1
|
Conejo J, Han S, Atria PJ, Stone-Hirsh L, Dubin J, Blatz MB. Full digital workflow to resolve angled adjacent dental implants: A dental technique. J Prosthet Dent 2024; 132:306-309. [PMID: 36114017 DOI: 10.1016/j.prosdent.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022]
Abstract
The digital acquisition, fabrication process, and delivery of computer-aided design and computer-aided manufacture (CAD-CAM) implant-supported restorations on angled adjacent implants are described. The proximal surface of a scan post was modified for correct adaptation, permitting an accurate digital scan of adjacent implants in 1 step. Definitive screw-retained splinted implant-supported restorations were designed and milled in a zirconia material and delivered with a combined extraoral and intraoral cementation protocol.
Collapse
Affiliation(s)
- Julian Conejo
- Assistant Professor, Clinical Restorative Dentistry, and Director, Chairside CAD/CAM Dentistry, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa.
| | - Sean Han
- Chief Executive Officer of Maters' Arch, Phoenix, Ariz
| | - Pablo J Atria
- Assistant Professor, College of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Leslie Stone-Hirsh
- Clinical Associate Professor, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | - Jay Dubin
- Clinical Associate, Department of Preventive and Restorative Dentistry, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | - Markus B Blatz
- Professor of Restorative Dentistry and Chairman, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa; Assistant Dean, Digital Innovation and Professional Development, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| |
Collapse
|
2
|
Margvelashvili-Malament M, Thompson V, Polyakov V, Malament KA. Over 14-year survival of pressed e.max lithium disilicate glass-ceramic complete and partial coverage restorations in patients with severe wear: A prospective clinical study. J Prosthet Dent 2024:S0022-3913(24)00464-5. [PMID: 39084921 DOI: 10.1016/j.prosdent.2024.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 08/02/2024]
Abstract
STATEMENT OF PROBLEM Long-term clinical data are lacking on the comparative survival of adhesively luted lithium disilicate glass-ceramic complete and partial coverage restorations in patients with severe wear and the effect that different clinical variables have on their survival. PURPOSE The purpose of this study was to examine the 14-year survival of pressed e.max lithium disilicate glass-ceramic complete and partial coverage restorations in patients with severe wear and to evaluate associated clinical parameters. MATERIAL AND METHODS Patients demonstrating severe wear and requiring single unit defect-specific partial or complete coverage restorations were recruited in a clinical private practice and received lithium disilicate restorations. The effect of various clinical parameters was evaluated using Kaplan-Meier survival curves to account for attrition bias and other causes of failure. The statistical significance of differences between parameters was determined by using the log rank test (α=.05). RESULTS A total of 53 participants (24 men and 29 women) requiring 662 lithium disilicate restorations were evaluated. The mean age of the participants at the time of restoration placement was 60 (range 25 to 85 years). Of 662 units, 551 were anterior and posterior complete and 111 were posterior partial coverage restorations. Six failures (bulk fracture or large chip) requiring replacement occurred with the average time to failure of 4.5 (range 2 to 8) years, yielding a crude estimate of annual failure of 0.1% (cumulative monitoring period of 4650 years, overall survival rate of 98.6%). Of the 551 complete coverage restorations, 4 failed (0 anterior, 4 posterior), yielding a crude estimate of 0.1% annual failure with the survival function time at 14 years. Of the 111 partial coverage restorations, 2 failed, yielding a crude estimate of 0.4% annual failure with the survival function time at 12 years. The only statistically significant difference was seen between anterior crowns and posterior onlays, with no failures in anterior crowns (P<.001). Other clinical variables had no significant effect on survival (P>.05). CONCLUSIONS Pressed e.max lithium disilicate partial and complete coverage restorations both showed high survival rates in patients with severe wear over 14 years with an overall yearly failure rate of 0.1%. Risk of failure at any age was minimal for both men and women. All anterior crowns survived. The highest annual failure rate (0.4%) was for posterior onlay partial coverage restorations.
Collapse
Affiliation(s)
- Mariam Margvelashvili-Malament
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.; and Private practice, Boston, Mass.
| | - Van Thompson
- Professor Emeritus, King's College London Faculty of Dentistry, Oral and Craniofacial Sciences, London, England, United Kingdom
| | - Valery Polyakov
- Scientific Advisor, Schlumberger-Doll Research, Boston, Mass
| | - Kenneth A Malament
- Clinical Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.; and Private practice, Boston, Mass
| |
Collapse
|
3
|
Muhetaer A, Tang C, Anniwaer A, Yang H, Huang C. Advances in ceramics for tooth repair: From bench to chairside. J Dent 2024; 146:105053. [PMID: 38729288 DOI: 10.1016/j.jdent.2024.105053] [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: 03/24/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES To give a comprehensive review of advancement in dental ceramics, fabrication methods, and the challenges associated with clinical application. DATA, SOURCES AND STUDY SELECTION Researches on chemical composition, biomechanical behaviors, optical properties, bonding strategies and fabrication methods were included. The search of articles was independently conducted by two authors in the PubMed, Scopus, Medline and Web of Science. CONCLUSIONS Dental ceramics have shown significant advancements in terms of esthetics and function. However, improving fracture toughness without compromising optical properties remains a challenge. Repairing fractured zirconia or glass-matrix ceramic prostheses with the same material is difficult due to the sintering process. Developing innovative bonding techniques that provide strong and long-lasting bonding strength between ceramics and tooth structures poses a recurring obstacle. CLINICAL SIGNIFICANCE Despite the emergence of dental ceramics and fabrication techniques, certain limitations such as susceptibility to brittleness and fracture still exist. Therefore, the current review provided valuable information around the advanced dental ceramics in tooth repair. The laboratory test data and the clinical outcome are also presented in details, aiming to guide clinicians in making informed decisions regarding ceramic restorations.
