ is promising for clinical applications.

The Effects of a coffee beverage and whitening systems on surface roughness and gloss of CAD/CAM lithium disilicate glass ceramics

OBJECTIVES

To investigate the effects of a coffee beverage and two whitening systems on the surface roughness and gloss of glazed Lithium Disilicate Glass-Ceramics (LDGC) for computer-aided design/computer-aided manufacturing (CAD/CAM) systems.

METHODS

Sixty-eight LDGC disks (12 × 10 × 2 mm) were prepared from blocks of CAD/CAM systems (IPS e.max CAD ceramic). Baseline measurements for surface roughness (Ra) and gloss (GU) were taken using a 3-D optical profilometer and a glossmeter, respectively; then specimens were randomized into four groups (n = 17). All specimens were immersed in a coffee solution (24 h × 12 days) then subjected to two whitening systems. G1-negative control (kept moist × 7 days); G2-positive control (brushed with distilled water, 200 g/load, 2 min twice daily × 7 days); G3-whitening toothpaste (Colgate optic white; relative dentin abrasivity (RDA) = 100, 200 g/load, 2 min twice daily × 7 days); and G4-simulated at-home bleaching protocol (Opalescence,15% carbamide peroxide (CP), 6 h/day × 7 days). The study outcomes were measured at baseline and after the treatments. Data were analyzed using paired T-test and one-way ANOVA (α = 0.05).

RESULTS

The mean surface roughness significantly increased (p ⩽ 0.002) for all groups after the designated treatment protocols. Among groups, the mean surface roughness of G2 and G3 were significantly higher (p ⩽ 0.001) (Ra: 0.51 and 0.57 μm, respectively) compared to the control group (Ra: 0.23 μm), and were not significantly different from G4 (Ra: 0.46 μm). Surface gloss decreased with no significant change within or among groups after treatment.

CONCLUSION

All glazed LDGC had a significant increase in surface roughness after being subjected to simulated 1 year of coffee drinking and whitening systems (15% CP and whitening toothpaste), and the greatest change was associated with brushing (simulating 8 months). However, coffee beverages and whitening systems had no significant effect on the surface gloss.

Effects of charcoal-based whitening toothpastes on human enamel in terms of color, surface roughness, and microhardness: an in vitro study

OBJECTIVE

Charcoal based oral care products have gained popularity in the last few years. The aim of this in vitro study was to compare the effects of different charcoal based whitening toothpastes on color, surface roughness and microhardness of human enamel.

MATERIALS AND METHODS

Forty-eight specimens obtained from human permanent upper incisor teeth were randomly divided into 4 groups(n=12):Group-1:Colgate Total 12(CT); Group-2:Body Kingdom(BK); Group-3:Black is White(BW), Group-4:Colgate optic white(COW). Following 4 days cycle of darkening(2-min chlorhexidine and 60-min black tea per day), a 12- week brushing(twice daily for 1 min)was performed. Color of specimens was measured using a spectrophotometer. A contact type profilometer was used to measure surface roughness (Ra) and Vicker's hardness tester was used for the changes in microhardness(VHN). A representative sample from each group was visualized by SEM. Data were analyzed by One-way ANOVA, Welch, Fisher's, Kruskall-Wallis, Wilcoxon Sign Rank and Paired t-tests(p<0.05).

RESULTS

After 12- week brushing, no differences were found among the groups in terms of color change(p=0.989). All toothpastes tested showed no clinically acceptable whitening performances. A substantial increase in surface roughness was found in all groups, except BW(p<0.05). An increase was found in microhardness with CT(p=0.013), while no changes were found with BK, BW and COW(p>0.05).Only few scratches were observed on the enamel surfaces by SEM evaluations.

CONCLUSION

Twelve week brushing with charcoal based whitening toothpastes and a regular fluoridated toothpaste presented similar effects in color of enamel. Surface roughness was increased(except BW) while microhardness was not affected(except CT) with charcoal based whitening toothpastes.

CLINICAL RELEVANCE

Charcoal based whitening toothpastes do not promise to whiten the human permanent teeth and their effects on enamel abrasion should not be disregarded.

