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Sezen E, Kaya U, Ak AT, Ay M. Effect of 38% silver diamine fluoride on fracture resistance of leucite reinforced feldspathic ceramic CAD/CAM class I inlay restorations. Folia Med (Plovdiv) 2023; 65:808-815. [PMID: 38351764 DOI: 10.3897/folmed.65.e97183] [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: 11/04/2022] [Accepted: 12/05/2022] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Silver diamine fluoride (SDF) is a topical agent that has recently gained popularity for its ability to stop and prevent dental caries.
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Affiliation(s)
| | - Umut Kaya
- Istanbul Aydin University, Istanbul, Turkiye
| | | | - Miray Ay
- Istanbul Aydin University, Istanbul, Turkiye
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2
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Hofsteenge JW, Carvalho MA, Borghans PM, Cune MS, Özcan M, Magne P, Gresnigt MMM. Effect of preparation design on fracture strength of compromised molars restored with lithium disilicate inlay and overlay restorations: An in vitro and in silico study. J Mech Behav Biomed Mater 2023; 146:106096. [PMID: 37659167 DOI: 10.1016/j.jmbbm.2023.106096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
PURPOSE The objective of this study was to determine the influence of different preparation designs on the fracture strength, failure type, repairability, formation of polymerization-induced cracks, and tooth deformation of structurally compromised molars restored with lithium disilicate inlays and overlays in combination with Immediate Dentin Sealing (IDS). MATERIAL AND METHODS Human molars (N = 64) were randomly assigned to four different preparation designs: Undermined Inlay (UI), Extended Inlay (EI), Restricted Overlay (RO), and Extended Overlay (EO). The teeth were restored using lithium disilicate partial restorations and subjected to thermomechanical fatigue in a chewing simulator (1,2 × 10 (Mondelli et al., 2007) cycles on 50 N, 8000x 5-55 °C), followed by load to failure testing. In silico finite element analysis was conducted to assess tooth deformation. Polymerization-induced cracks were evaluated using optical microscopy and transillumination. Fracture strengths were statistically analyzed using a Kruskal-Wallis test, while the failure mode, repairability, and polymerization cracks were analyzed using Fisher exact test. RESULTS The propagation of polymerization-induced cracks did not significantly differ among preparation designs. All specimens withstood chewing simulator fatigue, with no visible cracks in teeth or restorations. Fracture strength was significantly influenced by preparation design, with restricted overlay (RO) showing higher fracture strength compared to extended inlay (EI) (p = .042). Tooth deformation and fracture resistance correlated between in vitro and in silico analyses). UI exhibited a statistically less destructive failure pattern than EO (p < .01) and RO (p = .036). No statistically significant influence of the preparation design on repairability was observed. Groups with higher repairability rates experienced increased tooth deformation, leading to less catastrophic failures. CONCLUSIONS The preparation design affected the fracture strength of compromised molars restored with lithium disilicate inlays and overlays, with significantly lower fracture strength for an extended inlay. The failure pattern of lithium disilicate overlays is significantly more destructive than that of undermined and extended inlays. The finite element analysis showed more tooth deformation in the inlay restorations, with lower forces in the roots, leading to less destructive fractures. Since cusp coverage restorations fracture in a more destructive manner, this study suggests the undermined inlay preparation design as a viable option for restoring weakened cusps.
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Affiliation(s)
- Jelte W Hofsteenge
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands.
