The impact of in vitro aging on the mechanical and optical properties of indirect veneering composite resins

Impact of varnishing, coating, and polishing on the chemical and mechanical properties of a 3D printed resin and two veneering composite resins

STATEMENT OF PROBLEM

Three-dimensional (3D) printing enables the fast fabrication of definitive fixed dental prostheses (FDPs). However, data on the effects of surface treatments on their chemical and mechanical properties are lacking.

PURPOSE

The purpose of this in vitro study was to examine the influence of different surface treatments on a 3D printed resin in comparison with 2 veneering composite resins.

MATERIAL AND METHODS

A total of 288 specimens were manufactured from a 3D printed resin (VarseoSmile Crownplus) or veneering composite resins (GRADIA PLUS; VITA VM LC flow). Surfaces underwent varnishing, coating, polishing or remain untreated. Conversion rate (DC), surface roughness (SR), Martens parameter, flexural strength (FS), and 3-body wear (3BW) were determined (n=12). Statistical analysis was performed using Mann-Whitney-U, Kruskal-Wallis, and Spearman correlation tests (α=.05).

RESULTS

After polishing, the 3D printed resin showed higher DC, SR, and 3BW but lower Martens parameters compared with veneering composite resins (P<.007). After goat hair brushing, the 3D printed resin showed lower FS than VITA-VCR (P=.043). For the 3D printed resin, goat hair brushing or GC-Varnish reduced SR, while VITA-Varnish showed the lowest 3BW (P<.045). For both veneering composite resins, goat hair brushing led to low SR and 3BW and high EIT and FS (P<.043). Silicone polishing led to low EIT of the 3D printed resin and low EIT and FS of GC-VCR (P<.009). Coating resulted in a lower EIT than the untreated surface and higher 3BW than GC-Varnish (P<.030).

CONCLUSIONS

The 3D printed resin showed higher DC, SR, 3BW and lower HM, EIT, and FS values than the veneering composite resins. Polishing with a goat hair brush can be recommended for all tested materials. For the 3D printed resin, varnishing presents a promising alternative with regard to SR and 3BW. Silicone polishing and coating cannot be recommended.

Comparison of volumetric loss and surface roughness of composite dental restorations obtained by additive and subtractive manufacturing methods

Statement of problem

Permanent crown materials produced with new generation additive manufacturing and traditional subtractive manufacturing materials have not been compared in terms of wear resistance.

Purpose

This study aims to compare the volumetric loss related to wear and resulting surface roughness after aging in a chewing simulator between resin nano ceramics produced with milling technique and permanent crown materials produced with three dimensional (3D) printing.

Materials and methods

Three different hybrid composite-ceramic (HCC) (The three materials are GC: Cerasmart, VE: Vita Enamic, and GV: Grandio Voco.) and one 3D printed definitive crown resin (FormLabs Permanent Crown Resin) were investigated before aging (n:8), the surface roughness of all samples was measured with a profilometer, and 1 randomly selected sample from each subgroup was imaged with scanning electron microscope (SEM). 3D scans of each sample were obtained with a desktop scanner. Thermomechanical aging was performed using a chewing simulator. Four hundred thousand cycles were completed under a vertical occlusal force of 49 ± 0.7 N with a thermal cycle of 1.7 Hz 5-55° and with a dwell time of 120 s, mimicking 2 years of aging. The imaging procedures were repeated, and the change in surface roughness was evaluated. 3D images were also overlapped, and the volumetric loss was calculated with the relevant inspector software. The data obtained were analyzed by two-way ANOVA (p < 0.05).

Result

The results showed significant statistical differences for both parameters (p > 0.05). The highest volumetric loss was found in the GV group while the lowest volumetric loss was in the VE group. The highest surface roughness values were observed in the GV group, while the lowest values belonged to the VE one.

Conclusion

Of the restorative materials evaluated, the VE group is suitable for long-term restorations, whereas the GV one is suitable for medium-term restorations. It is promising in terms of 3D printing technologies that the 3D material gives comparable results with the GV group.

Clinical i̇mplication

Additive manufacturing techniques are a successful method that accelerates the manufacturing process. Permanent crown resins are promising alternatives to conventional production.