Effect of a continuous mechanical polishing protocol on the color stainability, microhardness, mass, and surface roughness of denture base acrylic resin

STATEMENT OF PROBLEM

The acrylic resin used in dental prostheses, which is subject to changes in its properties caused by hygiene chemicals, brushing, and colored beverages, can benefit from mechanical polishing methods. However, studies evaluating whether such procedures can be performed continuously without damaging the prosthetic materials are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of a continuous mechanical polishing protocol on the color stainability, surface roughness, microhardness, and mass of a denture base acrylic resin.

MATERIAL AND METHODS

The polishing protocol was tested in specimens submitted to one of the following conditions: immersion in coffee (CF) (n=20); toothbrushing (Br, 35 600 cycles in a brushing simulation machine) (n=20); and immersion in 1% sodium hypochlorite (HYP) (n=20). For each condition, half of the specimens were polished (aluminum oxide paste and felt wheel attached to an electric motor, 3000 rpm) at simulated biweekly intervals. Two groups (n=10) of specimens were immersed in distilled water and used as the control for the immersion groups. Thus, the present study consisted of a total of 8 groups (n=80). Before and after simulated periods of 12 and 24 months, surface roughness was evaluated by using a contact profilometer; a spectrophotometer was used to calculate color changes (ΔE₀₀); and a Knoop microdurometer and a precision balance were used to assess microhardness and mass changes. Data were compared by using 2-way mixed ANOVA. The Tukey HSD and Student t tests were used for post hoc analysis (α=.05).

RESULTS

The polishing influenced surface roughness (Br, CF, HYP: P<.001) and color stainability (Br: P=.008; CF: P<.001). Significant increase in roughness was observed for the Br and HYP groups, and the polishing significantly reduced roughness under all experimental conditions. In general, the polishing did not affect the microhardness and caused minimum wear of the acrylic resin. ΔE₀₀ values were above the clinical perceptibility threshold (ΔE₀₀>1.30) for the Br group, exceeding the clinical acceptability threshold for the CF group (ΔE₀₀= 2.51). Polishing reduced ΔE₀₀ in these groups, making values similar to those found in the groups immersed in distilled water. The color in the HYP group was not influenced by polishing.

CONCLUSIONS

In general, the tested polishing protocol reduced the deleterious effects of brushing and contact with 1% sodium hypochlorite and coffee, reducing surface roughness and color change without affecting microhardness and mass in any clinically relevant way.

Effect of tooth brush abrasion on the color, gloss and surface roughness of internally and externally stained monolithic ceramic materials

PURPOSE

To measure the durability of the color, change in surface roughness and gloss of stained monolithic ceramic materials subjected to artificial tooth brush abrasion.

MATERIALS AND METHODS

Standardized specimens were manufactured from pressable lithium-disilicate glass ceramic (PC; IPS e.max Press), machinable lithium-disilicate glass ceramic (MC; IPS e.max CAD), and zirconia (ZR; Zenostar). Ceramic staining was applied before (internal; in) and after crystallization/sintering (external; ex). Of each ceramic material, specimens without staining were prepared (no staining; no). Porcelain-fused-to-metal specimens served as control (PFM). Each group consisted of 15 specimens. Tooth brushing was simulated with tooth brushing strokes of 21.6 k, 43.2 k, and 64.8 k. Color, gloss and roughness were measured at baseline and after cycle intervals. Kruskal-Wallis and paired Post-hoc Conover tests were applied to detect statistical differences between treatment groups. Differences before and after aging were calculated by Wilcoxon signed rank test (α=0.05).

RESULTS

In all groups, color difference (∆E) was statistically significant after aging: no-PC (P<.001, 95% CI[0.14,0.84]), no-MC (P=.003, 95% CI[0.23,1.12]), no-ZR (P=.003, 95% CI [0.33,0.62]), in-MC (P=.003, 95% CI[0.35,0.73]), in-ZR (P=.003, 95% CI[0.09,0.32]), ex-PC (P=.003, 95% CI[0.54,0.98]), ex-MC (P<.001, 95% CI[0.23,1.26]), ex-ZR (P=.003, 95% CI[0.27,0.55]), and PFM (P=.002, 95% CI[0.22,0.34]). Aging increased surface roughness and decreased the gloss within all subgroups showing statistical significance.