Collapse
Affiliation(s)
- Aihemaiti Muhetaer
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Prosthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Chuliang Tang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Prosthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Annikaer Anniwaer
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Hongye Yang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Prosthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China.
| | - Cui Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Prosthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China.
| |
Collapse
|
4
|
Ozturk D, Sen N, Isler S. Effect of non-thermal plasma treatment and resin cements on the bond strength of zirconia ceramics with different yttria concentrations. BIOMED ENG-BIOMED TE 2024; 69:249-255. [PMID: 38143322 DOI: 10.1515/bmt-2023-0336] [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: 07/22/2023] [Accepted: 12/12/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To investigate the effect of different surface treatments and resin cements on the shear bond strength of zirconia ceramics with different yttria concentrations. METHODS Zirconia blocks characterized by different yttria concentrations [Vita YZ HT (HT), Vita YZ ST (ST) and Vita YZ XT (XT)] were used to prepare disc-shaped specimens (n=252). Specimens prepared to investigate shear bond strength (SBS), water contact angle and surface roughness (Ra) were divided into four subgroups; control (C), sandblasting (S), sandblasting + nonthermal plasma treatment (SNTP) and nonthermal plasma treatment (NTP). For SBS testing, specimens were further divided into two groups (n=108) according to the luting cement used [Panavia F2.0 (P) and Rely X U200 (R)]. The water contact angles were determined by sessile drop technique and Ra was analyzed with optical profilometer. SBS tests were performed in a universal testing machine at a crosshead speed of 0.5 mm/min. The data sets were statistically analyzed with two and three-way ANOVAs followed by post-hoc comparisons (α=0.05). RESULTS The water contact angle and Ra data were significantly affected by surface treatments. The mean Ra values of ST and XT were significantly lower than HT for the surface treatment groups of C and NTP. The SBS values were significantly different among the groups subjected to different surface treatments. The mean SBS values of surface treatment groups (S, SNTP and NTP) when cemented with R were significantly higher than the groups of C (p<0.05). CONCLUSIONS For the tested zirconia ceramics with different yttria concentrations, non-thermal plasma activation helps to improve SBS and is a promising tool in practical use.
Collapse
Affiliation(s)
- Deniz Ozturk
- Department of Prosthodontics, Health Science Institute, University of Istanbul, Istanbul, Türkiye
| | - Nazmiye Sen
- Department of Prosthodontics, Faculty of Dentistry, University of Istanbul, Istanbul, Türkiye
- Department of Prosthodontics, Faculty of Dentistry, Kent University, Istanbul, Türkiye
| | - Sabire Isler
- Department of Prosthodontics, Faculty of Dentistry, University of Istanbul, Istanbul, Türkiye
| |
Collapse
|
5
|
Alzahrani SJ, Hajjaj MS, Abu Haimed TS, Alnoury A, Khouja N, Abuelenain DA, AlNowailaty Y, Abu-Nawareg M, Abuljadayel R, Naguib GH. Effect of Dentin Contamination with Hemostatic Agents and Cleaning Techniques on Bonding with Self-Adhesive Resin Cement. Med Sci Monit 2024; 30:e943353. [PMID: 38825814 PMCID: PMC11159572 DOI: 10.12659/msm.943353] [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: 11/30/2023] [Accepted: 04/05/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Dentin contamination with hemostatic agents before bonding indirect restorations negatively affects the bond strength. However, the consensus on which materials could be used to clean contamination of hemostatic agents has not been explored. The aim of this study was to assess the effect of Katana Cleaner applied on the surface of dentin contaminated with hemostatic agents on the shear bond strength (SBS) of self-adhesive resin cement by comparing it with three other surface cleaners. MATERIAL AND METHODS Ninety dentin specimens were divided into a no contamination group (control) (n=10), 4 groups contaminated with 25% aluminum chloride (Viscostat Clear) (n=40), and 4 groups contaminated with 20% ferric sulfate (Viscostat) (n=40). Subsequently, 4 different cleaners were used for each contamination group (water rinse, phosphoric acid, chlorhexidine, and Katana Cleaner). Then, self-adhesive resin cement was directly bonded to the treated surfaces. All specimens were subjected to 5000 thermal cycles of artificial aging. The shear bond strength was measured using a universal testing machine. RESULTS Two-way analysis of variance showed that the contaminant type as the main factor was statistically non-significant (p=0.655), cleaner type as the main factor was highly significant (p<0.001), and interaction between the contaminant and cleaner was non-significant (p=0.51). The cleaner type was the main factor influencing the bond strength. Phosphoric acid and chlorhexidine showed better performance than Katana Cleaner. CONCLUSIONS Cleaning dentin surface contamination with phosphoric acid and chlorhexidine had better performance than with Katana Cleaner.
Collapse
|
6
|
El-Sheikh NA, Wahsh MM, Hussein GA. Laser debonding of ultrathin occlusal veneers fabricated from different CAD/CAM ceramic materials. BMC Oral Health 2024; 24:570. [PMID: 38802801 PMCID: PMC11129369 DOI: 10.1186/s12903-024-04314-6] [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: 04/11/2024] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Erbium lasers safely offer the possibility of reuse for debonded restorations. Since these lasers have a high affinity for water molecules, they are absorbed by resin cement causing explosive ablation of the cement and thus, the restoration debonds. The efficiency of this process depends on many factors, including the ceramic type, its chemical composition and thickness. Therefore, this study was designed to test the time taken to debond ultrathin occlusal veneers made of three types of milled ceramic materials and evaluate the integrity of these restorations after debonding. METHODS Three ceramic types were evaluated in this study: lithium disilicate (IPS Emax CAD), highly condensed lithium disilicate (GC initial®LiSi), and translucent zirconia (Katana zirconia STML). Each group consisted of 8 occlusal veneers of 0.5 mm thickness. The samples were cemented to the occlusal surfaces of the upper molar teeth. An Er; Cr: YSGG laser was applied to the occlusal veneers using the scanning method, and time until debonding was calculated. The debonded samples were then inspected under a stereomicroscope for possible damage. Numerical data are presented as the mean with 95% confidence interval (CI), standard deviation (SD), minimum (min.) and maximum (max.) values. Normality and variance homogeneity assumptions were confirmed using Shapiro-Wilk's and Levene's tests, respectively. Data were normally distributed and were analyzed using one-way ANOVA followed by Tukey's post hoc test. The significance level was set at p < 0.05 for all tests. Statistical analysis was performed with R statistical analysis software version 4.3.2 for Windows (R Core Team (2023). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/). RESULTS There was no significant difference in debonding time between the different materials (p = 0.995). The longest debonding time was found for Katana STML (87.52 ± 20.45) (seconds), followed by Emax (86.94 ± 20.63) (seconds), while the lowest value was found for LiSi initial (86.14 ± 25.16) (seconds). In terms of damage to the debonded veneers, The Emax and zirconia samples showed no damage. However, 40% of the LiSi samples fractured during debonding, and 20% exhibited cracks. Only 40% of the LiSi samples were sound after debonding. CONCLUSION Er; Cr: YSGG laser can be used efficiently to remove ceramic occlusal veneers. However, its effect on LiSi restorations needs further research.