Color Stability, Gloss Retention, and Surface Roughness of 3D-Printed versus Indirect Prefabricated Veneers

The long-term color stability and surface properties of anterior laminate veneers are among the crucial factors affecting the clinical longevity of aesthetic restorations. Novel 3D-printed materials are being introduced as definitive restorative treatment. In light of the existing variety of indirect yet minimally invasive composite resin veneers, research on their surface properties is warranted. This in vitro study evaluated the effect of artificial aging by immersion in different staining solutions on the color changes, gloss, and surface roughness (Ra) of 3D-printed veneers compared to the prefabricated resin composite veneer systems (PRCVs) manufactured by Componeer and Edelweiss. Moreover, this study compared the effects of two methods for stain removal: repolishing with Sof-Lex disks and in-office bleaching with 40% hydrogen peroxide. The veneers (n = 24) were randomly divided according to the immersion solutions used, i.e., tea and coffee. Colorimetric measurements, surface roughness, and surface gloss were determined before and after staining and surface treatment with either in-office bleaching or surface polishing. The data were statistically analyzed using two-way ANOVA followed by the Tukey's post hoc test (α = 0.05). Artificial aging with immersion in staining solutions led to significant color changes, increased surface roughness, and gloss reduction in all materials (p  <  0.05). The 3D-printed veneers showed higher ΔE values (coffee = 10.112 ± 0.141) and (tea = 10.689 ± 0.771) compared to baseline after 7 days of aging. The 3D-printed veneers had a statistically significant surface roughness Ra (0.574 µm ± 0.073). The gloss was >70% in all groups at baseline; these values dropped in all groups after 7 days of artificial aging. After the stain-removing procedures, the ΔE values decreased in all tested veneers. That being said, they failed to return to the baseline values, and both stain-removing methods were found to have an adverse effect on surface roughness and gloss retention in all tested veneers.

Effect of two artificial aging protocols on color and gloss of single-shade versus multi-shade resin composites

The long-term color stability and gloss retention of resin composites are among the crucial factors that affect the clinical longevity of esthetic restorations, especially in anterior teeth. This study evaluated the effect of artificial aging by immersion in different storage media and thermocycling on color and gloss of dental single-shade resin composite (Omnichroma) versus multi-shade one (Filtek Z350XT). One hundred resin-composite disc-shaped specimens were used, 50 from each group, Omnichroma and Filtek Z350XT. Ten specimens from each material acted as control group (incubated in saliva). For each material, 40 specimens were divided according to the artificial-aging protocol (immersion at 37 °C for 12 days or thermocycling for 10,000 cycles) and storage media (tea, red wine). Color and gloss were measured before and after artificial aging. Color difference (∆E₀₀) was compared with perceptibility threshold and acceptability threshold. Data were statistically analyzed; independent t test was used to compare results between two tested materials, while two-way ANOVA was used to compare results among the different immersion media within the same material. Artificial aging (immersion or thermocycling) in tea and red wine led to significant color changes and gloss reduction in both materials (P < 0.05), in contrast to control group. Red wine produced highest color differences. Both dental resin-composites; the single-shade (Omnichroma) and multi-shade (Filtek Z350XT) displayed unacceptable discoloration and gloss reduction after artificial-aging in tea and red-wine by immersion or thermocycling simulating one-year clinical-service.

Clinical Longevity of Indirect Composite Resin Inlays and Onlays: An Up to 9-Year Prospective Study

Objective This clinical study evaluated the clinical performance of composite resin inlays and onlays over 9 years.

Materials and Methods Sixty composite resin inlays and onlays were placed in 32 patients, aged 20 to 60 years, by a single operator using the same clinical procedure. The restorations were examined for fracture rate; esthetics; and patient acceptance and marginal integrity, including caries, marginal discoloration, tooth integrity, and surface texture. All restorations were evaluated at the time of placement and 3, 6, and 9 years after placement by using the modified U.S. Public Health Service criteria.

Results At the 3-year follow-up, an Alpha score was given to 88.4% of restorations, while a Bravo score was given to the remaining 11.6%. There was not any failure. At the 6-year follow-up, the success rate of the restorations was 100% without failure. None of the restorations was scored with Delta (D). An Alpha score was given to 60% of the restorations, a Bravo score was assigned to 35%, and a Charlie score was 5% of the restorations. Overall, the success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%. An Alpha score was given to 15% of the restorations, a Bravo score was given to 50%, a Charlie score was assigned to 20%, and a D score was given to 15% of the restorations.

Conclusion Indirect resin composite inlays and onlays showed acceptable long-term clinical results. The success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%.

Clinical Longevity of Indirect Composite Resin Inlays and Onlays: An Up to 9-Year Prospective Study

OBJECTIVE

 This clinical study evaluated the clinical performance of composite resin inlays and onlays over 9 years.

MATERIALS AND METHODS

 Sixty composite resin inlays and onlays were placed in 32 patients, aged 20 to 60 years, by a single operator using the same clinical procedure. The restorations were examined for fracture rate; esthetics; and patient acceptance and marginal integrity, including caries, marginal discoloration, tooth integrity, and surface texture. All restorations were evaluated at the time of placement and 3, 6, and 9 years after placement by using the modified U.S. Public Health Service criteria.

