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Jiang L, Li XY, Lu ZC, Yang S, Chen R, Yu H. Er:YAG laser settings for debonding zirconia restorations: An in vitro study. J Mech Behav Biomed Mater 2024; 151:106331. [PMID: 38176195 DOI: 10.1016/j.jmbbm.2023.106331] [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: 10/29/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024]
Abstract
This in vitro study aimed to determine the optimal frequency and energy settings for debonding zirconia restorations using an erbium-doped yttrium aluminum garnet (Er:YAG) laser. A total of 200 zirconia specimens (5 mm × 5 mm × 1.5 mm) were fabricated from two types of materials: (1) 3 mol% yttria oxide stabilized tetragonal zirconia polycrystalline (3Y-TZP) and (2) 5 mol% yttria oxide stabilized tetragonal zirconia polycrystalline (5Y-TZP). The zirconia specimens were bonded to dentin using resin cement (RelyX Ultimate, 3 M) and divided into 20 groups based on their laser treatments (n = 5). Er:YAG laser treatment was applied at various frequencies (10 Hz and 20 Hz) and energies (80 mJ, 100 mJ, 120 mJ, 140 mJ, 160 mJ, 180 mJ, 200 mJ, 220 mJ, 240 mJ, and 260 mJ). The time required to debond the specimens and the temperature changes that dentin underwent during the laser treatment were recorded. The surface morphologies of the debonded dentin and zirconia specimens were observed using scanning electron microscopy (SEM). Additional zirconia specimens were fabricated for 4-point flexural strength testing and surface roughness measurements. Statistical analyses were conducted using three-way analysis of variance (ANOVA) and Student-Newman-Keuls (SNK)-q tests (α = 0.05). The debonding time of each specimen varied between 4.8 and 160.4 s, with an average value of 59.2 s. The dentin temperature change for each specimen ranged from 2.3 to 3.6 °C, with an average value of 2.7 °C. The debonding time was significantly influenced by the zirconia material type and laser energy, but it was not affected by the laser frequency. Among the specimens, those made of 3Y-TZP needed significantly more time for debonding than 5Y-TZP. The optimal energies were 220 mJ for 3Y-TZP and 200 mJ for 5Y-TZP. The laser frequency, laser energy, and type of zirconia material had no effect on the dentin temperature change. Additionally, no surface alternations were observed on the dentin or zirconia materials after laser treatment. The surface roughness and flexural strength of the zirconia materials remained unchanged after laser treatment. In summary, Er:YAG laser treatment effectively and safely removes zirconia restorations without impacting their mechanical properties, with a safe temperature change of less than 5.6 °C. The optimum frequency and energy settings for debonding 3Y-TZP and 5Y-TZP restorations were found to be 10/20 Hz and 220 mJ and 10/20 Hz and 200 mJ, respectively.
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Affiliation(s)
- Lei Jiang
- 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, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China
| | - Xue-Yu Li
- 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, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China
| | - Zhi-Cen Lu
- 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, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China
| | - Song Yang
- 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, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China
| | - Run Chen
- 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, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, 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, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China; Clinic of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Switzerland; Department of Applied Prosthodontics Graduate School of Biomedical Sciences, Nagasaki University, Japan
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Aziz AM, El-Mowafy O. Clinical evaluation of zirconia crowns cemented with two different resin cements: A retrospective study. J Oral Rehabil 2023; 50:1481-1486. [PMID: 37638559 DOI: 10.1111/joor.13580] [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: 03/22/2023] [Revised: 05/28/2023] [Accepted: 08/17/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Self-adhesive resin cement has been used extensively with zirconia crowns. Several in vitro studies showed that adhesive resin cementation may increase zirconia crowns' retention and their fatigue resistance. OBJECTIVES This retrospective study aimed to evaluate the clinical performance, survival and success rates and complications encountered with zirconia crowns cemented with two different self-adhesive resin cements. METHODS A total of 112 patients who received 176 monolithic zirconia crowns were evaluated. Crowns were cemented with RelyX Unicem 2 (n = 74) and Panavia SA (n = 102) self-adhesive resin cements. Clinical assessments of the crowns and supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Intraoral photographs and periapical and bitewing radiographs were obtained for further assessment by two evaluators. Descriptive statistics, McNemar, t-test, log rank (Mantel-Cox) tests and Kaplan-Meier survival analyses were performed (a = .05). RESULTS The 5-year survival and success rates were 100% and 96.4%, respectively. The complications encountered were recurrent caries (2.2%) and the need for endodontic treatment (0.5%). No technical complications, such as fracture or loss of retention, were observed. The type of cement and patient-related factors did not influence the survival and success rates of the crowns. CONCLUSIONS Survival rate of zirconia crowns cemented with two different self-adhesive resin cements was 100% after 5 years.