Collapse
Affiliation(s)
- Nourhan Ali El-Sheikh
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, African Unity St, Cairo, Egypt.
| | - Marwa Mohamad Wahsh
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, African Unity St, Cairo, Egypt
| | - Ghada Abdelfattah Hussein
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, African Unity St, Cairo, Egypt
| |
Collapse
|
7
|
Bömicke W, Schwindling FS, Rammelsberg P, Rues S. Bond Strength of Milled and Printed Zirconia to 10-Methacryloyloxydecyl Dihydrogen Phosphate (10-MDP) Resin Cement as a Function of Ceramic Conditioning, Disinfection and Ageing. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2159. [PMID: 38730965 PMCID: PMC11085335 DOI: 10.3390/ma17092159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024]
Abstract
This study aimed to assess the suitability of printed zirconia (ZrO2) for adhesive cementation compared to milled ZrO2. Surface conditioning protocols and disinfection effects on bond strength were also investigated. ZrO2 discs (n = 14/group) underwent either alumina (Al2O3) airborne particle abrasion (APA; 50 µm, 0.10 MPa) or tribochemical silicatisation (TSC; 110 µm Al2O3, 0.28 MPa and 110 µm silica-modified Al2O3, 0.28 MPa), followed by disinfection (1 min immersion in 70% isopropanol, 15 s water spray, 10 s drying with oil-free air) for half of the discs. A resin cement containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) was used for bonding (for TSC specimens after application of a primer containing silane and 10-MDP). Tensile bond strength was measured after storage for 24 h at 100% relative humidity or after 30 days in water, including 7500 thermocycles. Surface conditioning significantly affected bond strength, with higher values for TSC specimens. Ageing and the interaction of conditioning, disinfection and ageing also impacted bond strength. Disinfection combined with APA mitigated ageing-related bond strength decrease but exacerbated it for TSC specimens. Despite these effects, high bond strengths were maintained even after disinfection and ageing. Adhesive cementation of printed ZrO2 restorations exhibited comparable bond strengths to milled ZrO2, highlighting its feasibility in clinical applications.
Collapse
Affiliation(s)
- Wolfgang Bömicke
- Department of Prosthetic Dentistry, University of Heidelberg, 69120 Heidelberg, Germany; (P.R.); (S.R.)
| | | | - Peter Rammelsberg
- Department of Prosthetic Dentistry, University of Heidelberg, 69120 Heidelberg, Germany; (P.R.); (S.R.)
| | - Stefan Rues
- Department of Prosthetic Dentistry, University of Heidelberg, 69120 Heidelberg, Germany; (P.R.); (S.R.)
| |
Collapse
|
8
|
Ellithy MS, Abdelrahman MH, Afifi RR. Comparative clinical evaluation between self-adhesive and conventional bulk-fill composites in class II cavities: A 1-year randomized controlled clinical study. J ESTHET RESTOR DENT 2024. [PMID: 38655672 DOI: 10.1111/jerd.13242] [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: 02/22/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This randomized controlled clinical trial compared the clinical efficacy of self-adhesive bulk-fill Surefil One with a traditional bulk-fill composite in class II restorations. MATERIALS AND METHODS Sixty-four direct class II composite restorations were categorized into two groups. Group I, control group (n = 32): cavities were restored by Filtek One bulk-fill composite with Scotchbond Universal (SBU) adhesive in self-etch mode, Group II, test group (n = 32): cavities were restored by Surefil One self-adhesive bulk-fill composite. The study involved a follow-up period of 1 year, during which restorations were assessed at baseline (BL), 6 months, and 12 months using Federation Dentaire Internationale (FDI) criteria. Data analysis was performed using nonparametric tests. A comparison of restoration characteristics was performed utilizing the chi-square test (X2). The significance level was set at 0.05. RESULTS Filtek One and Surefil One bulk-fill composites revealed clinically acceptable FDI scores over 12-month recalls. Thirty-two patients (64 restorations) were available for all follow-up visits; 100% of the restorations survived. For esthetic properties, Filtek One was far better than Surefil One at all time points. However, in terms of functional and biological properties, both restorations demonstrated comparable performances. CONCLUSIONS Filtek One bulk-fill restorations were superior in terms of surface luster, surface staining, color match, and translucency, but Surefil One restorations performed well and were similar to Filtek One restorations; however, additional advancements and research are needed to obtain better esthetics. Furthermore, longitudinal studies with extended follow-up periods are needed to assess the clinical potential of both materials. CLINICAL SIGNIFICANCE Both Filtek One and Surefil One met the FDI criteria, with Filtek One demonstrating superior esthetic and functional qualities and similar performance regarding biological criteria. Both innovative restorative materials show potential for clinical use. Trial registered on ClinicalTrials.gov under registration number; NCT06120868:07/11/2023.