| | | | - Pauline M Borghans
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands
| | - Marco S Cune
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; St. Antonius Hospital Nieuwegein, Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, the Netherlands
| | - Mutlu Özcan
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; University of Zurich, Center of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Zurich, Switzerland
| | - Pascal Magne
- Center for Education and Research in Biomimetic Restorative Dentistry (CER BRD), Beverly Hills, CA, USA
| | - Marco M M Gresnigt
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; Martini Hospital, Department of Special Dental Care, Groningen, the Netherlands
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Demirel MG, Mohammadi R, Keçeci M. Crack Propagation and Fatigue Performance of Partial Posterior Indirect Restorations: An Extended Finite Element Method Study. J Funct Biomater 2023; 14:484. [PMID: 37754898 PMCID: PMC10532640 DOI: 10.3390/jfb14090484] [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: 08/30/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
Dental ceramics are susceptible to slow, progressive crack growth after cyclic loading. The purpose of this study was to investigate the progressive patterns of cracks in two different types of CAD/CAM ceramic materials used with three different partial posterior indirect restoration (PPIR) designs and to determine the materials' failure risk using a fatigue test. Standard initial cracks were formed in Standard Tessellation Language (STL) files prepared for three different PPIRs. The materials chosen were monolithic lithium disilicate (LS) and polymer-infiltrated ceramic networks (PICNs). The extended finite element method (XFEM) was applied, and the fatigue performance was examined by applying a 600 N axial load. The cracks propagated the most in onlay restorations, where the highest displacement was observed. In contrast, the most successful results were observed in overlay restorations. Overlay restorations also showed better fatigue performance. LS materials exhibited more successful results than PICN materials. LS materials, which can be used in PPIRs, yield better results compared to PICN materials. While inlay restorations demonstrated relatively successful results, overlay and onlay restorations can be specified as the most and the least successful PPIR types, respectively.
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Affiliation(s)
| | - Reza Mohammadi
- Faculty of Dentistry, Necmettin Erbakan University, Konya 42090, Turkey;
| | - Murat Keçeci
- Department of Prosthodontics, Faculty of Dentistry, Karamanoğlu Mehmet Bey University, Karaman 70000, Turkey;
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Fathy H, Hamama HH, El-Wassefy N, Mahmoud SH. Effect of different surface treatments on resin-matrix CAD/CAM ceramics bonding to dentin: in vitro study. BMC Oral Health 2022; 22:635. [PMID: 36564766 PMCID: PMC9789622 DOI: 10.1186/s12903-022-02674-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Evaluating the effect of different surface treatment methods on the micro-tensile bond strength (µTBS) of two different resin-matrix computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics (RMCs). METHODS A standardized inlay preparations were performed on 100 intact maxillary premolars. According to the type of the restorative material, the teeth were randomly divided into two equally sized groups (n = 50): (polymer-infiltrated ceramic (Vita Enamic) and resin-based composites (Lava Ultimate)). The inlays were fabricated using CAD/CAM technology. In each group, the specimens were randomly assigned to five subgroups (n = 10) according to the surface treatment method: group 1 used was the control group (no surface treatment); group 2, was treated with air abrasion with 50 μm Al2O3 (A) and universal adhesive (UA); group 3, was treated with air abrasion with 50 μm Al2O3 (A) and silane coupling agent (S); group 4, was treated with hydrofluoric acid (HF) and universal adhesive (UA) and group 5, was treated with Hydrofluoric acid (HF) + silane coupling agent (S). The inlays were then cemented to their respective preparations using dual-cure self-adhesive resin cement (RelyX U200, 3 M ESPE) according to the manufacturer's instructions. The µTBS test was conducted in all groups, and stereomicroscope and scanning electron microscope were used to inspect the failure mode. The data were statistically analyzed using a two-way analysis of variance (ANOVA) and Tukey's post-hoc multiple comparison tests at a significance level of p < 0.05. RESULTS Surface treatments significantly increased the µTBS of the materials compared to the control group (p < 0.05). For CAD/CAM RBCs, the µTBS value highest in group 2 whereas, for PICN, the µTBS value was highest in group 3. Cohesive failure of CAD/CAM restorative material was the most predominant mode of failure in all treated groups, whereas adhesive failure at restoration-cement interface was the most predominant failure mode in the control group. CONCLUSION Surface treatments increase the µTBS of resin-matrix CAD/CAM ceramics to tooth structure. Air abrasion followed by universal adhesive and hydrofluoric acid followed by silane application appears to be the best strategies for optimizing the bond strength of CAD/CAM RBCs and PICN respectively.