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Affiliation(s)
- Ahmed M Aziz
- Department of Restorative and Preventive Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Omar El-Mowafy
- Department of Restorative Dentistry, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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Shihabi S, Chrcanovic BR. Clinical outcomes of tooth-supported monolithic zirconia vs. porcelain-veneered zirconia fixed dental prosthesis, with an additional focus on the cement type: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:5755-5769. [PMID: 37626273 PMCID: PMC10560185 DOI: 10.1007/s00784-023-05219-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE To compare the failure rates and the prevalence of technical complications between full-coverage tooth-supported monolithic zirconia (MZ) and porcelain-veneered zirconia (PVZ) fixed dental prosthesis, based on a systematic literature review. METHODS An electronic search was performed in three databases, supplemented by hand searching. Several statistical methods were used. RESULTS Seventy-four publications reported 6370 restorations (4264 PVZ; 2106 MZ; 8200 abutment teeth; 3549 patients), followed up until 152 months. A total of 216 prostheses failed, and survival was statistically significant different between groups. PVZ had higher occurrence of complications than MZ; the difference was especially greater for either minor or major chipping. The difference in prevalence of either minor or major chipping was statistically significant for PVZ prostheses between cementation with glass ionomer and adhesive resin cement (higher), adhesive resin and resin-modified glass ionomer cement (RMGIC, higher), and between RMGIC (higher) and glass ionomer cement. For MZ the difference was significant only for minor chipping between RMGIC (higher) and adhesive resin cement. Abutment teeth to PVZ prostheses more often lost vitality. Decementation was not observed with RMGIC. Air abrasion did not seem to clinically decrease the decementation risk. The 5-year difference in the occurrence of minor or major chipping between MZ and PVZ prostheses was statistically significant, but nor for catastrophic fracture. CONCLUSION Tooth-supported PVZ prostheses present higher failure and complication rates than MZ prosthesis. The difference in complications is striking when it comes to chipping. CLINICAL RELEVANCE Awareness of the outcome differences between different types of zirconia prostheses is important for clinical practice.
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Affiliation(s)
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Carl Gustafs Väg 34, 214 21 Malmö, Sweden
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Clinical reliability of self-adhesive luting resins compared to other adhesive procedures: A systematic review and meta-analysis. J Dent 2023; 129:104394. [PMID: 36566829 DOI: 10.1016/j.jdent.2022.104394] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES This systematic review aimed to collect and interpret the randomized clinical trials (RCTs) that investigated the outcome of the self-adhesive luting resins (SA) compared to total-etch (TE), selective etch with dentin adhesives (Sle), selective etch without dentin adhesives (SleSA) or self-etch adhesives (SE). DATA SOURCES A thorough search of Internet databases was conducted without language restrictions, and the search ran up to and including April 2022. The illegible records citations were checked for more relevant clinical studies. STUDY SELECTION/RESULTS The inclusion criteria were randomized controlled trials (RCTs) that compared self-adhesive luting resins with total-etch, selective-etch, or self-etch adhesives regarding postoperative sensitivity, incidences of debonding, and survival rates of indirect restorations. From 1732 records, 9 RCTs met the eligibility criteria. Three RCTs compared total-etch adhesive to self-adhesive luting resin for intracoronal restorations, one RCT compared selective etch to self-adhesive luting resin for inlays, and 5 RCTs compared self-adhesive to other protocols for partial ceramic crowns. Postoperative sensitivity showed a non-statistically significant difference between SA and other adhesive protocols, SA revealed a non-statistically significant difference in debonding and survival to TE, but a lower statistically significant difference to Sle, SleSA, and SE. CONCLUSIONS Postoperative sensitivity might not be affected by the adhesive protocol. In relatively short observation, TE revealed comparable survival to SA for intracoronal restorations. SE and Sle exhibited the best clinical outcomes, followed by SleSA. Selective etch, and self-etch adhesives are preferable to self-adhesive resins. CLINICAL SIGNIFICANCE The significance of enamel etching and the superiority of self-etching adhesives over self-adhesive luting resins for reliable and durable bonding and improved clinical outcomes. However, long-term RCTs, particularly for total-etch comparison to self-adhesive luting resins, might be recommended to derive further evidence.