Collapse
Affiliation(s)
- Mohamed S Ellithy
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed H Abdelrahman
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania R Afifi
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| |
Collapse
|
9
|
Alqutaibi AY, Alghauli MA, Almuzaini SA, Alharbi AF, Alsani AA, Mubarak AM, Alhajj MN. Failure and complication rates of different materials, designs, and bonding techniques of ceramic cantilever resin-bonded fixed dental prostheses for restoring missing anterior teeth: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2024. [PMID: 38623053 DOI: 10.1111/jerd.13238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES The objective of this review was to assess clinical trials that have examined the materials, design, and bonding of ceramic cantilevered resin-bonded fixed dental prostheses (RBFDPs) as a potential option for replacing missing anterior teeth. The evaluation primarily focuses on the rate of restoration failure and clinical complications. MATERIALS AND METHODS A thorough search of databases including PubMed/MEDLINE, Scopus, and the Cochrane Library, was conducted. The most recent search was performed in October 2023. Clinical studies that compared ceramic cantilevered RBFDPs with double retainers or cantilevered RBFDPs using different ceramic materials or bonding systems were included. The outcome measures considered were restoration failure and complication rates. RESULTS Twelve studies met the eligibility criteria. The pooled data showed a statistically significant decrease in complication events when using cantilever designs compared with double retainer designs (p < 0.05); however, there were no differences found between the two designs in terms of restoration failure. The complication and failure rate of cantilever RBFDPs did not show a statistically significant difference with or without ceramic primer application before luting with phosphate monomer-containing luting resin (p > 0.05). CONCLUSIONS Ceramic cantilevered RBFDPs have lower complication rates compared with those with double retainers. The use of a ceramic primer prior to luting composite resin for ceramic cantilevered RBFDPs decreases the occurrence of complications and failures, although this effect was not statistically significant. Additional research is required to confirm these findings. Glass ceramic cantilever RBFDPs showed a decrease in success after 6 years, requiring ongoing monitoring, but both zirconia and glass-infiltrated alumina cantilever RBFDPs have demonstrated durability with excellent long-term success and survival rates for up to 10 and 15 years. CLINICAL SIGNIFICANCE Cantilever ceramic RBFDPs in the anterior region are a less invasive and valuable treatment option, providing good esthetic results.
Collapse
Affiliation(s)
- Ahmed Yaseen Alqutaibi
- Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
- Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | | | | | | | | | - Arwa M Mubarak
- College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
| | | |
Collapse
|
10
|
Gseibat M, Sevilla P, Lopez-Suarez C, Rodriguez V, Pelaez J, Suarez MJ. Performance of posterior third-generation monolithic zirconia crowns in a complete digital workflow: A three-year prospective clinical study. J Dent Sci 2024; 19:871-877. [PMID: 38618120 PMCID: PMC11010711 DOI: 10.1016/j.jds.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/20/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Translucent monolithic zirconia restorations have recently introduced. The purpose of this study was to evaluate the clinical behavior and the survival rate of the posterior third-generation monolithic zirconia crowns (MZCs) during three years of clinical service. Materials and methods Twenty-four patients who needed thirty crowns were enrolled in this study. Digital impressions were made, and the crowns were milled and cemented with a resin cement. The crowns outcomes were assessed using the California Dental Association's (CDA) criteria. Gingival index (GI), plaque index (PI), and periodontal probing depth (PPD) for MZCs and contralateral natural teeth (control) were assessed. Margin index (MI) for MZCs was also assessed. Data analysis was conducted using the Wilcoxon signed-rank and the Friedman tests. Results The 3-year survival rate was 100%. All MZCs were rated as satisfactory throughout the follow-up period, and no biological or mechanical complications were observed. No differences were recorded when GI, PI and PPD at 3-year of follow-up were compared to baseline. No differences were recorded between crowned and control teeth. The MI remained stable throughout the study period. Conclusion The third-generation monolithic zirconia appears to be a good treatment option for the rehabilitation of posterior single teeth.
Collapse
Affiliation(s)
- Mustafa Gseibat
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Pablo Sevilla
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Carlos Lopez-Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Veronica Rodriguez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Jesus Pelaez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Maria J. Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| |
Collapse
|
11
|
Takamizawa T, Aoki R, Hayashi K, Shoji M, Kasahara Y, Barkmeier WW, Latta MA, Kamimoto A, Miyazaki M. Scanning electron microscopy observation of dentin bond interfaces in different types of resin luting cements. Dent Mater J 2024; 43:179-190. [PMID: 38246629 DOI: 10.4012/dmj.2023-219] [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] [Indexed: 01/23/2024]
Abstract
This study aimed to observe and compare the resin luting cement (RLC)/dentin interfaces of different types of RLC systems with scanning electron microscopy (SEM). This study evaluated six self-adhesive resin luting cement systems (SARLCs), four systems combining a SARLC with a tooth primer (SARLCPs), and six conventional resin luting cement systems (CVRLCs). Cured resin composite rods were bonded to bovine dentin using RLCs in different etching modes. The morphological features at the interfaces were observed using SEM. Although all RLCs in etch-&-rinse (ER) mode showed a clear hybrid layer, most SARLCs had a thinner and more porous hybrid layer than the SARLCPs and CVRLCs. All SARLCPs with primer and CVRLCs showed a thin high-density layer below the primer layer in both etching modes. CVRLCs and SARLCPs with primer treatment systems may be more versatile and reliable when compared to simplified RLC systems.