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Affiliation(s)
- Hanan Fathy
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
| | - Hamdi H Hamama
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.
| | - Noha El-Wassefy
- Dental Biomaterials Science Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Salah H Mahmoud
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
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Wang B, Fan J, Wang L, Xu B, Wang L, Chai L. Onlays/partial crowns versus full crowns in restoring posterior teeth: a systematic review and meta-analysis. Head Face Med 2022; 18:36. [PMID: 36411462 PMCID: PMC9677648 DOI: 10.1186/s13005-022-00337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/20/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Tooth-colored onlays and partial crowns for posterior teeth have been used increasingly in clinics. However, whether onlays/partial crowns could perform as well as full crowns in the posterior region was still not evaluated thoroughly. METHODS A literature search was conducted without language restrictions in Pubmed, Embase, Cochrane Central Register of Controlled Trial and Web of science until September 2021. RCTs, prospective and retrospective observational studies with a mean follow-up of 1 year were selected. Cochrane Collaboration's tool was adopted for quality assessment of the RCT. The quality of observational studies was evaluated following Newcastle-Ottawa scale. The random-effects and fixed-effects model were employed for meta-analysis. RESULTS Four thousand two hundred fifty-seven articles were initially searched. Finally, one RCT was identified for quality assessment and five observational studies for qualitative synthesis and meta-analysis. The RCT was of unclear risk of bias while five observational studies were evaluated as low risk. The meta-analysis indicated no statistically significant difference in the survival between onlays/partial crowns and full crowns after 1 year (OR = 0.55, 95% CI: 0.02-18.08; I2 = 57.0%; P = 0.127) and 3 years (OR = 0.65, 95% CI: 0.20-2.17; I2 = 0.0%; P = 0.747). For the success, onlays/partial crowns performed as well as crowns (OR = 0.58, 95% CI: 0.20-1.72; I2 = 0.0%; P = 0.881) at 3 years. No significant difference of crown fracture existed between the two methods (RD = 0.00, 95% CI: - 0.03-0.03; I2 = 0.0%; P = 0.972). CONCLUSIONS Tooth-colored onlays/partial crowns performed as excellently as full crowns in posterior region in a short-term period. The conclusions should be further consolidated by RCTs with long-term follow-up.
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Affiliation(s)
- Bingjie Wang
- grid.203507.30000 0000 8950 5267Department of Stomatology, The Affiliated People’s Hospital of Ningbo University (Ningbo Yinzhou People’s Hospital), No.251, Baizhang Road(E), Ningbo, 315000 China
| | - Jiayan Fan
- grid.459833.00000 0004 1799 3336Department of Stomatology, Ningbo No.2 Hospital, Ningbo, 315000 China
| | - Lutao Wang
- grid.459833.00000 0004 1799 3336Department of Stomatology, Ningbo No.2 Hospital, Ningbo, 315000 China
| | - Bin Xu
- grid.459833.00000 0004 1799 3336Department of Stomatology, Ningbo No.2 Hospital, Ningbo, 315000 China
| | - Liang Wang
- grid.459833.00000 0004 1799 3336Department of Stomatology, Ningbo No.2 Hospital, Ningbo, 315000 China
| | - Luyi Chai
- grid.203507.30000 0000 8950 5267Department of Stomatology, The Affiliated People’s Hospital of Ningbo University (Ningbo Yinzhou People’s Hospital), No.251, Baizhang Road(E), Ningbo, 315000 China
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Fathy H, Hamama HH, El-Wassefy N, Mahmoud SH. Clinical performance of resin-matrix ceramic partial coverage restorations: a systematic review. Clin Oral Investig 2022; 26:3807-3822. [PMID: 35320383 PMCID: PMC9072524 DOI: 10.1007/s00784-022-04449-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate clinical performance of the new CAD/CAM resin-matrix ceramics and compare it with ceramic partial coverage restorations. MATERIALS AND METHODS An electronic search of 3 databases (The National Library of Medicine (MEDLINE/PubMed), Scopus, and the Cochrane Central Register of Controlled Trials) was conducted. English clinical studies published between 2005 and September 2020 that evaluated the clinical performance of CAD/CAM resin-matrix ceramics inlays, onlays, or overlays were selected. The primary clinical question was applied according to PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). The included studies were individually evaluated for risk of bias according to the modified Cochrane Collaboration tool criteria. RESULTS A total of 7 studies were included according to the established inclusion and exclusion criteria. From the included studies, 6 were randomized clinical trials while one study was longitudinal observational study without control group. According to the results of the included studies, the success rate of CAD/CAM resin-based composite ranged from 85.7 to 100% whereas the success rate reported for ceramic partial coverage restorations ranged from 93.3 to 100%. Fractures and debondings are found to be the most common cause of restorations failure. CONCLUSION CAD/CAM resin-based composite can be considered a reliable material for partial coverage restorations with clinical performance similar to glass ceramic restorations. However, this result needs to be confirmed in long-term evaluations. CLINICAL RELEVANCE CAD/CAM resin-based composites provide a potential alternative to ceramic indirect restorations. However, clinicians must be aware of the lake of knowledge regarding long-term outcome.