RESULTS

 At the 3-year follow-up, an Alpha score was given to 88.4% of restorations, while a Bravo score was given to the remaining 11.6%. There was not any failure. At the 6-year follow-up, the success rate of the restorations was 100% without failure. None of the restorations was scored with Delta (D). An Alpha score was given to 60% of the restorations, a Bravo score was assigned to 35%, and a Charlie score was 5% of the restorations. Overall, the success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%. An Alpha score was given to 15% of the restorations, a Bravo score was given to 50%, a Charlie score was assigned to 20%, and a D score was given to 15% of the restorations.

CONCLUSION

 Indirect resin composite inlays and onlays showed acceptable long-term clinical results. The success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%.

The Influence of Popular Beverages on Mechanical Properties of Composite Resins

Currently, composite resins are used in many restorative procedures. Previous studies showed that drinking beverages may affect the mechanical properties such as microhardness or flexural strength of dental composite resins. The aim of the present study was to investigate the influence of common beverages on the mechanical properties of composite resins. Samples of the materials were prepared according to the ISO 4049:2010 standard and producer’s recommendations. The samples were next conditioned in tested fluids: distilled water, sparkling water, Coca-Cola, Red Bull and orange juice for 7 days. Vickers microhardness and flexural strength testing was performed after 7 days. Performed statistic tests confirmed the significance of microhardness changes of the tested materials in terms of both different conditioning of the samples and different composite materials. The mean flexural strength of composites was highest in distilled water and it was reduced after one week in different beverages. We conclude that all tested beverages influenced on Vickers microhardness of tested composite resins. Flexural strength only in one material was statistically significantly influenced by tested beverages. The results of this study should be taken into consideration by a dentist preparing recommendations for the patients after dental treatment with usage of composite material or after cementing composite based fixed dentures.

Effects of laser modalities on shear bond strengths of composite superstructure to zirconia and PEEK infrastructures: an in vitro study

In the last decade, demand for metal-free esthetic restorations has grown considerably due to the development of materials to fulfill the need for an esthetic prosthesis. We examined the effects of erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser applications on the shear bond strength (SBS) of nanohybrid composite superstructures to zirconia and PEEK infrastructures. Zirconia and PEEK specimens were prepared with CAD/CAM technology in accordance with ISO 11405 standards. The disc-shaped samples were randomly separated into four groups (n = 8) according to applied laser type: no treatment and Er:YAG, Nd:YAG, and KTP lasers. Nanohybrid composite resin was applied as a veneering material to each infrastructure. After surface treatment of infrastructures by the lasers, the SBS test was carried out to determine the bonding of infrastructures, which were also examined with a stereomicroscope. The SBS were significantly higher in the PEEK specimens treated with the studied lasers. Nd:YAG laser was the most effective method, followed by Er:YAG laser and KTP laser. The lowest SBS value was obtained in the no-treatment group. Stereomicroscopically, the studied lasers produced different irregularities on the infrastructures. PEEK as a framework provides meaningfully higher bonding strength to composite resins compared to zirconia. Nd:YAG, Er:YAG, and KTP, in descending order, are efficacious in increasing the attachment of studied structures.

New Experimental Zirconia-Reinforced Rice Husk Nanohybrid Composite and the Outcome of Its Surface Roughness and Microhardness in Comparison with Commercialized Nanofilled and Microhybrid Composite Resins

Background:

An ideal composite resin should demonstrate smooth surface after polishing and high hardness value to provide long-term success. Thus, this study aimed to compare the surface roughness and microhardness of new experimental zirconia-reinforced rice husk nanohybrid composite (Zr-Hybrid) with commercialized nanofilled (Filtek-Z350-XT) and microhybrid composite (Zmack-Comp) resins before and after artificial ageing.

Methods:

One hundred and eighty standardized disc samples were prepared, of which ninety samples each were used for surface roughness and microhardness test, respectively. They were divided equally into: Group 1 (Filtek-Z350-XT), Group 2 (Zmack-Comp), and Group 3 (Zr-Hybrid). For surface roughness test, all samples were polished with aluminium oxide discs and further subdivided into aged and unaged subgroups, in which composite samples in aged subgroups were subjected to 2500 thermal cycles. Next, all the samples were subjected to surface roughness test using a contact stylus profilometer. As for microhardness test, all the aged and unaged samples were tested using a Vickers hardness machine with a load of 300 kgf for 10 s and viewed under a digital microscope to obtain microhardness value. Data were analyzed using two-way ANOVA followed by post hoc Tukey's honestly significant difference and paired sample t-test with significance level set at P = 0.05.