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Wittneben J, Yilmaz B, Wismeijer D, Shahdad S, Brägger U, Abou‐Ayash S. Patient‐reported outcome measures focusing on the esthetics of implant‐compared to tooth‐supported single crowns—A systematic review and meta‐analysis. J ESTHET RESTOR DENT 2022; 35:632-645. [DOI: 10.1111/jerd.12983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Julia‐Gabriela Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine Boston Massachusetts USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine University of Bern Bern Switzerland
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, ACTA University of Amsterdam and VU University Amsterdam The Netherlands
| | - Shakeel Shahdad
- Institute of Dentistry Queen Mary University of London London UK
- Restorative Dentistry The Royal London Dental Hospital London UK
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
| | - Samir Abou‐Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
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Do tooth-supported zirconia restorations present more technical failures related to fracture or loss of retention? Systematic review and meta-analysis. Clin Oral Investig 2022; 26:5129-5142. [PMID: 35660957 DOI: 10.1007/s00784-022-04573-z] [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: 01/13/2022] [Accepted: 05/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This systematic review was performed to determine the main cause of technical failure of tooth-supported zirconia crowns and fixed partial dentures (FPDs), categorizing them as fracture/chipping or loss of retention/decementation. MATERIALS AND METHODS Electronic and manual searches were performed for randomized clinical trials, prospective clinical trials, and prospective cohort studies that reported the technical failure rates of zirconia restorations. The Cochrane Collaboration risk-of-bias tool and Newcastle-Ottawa scale were used to assess the quality of the studies. RESULTS Fifty-two studies were included and most of them had unclear risk of bias. Considering all reported fractures/chipping, for veneered crowns with 1 to 3 years of follow-up, the relative risk (RR) of fracture in relation to loss or retention was 3.95 (95% CI 1.18-13.23; p = 0.03). For 4 to 6 years of follow-up, the RR was 5.44 (95% CI 1.41-20.92; p = 0.01). For veneered FPDs with 1 to 3 years of follow-up, the RR was 5.98 (95% CI 2.31-15.01; p = 0.0002). For 4 to 6 years of follow-up, the RR was 3.70 (95% CI 1.63-8.41; p = 0.002). For 7 years or more of follow-up, the RR was 3.45 (95% CI 1.84-6.46; p = 0.0001). When only framework fractures were considered, there were no significant differences for the RR in all follow-up periods (p > 0.05). CONCLUSIONS Higher RR for fracture/chipping in relation to decementation for veneered zirconia crowns and FPDs at all follow-up times. For framework fractures, no difference was observed between the risk of failure of the restoration due to fracture or decementation. CLINICAL RELEVANCE Zirconia crowns and FPDs showed relatively high success and survival rates. However, considering the technical failures, there is approximately four times higher chance of fracture/chipping than loss of retention for both single and multi-unit tooth-supported veneered zirconia restorations.