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Affiliation(s)
- Hanan Fathy
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, 35516, Egypt
| | - Hamdi H Hamama
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, 35516, Egypt.
| | - Noha El-Wassefy
- Dental Biomaterials Science Dept, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Salah H Mahmoud
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, 35516, Egypt
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Influence of Cavity Geometry on the Fracture Strength of Dental Restorations: Finite Element Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11094218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The main purpose of this work was to analyze the stress distribution in premolars restored with indirect IPS Empress® CAD onlays or inlays. The three-dimensional geometry of a human first premolar was created using modeling software. The tooth fixation system was simulated through box geometry, comprising a cortical bone layer with 2 mm of thickness over a layer of trabecular bone with 15 mm of thickness. The tooth had the following approximated crown dimensions: 10.35 mm buccolingual length; 7.1 mm mesiodistal width; and 7.0 mm cervico-occlusal height. The mesio-occluso-distal (MOD) cavity preparations followed the suggestions available in the literature. The cement geometry was modified to include cohesive zone models (CZM) to perform the adhesive joint’s strength prediction. The loading body was created assuming contact between the food bolus and the tooth surface. Numerical solutions were obtained by performing static analysis and damage analysis using the finite element method. Von Mises stress values generated in the ceramic inlay restoration ranged from 1.39–181.47 MPa, which were on average 4.4% higher than those of the onlay ceramic restoration. The fracture strength of the onlay restoration was about 18% higher than that of the inlay restoration. The onlay design seems to contribute to higher homogenization of the adhesive resin cement strain and higher tooth structure protection.
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8
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de Mesquita CB, Melara R, Luisi SB, Burnett LH, de Melo TAF. Influence of dental crown topography on fracture resistance of premolars with MOD preparation and subjected to different restorative protocols. AUST ENDOD J 2021; 47:493-498. [PMID: 33793027 DOI: 10.1111/aej.12511] [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: 03/18/2021] [Indexed: 12/01/2022]
Abstract
To evaluate whether dental crown topography influences the fracture resistance of premolars treated endodontically and with MOD preparation subjected to different restorative protocols. Sixty-four human premolars with one or two roots in equal numerical proportions (n) were selected and randomly divided into four groups (n = 8): (S = single-rooted; D = double-rooted) SS: sound single-rooted; SNR: endodontics (E) + MOD cavity preparation; SR: E + MOD + resin restoration (RS); SP: E + MOD + RS + horizontal zirconia post (ZP); DS: sound double-rooted; DNR: E + MOD; DR: E + MOD + RS; and DP: E + MOD + RS + ZP. After allocation to the groups, the samples were thermocycled and then subjected to the fracture resistance test. Failures after the fracture test were classified as irreparable (with pulp floor fracture) or reparable (without pulp floor fracture). Data were analysed using one-way anova and the Tukey test (α = 0.05). Single-rooted premolars were more resistant to fracture than double-rooted premolars. The restorative treatment using a horizontally transfixed zirconia post improved fracture resistance, resembling that of a healthy tooth.