Results:

In both the aged and unaged groups, Zr-Hybrid showed statistically significantly lower surface roughness (P < 0.05) than Filtek-Z350-XT and Zmack-Comp, but no statistically significant difference was noted between Filtek-Z350-XT and Zmack-Comp (P > 0.05). A similar pattern was noted in microhardness test, whereby Zr-Hybrid showed the highest value (P < 0.05) followed by Filtek-Z350-XT and lastly Zmack-Comp. Besides, significant differences in surface roughness and microhardness were noted between the aged and unaged groups.

Conclusion:

Zr-Hybrid seems to demonstrate better surface roughness and microhardness value before and after artificial ageing.

Edge chipping resistance of veneering composite resins

OBJECTIVES

To investigate the edge chipping resistance (ECR) of six veneering composite resins after different treatment protocols.

MATERIALS AND METHODS

Rectangular bar specimens were manufactured from Ceramage Incisal (CER; Shofu), dialog Vario Occlusal (DIA; Schütz Dental), Gradia Plus Heavy Body Enamel (GRA; GC Europe), in:joy incisal (INJ; Dentsply Sirona Deutschland), SR Nexco Paste Incisal (SRN; Ivoclar Vivadent), and Signum composite enamel (SIG; Kulzer). ECR was determined after five treatment protocols: (1) no treatment, (2) after storage in distilled water at 37 °C for 7 days, (3) storage in distilled water with an additional 10 000 thermal cycles (5 °C/55 °C), and hydrothermal treatment at 134 °C at a water vapor pressure of 0.2 MPa for a duration of (4) 3.5 min or (5) 23.5 min. Force was applied with the universal testing machine ZHU 0.2 (Zwick Roell) mounted with a Vickers diamond indenter until the chip fractured off the specimen and ECR values were computed by dividing the applied maximum force by the distance to the center of the applied force. Fracture analysis was performed employing light microscope imaging. Univariate and one-way ANOVA, Scheffé and Tukey-B post hoc, and partial eta squared (ƞ_p²) were computed (p < 0.05).

RESULTS

DIA presented consistently high ECR values, while CER showed low results. For some groups, seven days' storage in water and hydrothermal treatment for 3.5 min led to higher ECR results than observed in the initial state, while an additional 10 000 thermal cycles and hydrothermal treatment for 23.5 min resulted in lower ECR values.

CONCLUSIONS

The examined veneering composite resins differed in regard to their mechanical properties, with DIA possessing the highest resistance to chipping. While post-processing can initially increase a material's edge chipping resistance, intensified treatment protocols reduced the mechanical properties of veneering composite resins.

Mechanical and optical properties of indirect veneering resin composites after different aging regimes

This study tested and compared properties of six modern indirect veneering resin composites (VRC), namely Ceramage (Shofu), dialog Vario (Schütz Dental), Gradia Plus (GC Europe), in:joy (Dentsply), Signum composite (Heraeus Kulzer), and SR Nexco (Ivoclar Vivadent). Specimens were fabricated from dentin and enamel pastes and following properties were analyzed: (1) two-body wear (TB), (2) surface roughness (SR), (3) Martens hardness parameters (HM and E_IT), and (4) translucency (T). The highest impact on HM and E_IT was exerted by VRC brand (HM: η_P²=0.960/ E_IT: η_P²=0.968; p<0.001), followed by VRC paste material (HM: η_P²=0.502/ E_IT: η_P²=0.580; p<0.001), and aging duration (HM: η_P²=0.157/ E_IT: η_P²=0.112; p<0.001). Lowest and highest TB were measured for Signum composite and dialog Vario, respectively (p<0.001). Highest T was showed Signum composite and Ceramage (p<0.001). VRCs should be individually selected with respect to the indication area, due to different surface properties.

Influence of silica nanocoating on stain susceptibility and superficial integrity of dimethacrylate-based composites

The aim of this study was to investigate the ability of a novel silica (SiO₂ )-based nanocoating approach to extend the superficial integrity of current composites. Cylindrical discs (7 × 2 mm) were produced from nanohybrid and nanofilled composites. Specimens in control groups were not coated, but SiO₂ nanocoating was performed on specimens in experimental groups (n = 8). Specimens were stored for 24 h in distilled water at 37°C (baseline) and then artificially aged for 15, 90, or 180 d in a low-pH staining solution. Surface roughness (Ra) was measured using a profilometer, and a goniometer was used to determine surface free energy (SFE). Color change was evaluated by a reflectance spectrophotometer, applying the color distance metric, ΔE₀₀ , according to the Commission Internationale de l'Eclairage (CIE) L*a*b* coordinates. Data were subjected to repeated-measures anova and the Tukey post-hoc test. Composites presented visually perceptible color changes (ΔE₀₀  > 0.81) as early as 15 d of aging, with significantly higher ΔE₀₀ values recorded over time. Nanocoating with SiO₂ significantly reduced the SFE of composites at all storage times, and significantly lower Ra values were identified after aging. Nanohybrid and nanofilled composites were susceptible to substantial hydrolytic superficial degradation and staining, which was dramatically attenuated by the proposed SiO₂ nanocoating approach. Nanocoating effectively lowered the SFE of composites, thus minimizing water-composite interactions, which contributed to reduced superficial deterioration and lower stain susceptibility over time.