CONCLUSIONS

Color, gloss and roughness of stained monolithic ceramic materials changed significantly by means of tooth brush abrasion in vitro. Color changes were below the threshold value for the detection by the human eye (∆E 1.8).

Effect of surface treatment and glaze application on shade characterized resin-modified ceramic after toothbrushing

STATEMENT OF PROBLEM

The extrinsic characterization with pigments and glaze application on the surface of ceramic restorations promotes individualization and esthetics. However, whether this characterization is resistant to toothbrushing abrasive wear is unclear.

PURPOSE

The purpose of this in vitro study was to investigate the abrasive wear resistance of characterized and glazed resin-modified ceramic with different surface treatments before characterization.

MATERIAL AND METHODS

Eighty rectangular specimens (10×8×6 mm) were precision cut from Vita Enamic and randomly divided in 4 groups as per the surface treatment before the characterization technique. These groups included the following: no additional treatment or polishing only, acid etching, airborne-particle abrasion, and self-etching silanization. For each surface treatment, 2 subgroups were created considering the presence or absence of the glaze layer after shade characterization, totaling 8 groups (n=10). The specimens were submitted to toothbrushing simulation (150 000 cycles, 2.45-N, 180 strokes per minute) with a soft and straight toothbrush and a solution of toothpaste and distilled water (250 g/L). After each 50 000 cycles, the wear of the characterized surface was measured by using a contact profilometer in μm which was equivalent to 5, 10, and 15 years of simulated toothbrushing. The rates were analyzed by using 3-way ANOVA and the post hoc Tukey test (α=.05). Scanning electron microscopy analysis was performed to access the surface profile between the evaluated periods.

RESULTS

The mean wear rate (Rz) of the characterized surface was affected by the isolated factors, including surface treatment, glaze, and time (P<.001), with no interactive effects noted. A higher mean value of Rz was observed for polishing only (12.9 ±4.4 μm), followed by airborne-particle abrasion (10.2 ±4.5 μm), acid etching (9.4 ±2.4 μm), and then self-etching silanization (7.6 ±2.9 μm). Mean wear rate was also increased by the glaze (11.1 ±4.7 μm) compared with its absence (9 ±3.2 μm) and by the length of time, with 15 years (11.3 ±4.5 μm) followed by 10 years (9.8 ±4.0 μm) and 5 years (9 ±3.6 μm). The scanning electron microscopy images showed similar worn surfaces for each subgroup, glaze removal after 150 000 cycles, and surface homogeneity in function of time.

CONCLUSIONS

Self-etching silanization was found to be the treatment suitable for reducing the wear of characterized resin-modified ceramic during prolonged brushing of more than 5 years. Glaze application did not protect the characterization from surface wear, regardless of the ceramic surface treatment performed on the specimens.

Effect of chemical aging on color stability and surface properties of stained all-ceramic restorations

OBJECTIVES

To study the effect of artificial aging on color stability, translucency, and surface roughness of stained all-ceramic restorations.

MATERIALS AND METHODS

Disc-shaped specimens were fabricated from six different all-ceramic materials: two glass ceramics (Vita Mark II and Empress CAD), two lithium disilicate based ceramics (e.max and Suprinity), and two zirconia-based materials (ZirCAD LT and ZirCAD MT Multi). The discs were stained using two universal stains; ^IPS Ivocolor stain or Vita Akzent stain. Color change (ΔE) and the translucency parameter (TP) were measured before and after artificial aging. The surface roughness (Ra) was evaluated using atomic force microscopy, while the surface microstructure was evaluated using scanning electron microscopy (SEM). Quantitative elemental analysis was performed using the energy dispersive X-ray (EDX). Leached ions were analyzed by inductively coupled plasma (ICP) (n = 12, α = 0.05).

RESULTS

Artificial aging had significantly changed the color (ΔE) and decreased the translucency (TP) of all stained ceramics. The mean surface roughness (Ra) was significantly increased in all specimens, which was also confirmed in the SEM scans. EDX analysis revealed a decrease in the elemental composition of the stained surface as a result of ceramic degradation, except for Ca and Zn in ^IPS Ivocolor stain. Furthermore, the ICP analysis revealed that most compositional elements of stain and glaze were detected in the aging solution.