Collapse
Affiliation(s)
| | - Ryota Aoki
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Kana Hayashi
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Mone Shoji
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Yuta Kasahara
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Wayne W Barkmeier
- Department of General Dentistry, Creighton University School of Dentistry
| | - Mark A Latta
- Department of General Dentistry, Creighton University School of Dentistry
| | - Atsushi Kamimoto
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry
| | - Masashi Miyazaki
- Department of Operative Dentistry, Nihon University School of Dentistry
| |
Collapse
|
12
|
Badr Z, Hamdan M, Han S, Sulaiman T. Effect of surface finish and resin cement on the bond strength to CAD-CAM ceramics for interim resin-bonded prostheses. J Prosthet Dent 2024; 131:458.e1-458.e7. [PMID: 38182455 DOI: 10.1016/j.prosdent.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024]
Abstract
STATEMENT OF PROBLEM Resin-bonded prostheses, including interim resin-bonded prostheses, are effective in preserving tooth structure compared with other types of fixed dental prostheses for the replacement of missing teeth. However, loss of retention remains a notable concern with these types of prostheses. PURPOSE The purpose of this in vitro study was to investigate the influence of glass-ceramic type, resin type, and surface finish on the shear bond strength (SBS) to the CAD-CAM ceramics used to fabricate interim resin-bonded prostheses. MATERIAL AND METHODS Eighty 10×2-mm glass-ceramic disks were fabricated by using a diamond saw (IsoMet 1000), 40 from feldspathic porcelain blocks (Vita Mark II) and 40 from lithium disilicate blocks (IPS e.max CAD). Half of the specimens in each group were left with a dull or matte surface finish after cutting, while the other half were glazed with an add-on glaze (VitaAkzento Plus Glaze Spray and IPS e.max CAD Glaze Spray, respectively). The disks were mounted in acrylic resin, and each group was subdivided into 2, with 1 receiving a photopolymerized resin cement (RelyX Veneer) and the other receiving a flowable composite resin (Filtek Supreme Ultimate Flow) to form 2.38×2-mm cylinders. SBS was determined using a universal testing machine (Instron 4411) in accordance with the International Organization for Standardization (ISO) 29022:2013 standard, and failure modes were analyzed by using a stereomicroscope with ×40 magnification. The data were analyzed with a 3-way analysis of variance and Tukey post hoc analysis. The chi-squared test was used to analyze the failure mode (α=.05 for all tests). RESULTS Ceramic type, resin type, and surface finish significantly impacted SBS (P<.001, P=.003, P<.001, respectively). Lithium disilicate showed higher SBS than feldspathic porcelain, and flowable composite resin exhibited higher SBS than resin cement. Glazed surfaces displayed lower SBS compared with the dull or matte surfaces. The combinations among the 3 materials also impacted SBS (P=.03). In addition, the combinations between ceramic type and surface finish affected SBS (P<.001), regardless of resin cement type. No other combinations affected the SBS (P>.05). The mode of failure was different among the groups (P<.001). In comparison with all other groups, cohesive failures were most prevalent in feldspathic porcelain with a dull or matte surface finish, regardless of the resin type used. CONCLUSIONS The SBS to glass-ceramics was influenced by ceramic material, resin cement type, and surface finish. Flowable composite resin showed higher SBS than resin cement. A dull or matte surface finish exhibited greater bond strength than a glazed surface. Lithium disilicate had higher SBS than feldspathic porcelain.
Collapse
Affiliation(s)
- Zaid Badr
- Clinical Assistant Professor and Director, Technological Innovation Center, Department of General Dental Sciences, School of Dentistry, Marquette University, Milwaukee, Wis
| | - Manal Hamdan
- Assistant Professor and Predoctoral Director, Oral and Maxillofacial Radiology, Department of General Dental Sciences, School of Dentistry, Marquette University, Milwaukee, Wis
| | - Shengtong Han
- Assistant Professor, Biostatistics, Dean's Office, School of Dentistry, Marquette University, Milwaukee, Wis
| | - Taiseer Sulaiman
- Associate Professor, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| |
Collapse
|
13
|
Brunetto JL, Pesqueira AA, do Vale-Souza JP, Piacenza LT, Dos Santos DM, Goiato MC. Comparison of self-etching and conventional bifunctional coupling agent in lithium disilicate ceramic: A systematic review and meta-analysis. J Clin Exp Dent 2024; 16:e367-e376. [PMID: 38600931 PMCID: PMC11003285 DOI: 10.4317/jced.61369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/05/2024] [Indexed: 04/12/2024] Open
Abstract
Background The aim of this systematic review is to determine the effectiveness of self-etching primers in comparison to the conventional protocol with hydrofluoric acid and silane treatment for bonding lithium disilicate ceramics. Material and Methods The formulated PICO question for this research was: "Does self-etching silane primer surface treatment in lithium disilicate ceramics present a similar bond strength value compared to conventional hydrofluoric acid and silane treatment?". Combinations of words and appropriate truncations were adapted for each database. For the selection, duplicate articles were systematically eliminated using Mendeley software. The Cohen's Kappa statistic was then computed, RoBDEMAT questions were addressed, and the meta-analyses were conducted using RevMan 5.4, at a significance level of 5%. Results Two independent reviewers conducted a blind and independent analysis of 190219 articles from PubMed, Scopus, Web of Science, and OpenGrey. Subsequently, they extracted data from 21 studies for the systematic review and in 16 the meta-analysis. In all in vitro studies, the most frequently cited concentration of hydrofluoric acid was 5%. In the meta-analysis, no statistical differences were observed between the two treatments concerning bond strength. Conclusions Self-etching silane primers demonstrate promising results in lithium disilicate bonding, suggesting their potential as an alternative surface treatment to hydrofluoric acids + silane. Key words:Lithium disilicate, Hydrofluoric acid, Dental Porcelain, Ceramics, Silanes.