Simple and Low-Cost Thermal Treatments on Direct Resin Composites for Indirect Use

Abstract The aim of this study was to evaluate the influence of three low-cost additional thermal treatments, available in the dental office, on the mechanical, chemical and optical properties of a light-cured resin composite indicated for direct restorations but used as indirect restorative. The direct resin composite TPH3 (Dentsply) was light-polymerized using a light-emitting diode curing unit and submitted to three experimental additional thermal treatments: dry heat at 170 °C for 5 min, autoclave at 121 °C for 6 min, or microwave oven at 450 W for 3 min. The resin composite without any thermal treatment was used as negative control group. An indirect resin composite (Vita CM LC, Vita Zahnfabrik) was tested as a reference. Flexural strength, elastic modulus, microhardness, degree of C=C conversion, roughness before and after simulated toothbrush abrasion, translucency parameter and color difference (ΔE00) were evaluated. Data were analyzed at α=0.05. The indirect resin composite presented lower C=C conversion and mechanical performance. The flexural strength was significantly higher in the dry oven group compared with the control. The roughness was not different among groups before or after brushing, but the thermal treatments caused an increase in C=C conversion, microhardness, and elastic modulus without affecting the translucency parameter or showing visible color alteration (ΔE00<1.8). These results suggest that the use of additional thermal methods of polymerization represents an economical and simple alternative to enhance the mechanical and chemical properties of direct resin composites when used as indirect restoratives.

Four-Year Follow-up of Increased Vertical Dimension of Occlusion using Resin Composites

The objectives of this case report were to treat a severe loss of the vertical dimension of occlusion with indirect composite and to evaluate the durability of the restorations. A 55-year-old male complains from severe wear of teeth, leading to a change in normal occlusal plane. Two major treatment modalities were proposed to this patient; a conventional invasive crown placement with root canal treatments or a minimally invasive approach relying on adhesion. The latter was adopted and used to treat this patient. This paper describes a step-by-step approach of the different treatment phases starting with teeth preparation, then provisional prostheses, and ending with the placement of indirect anterior veneers and posterior onlays, all made with laboratory resin composite. Satisfactory clinical results were observed over the 4-year follow-up, with minimum failures limited to one partial fracture of inlay treated with direct adhesive repair.

Effect of Storage Medium and Aging Duration on Mechanical Properties of Self-Adhesive Resin-Based Cements

Background

The aim of this study was to investigate the effects of storage medium and aging duration on Martens hardness (HM) and indentation modulus (EIT) of self-adhesive resin-based cements (SARCs).

Methods

A total of 416 discs were fabricated from 8 SARCs (n = 52 per SARC): (i) BeautyCem (BEA), (ii) Bifix SE (BIF), (iii) Clearfil SA Cement Automix (CLE), (iv) RelyX Unicem2 Automix (RXU), (v) SeT (SET), (vi) SmartCem 2 (SMC), (vii) SoloCem (SOC) and (viii) SpeedCEM (SPC). The specimens were ground and stored in (a) physiological saliva, (b) artificial saliva, (c) sodium chloride and (d) distilled water, at 37°C for 1, 7, 14, 28, 90 and 180 days. Non-aged specimens (3 hours after photo-initiation) of each SARC acted as control groups. HM and EIT were assessed using a universal hardness testing machine. Data were analyzed using Kolmogorov-Smirnov and Kruskal-Wallis tests and paired t-test, and 3-, 2- and 1-way ANOVA with post hoc Scheffé test (p<0.05).

Results

SARC materials exerted the highest influence on HM and EIT values (p<0.001, partial eta squared [ηP²] = 0.753 and 0.433, respectively), closely followed by aging duration (p<0.001, ηP² = 0.516 and 0.255) and storage medium (p<0.001, ηP² = 0.043 and 0.033). The interaction effect of the combinations of the 3 independent parameters was also significant (p<0.001, ηP² = 0.163 and 0.133). The lowest initial HM and EIT was presented by CLE, followed by SET and SPC; highest HM was for BIF, followed by RXU and SMC. SET gave a greater HM and EIT percentage decrease than SOC, SPC, BEA, SMC, RXU or CLE.