CONCLUSIONS

Chemical aging had significantly affected the optical parameters and surface texture of stained monolithic ceramics.

CLINICAL SIGNIFICANCE

Stained ceramics are liable to color degradation. Each type of stain should be used with its corresponding type of ceramic. Stained all-ceramic restorations are liable to color change and surface degradation during function.

Toothbrushing Wear Resistance of Stained CAD/CAM Ceramics

Aim: To investigate the effect of toothbrushing on different stained Computerd Aided Design/Computer Aided Manufacturing CAD/CAM ceramics. Materials and Methods: Fifty specimens (high translucency zirconia, YZHT; zirconia-reinforced lithium silicate, ZLS; feldspathic, FDL; hybrid ceramic, HC; all from Vita Zahnfabrik) were divided into five groups according to their staining technique. ZLS allowed the composition of two groups: ZLS1 with crystallization and staining together; ZLS2, with the stain firing after the crystallization. YZHT received a stain firing after the sintering process, and FDL received stain firing directly. The HC was stained with acrylic staining, and was light-cured on its surface. The specimens were brushed in total for 150,000 cycles at 2.45 N with 180 strokes/min. Surface measurements to obtain Rz were performed after 50,000, 100,000 and 150,000 cycles, with five evaluation lines (5 mm) per specimen orthogonal to the brushing direction, covering brushed and unbrushed areas. The wear was analyzed using two-way ANOVA and Tukey tests (α = 5%). Scanning electron microscopy (SEM) was performed to access the surface profile. The wear was affected by material (p < 0.001) and time (p = 0.139). Superior wear (µm) was observed for HC (6.6 ± 4.4; 6.8 ± 4.0; 9.2 ± 3.5) compared to ZLS2 (1.0 ± 0.3; 1.2 ± 2.2; 1.3 ± 0.3), YZHT (1.0 ± 0.1; 1.2 ± 0.3; 1.2 ± 0.3), ZLS1 (0.9 ± 0.1; 1.1 ± 0.5; 1.2 ± 0.3) and FDL (0.9 ± 0.1; 0.9 ± 0.1; 1.0 ± 0.2) after 5, 10 and 15 years of simulation, respectively. SEM showed different wear patters for HC with the removal of the glaze layer. HC showed a higher staining wear rate compared to the glass-based and polycrystalline ceramics after 15 years. The extrinsic characterization of feldspathic ceramic showed its superior longevity compared to the evaluated high-translucency zirconia, zirconia-reinforced lithium silicate, and hybrid ceramic.

Effect of erosive and abrasive challenges on the glaze layer applied to ceramic materials

PURPOSE

This study aims to evaluate the effect of erosive, abrasive, and erosive/abrasive challenges on the glaze layer of ceramic materials.

METHODS

Ninety-five samples of monolithic zirconia (MZ) (LuxaCam Zircon HT-Plus) and lithium disilicate (LD) (IPS e.max CAD) were divided according to the response variables: Surface roughness and surface loss (n = 10), evaluated with optical profilometry; surface topography, with scanning electron microscopy SEM (n = 3); and biofilm deposition, with microbiological assay (n = 5). The evaluations were performed in three different time evaluations: (a) Sintered, (b) Glaze, and (c) Challenge (Erosion, Abrasion, and Erosion/Abrasion). Erosion consisted in immersing specimens in HCl solution, abrasion was performed with brushing machine, and erosion/abrasion consisted of a combination of the two previous protocols. Data were analyzed with parametric tests (P < 0.05).

RESULTS

MZ glaze layer presented significantly higher surface roughness (P = 0.00), surface loss (P = 0.03), and biofilm deposition (P = 0.00) than LD. Abrasion and erosion/abrasion showed similar outcomes, generating significantly higher surface roughness (P = 0.00), surface loss (P = 0.00), and biofilm deposition (P = 0.01) than erosion.

CONCLUSIONS

Glaze layer properties were altered by the challenges, with abrasion and erosion/abrasion generating higher surface roughness, surface loss, and biofilm deposition than erosion. A significant correlation was found between the surface roughness and biofilm deposition.