Collapse
Affiliation(s)
- Juliana-Lujan Brunetto
- DDS,MSc, PhD student at the Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Aldiéris-Alves Pesqueira
- Profesor at the Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - João-Paulo do Vale-Souza
- DDS,MSc, PhD student at the Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Lucas-Tavares Piacenza
- DDS,MSc, PhD student at the Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Daniela-Micheline Dos Santos
- Profesor at the Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Marcelo-Coelho Goiato
- Associate Profesor at the Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University, Araçatuba, São Paulo, Brazil
| |
Collapse
|
14
|
da Rosa LS, Pilecco RO, Soares PM, Rippe MP, Pereira GKR, Valandro LF, Kleverlaan CJ, Feilzer AJ, Tribst JPM. Repair protocols for indirect monolithic restorations: a literature review. PeerJ 2024; 12:e16942. [PMID: 38406292 PMCID: PMC10893862 DOI: 10.7717/peerj.16942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Despite the advancements in indirect monolithic restorations, technical complications may occur during function. To overcome this issues, intraoral repair using resin composite is a practical and low-cost procedure, being able to increase the restoration's longevity. This review aimed to evaluate the need for repair and suggest a standardized repair protocol to the main indirect restorative materials. For this, studies were surveyed from PubMed with no language or date restriction, to investigate the scientific evidence of indirect monolithic restoration repair with direct resin composite. A classification to guide clinical decisions was made based on the FDI World Dental Federation criteria about defective indirect restorations considering esthetic and functional standards, along with the patient's view, to decide when polishing, repairing or replacing a defective restoration. Based on 38 surveyed studies, different resin composite intraoral repair protocols, that included mechanical and chemical aspects, were defined depending on the substrate considering resin-based, glass-ceramic or zirconia restorations. The presented criteria and protocols were developed to guide the clinician's decision-making process regarding defective indirect monolithic restorations, prolonging longevity and increasing clinical success.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Cornelis Johannes Kleverlaan
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - Albert J. Feilzer
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - João Paulo Mendes Tribst
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| |
Collapse
|
15
|
Benalcazar Jalkh EB, Ramalho IS, Bergamo ETP, Alves LMM, Tanaka R, Witek L, Coelho PG, Hirata R, Bonfante EA. Ultrathin lithium disilicate and translucent zirconia crowns for posterior teeth: Survival and failure modes. J ESTHET RESTOR DENT 2024; 36:381-390. [PMID: 37676053 DOI: 10.1111/jerd.13127] [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: 05/17/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE To evaluate the reliability and failure modes of ultrathin (0.5 mm) lithium disilicate, translucent and ultra-translucent zirconia crowns for posterior teeth restorations. MATERIALS AND METHODS Fifty-four mandibular first molar crowns of three ceramic materials: (1) Lithium disilicate (e.max CAD, Ivoclar Vivadent), (2) 3Y-TZP (Zirconn Translucent, Vipi), and (3) 5Y-PSZ (Cercon XT, Dentsply Sirona), with 0.5 mm of thickness were milled and cemented onto composite resin abutments. Eighteen samples of each group were tested under mouth-motion step-stress accelerated life testing in a humid environment using mild, moderate, and aggressive profiles. Data was subjected to Weibull statistics. Use level curves were plotted and reliability was calculated for a given mission of 100,000 cycles at 100, 200, and 300 N. Fractographic analyses of representative samples were performed in scanning electron microscope. RESULTS Beta (β) values suggest that failures were dictated by material's strength for lithium disilicate and by fatigue damage accumulation for both zirconias. No significant differences were detected in Weibull modulus and characteristic strength among groups. At a given mission of 100,000 cycles at 100 N, lithium disilicate presented higher reliability (98% CB: 95-99) regarding 3Y-TZP and 5Y-PSZ groups (84% CB: 65%-93% and 79% CB: 37&-94%, respectively). At 200 N, lithium disilicate reliability (82% CB: 66%-91%) was higher than 5Y-PSZ (20% CB: 4%-44%) and not significantly different from 3Y-TZP (54% CB: 32%-72%). Furthermore, at 300 N no significant differences in reliability were detected among groups, with a notable reduction in the reliability of all materials. Fractographic analyses showed that crack initiated at the interface between the composite core and the ceramic crowns due to tensile stress generated at the intaglio surface. CONCLUSIONS Ultrathin lithium disilicate crowns demonstrated higher reliability relative to zirconia crowns at functional loads. Lithium disilicate and zirconia crown's reliability decreased significantly for missions at higher loads and similar failure modes were observed regardless of crown material. The indication of 0.5 mm thickness crowns in high-load bearing regions must be carefully evaluated. CLINICAL SIGNIFICANCE Ultraconservative lithium disilicate and zirconia crowns of 0.5 mm thickness may be indicated in anterior restorations and pre-molars. Their clinical indication in high-load requirement regions must be carefully evaluated.
Collapse
Affiliation(s)
- Ernesto B Benalcazar Jalkh
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Ilana S Ramalho
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Biomaterials Division, New York University College of Dentistry, New York, New York, USA
- Department of Prosthodontics, New York University College of Dentistry, New York, New York, USA
| | - Larissa M M Alves
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Lukasz Witek
- Biomaterials Division, New York University College of Dentistry, New York, New York, USA
- Department of Biomedical Engineering, New York Univeristy Tandon School of Engineering, Brooklyn, New York, USA
| | - Paulo G Coelho
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ronaldo Hirata
- Biomaterials Division, New York University College of Dentistry, New York, New York, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| |
Collapse
|
16
|
Tatiana R, Bérangère C, Prudence Felix T, Arnaud E, Fabio L, Jean R, Romain C, Hamdi J, Olivier E. Shear bond strength between standard or modified zirconia surfaces and two resin cements incorporating or not 10-MDP in their matrix. Dent Mater 2024; 40:370-378. [PMID: 38151431 DOI: 10.1016/j.dental.2023.12.015] [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: 05/29/2023] [Accepted: 12/19/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE This study aimed first to compare the shear bond strength between zirconia samples luted to enamel with a 10-MDP- containing resin cement (Panavia F2.0, Kuraray, Japan) and those luted with a resin cement using a separated 10-MDP monomer-containing bottle (Panavia V5, Kuraray, Japan). The second objective was to evaluate the bond stability after 150 days of aging in water, between enamel and zirconia ceramic surface enhanced with a glass-ceramic coating. MATERIALS AND METHODS 80 specimens composed of ceramic cylinders and enamel disks were obtained, within eight experimental groups (n = 10). 60 zirconia cylinders (Katana STML zirconia, Kuraray, Japan) were assigned to 3 groups according to their surface treatment: milled/sintered surface (ZRCT), tribochemical silica-coating (Cojet™ Sand, 3 M ESPE, Seefeld, Germany) (ZRTC), and glass-ceramic coating (IPS e.max Zirpress) (ZRZP). 20 cylinders of lithium disilicate had a milled surface (IPS e.max CAD, Ivoclar-Vivadent, Schaan, Liechtenstein) (ECAD). The cylinders of each group were further divided into two subgroups according to the resin cement used: Panavia F2.0 (-PF) and Panavia V5 (-PV). All specimens were stored in distilled water for 150 days before shear bond strength (SBS) tests. The fracture mode was analyzed, and data were statistically computed (two-way ANOVA, post hoc Tukey test, p < 0.05, SPSS, IBM, v26). RESULTS The ECAD-PF group recorded the highest SBS values (31.75 ± 2.2), and the ZRCT-PF group recorded the lowest values (5.59 ± 1.1). The two-way ANOVA test showed that ceramic surface treatment had a statistically significant effect on SBS (F (3,72) = 38.95, p < 0.001) while the type of ARC did not (F (1,72) = 2.40, p = 0.126). Tukey's post hoc test revealed no statistical difference between the ZRZP and the ZRTC or ECAD groups. CONCLUSION Within the limitations of this study, the PV resin achieved similar shear bond strength results between tribocoated zirconia and enamel compared to the one for glass-ceramic and enamel. Furthermore, a long-term durable bond, similar to the glass-ceramic one, was achieved with the heat pressed ceramic coated specimens. Thus, this new surface treatment could be recommended for anterior cantilever bridges for its fracture resistance and bonding ability.