Conclusions

Aging duration is a major factor affecting the micromechanical properties of SARCs, while storage medium was shown to have a significant but minor role.

The Effect of Different Storage Media on Color Stability of Self-Adhesive Composite Resin Cements for up to One Year

The aim of this study was to analyze the long-term color stability of eight self-adhesive composite resin cements (SACRCs) after storage in diverse media for up to one year. 480 discs (diameter: 12 mm/thickness: 1.0 ± 0.05 mm) were fabricated (n = 60/SACRC): (1) BeautyCem (BEA); (2) Bifix SE (BIF); (3) Clearfil SA Cement Automix (CLE); (4) RelyX Unicem 2 Automix (RXU); (5) SeT (SET); (6) SmartCem 2 (SMC); (7) SoloCem (SOC); and (8) SpeedCEM (SPC). After polishing, specimens were immersed in (a) red wine (RW); (b) curry-solution (CU); (c) cress-solution (CR); and (d) distilled water (DW) at 37 °C and measured after 7, 28, 90, 180, and 365 days for color differences (ΔE) and water absorption (WA). Non-aged specimens were used as baselines. After 365 days, all of the discs were polished and their ΔE was measured. Data were analyzed using Kolmogorov-Smirnov, partial-eta-squared/η_P², 3-/1-way ANOVA with Tukey-HSD post-hoc test (α = 0.05). Significant differences occurred between all SACRCs for WA (p ≤ 0.003), except in RXU and in SET and in ΔE (p ≤ 0.002), except in SET and SPC. The significantly highest WA presented in SOC; the lowest showed in BEA. Significant ΔE differences and a decrease after polishing between all storage media were found (p < 0.001) with highest values for RW, followed by CU, CR, and DW. The lowest ΔE was measured for CLE, followed by SOC, BIF, RXU, BEA, SPC, SET, and SMC (p < 0.001) and increased significantly during aging. The highest ΔE decrease presented in BEA. SACRCs showed an increase in WA/ΔE within total aging time. Discoloration could not be removed completely by polishing. SACRCs need to be carefully selected for restorations in the esthetical zone with visible restoration margins. Polishing can significantly reduce the marginal discoloration.

In Vitro Comparative Analysis of Fracture Resistance in Inlay Restoration Prepared with CAD-CAM and Different Systems in the Primary Teeth

Objective. The aim of this study was to compare to fracture resistance test of inlay restorations prepared using direct inlay technique (Gradia® Direct Composite) and Indirect Restoration System® (Gradia Indirect Composite) and CAD/CAD system (Vita Enamic® Block). Study Design. 48 noncarious extracted maxillary second primary molars were randomly divided into 4 groups with 12 in each group. All the teeth were prepared based on inlay class II preparations except for the control group. Other groups were restored with Gradia Direct Composite, Gradia Indirect Composite, and Vita Enamic Block, respectively. All restorations were cemented self-adhesive dual cure resin (3M Espe, RelyX™ Unicem Aplicap). A fracture test was performed using a compressive load. Results were analyzed using one-way analysis of variance and Duncan's post hoc multiple comparison tests (α = 0.05). Results. Vita Enamic Block and Gradia Indirect Composite showed significantly higher fracture resistance than Gradia Direct Composite (p < 0.05). There was no significant difference fracture resistance between Vita Enamic Block and Gradia Indirect Composite (p > 0.05). All restorations tested led to a significant reduction in fracture resistance (p < 0.05). Conclusion. In inlay restorations, Indirect Restoration Systems and CAD/CAM systems were applied successfully together with the self-adhesive dual cure resin cements in primary molars.

Effects of simulated gastric juice on color stability, surface roughness and microhardness of laboratory-processed composites

Medical problems such as gastroesophageal reflux disease can cause considerable damage to restorations in the oral environment. This study evaluated the effects of gastric juice on the surface characteristics of different types of laboratory-processed indirect composites with different filler particles and polymerization modes. Specimens were prepared from Tescera (TES; Bisco), Sinfony (SIN; 3M ESPE), Solidex (SOL; Shofu), and Adoro (AD; Ivoclar Vivadent). Before exposing the specimens to simulated gastric juice for 24 h, color, surface roughness, and microhardness were measured on one half of the polished flat surface of each specimen. After exposure to the simulated gastric juice, the same tests were repeated on the other half of specimen surface. Results indicated that gastric juice had a significant impact on color change (p<0.001). AD showed the largest surface roughness change among the resins (p<0.001). Gastric juice also significantly affected the microhardness of the materials, and AD and TES showed statistically similar change in microhardness (p>0.05).