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Passos IDAG, Marques JDN, Câmara JVF, Simão RA, Prado MD, Pereira GDDS. Effect of non-thermal argon plasma on the shear strength of adhesive systems. POLIMEROS 2022. [DOI: 10.1590/0104-1428.20220019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kohli S, Bhatia S, Al-Haddad A, Pulikkotil SJ, Jamayet NB. Pulpal and Periapical Status of the Vital Teeth Used as Abutment for Fixed Prosthesis-A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:102-114. [PMID: 34516686 DOI: 10.1111/jopr.13433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This is a systematic review to identify the incidence of pulp necrosis and/or periapical changes among vital teeth which are used as an abutment for crown and fixed partial dentures (FPDs). MATERIALS AND METHODS Two reviewers independently searched two electronic databases, PubMed and Scopus. The search was complemented from references of included studies and published reviews. Studies published in the English language through January 2021 that had assessed and documented the clinical and radiographic failure of crown or FPD in vital permanent teeth due to pulpal or periapical pathology with a follow-up of at least 12 months were selected. Data screening, data collection and extraction of data was performed. Quality of studies involved was analyzed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Meta-analysis was done using random effects model. Publication bias was assessed using funnel plots. RESULTS Electronic searches provided 10,075 records among which 20 studies were selected for systematic review and 7 studies were selected for meta-analysis. With respect to quality assessment, all the studies involved were considered as high quality as the score in scale ranged between 6 and 9 as per the Newcastle-Ottawa Quality Assessment Scale for cohort studies. The meta-analyses showed that there was no statistically significant difference in the incidence of the loss of pulp vitality or pulp necrosis through clinical and radiographic examination with the follow up period of 5 years: p < 0.001, 95% CI: 0.96-1.00, I2 = 77.84%; 10 years: p < 0.001, 95% CI: 0.88-0.95, I2 = 93.59%; 15 years: p < 0.001, 95% CI: 0.92-0.96, I2 = 94.83%; and 20 years: p < 0.001, 95% CI: 0.94-0.96, I2 = 95.01%. CONCLUSIONS The meta-analysis revealed clinical and radiographic success rate ranging between 92% to 98% at different follow up periods ranging between 5 years and 20 years. Future high-quality randomized clinical controlled trials with a larger population are required to confirm the evidence as only observational studies were considered in this paper.
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Affiliation(s)
- Shivani Kohli
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Shekhar Bhatia
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Selangor, Malaysia
| | - Shaju Jacob Pulikkotil
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Nafij Bin Jamayet
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Maciel LC, Amaral M, Queiroz DA, Baroudi K, Silva-Concílio LR. The effect of repeated surface treatment of zirconia on its bond strength to resin cement. J Adv Prosthodont 2020; 12:291-298. [PMID: 33149850 PMCID: PMC7604241 DOI: 10.4047/jap.2020.12.5.291] [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: 03/10/2020] [Revised: 06/15/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate the influence of repeated surface treatments on wettability and surface roughness for zirconia surface and bond strength of zirconia-based ceramics to resin cement. MATERIALS AND METHODS Seventy blocks (10 × 10 × 3 mm) of zirconia-based ceramics were fabricated and divided into two groups according to the surface treatments: (A) 110 µm Al2O3 airborne-particle abrasion and (R) 110 µm silica modified Al2O3 airborne-particle abrasion. At stage 2, each group was subdivided into 5 groups according to the surface retreatments: (a) 110 µm Al2O3 airborne-particle abrasion, (r) 110 µm silica modified Al2O3 airborne-particle abrasion, (D) diamond bur, (Da) diamond bur + 110 µm Al2O3 airborne-particle abrasion, and (Dr) diamond bur + 110 µm silica modified Al2O3 airborne-particle abrasion. Cylinders of self-adhesive resin cement were cemented onto each treated ceramic surface and subjected to micro-shear bond strength test. Additional specimens were prepared for roughness and wettability analyses. The data were subjected to t-test and One-way ANOVA followed by Tukey's post hoc test (α=.05). RESULTS At stage 1, group R presented higher bond strength values than group A (P=.000). There was a statistically significant increase of bond strength at stage 2 for group A (P=.003). The diamond bur influenced the surface roughness, increasing the values (P=.023). Group R provided better wettability. Regardless of the applied surface treatment, most of failures were adhesive. CONCLUSION The combination of application and reapplication of Rocatec Plus showed the best results of bond strength. Surface retreatment and recementation might be an indicated clinical strategy.