CLINICAL SIGNIFICANCE

The glaze layer is susceptible to challenges, especially to abrasion and erosion/abrasion, which generated greater surface roughness and surface loss than erosion. The greater surface roughness lead to a greater biofilm deposition on the glaze layer.

Durability of staining and glazing on a hybrid ceramics after the three-body wear

Hybrid ceramic is a promising material for monolithic restorations that could require an individualization through the extrinsic staining to improve aesthetics. Due to the possibilities to treat this ceramic prior to staining, this study evaluated the wear resistance of surface treatments prior to staining and glazing a hybrid ceramic. Thirty-two specimens (Vita Enamic) were divided into 8 groups according to the surface treatment prior to the staining (Polishing: Pol, Acid etching: Ac, Sandblasting with Al₂O₃: Sd or Self-etching silane: Ses) and glaze application (with: gl or without: gl). The specimens were submitted to the ACTA wear machine simulating the presence of food bolus and antagonist. The wear rate of the stain was determined after 7 intervals of 20,000 cycles, using a profilometer. The surface before and after staining, and after wear were inspected using Scanning Electron Microscopy (SEM). The rates were analyzed using three-way ANOVA and Tukey test. The wear was affected by surface treatment, glaze application and number of cycles (p < 0.001). 100% of the staining was removed after 20,000 cycles for Pol, 40,000 for Pol + gl, 60,000 for Ses + gl, 80,000 for Ac, 100,000 for Sd and Ses, 120,000 for Ac + gl and 140,000 for Sd + gl. SEM showed similar worn surfaces. Sandblasting followed by glaze application was the most durable treatment to maintain the external staining on the hybrid ceramic surface when subjected to three-body wear.

Ceramic Materials and Technologies Applied to Digital Works in Implant-Supported Restorative Dentistry

Computer-aided design and manufacturing technology has been closely associated with implant-supported restoration. The digital system employed for prosthodontic restorations comprises data acquisition, processing, and manufacturing using subtractive or additive methods. As digital implantology has developed, optical scanning, computer-based digital algorithms, fabricating techniques, and numerical control skills have all rapidly improved in terms of their accuracy, which has resulted in the development of new ceramic materials with advanced esthetics and durability for clinical application. This study reviews the application of digital technology in implant-supported dental restoration and explores two globally utilized ceramic restorative materials: Yttria-stabilized tetragonal zirconia polycrystalline and lithium disilicate glass ceramics.

Alqahtani N, Alhassan Mujayri F. Effect of Hydrothermal Aging and Beverages on Color Stability of Lithium Disilicate and Zirconia Based Ceramics

Background and Objectives: All-ceramic prosthesis is widely used in modern dental practice because of its improved physico-mechanical and optical properties. These restorations are exposed to coloring agents from various nutrition and beverages in the oral cavity. Long-term color stability is critical for the success of these restorative materials. The purpose of this in vitro study was to assess the effect of common beverages and mouthwash on the color stability of lithium disilicate (LD), monolithic zirconia (MZ) and bilayer zirconia (BZ) surfaces. Materials and Method: Thirty disc-shaped specimens from each material were fabricated; each group was subdivided (n = 10) according to coffee, green tea and chlorhexidine immersion solutions. The baseline color of ceramic discs was recorded according to the CIE L*a*b* system with a portable spectrophotometer. The second measurement was recorded after 3000 thermocycling and immersion in coloring agents for 7 days. The mean color difference was calculated and data were compared with Kruskal-Wallis and Mann-Whitney post hoc tests (0.05). Results: ΔE values for LD with the immersion of coffee, tea, and Chlorhexidine gluconate (CHG) were 1.78, 2.241 and 1.58, respectively. Corresponding ΔE values for MZ were 5.60, 5.19, and 4.86; marginally higher than the clinically acceptable level of 3.5. Meanwhile, BZ showed better color stability compared to MZ with ΔE values of 4.22, 2.11 and 1.43. Conclusions: Among the ceramics evaluated, LD ceramic was found to be more color stable, while MZ ceramics displayed a higher susceptibility to discoloration. MZ and BZ ceramic colors were significantly altered with coffee immersion, while LD ceramics were more affected by green tea.