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Affiliation(s)
| | - Rafael Melara
- Restorative Dentistry Division, Department of Conservative Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Simone Bonato Luisi
- Endodontic Division, Department of Conservative Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luiz Henrique Burnett
- Post-Graduate Program, Clinical Department, Dental School, Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Tiago André Fontoura de Melo
- Endodontic Division, Department of Conservative Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Bresser RA, van de Geer L, Gerdolle D, Schepke U, Cune MS, Gresnigt MMM. Influence of Deep Margin Elevation and preparation design on the fracture strength of indirectly restored molars. J Mech Behav Biomed Mater 2020; 110:103950. [PMID: 32957242 DOI: 10.1016/j.jmbbm.2020.103950] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/21/2020] [Indexed: 10/23/2022]
Abstract
The objectives of this in-vitro study were to investigate the influence of Deep Margin Elevation (DME) and the preparation design (cusp coverage) on the fracture strength and repairability of CAD/CAM manufactured lithium disilicate (LS2) restorations on molars. Sound extracted human molars (n = 60) were randomly divided into 4 groups (n = 15) (inlay without DME (InoD); inlay with DME (IWD); onlay without DME (OnoD); onlay with DME (OnWD)). All samples were aged (1.2 × 106 cycles of 50N, 8000 cycles of 5-55 °C) followed by oblique static loading until fracture. Fracture strength was measured in Newton and the fracture analysis was performed using a (scanning electron) microscope. Data was statistically analyzed using two-way ANOVA and contingency tables. DME did not affect the fracture strength of LS2 restorations to a statistically significant level (p = .15). Onlays were stronger compared to inlays (p = .00). DME and preparation design did not interact (p = .97). However, onlays with DME were significantly stronger than inlays without DME (p = .00). More repairable fractures were observed among inlays (p = .00). Catastrophic, crown-root fractures were more prevalent in onlays (p = .00). DME did not influence repairability of fractures or fracture types to a statistically significant level (p > .05). Within the limitations of this in-vitro study, DME did not statistical significantly affect the fracture strength, nor the fracture type or repairability of LS2 restorations in molars. Cusp coverage did increase the fracture strength. However, oblique forces necessary to fracture both inlays and onlays, either with or without DME, by far exceeded the bite forces that can be expected under physiological clinical conditions. Hence, both inlays and onlays are likely to be fracture resistant during clinical service.
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Affiliation(s)
- R A Bresser
- University Medical Center Groningen, University of Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands
| | - L van de Geer
- University Medical Center Groningen, University of Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands
| | | | - U Schepke
- University Medical Center Groningen, University of Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands
| | - M S Cune
- University Medical Center Groningen, University of Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands; St. Antonius Hospital, Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, the Netherlands; University of Utrecht, University Medical Center Utrecht, Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, Utrecht, the Netherlands
| | - M M M Gresnigt
- University Medical Center Groningen, University of Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands; Martini Hospital, Department of Special Dental Care, Groningen, the Netherlands.
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Dejak B, Młotkowski A. A comparison of mvM stress of inlays, onlays and endocrowns made from various materials and their bonding with molars in a computer simulation of mastication - FEA. Dent Mater 2020; 36:854-864. [PMID: 32473834 DOI: 10.1016/j.dental.2020.04.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/14/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The purpose of the study was to compare the mvM stresses occurring in inlays, onlays and endocrowns made from different materials and their bonding with molars in a computer simulation of mastication. METHODS The study was conducted using the finite elements method with contact elements. Sixteen 3D first molar models were created of a intact tooth - T; a tooth with a ceramic inlay - IN; a tooth with an onlay - ON; and a tooth with an endocrown - EN. The restorations were made of: Comp - resin nanoceramic; Hc - hybrid ceramic; Le - leucite ceramic; Dlit - lithium disilicate; and Zr - zirconia. Computer simulations of mastication were performed. The equivalent stresses according to the modified von Mises criterion (mvM) were calculated in model materials and contact stresses at the interface cement-dental tissue around the examined restorations. RESULTS The highest equivalent mvM stresses were concentrated in buccal margins of inlays. The mvM stresses recorded in onlays were 1.6-5 times lower than those found in inlays, while in endocrowns they were 2.3-6.5 times lower. Around the onlays and endocrowns, in tooth structures and luting cement, mvM stresses were significantly lower compared to teeth restored with inlays. The tensile and shear contact stresses between inlays and teeth were several times lower than under another restorations. The highest stresses (58.5MPa) occurred in the zirconia inlay. The stresses observed in the enamel of a tooth restored with an INZr inlay were half those noted in INComp, and a third of those observed in cement. Tensile contact stresses at the interface between the INZr inlay and dental tissue were 4.5 times lower than in the INComp, and the shear stresses were more than 7 times lower. SIGNIFICANCE The highest values and unfavorable of stress levels occurred in teeth restored with inlays. Cavities MOD in molars should be reconstructed with cusp-covering restorations. The endocrown in molars should withstand physiological loading. The higher the modulus of elasticity of the restoration material, the higher the stresses in the restorations, while the lower stresses were observed in the tooth structures, luting cement and at the interface between the restoration and the dental tissue. Ceramic restorations should provide better protection and marginal seal of the reconstructed tooth than composite ones.