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Affiliation(s)
| | - Marina Amaral
- Department of Dental Prosthesis, School of Dentistry, University of Taubaté, Taubaté, Brazil
| | - Daher Antonio Queiroz
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - Kusai Baroudi
- Postgraduate Program, School of Dentistry, University of Taubaté, Taubaté, Brazil
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Li R, Wang C, Ma SQ, Liu ZH, Zang CC, Zhang WY, Sun YC. High bonding strength between zirconia and composite resin based on combined surface treatment for dental restorations. J Appl Biomater Funct Mater 2020; 18:2280800020928655. [PMID: 33147097 DOI: 10.1177/2280800020928655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Zirconia is the preferred material for dental restorations; however, dental restorations are usually affected by zirconia fractures due to chipping and delamination of the veneer ceramic. One effective solution for repairing chemically inert zirconia frameworks is to strongly chemically bond them with the composite resin via surface modification. Thus, the bonding strength between the zirconia and composite resin determines the performance of dental restoration. Herein, we investigate the shear bond strength between zirconia ceramic and two ceramic repair systems before and after thermal cycling based on different surface pretreatments, including air-abrasion and a novel silane coupling agent. When treated with combined sandblasting, novel silane and 10-methacryloyloxydecyl hydrogen phosphate act as a bonding agent for the zirconia surface, and the maximum shear bond strength achieves 27.5 MPa, as measured by a universal testing machine through the average of 16 separate measurements. The results show that the combined treatment resists the interface damage caused by expansion and contraction during thermal cycling. The long-term bond durability is due to the micro-mechanical bond force formed by resin and ceramic, and the chemical bonds of Zr-O-Si at the interface. Results indicate that selective pretreating the surface results in high bond strength between the zirconia and the composite resin, which is meaningful to optimize dental restoration.
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Affiliation(s)
- Rui Li
- Department of Prosthodontics, Stomatological Hospital, Tianjin Medical University, Tianjin, China
| | - Chen Wang
- Department of Prosthodontics, Stomatological Hospital, Tianjin Medical University, Tianjin, China
| | - Shi Qing Ma
- Department of Prosthodontics, Stomatological Hospital, Tianjin Medical University, Tianjin, China
| | - Zi Hao Liu
- Department of Prosthodontics, Stomatological Hospital, Tianjin Medical University, Tianjin, China
| | - Cheng Cheng Zang
- Department of Prosthodontics, Stomatological Hospital, Tianjin Medical University, Tianjin, China
| | - Wen Yi Zhang
- Department of Prosthodontics, Stomatological Hospital, Tianjin Medical University, Tianjin, China
| | - Ying Chun Sun
- Department of Prosthodontics, Stomatological Hospital, Tianjin Medical University, Tianjin, China
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Habibi Y, Dawid M, Waldecker M, Rammelsberg P, Bömicke W. Three‐year clinical performance of monolithic and partially veneered zirconia ceramic fixed partial dentures. J ESTHET RESTOR DENT 2020; 32:395-402. [DOI: 10.1111/jerd.12568] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/16/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Yasamin Habibi
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Marie‐Theres Dawid
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Moritz Waldecker
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Peter Rammelsberg
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Wolfgang Bömicke
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
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Kontonasaki E, Rigos AE, Ilia C, Istantsos T. Monolithic Zirconia: An Update to Current Knowledge. Optical Properties, Wear, and Clinical Performance. Dent J (Basel) 2019; 7:dj7030090. [PMID: 31480688 PMCID: PMC6784470 DOI: 10.3390/dj7030090] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/22/2019] [Accepted: 08/20/2019] [Indexed: 01/09/2023] Open
Abstract
The purpose of this paper was to update the knowledge concerning the wear, translucency, as well as clinical performance of monolithic zirconia ceramics, aiming at highlighting their advantages and weaknesses through data presented in recent literature. New ultra-translucent and multicolor monolithic zirconia ceramics present considerably improved aesthetics and translucency, which, according to the literature reviewed, is similar to those of the more translucent lithium disilicate ceramics. A profound advantage is their high strength at thin geometries preserving their mechanical integrity. Based on the reviewed articles, monolithic zirconia ceramics cause minimal wear of antagonists, especially if appropriately polished, although no evidence still exists regarding the ultra-translucent compositions. Concerning the survival of monolithic zirconia restorations, the present review demonstrates the findings of the existing short-term studies, which reveal promising results after evaluating their performance for up to 5 or 7 years. Although a significant increase in translucency has been achieved, new translucent monolithic zirconia ceramics have to be further evaluated both in vitro and in vivo for their long-term potential to preserve their outstanding properties. Due to limited studies evaluating the wear properties of ultra-translucent material, no sound conclusions can be made, whereas well-designed clinical studies are urgently needed to enlighten issues of prognosis and long-term survival.