All-ceramic single crowns supported by zirconia implants: 5-year results of a prospective multicenter study

OBJECTIVES

To assess survival/success rates and patient-reported outcome of zirconia-based posterior single crowns (SCs) supported by zirconia implants in a prospective two-center study after five years of observation.

MATERIAL AND METHODS

Forty-five patients were restored with 45 zirconia implant-supported posterior SCs composed of zirconia frameworks hand-layered with a leucite-reinforced feldspathic ceramic. Survival rates of SCs were assessed and technical success was evaluated according to modified United States Public Health Care (USPHS) criteria. Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Wilcoxon matched-pairs signed-rank test, mixed-effects ordered logistic regression, and linear mixed models were used to evaluate time effects on response variables.

RESULTS

Forty patients were available after a mean observation period of 61.0 ± 1.4 months. One SC had to be replaced, resulting in a Kaplan-Meier (KM) survival estimate for the SCs of 97.5 ± 2.47%. Since nine reconstructions showed at least in one category a major deviation from the ideal (five major chippings, four with increased occlusal roughness, one significant crevice, and one pronounced over-contouring), the KM success estimate was 79.3 ± 5.8%. Incidence of chipping (n = 19) and occlusal roughness (n = 35) was frequent (p < 0.001). All PROMs at prosthetic delivery except for speech (p = 0.139) showed significantly improved VAS scores (81%-94%; p < 0.001) compared to pre-treatment evaluations. Thereafter, no decrease in satisfaction could be observed until the 5-year follow-up (93%-97%).

CONCLUSION

Veneered zirconia-based SCs supported by zirconia implants showed high survival rates and highly satisfied patients' needs. However, significant incidence of technical complications is compromising the clinical long-term outcome for this indication.

Optical and Surface Properties of Monolithic Zirconia after Simulated Toothbrushing

This in vitro study investigated the impact of various dentifrices on the shade, translucency, gloss, and surface characteristics of polishing- or glazing-finished monolithic zirconia surfaces after simulated toothbrushing. Eighty square-shaped monolithic zirconia specimens were divided into two major groups based on the finishing methods—polished (P) and glazed (G). Next, specimens from the two major groups were categorized into four subgroups: stored in distilled water (DW, control); brushed with a fluoride-free conventional dentifrice (C); brushed with a fluoride dentifrice (F); and brushed with a whitening dentifrice (W). Overall, eight groups were created—PDW, PC, PF, PW, GDW, GC, GF, and GW (n = 10 each). Shade, translucency, surface gloss, surface roughness, crystalline phase, and superficial topography data were obtained. Repeated-measures ANOVA and two-way ANOVA were used for intergroup comparison (all α = 0.05). The color differences (ΔE₀₀) between pre- and posttreatment were 0.3158 (PDW), 0.7164 (PC), 0.7498 (PF), 0.8106 (PW), 0.1953 (GDW), 0.301 (GC), 0.3051 (GF), and 0.4846 (GW). A statistically significant difference was observed among the ΔE₀₀, surface gloss, and surface roughness of monolithic zirconia. Thus, brushing with several dentifrices markedly affects the optical properties and surface characteristics of monolithic zirconia finished with polishing or glazing methods.

Surface deterioration of monolithic CAD/CAM restorative materials after artificial abrasive toothbrushing

PURPOSE

The purpose of this in vitro study was to evaluate the effect of abrasive toothbrushing on the surface properties of monolithic computer-assisted design and computer-assisted manufacturing (CAD/CAM) materials stored in food-simulating liquids (FSLs).

MATERIALS AND METHODS

Fourty-eight disk-shaped test specimens of each material (Paradigm MZ100/PMZ, Lava Ultimate/LU, Vita Enamic/VE, and Vita Mark II/VMII) with a diameter of 10.0 mm and a thickness of 3.0 ± 0.05 mm were prepared. Specimens were divided into 4 subgroups (n=12) and stored in air, distilled water, 0.02 M citric acid, or 75% ethanol/water solution for 7 days at 36.5℃. Then, the specimens were brushed in a multi-station brushing machine under a vertical load of 2.0 N for 3 hours. Surface gloss (GU), roughness (Ra), and hardness (Vickers [VHN]) were measured after storage and brushing simulation. The data sets were statistically analyzed with 2 and 3-way ANOVAs followed by the Tukey's post-hoc comparisons (α=.05).