Collapse
Affiliation(s)
- Roman Tatiana
- DDS, Dental School of Medicine, University of Strasbourg, France; Inserm U1121, Strasbourg, France
| | - Cournault Bérangère
- DDS, Dental School of Medicine, University of Strasbourg, France; Inserm U1121, Strasbourg, France
| | - Teyagirwa Prudence Felix
- DDS, Dental School of Medicine, University of Strasbourg, France; Inserm U1121, Strasbourg, France
| | - Erkel Arnaud
- DDS, Dental School of Medicine, University of Strasbourg, France
| | | | | | | | - Jmal Hamdi
- Icube Laboratory, UMR 7357, CNRS, Strasbourg, France
| | - Etienne Olivier
- DDS, Dental School of Medicine, University of Strasbourg, France; Inserm U1121, Strasbourg, France; Prosthodontics, University of Strasbourg, France.
| |
Collapse
|
17
|
Temp RW, Packaeser MG, Machry RV, Dapieve KS, Rippe MP, Pereira GKR, Valandro LF. Characteristic fatigue strength and reliability of dental glass-ceramics: Effect of distinct surface treatments - Hydrofluoric acid etching and silane treatment vs one-step self-etching ceramic primer. J Mech Behav Biomed Mater 2024; 150:106338. [PMID: 38159495 DOI: 10.1016/j.jmbbm.2023.106338] [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: 10/30/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
The aim of this study was to mechanically characterize through flexural fatigue test two CAD-CAM glass-ceramics according to distinct surface etching protocols. To do so, feldspathic (FELD) and lithium disilicate (LD) glass ceramics were subjected to different surface treatments: (1) control - no treatment (Ctrl); (2) conventional protocol etching with 5% hydrofluoric acid followed by silane coupling agent application (HF + SIL; Monobond N, Ivoclar); or (3) using a self-etching ceramic primer (E&P; Monobond Etch & Prime, Ivoclar). Ceramic discs (N = 120; Ø = 12 mm; thickness = 1.2 mm) were produced from CAD-CAM blocks, with 60 being from FELD (VITABLOCS Mark II, Vita Zahnfabrik) and 60 from LD (IPS e.max CAD, Ivoclar). Next, 20 disks of each ceramic were allocated into three groups: Ctrl, HF + SIL, or E&P. Surface roughness data were collected on all samples before and after surface treatments (except for Ctrl). Cyclic fatigue (n = 15) biaxial flexural strength tests were performed by the piston-on-three-balls geometry (ISO 6872) considering the test parameters established from a monotonic test (n = 5). The monotonic test was carried out at a 1 mm/min loading rate and 500 kgf loading cell until fracture to obtain the failure data. The cyclic fatigue test was executed underwater at a frequency up to 20 Hz, with the first stress being 25% of the monotonic test for 5000 cycles, followed by increments of 5% of the monotonic test at each step of 10,000 cycles until failure (fracture). Complementary fractography, topography and Atomic Force Microscopy (AFM) analyses were performed. Characteristic Fatigue Strength (CFS) and Weibull modulus were analyzed by Weibull analysis using the fatigue test data. Roughness and complementary analysis data were analyzed by one-way ANOVA. The statistical results exhibited similar CFS among Ctrl, HF + SIL and E&P for both glass-ceramics. The survival analysis corroborates the findings, however the Weibull modulus pointed out superior structural reliability of FELD treated with the E&P group compared to HF + SIL. According to the complementary analyses, HF + SIL exhibited a higher surface area than E&P and Ctrl for FELD (p = 0.001). Roughness showed statistically significant differences among conditions for FELD (E&P < Ctrl = HF + SIL; p < 0.05) and no difference for LD (p > 0.05). Therefore, the CFS were not influenced by any condition evaluated for FELD and LD glass-ceramics; however, superior structural reliability (higher Weibull modulus) for the feldspathic ceramic treated with the E&P was observed.
Collapse
Affiliation(s)
- Renatta Wrasse Temp
- Post-Graduate Program in Oral Sciences (Prosthodontic Unit), Faculty of Odontology, Center for Development of Advanced Materials, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Maria Gabriela Packaeser
- Post-Graduate Program in Oral Sciences (Prosthodontic Unit), Faculty of Odontology, Center for Development of Advanced Materials, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Renan Vaz Machry
- Post-Graduate Program in Oral Sciences (Prosthodontic Unit), Faculty of Odontology, Center for Development of Advanced Materials, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Kiara Serafini Dapieve
- Post-Graduate Program in Oral Sciences (Prosthodontic Unit), Faculty of Odontology, Center for Development of Advanced Materials, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Marilia Pivetta Rippe
- Post-Graduate Program in Oral Sciences (Prosthodontic Unit), Faculty of Odontology, Center for Development of Advanced Materials, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences (Prosthodontic Unit), Faculty of Odontology, Center for Development of Advanced Materials, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences (Prosthodontic Unit), Faculty of Odontology, Center for Development of Advanced Materials, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| |
Collapse
|
18
|
Aoki R, Takamizawa T, Hayashi K, Arai Y, Ishii R, Shoji M, Kamimoto A, Miyazaki M. Influence of different curing modes on the bonding effectiveness of self-adhesive resin luting cements in combination with universal adhesives. Dent Mater 2024; 40:379-385. [PMID: 38176997 DOI: 10.1016/j.dental.2023.12.016] [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: 01/12/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES This study aimed to investigate the immediate dentin bond performance and bond durability of self-adhesive resin luting cements (RLCs) in combination with universal adhesives in different curing modes. METHODS Two self-adhesive RLCs were used with universal adhesives as primers. They were also used alone as self-adhesive RLCs. Two multiple-step RLC systems were used as comparison materials. To measure the shear bond strength (SBS) in different curing modes, 12 specimens were prepared for each group. Stainless-steel rods were bonded to bovine dentin, and the bonded specimens were assigned to the baseline group (stored for 24 h) and artificially aged group (thermal cycling [TC], 10,000 cycles). After each storage period, the SBS of the bonded specimens was measured. The Knoop hardness number (KHN) of the cured RLCs was measured with or without primer application in different curing modes at 24 h and after 10,000 TC. The representative RLC/dentin interfaces were observed using scanning electron microscopy (SEM). RESULTS Dentin SBS was significantly influenced by the RLC system but not by the curing mode. Self-adhesive RLCs alone showed significantly lower SBS values than self-adhesive RLCs with primer regardless of the curing mode or storage period. The storage period, curing mode, and RLC system significantly influenced the KHN. SIGNIFICANCE The use of universal adhesives as a primer may help enhance the immediate dentin bond performance and bond durability of self-adhesive RLCs.