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Affiliation(s)
- Eleana Kontonasaki
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
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Maroulakos G, Thompson GA, Kontogiorgos ED. Effect of cement type on the clinical performance and complications of zirconia and lithium disilicate tooth-supported crowns: A systematic review. Report of the Committee on Research in Fixed Prosthodontics of the American Academy of Fixed Prosthodontics. J Prosthet Dent 2019; 121:754-765. [DOI: 10.1016/j.prosdent.2018.10.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 10/17/2018] [Accepted: 10/22/2018] [Indexed: 12/28/2022]
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Tabatabaian F, Aflatoonian K, Namdari M. Effects of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations. J Dent Res Dent Clin Dent Prospects 2019; 13:68-74. [PMID: 31217922 PMCID: PMC6571521 DOI: 10.15171/joddd.2019.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/17/2019] [Indexed: 11/28/2022] Open
Abstract
Background. Effects of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations are unclear. The aim of this study was to evaluate the impacts of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations.
Methods. Forty A2 shade veneered zirconia disk specimens (10 mm in diameter) were fabricated, with veneering porcelain thicknesses of 1.6, 1.8, 2.0 and 2.2 mm. Three backgrounds were made of A2 shade composite resin (A2), nickel-chromium alloy (NC) and amalgam (AM). The veneered zirconia specimens were placed on the backgrounds. CIELab values were measured with a spectrophotometer. ΔE values were measured to determine color differences between the specimens and the A2 VITA classical shade (target shade). ΔE values were compared with an acceptability threshold (ΔE=3.7). Repeated measures ANOVA, Bonferroni, and 1-sample t-test were used to analyze data (P<0.05).
Results. Mean ΔE values ranged between 1.9 and 5.0. The veneering porcelain thickness, the background shade and their interaction affected the ΔE (P<0.0001). The minimum veneering porcelain thickness for the shade match was 2 mm for NC and 1.8 mm for AM.
Conclusion. Veneering porcelain thickness and background shade affected the shade match of zirconia-based restorations. With dark-shaded backgrounds, the amount of veneering porcelain thickness needed for the shade match might be beyond acceptable clinical limits. Tooth-shaded backgrounds are esthetically advocated rather than dark-shaded backgrounds in zirconia-based restorations.
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Affiliation(s)
- Farhad Tabatabaian
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mahshid Namdari
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Preis V, Hahnel S, Behr M, Rosentritt M. In vitro performance and fracture resistance of novel CAD/CAM ceramic molar crowns loaded on implants and human teeth. J Adv Prosthodont 2018; 10:300-307. [PMID: 30140397 PMCID: PMC6104500 DOI: 10.4047/jap.2018.10.4.300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 03/07/2018] [Accepted: 05/08/2018] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the fatigue and fracture resistance of computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic molar crowns on dental implants and human teeth. MATERIALS AND METHODS Molar crowns (n=48; n=8/group) were fabricated of a lithium-disilicate-strengthened lithium aluminosilicate glass ceramic (N). Surfaces were polished (P) or glazed (G). Crowns were tested on human teeth (T) and implant-abutment analogues (I) simulating a chairside (C, crown bonded to abutment) or labside (L, screw channel) procedure for implant groups. Polished/glazed lithium disilicate (E) crowns (n=16) served as reference. Combined thermal cycling and mechanical loading (TC: 3000×5℃/3000×55℃; ML: 1.2×106 cycles, 50 N) with antagonistic human molars (groups T) and steatite spheres (groups I) was performed under a chewing simulator. TCML crowns were then analyzed for failures (optical microscopy, SEM) and fracture force was determined. Data were statistically analyzed (Kolmogorow-Smirnov, one-way-ANOVA, post-hoc Bonferroni, α=.05). RESULTS All crowns survived TCML and showed small traces of wear. In human teeth groups, fracture forces of N crowns varied between 1214±293 N (NPT) and 1324±498 N (NGT), differing significantly (P≤.003) from the polished reference EPT (2044±302 N). Fracture forces in implant groups varied between 934±154 N (NGI_L) and 1782±153 N (NPI_C), providing higher values for the respective chairside crowns. Differences between polishing and glazing were not significant (P≥.066) between crowns of identical materials and abutment support. CONCLUSION Fracture resistance was influenced by the ceramic material, and partly by the tooth or implant situation and the clinical procedure (chairside/labside). Type of surface finish (polishing/glazing) had no significant influence. Clinical survival of the new glass ceramic may be comparable to lithium disilicate.