RESULTS

Statistically significant difference was found among the materials concerning the results of surface properties. VMII showed the highest VHN, while PMZ produced the lowest. Storage in FSLs significantly affected the VHN of PMZ and LU. VMII showed the lowest Ra and highest GU irrespective of FSLs and of abrasive toothbrushing. VE, LU, and PMZ produced significant decrease in GU and increase in Ra after toothbrushing.

CONCLUSION

Surface properties of monolithic CAD/CAM restorative materials were differently affected by the storage media and abrasive toothbrushing.

Recent advances in understanding the fatigue and wear behavior of dental composites and ceramics

Dental composite and ceramic restorative materials are designed to closely mimic the aesthetics and function of natural tooth tissue, and their longevity in the oral environment depends to a large degree on their fatigue and wear properties. The purpose of this review is to highlight some recent advances in our understanding of fatigue and wear mechanisms, and how they contribute to restoration failures in the complex oral environment. Overall, fatigue and wear processes are found to be closely related, with wear of dental ceramic occlusal surfaces providing initiation sites for fatigue failures, and subsurface fatigue crack propagation driving key wear mechanisms for composites, ceramics, and enamel. Furthermore, both fatigue and wear of composite restorations may be important in enabling secondary caries formation, which is the leading cause of composite restoration failures. Overall, developing a mechanistic description of fatigue, wear, and secondary caries formation, along with understanding the interconnectivity of all three processes, are together seen as essential keys to successfully using in vitro studies to predict in vivo outcomes and develop improved dental restorative materials.

Effect of Aging on Stained Monolithic Resin-Ceramic CAD/CAM Materials: Quantitative and Qualitative Analysis of Surface Roughness

PURPOSE

The aim of this in vitro study was to measure the effect of staining and artificial aging on the surface roughness of commercially available resin-ceramic computer-aided design and computer-aided manufacturing (CAD/CAM) materials both quantitatively and qualitatively and to compare it to feldspathic material.

MATERIALS AND METHODS

Test specimens (n = 15 per material) were prepared of CAD/CAM ingots from a resin nanoceramic (Lava Ultimate, LVU), a polymer-infiltrated ceramic (Vita Enamic, ENA), and a resin nanoceramic (Cerasmart, CER). In the staining protocol, test specimens were (i) roughened in a standardized manner and (ii) stained with the manufacturer's recommended staining kit by means of photo-polymerization (Bluephase Polywave). The control specimens were prepared out of a feldspathic ceramic (Vita Mark II,VM2) and stained in a ceramic furnace. As negative control of each group, 15 specimens were prepared and polished in a standardized manner. Surface roughness (Ra) was measured after finishing procedures and after simulation of clinical service up to 5 years by means of toothbrushing. After each year of aging, one specimen per group was randomly selected for scanning electron microscopy (SEM) analysis. Kruskal-Wallis test and paired post-hoc test were applied to detect differences between treatment groups (alpha = 0.05).

RESULTS

The mean roughness measurements of the stained CAD/CAM materials were 0.14 ± 0.04 μm (ENA), 0.15 ± 0.03 μm (LVU), 0.22 ± 0.03 μm (VM2), and 0.26 ± 0.12 μm (CER). In the polished CAD/CAM materials the measurements were 0.01 ± 0.01 μm (CER), 0.02 ± 0.01 μm (LVU), 0.02 ± 0.00 μm (VM2), and 0.03 ± 0.01μm (ENA). Irrespective of the restoration material, the applied staining protocol resulted in a higher surface roughness compared to the polished specimens (p < 0.001). After 5 years of simulated aging the mean surface roughness in the stained CAD/CAM materials were 0.22 ± 0.03 μm (VM2), 0.24 ± 0.09 μm (ENA), 0.25 ± 0.06 μm (CER), and 0.37 ± 0.09 μm (LVU). Aging had a significant effect on surface roughness in groups ENA and LVU (p < 0.001). SEM analysis showed that the staining layer on resin-ceramic CAD/CAM materials was partially removed over time.