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Affiliation(s)
- Beata Dejak
- Department of Prosthetic Dentistry, Medical University of Łódź, Łódź, Poland.
| | - Andrzej Młotkowski
- Department of Strength of Materials and Structures, Technical University of Łódź, Łódź, Poland
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Moradi Z, Abbasi M, Khalesi R, Tabatabaei MH, Shahidi Z. Fracture Toughness Comparison of Three Indirect Composite Resins Using 4-Point Flexural Strength Method. Eur J Dent 2020; 14:212-216. [PMID: 32283561 PMCID: PMC7274826 DOI: 10.1055/s-0040-1708438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objectives
The advantages of indirect composite restorations such as less crack formation during their computer-aided design/computer-aided manufacturing process, compared with ceramic restorations, have resulted in their growing popularity. However, restoration failure is a major concern with regard to the long-term clinical success of restorations and may occur as the result of propagation of a crack originated from an internal flaw in the restoration. This study aimed to compare the fracture toughness of three indirect composite resins.
Materials and Methods
In this
in vitro
experimental study, 10 specimens measuring 3 × 3 × 18 mm were fabricated of Gradia, Crios, and high impact polymer composite indirect composites. A single edge notch with a diameter < 0.3 mm and 0.3 mm length was created in the 9 mm longitudinal dimension of specimens using a no. 11 surgical scalpel. The specimens were then subjected to 4-point flexural strength test in a universal testing machine with a crosshead speed of 0.1 mm/s until failure.
Statistical Analysis
Data were analyzed using IBM SPSS Statistics via one-way analysis of variance (ANOVA) and Tukey’s HSD (honestly significant difference) test. The statistical power was set at
p
˂ 0.05.
Results
One-way ANOVA showed a significant difference in fracture toughness of the three composite groups (
p
= 0.000). According to the Tukey HSD analysis, the fracture toughness of HIPC was significantly higher than that of the other two composites. The fracture toughness of Gradia was significantly lower among all.
Conclusions
Within the limitations of this study, the results showed that high temperature-pressure polymerization can increase resistance to crack propagation and subsequently improve the clinical service of indirect composite restorations. Although we do not know the filler volume percentage of HIPC, it seems that filler volume percentage of the composite is inversely correlated with fracture toughness.
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Affiliation(s)
- Zohreh Moradi
- Department of Restorative Dentistry, Tehran University of Medical Science, Tehran, Iran
| | - Mahdi Abbasi
- Department of Restorative Dentistry, Tehran University of Medical Science, Tehran, Iran
| | - Rayhaneh Khalesi
- Department of Restorative Dentistry, Jondishapour University of Medical Science, Ahvaz, Iran
| | | | - Zahra Shahidi
- Department of Restorative Dentistry, Tehran University of Medical Science, Tehran, Iran
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Prechtel A, Stawarczyk B, Hickel R, Edelhoff D, Reymus M. Fracture load of 3D printed PEEK inlays compared with milled ones, direct resin composite fillings, and sound teeth. Clin Oral Investig 2020; 24:3457-3466. [PMID: 31989370 DOI: 10.1007/s00784-020-03216-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/17/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective of this in vitro study was to investigate fracture load, fracture types, and impact of chewing simulation of human molars restored with 3D printed indirect polyetheretherketone (PEEK) inlays and compare these with milled indirect PEEK inlays, direct resin composite fillings, and sound teeth. MATERIALS AND METHODS A total of 112 molars with form congruent class I cavities were restored with (n = 16/group) 3D printed indirect PEEK inlays via fused layer manufacturing (FLM): (1) Essentium PEEK (ESS), (2) KetaSpire PEEK MS-NT1 (KET), (3) VESTAKEEP i4 G (VES), (4) VICTREX PEEK 450G (VIC), (5) milled indirect PEEK inlays JUVORA Dental Disc 2 (JUV), and (6) direct resin composite fillings out of Tetric EvoCeram (TET). Sound teeth (7) acted as positive control group. Half of the specimens of each group (n = 8) were treated in a chewing simulator combined with thermal cycling (1.2 million × 50 N; 12,000 × 5 °C/55 °C). Fracture load and fracture types of all molars were determined. Statistical analyses