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Affiliation(s)
- Verena Preis
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Michael Behr
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
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16
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Tabatabaian F, Bakhshaei D, Namdari M. Effect of Resin Cement Brand on the Color of Zirconia‐Based Restorations. J Prosthodont 2018; 29:350-355. [DOI: 10.1111/jopr.12953] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Farhad Tabatabaian
- Dental Research Center, Research Institute of Dental Sciences, School of DentistryShahid Beheshti University of Medical Sciences Tehran Iran
- Department of Prosthodontics, School of DentistryShahid Beheshti University of Medical Sciences Tehran Iran
| | | | - Mahshid Namdari
- Department of Community Oral Health, School of DentistryShahid Beheshti University of Medical Sciences Tehran Iran
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17
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Spitznagel FA, Boldt J, Gierthmuehlen PC. CAD/CAM Ceramic Restorative Materials for Natural Teeth. J Dent Res 2018; 97:1082-1091. [PMID: 29906206 DOI: 10.1177/0022034518779759] [Citation(s) in RCA: 169] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Advances in computer-aided design (CAD) / computer-aided manufacturing (CAM) technologies and their ease of application enabled the development of novel treatment concepts for modern prosthodontics. This recent paradigm shift in fixed prosthodontics from traditional to minimally invasive treatment approaches is evidenced by the clinical long-term success of bonded CAD/CAM glass-ceramic restorations. Today, defect-oriented restorations, such as inlays, onlays, and posterior crowns, are predominately fabricated from glass-ceramics in monolithic application. The variety of CAD/CAM ceramic restorative systems is constantly evolving to meet the increased demands for highly aesthetic, biocompatible, and long-lasting restorations. Recently introduced polymer-infiltrated ceramic network CAD/CAM blocks add innovative treatment options in CAD/CAM chairside 1-visit restorations. The material-specific high-edge stability enables the CAD/CAM machinability of thin restoration margins. Full-contour zirconia restorations are constantly gaining market share at the expense of bilayered systems. Advancements in material science and bonding protocols foster the development of novel material combinations or fabrication techniques of proven high-strength zirconia ceramics. CAD/CAM applications offer a standardized manufacturing process resulting in a reliable, predictable, and economic workflow for individual and complex teeth-supported restorations. More evidence from long-term clinical studies is needed to verify the clinical performance of monolithic polymer-infiltrated ceramic network and zirconia teeth-supported minimally invasive and extensive restorations.
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Affiliation(s)
- F A Spitznagel
- 1 Department of Prosthodontics, School of Dentistry, Heinrich-Heine-University, Düsseldorf, Germany
| | - J Boldt
- 1 Department of Prosthodontics, School of Dentistry, Heinrich-Heine-University, Düsseldorf, Germany
| | - P C Gierthmuehlen
- 1 Department of Prosthodontics, School of Dentistry, Heinrich-Heine-University, Düsseldorf, Germany
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18
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Miura S, Kasahara S, Yamauchi S, Egusa H. Effect of finish line design on stress distribution in bilayer and monolithic zirconia crowns: a three-dimensional finite element analysis study. Eur J Oral Sci 2018; 126:159-165. [DOI: 10.1111/eos.12402] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Shoko Miura
- Division of Molecular and Regenerative Prosthodontics; Tohoku University Graduate School of Dentistry; Sendai Miyagi Japan
| | - Shin Kasahara
- Division of Molecular and Regenerative Prosthodontics; Tohoku University Graduate School of Dentistry; Sendai Miyagi Japan
| | - Shinobu Yamauchi
- Division of Molecular and Regenerative Prosthodontics; Tohoku University Graduate School of Dentistry; Sendai Miyagi Japan
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics; Tohoku University Graduate School of Dentistry; Sendai Miyagi Japan
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19
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Tabatabaian F. Color in Zirconia-Based Restorations and Related Factors: A Literature Review. J Prosthodont 2018; 27:201-211. [DOI: 10.1111/jopr.12740] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Farhad Tabatabaian
- Department of Prosthodontics, School of Dentistry; Shahid Beheshti University of Medical Sciences; Tehran Iran
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20
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Murakami T, Takemoto S, Nishiyama N, Aida M. Zirconia surface modification by a novel zirconia bonding system and its adhesion mechanism. Dent Mater 2017; 33:1371-1380. [PMID: 29050817 DOI: 10.1016/j.dental.2017.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/08/2017] [Accepted: 09/07/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Takahiro Murakami
- Nihon University Graduate School of Dentistry at Matsudo, Crown Bridge Prosthodontics, Chiba 271-8587, Japan; Department of Crown Bridge Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Shinji Takemoto
- Department of Biomedical Engineering, Iwate Medical University, Iwate 028-3694, Japan
| | - Norihiro Nishiyama
- Department of Dental Biomaterials, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Masahiro Aida
- Department of Crown Bridge Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan.