CONCLUSIONS

The applied staining protocol significantly increased surface roughness of CAD/CAM materials. Instability of the staining layer on resin-ceramic CAD/CAM materials could be anticipated over time as a consequence of toothbrushing, whereas feldspathic ceramic did not suffer from such aging effect.

Effect of brushing and thermocycling on the shade and surface roughness of CAD-CAM ceramic restorations

STATEMENT OF PROBLEM

The effects of toothbrushing (B) and thermocycling (TC) on the surface texture of different materials with various fabrication processes have been investigated. However, studies of computer-aided design and computer-aided manufacturing (CAD-CAM) ceramic restorations are limited.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of B and TC on the color stability and surface roughness of extrinsically characterized and glazed CAD-CAM ceramic restorations.

MATERIAL AND METHODS

Lithium disilicate CAD ceramic (n=90) and zirconia ceramic (n=90) were studied. All specimens were crystallized/sintered, characterized, and glazed following the manufacturer's recommendation. The specimens were divided into 9 different groups: B, TC, and a combination of B plus TC (B+TC). Brushing was performed at 50 000, 100 000, and 150 000 cycles, simulating an oral environment of 5, 10, and 15 years. Thermocycling was performed at 6000, 12 000, and 18 000 cycles, simulating an oral environment of 5, 10, and 15 years. Brushing plus TC was performed with the combination of the 50 000 cycles of B, then 6000 cycles of TC, and 10 000 cycles of B, then 12 000 cycles of TC, and 15 000 cycles of B, then 18 000 cycles of TC. The color and surface roughness of each specimen were measured before and after all interventions with simulated cycles. Color differences (ΔE) and surface roughness (ΔR_a) data were analyzed using 2-way ANOVA, followed by the least significant difference test (α=.05). The correlation between ΔE and ΔR_a was statistically analyzed using the Pearson correlation analysis.

RESULTS

Within the lithium disilicate CAD groups, intervention did not result in any significant differences in color change (P>.05). Within the zirconia groups, a 15-year clinical simulation revealed significantly higher ΔE values than a simulated 5-year exposure (P=.017). Increased simulated cycles showed significantly higher R_a values for all groups. Within the zirconia groups, B revealed significantly smoother surfaces than TC (P<.001) and B+TC interventions (P<.001). For the zirconia, simulating B+TC for15 years revealed significantly higher R_a values than the groups of B+TC for 5 years (P<.001) and B+TC for 10 years (P=.003). No correlation (lithium disilicate CAD, r=.079; P=.462; zirconia, r=.001; P=.989) was found between the color change and surface roughness.

CONCLUSIONS

For both lithium disilicate CAD and zirconia, color changes were below the selected clinical perceptible threshold (ΔE=2.6) after all intervention and simulated cycles. All mean surface roughness measurements were below 0.2 μm. Generally, the surface of both lithium disilicate CAD and zirconia became rougher. No correlation was found between color difference and surface roughness for either material.

Evaluation of color changes of dental luting materials in food colorant solutions

BACKGROUND

The purpose of this study was to compare the color stability and water absorption of 3 commercially available resin cements in vitro by storing them in 0.15% erythrosine, dark brown and sunset yellow for 30 days.

METHODS

2 self-adhesive resin cements and 1 dual/light curing, resin-based dental luting material were evaluated (total 120 samples). The CIE L, a, b of 10 mm diameter-2.0 mm height disk shaped samples was measured using a spectrophotometer for color stability on a white background, 10 mm diameter-1.0 mm height disk shaped samples were measured for water absorption before and after storage in food colorant solutions.

RESULTS

The self-adhesive resin cement-sunset yellow group caused the most severe discoloration (27.89 ± 3.64) that is clinically unacceptable. The lowest discoloration was seen in the self-adhesive resin cement control group (3.35 ± 1.13). The highest water absorption was observed in the self-adhesive resin cement-dark brown group (2.41 ± 0.60) and the lowest water absorption in the dental luting material-control group (0.65 ± 0.17).

CONCLUSIONS

Storage food colorant solutions affected the color stability and water absorption of different resin cement materials.