Effect of staining on the mechanical, surface and biological properties of lithium disilicate

The impact of Streptococcus mutans biofilms on the color stability and topographical features of three lithium disilicate ceramics

PURPOSE

Secondary caries around ceramic restorations is the most common reason for the replacement of fixed dental prostheses (FDPs). Therefore, it is important to examine the susceptibility of different ceramic materials to biofilm formation. This study aimed to evaluate biofilm development and associated roughness and color alterations in three lithium disilicate ceramics: Emax CAD (EC), Emax Press (EP), and LiSi Press (LP).

MATERIALS AND METHODS

Streptococcus mutans biofilms were grown on the three ceramics (n = 10 per group) for 7 days. Surface roughness values and color alteration were assessed before and after the biofilm using a non-contact profilometer and spectrophotometer, respectively. Biofilm growth was evaluated using colony-forming units (CFUs) and scanning electron microscope (SEM) images. The data were analyzed using one-way ANOVA and Tukey tests.

RESULTS

There was a significant (p ≤ 0.001) growth of S. mutans colonies on EC (6.75 ± 0.56) and EP (6.72 ± 0.54) specimens compared to LP, which showed no biofilm growth. The change in average surface roughness (∆Ra, nm) was significantly lower (p < 0.001) in the EC specimens (0.029 ± 0.003) compared to the EP (0.055 ± 0.012) and LP (0.041 ± 0.010). When the changes in the Rv and Rt values were investigated, no significant difference was observed among the groups. Following the biofilm challenge, the change in color (∆E00) was significantly lower (p = 0.005) in the LP group (1.68 ± 1.45) compared to the EC group (3.89 ± 1.50) and no significant difference was observed between the EP group (2.74 ± 1.01) and the other two ceramics (p ≥ 0.05).

CONCLUSION

LP ceramics exhibited superior resistance to S. mutans biofilm formation and associated changes in surface roughness and color compared to the Emax CAD and Emax Press ceramics. These findings suggest that the LiSi Press material may be more favorable to mitigate the risk of secondary caries.

Effect of glazing and thermocycling on the fracture toughness and hardness of a New fully crystallized aluminosilicate CAD/CAM ceramic material

BACKGROUND

The mechanical properties of fully crystallized lithium aluminosilicate ceramics may be influenced by intraoral temperature variations and postmilling surface treatment. The purpose of this study is to explore the interplay among glazing, thermocycling, and the mechanical characteristics (namely, fracture toughness and hardness) of fully crystallized lithium aluminosilicate ceramics.

METHODS

Bending bars (n = 40) cut from LisiCAD blocks (GC, Japan) were randomly assigned to glazed or unglazed groups (n = 20) and subjected to the single edge v-notch beam method to create notches. A glazing firing cycle was applied to the glazed group, while the unglazed group was not subjected to glazing. Half of the specimens (n = 10) from both groups underwent thermocycling before fracture toughness testing. The fracture toughness (KIC) was evaluated at 23 ± 1 °C using a universal testing machine configured for three-point bending, and the crack length was measured via light microscopy. Seven specimens per group were selected for the hardness test. Hardness was assessed using a Vickers microhardness tester with a 1 kg load for 20 s, and each specimen underwent five indentations following ISO 14705:2016. The Shapiro-Wilk and Kolmogorov-Smirnov tests were used to evaluate the normality of the data and a two-way ANOVA was utilized for statistical analysis. The significance level was set at (α = 0.05).

RESULTS

Regardless of the thermocycling conditions, the glazed specimens exhibited significantly greater fracture toughness than did their unglazed counterparts (P < 0.001). Thermocycling had no significant impact on the fracture toughness of either the glazed or unglazed specimens. Furthermore, statistical analysis revealed no significant effects on hardness with thermocycling in either group, and glazing alone did not substantially affect hardness.

CONCLUSIONS

The impact of glazing on the fracture toughness of LiSiCAD restorations is noteworthy, but it has no significant influence on their hardness. Furthermore, within the parameters of this study, thermocycling was found to exert negligible effects on both fracture toughness and hardness.

Clinical performance comparison between lithium disilicate and hybrid resin nano-ceramic CAD/CAM onlay restorations: a two-year randomized clinical split-mouth study

A total of 20 lithium disilicate glass-ceramics (IPS e.max CAD, Ivoclar Vivadent) and 20 resin nano-ceramic (Voco Grandio Blocks) onlay restorations were performed in 20 patients using a split-mouth design to compare the two-year clinical performance of lithium disilicate and resin nano-ceramic onlay restorations. Both restorations were evaluated at baseline, one-year, and two-year clinical follow-ups based on the modified United States Public Health Service (USPHS) criteria. Chi-square and Fisher's exact tests showed no statistically significant difference between Voco Grandio and IPS e.max ceramic restorations for all evaluated parameters during the different follow-up periods (p > 0.05). Cochrane's and MC-Nemar's tests indicated statistically significant differences regarding color match within the Voco Grandio group. They also indicated statistically significant differences in marginal discoloration, marginal adaptation, surface texture, and postoperative hypersensitivity within both ceramic material groups (p < 0.05). Kaplan-Meier curve indicated that the survival rate of both ceramic materials was 90%. After two years of clinical service, IPS e.max CAD and Voco Grandio onlay restorations exhibited similar clinical performance.

Effect of glazing technique and firing on surface roughness and flexural strength of an advanced lithium disilicate

OBJECTIVE

The objective of this study was to investigate the effects of glazing technique and firing on the surface roughness and flexural strength of an advanced lithium disilicate (ALD) and lithium disilicate (LD).

METHODS

Eight groups of bar-shaped specimens (1 mm × 1 mm × 12 mm, N=160, 20/group) were manufactured from ALD (CEREC Tessera, Dentsply Sirona) and LD (IPS e.max CAD, Ivoclar). The specimens were then submitted to various posttreatments: crystallization (c), crystallization followed by a second firing (c-r), crystallization with glaze in one step (cg), and crystallization followed by a glaze layer firing (c-g). Surface roughness was measured by means of a profilometer, and flexural strength was determined using a three-point bending test. Surface morphology, fractography, and crack healing analysis were conducted using scanning electron microscopy.

RESULTS

Refiring (c-r) did not affect the surface roughness (Ra) while applying glaze at both cg and c-g procedures increased the roughness. ALDc-g (442.3 ± 92.5 MPa) promoted higher strength than ALDcg (282.1 ± 64.4 MPa), whereas LDcg (402.9 ± 78.4 MPa) was stronger than LDc-g (255.5 ± 68.7 MPa). Refiring completely closed the crack in ALD, but it had a limited effect on LD.

CONCLUSIONS

Two-step crystallization and glazing improved ALD strength compared to the one-step protocol. Refiring and one-step glazing do not increase LD's strength, while two-step glazing has a negative effect.

CLINICAL RELEVANCE

Besides both materials being lithium-disilicate glass ceramics, the glazing technique and firing protocol affected their roughness and flexural strength differently. A two-step crystallization and glazing should be the first choice for ALD, while for LD, glazing is optional and when necessary, should be applied in one-step.