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21
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Blatz MB, Vonderheide M, Conejo J. The Effect of Resin Bonding on Long-Term Success of High-Strength Ceramics. J Dent Res 2017; 97:132-139. [PMID: 28876966 DOI: 10.1177/0022034517729134] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Digital manufacturing, all-ceramics, and adhesive dentistry are currently the trendiest topics in clinical restorative dentistry. Tooth- and implant-supported fixed restorations from computer-aided design (CAD)/computer-aided manufacturing (CAM)-fabricated high-strength ceramics-namely, alumina and zirconia-are widely accepted as reliable alternatives to traditional metal-ceramic restorations. Most recent developments have focused on high-translucent monolithic full-contour zirconia restorations, which have become extremely popular in a short period of time, due to physical strength, CAD/CAM fabrication, and low cost. However, questions about proper resin bonding protocols have emerged, as they are critical for clinical success of brittle ceramics and treatment options that rely on adhesive bonds, specifically resin-bonded fixed dental prostheses or partial-coverage restorations such as inlays/onlays and veneers. Resin bonding has long been the gold standard for retention and reinforcement of low- to medium-strength silica-based ceramics but requires multiple pretreatment steps of the bonding surfaces, increasing complexity, and technique sensitivity compared to conventional cementation. Here, we critically review and discuss the evidence on resin bonding related to long-term clinical outcomes of tooth- and implant-supported high-strength ceramic restorations. Based on a targeted literature search, clinical long-term studies indicate that porcelain-veneered alumina or zirconia full-coverage crowns and fixed dental prostheses have high long-term survival rates when inserted with conventional cements. However, most of the selected studies recommend resin bonding and suggest even greater success with composite resins or self-adhesive resin cements, especially for implant-supported restorations. High-strength ceramic resin-bonded fixed dental prostheses have high long-term clinical success rates, especially when designed as a cantilever with only 1 retainer. Proper pretreatment of the bonding surfaces and application of primers or composite resins that contain special adhesive monomers are necessary. To date, there are no clinical long-term data on resin bonding of partial-coverage high-strength ceramic or monolithic zirconia restorations.
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Affiliation(s)
- M B Blatz
- 1 Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - M Vonderheide
- 1 Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - J Conejo
- 1 Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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A Three-Year Retrospective Study on Survival of Ceramic-Veneered Zirconia (Y-TZP) Fixed Dental Prostheses Performed in Private Practices. Int J Dent 2017; 2017:9618306. [PMID: 28713427 PMCID: PMC5496317 DOI: 10.1155/2017/9618306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/15/2017] [Indexed: 01/02/2023] Open
Abstract
Objectives The aim of this retrospective study was to evaluate the three-year clinical outcome for ceramic-veneered zirconia fixed dental prostheses (FDPs). Methods All patients who were treated with ceramic-veneered zirconia FDPs, in three private practices in Sweden, during the period June 2003 to April 2007 were included. Case records from 151 patients, treated with a total of 184 zirconia FDPs (692 units), were analysed for clinical data. All complications noted in the charts were registered and compared to definitions for success and survival and statistical analysis was performed using the Kaplan-Meier method and a Cox regression model. Results In total, 32 FDPs in 31 patients experienced some type of complication (17.4% of FDPs, 20.5% of patients). Core fractures occurred in two (1.1%) FDPs. Two (1.1%) FDPs or 0.6% of units showed adhesive veneer fractures. Cohesive veneer fractures occurred in 10 (5.4%) FDPs (1.6% of units). The three-year cumulative success and survival rates (CSR) were 82.3% and 95.2%, respectively. Conclusions Ceramic-veneered zirconia is a promising alternative to metal-ceramic FDPs, even in the posterior area. However, the higher survival rate of metal-ceramic FDPs should be noted and both dentists and patients must be aware of the risks of complications.
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