Marginal and internal fit of nano-composite CAD/CAM restorations

Objectives

The purpose of this study was to compare the marginal and internal fit of nano-composite CAD-CAM restorations.

Materials and Methods

A full veneer crown and an mesio-occluso-distal (MOD) inlay cavity, which were prepared on extracted human molars, were used as templates of epoxy resin replicas. The prepared teeth were scanned and CAD-CAM restorations were milled using Lava Ultimate (LU) and experimental nano-composite CAD/CAM blocks (EB) under the same milling parameters. To assess the marginal and internal fit, the restorations were cemented to replicas and were embedded in an acrylic mold for sectioning at 0.5 mm intervals. The measured gap data were pooled according to the block types and measuring points for statistical analysis.

Results

Both the block type and measuring point significantly affected gap values, and their interaction was significant (p = 0.000). In crowns and inlays made from the two blocks, gap values were significantly larger in the occlusal area than in the axial area, while gap values in the marginal area were smallest (p < 0.001). Among the blocks, the restorations milled from EB had a significantly larger gap at all measuring points than those milled from LU (p = 0.000).

Conclusions

The marginal and internal gaps of the two nano-composite CAD/CAM blocks differed according to the measuring points. Among the internal area of the two nano-composite CAD/CAM restorations, occlusal gap data were significantly larger than axial gap data. The EB crowns and inlays had significantly larger gaps than LU restorations.

Two-body wear rate of CAD/CAM resin blocks and their enamel antagonists

STATEMENT OF PROBLEM

Computer-aided design and computer-aided manufacturing (CAD/CAM) resins exhibit good mechanical properties and can be used as long-term restorations. The wear rate of such resins and their enamel antagonists is unknown.

PURPOSE

The purpose of this study was to test and compare the 2-body wear rate of CAD/CAM resin blocks.

MATERIAL AND METHODS

Wear specimens (N=42, n=6) were made from 5 CAD/CAM resins: ZENO PMMA (ZP), artBloc Temp (AT), Telio CAD (TC), Blanc High-class (HC), CAD-Temp (CT); 1 manually polymerized resin: Integral esthetic press (negative control group, IEP); and 1 glass-ceramic: VITA Mark II (positive control group, VM2). The specimens for the wear resistance were aged in a thermomechanical loading machine (49 N, 1.67 Hz, 5/50°C) with human enamel antagonists. The material loss of all specimens before, during, and after aging was evaluated with a 3DS profilometer. The measured material loss data of all tested groups were statistically evaluated with linear mixed model analysis (a=.05).

RESULTS

Manually polymerized resin showed significantly higher material wear (P<.001) than all other tested groups. Glass-ceramic showed significantly lower wear values (P<.001) than CAD/CAM resins ZP, AT, HC, CT, and IES. CAD/CAM resin TC was not significantly different from the positive control group. Glass-ceramic showed the highest enamel wear values (P<.001) of all tested resins. No differences were found in the enamel wear among all resins. The glass-ceramic group showed damage in the form of cracks on the worn enamel surface in 50% of specimens.

CONCLUSIONS

CAD/CAM resins showed lower wear rates than those conventionally polymerized. Only one CAD/CAM resin, TC, presented material wear values comparable with glass-ceramic. The tested glass-ceramic developed cracks in the enamel antagonist and showed the highest enamel wear values of all other tested groups.

Long-term tensile bond strength of differently cemented nanocomposite CAD/CAM crowns on dentin abutment

OBJECTIVES

To test the tensile bond strength of luted composite computer aided design/computer aided manufacturing (CAD/CAM) crowns after use of different adhesive systems combined with different resin composite cements on dentin abutments.

METHODS

Human molars (n=200) were embedded in acrylic resin, prepared in a standardized manner and divided into 20 groups (n=10). The crowns were treated as follows: (i) Monobond Plus/Heliobond (MH), (ii) Ambarino P60 (AM), (iii) Visio.link (VL), (iv) VP connect (VP), and (v) non-treated as control groups (CG) and luted with Variolink II (VAR) or Clearfil SA Cement (CSA). Tensile bond strength (TBS) was measured initially (24h water, 37°C) and after aging (5000 thermal cycles, 5/55°C). The failure types were evaluated after debonding. TBS values were analyzed using three-way and one-way ANOVA, followed by post hoc Scheffé-test, and two-sample Student's t-tests.