using Kolmogorov-Smirnov test and two-way ANOVA with partial eta squared (ηp2) followed by Scheffé post hoc test, chi square test and Weibull modulus m with 95% confidence interval were computed (p < 0.05). RESULTS ESS and TET demonstrated the lowest fracture load with a minimum of 956 N, whereas sound molars showed the highest values of up to 2981 N. Chewing simulation indicated no impact (p = 0.132). With regard to Weibull modulus, KET presented a lower value after chewing simulation than JUV, whereas TET had the highest value without chewing simulation. All indirect restorations revealed a tooth fracture (75-100%), direct resin composite fillings showed a restoration fracture (87.5%), and 50% of the sound teeth fractured completely or had cusp fractures. CONCLUSIONS All 3D printed and milled indirect PEEK inlays as well as the direct resin composite fillings presented a higher fracture load than the expected physiological and maximum chewing forces. CLINICAL RELEVANCE 3D printing of inlays out of PEEK via FLM provided promising results in mechanics, but improvements in terms of precision and esthetics will be required to be practicable in vivo to represent an alternative dental material.
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Affiliation(s)
- Alexander Prechtel
- Department of Prosthetic Dentistry, Ludwig-Maximilians-Universität Munich, Goethestrasse 70, 80336, Munich, Germany.
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, Ludwig-Maximilians-Universität Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians-Universität Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, Ludwig-Maximilians-Universität Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Marcel Reymus
- Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians-Universität Munich, Goethestrasse 70, 80336, Munich, Germany
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Angerame D, De Biasi M, Agostinetto M, Franzò A, Marchesi G. Influence of preparation designs on marginal adaptation and failure load of full-coverage occlusal veneers after thermomechanical aging simulation. J ESTHET RESTOR DENT 2019; 31:280-289. [PMID: 30790399 DOI: 10.1111/jerd.12457] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/14/2018] [Accepted: 12/27/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the fracture resistance and marginal quality of maxillary molars restored using lithium disilicate glass-ceramic (LDG) occlusal veneers with two preparation designs. METHODS Sixteen extracted maxillary molars were assigned to two groups (n = 8). In group 1 (G1), the teeth received a preparation for a conservative full-coverage occlusal veneer restoration with a 90° rounded shoulder margin. In group 2 (G2), the teeth underwent a 1-mm cusp reduction with a marginal chamfer. LDG restorations (IPS e.max CAD) were obtained with the Cerec 3 CAD/CAM system and luted with Variolink II cement. After thermomechanical aging (1 250 000 cycles), the specimens were loaded to fracture. A semiquantitative marginal seal evaluation was performed observing resin replicas of the specimens at the scanning electron microscope. Cement thickness was assessed at the stereomicroscope on sectioned specimens. Collected data were statistically analyzed by parametric and nonparametric tests. RESULTS The maximum load to fracture was 2395.01 ± 150.96 N in G1 and 2408.39 ± 112.66 N in G2. Most of the observed specimens exhibited restorable fractures and continuous margins. Cement thickness was 132 ± 38 μm in G1 and 150 ± 41 μm in G2. No differences between the groups emerged. CONCLUSION This study demonstrated similar satisfactory performance of the two considered preparations designs for occlusal veneer with LDG. CLINICAL SIGNIFICANCE A new minimally invasive occlusal veneer preparation with marginal chamfer exhibited promising fracture resistance and marginal adaptation that were comparable to those of a standard conservative preparation for the restoration of molars with CAD/CAM lithium disilicate occlusal veneers.
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Affiliation(s)
- Daniele Angerame
- University Clinical Department of Medical, Surgical, and Health Sciences, University of Trieste, Trieste, Italy
| | - Matteo De Biasi
- University Clinical Department of Medical, Surgical, and Health Sciences, University of Trieste, Trieste, Italy
| | | | | | - Giulio Marchesi
- University Clinical Department of Medical, Surgical, and Health Sciences, University of Trieste, Trieste, Italy
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