RESULTS

Among VAR and after aging, CG presented significantly higher TBS (p=0.007) than groups treated with MH, AM and VP. Other groups showed no impact of pre-treatment. A decrease of TBS values after thermal aging was observed within CSA: CG (p=0.002), MH (p<0.001), VL (p<0.001), AM (p=0.002), VP (p<0.001) and within VAR: MH (p=0.002) and AM (p=0.014). Groups cemented with VAR showed significantly higher TBS then groups cemented with CSA: non-aged groups: CG (p<0.001), and after thermal aging: CG (p=0.003), MH (p<0.001), VL (p=0.005), VP (p=0.010).

SIGNIFICANCE

According to the study results nano-composite CAD/CAM crowns should be cemented with VAR. Pre-treatment is not necessary if the tested resin composite cements are used.

Effect of thermocycling on flexural strength and weibull statistics of machinable glass-ceramic and composite resin

To evaluate the durability of machinable dental restorative materials, this study performed an experiment to evaluate the flexural strength and Weibull statistics of a machinable lithium disilicate glass-ceramic and a machinable composite resin after being thermocycled for certain cycles. A total of 40 bar-shape specimens of were prepared with the dimension of 20 mm × 4 mm × 2 mm, which were divided into four groups of 10 specimens. Ten specimens of machinable lithium disilicate glass-ceramic (IPS e.max CAD, Ivoclar Vivadent, Liechtenstein) and 10 specimens of machinable composite resin (Paradigm MZ 100, 3M ESPE, USA) were subjected to 3-point flexural strength test. Other 10 specimens of each material were thermocycled between water temperature of 5 and 55 °C for 10,000 cycles. After that, they were tested using 3-point flexural strength test. Statistical analysis was performed using two-way analysis of variance and Tukey multiple comparisons. Weibull analysis was performed to evaluate the reliability of the strength. Means of strength and their standard deviation were: thermocycled IPS e.max CAD 389.10 (50.75), non-thermocycled IPS e.max CAD 349.96 (38.34), thermocycled Paradigm MZ 100 157.51 (12.85), non-thermocycled Paradigm MZ 100 153.33 (19.97). Within each material group, there was no significant difference in flexural strength between thermocycled and non-thermocycled specimens. Considering the Weibull analysis, there was no statistical difference of Weibull modulus in all experimental groups. Within the limitation of this study, the results showed that there was no significant effect of themocycling on flexural strength and Weibull modulus of a machinable glass-ceramic and a machinable composite resin.

The influence of polymerization conditions on color stability of three indirect composite materials

The aim of the present study was to evaluate color change and color stability against aqueous media of three indirect composite materials (Epricord, Estenia, and Twiny) that were polymerized with different systems. Disk-shaped specimens were prepared with their proprietary polymerization systems or with a metal halide light polymerization unit (Twinkle X). The specimens were then immersed in water or tea. Change in color from baseline (24 h) to 4 weeks was determined with a chromameter (ShadeEye NCC) using a white background. The L*, a*, and b* values for both states were determined, and ΔE*(ab) values were calculated. The Estenia specimens immersed in tea had significantly lower ΔL* (-7.0 to -5.6) and significantly higher ΔE*(ab) values (6.5 to 8.6) than did the Epricord and Twiny specimens, under all polymerization conditions. The results indicate that after tea immersion the Estenia material was less stable against color change than were the other two materials. The Twinkle X metal halide unit was suitable for polymerization of the three composite materials, using an exposure period of 60 s or longer.

Color changes in staining solutions of four light-cured indirect resin composites

The purpose of this study was to investigate the effect of different staining solutions on the color coordinates of indirect light-cured resin composites. 112 discs were made using four indirect composites, Signum+/Haraeus-Kulzer, Sinfony/3M-Espe, GC Gradia/GC, Ena HRi/Micerium, and divided into four groups which immersed in tea, coffee, chocolate and distilled water, at 37 °C, for 4 weeks. The color, before and after immersion for 1, 2, 3 and 4 weeks, was measured according to CIELAB system and ΔL*, Δa*, Δb* and ΔE* values were calculated for all immersion periods. The effect of time, solution and material on primary and secondary color coordinates was estimated using two-way repeated ANOVAs and pairwise comparisons, at a = 0.05. The results showed that coffee strongly affected all the materials (p < 0.05), followed by tea and chocolate. Sinfony presented the highest color change (p < 0.05), due to changes in b* and L* coordinates. Color coordinates were affected differently by material type and solution. In conclusion, this study showed that the color of indirect resin composites was affected by all three examined factors (immersion time, staining solution and material type), in a clinically appreciable level (ΔΕ* > 2.7 U) even from the first week, and in an unacceptable level (ΔΕ* > 5.5 U) in the second, third and fourth week, depending on the staining solution and the material.