Collapse
Affiliation(s)
- Ryota Aoki
- Department of Operative Dentistry, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Toshiki Takamizawa
- Department of Operative Dentistry, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan.
| | - Kana Hayashi
- Department of Operative Dentistry, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Yuiko Arai
- Department of Operative Dentistry, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Ryo Ishii
- Department of Operative Dentistry, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Mone Shoji
- Department of Operative Dentistry, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Atsushi Kamimoto
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Masashi Miyazaki
- Department of Operative Dentistry, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| |
Collapse
|
19
|
Ahmed WM, Azhari AA, Sedayo L, Alhaid A, Alhandar R, Almalki A, Jahlan A, Almutairi A, Kheder W. Mapping the Landscape of the Digital Workflow of Esthetic Veneers from Design to Cementation: A Systematic Review. Dent J (Basel) 2024; 12:28. [PMID: 38392232 PMCID: PMC10888163 DOI: 10.3390/dj12020028] [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: 11/02/2023] [Revised: 12/27/2023] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
The purpose of this systematic review was to map all the existing literature on digitally designed and fabricated esthetic veneers. We aimed to compare the accuracy of digitally designed preparation and cementation guides for esthetic indirect veneers with the conventional workflow. We evaluated studies comparing the accuracy and predictability of workflows between digitally fabricated indirect-esthetic veneers and conventional indirect veneers. Searches were performed in August 2023 across three databases, specifically Google Scholar, Cochrane, and PubMed, and were restricted to English-language publications. The search strategy was based on the PICO criteria. Reference lists of identified articles were manually checked to find further pertinent studies that were not discovered during the electronic search. The titles and abstracts were reviewed in the first stage, and then the full article texts were reviewed and cross-matched against the predetermined inclusion criteria. Following the search, 169 articles were identified: 41 from Google Scholar, 44 from Cochrane, and 71 from PubMed, with 13 added manually. Of these, 20 were chosen for a detailed quality assessment of the digital veneer workflow and the accuracy of digital preparations and cementation guides for laminate veneers. Based on our findings, the digitally fabricated laminate-veneer workflow demonstrated superior predictability and accuracy compared to the conventional workflow.
Collapse
Affiliation(s)
- Walaa Magdy Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah P.O. Box 80213, Saudi Arabia
| | - Amr Ahmed Azhari
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah P.O. Box 80213, Saudi Arabia
| | - Lamer Sedayo
- Faculty of Dental Medicine, Umm Al-Qura University, Makkah P.O. Box 16786, Saudi Arabia
| | - Alanod Alhaid
- Dental Department, King Khalid University, Asir P.O. Box 61421, Saudi Arabia
| | - Reem Alhandar
- Dental Department, Vision College, Riyadh P.O. Box 13226, Saudi Arabia
| | - Amirah Almalki
- Dental Department, Specialized Dental Complex, Jeddah P.O. Box 21444, Saudi Arabia
| | - Aishah Jahlan
- Department of Restorative Dentistry, Suliman Al-Habib Hospital, Riyadh P.O. Box 301578, Saudi Arabia
| | - Afnan Almutairi
- Department of Restorative Dentistry, Suliman Al-Habib Hospital, Riyadh P.O. Box 301578, Saudi Arabia
| | - Waad Kheder
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| |
Collapse
|
20
|
Abbas MH, Elerian FA, Elsherbiny AA, Elgohary NMM, Atout A. Influence of occlusal reduction design on the fracture resistance and biomechanical behavior of endocrowns restoring maxillary premolars. BMC Oral Health 2024; 24:113. [PMID: 38243249 PMCID: PMC10799380 DOI: 10.1186/s12903-023-03688-3] [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: 08/22/2023] [Accepted: 11/21/2023] [Indexed: 01/21/2024] Open
Abstract
PURPOSE To investigate the effect of different occlusal reduction design on stress distribution and fracture resistance of different endocrown systems. MATERIAL AND METHODS Sixty-four maxillary human premolars with endodontic treatment, prepared for endocrowns were divided into 2 groups (n = 32) according to the occlusal design: Butt joint preparation (B group) and Anatomical preparation (A group). Each group were subdivided into four groups according to ceramic systems: IPS E max CAD (EM group), monolithic zirconia (ZR group), Nacera Hyprid (NH group) and PEKKTON (PE group). After manufacturing of endocrowns and adhesive bonding the specimens were thermomechanically loaded and subsequently they were tested in a universal testing machine for evaluating the fracture resistance. The specimens failure mode was qualitatively assessed. The stress distribution in each group was assessed using three-dimensional finite element analysis (FEA). 1-way ANOVA and the Post Hoc Tukey HSD test were used to evaluate the data (a = .05). RESULTS The fracture resistance values between the groups showed statistically significant variations. The B PE and A PE groups had a higher ratio of fracture resistance values. Regarding failure mode, ceramic endocrowns recorded mainly irreparable failures. FEA showed that anatomical occlusal preparation have reduced the stress concentration under all endocrown systems. CONCLUSION Endocrowns could be used to restore endodontically treated maxillary premolars. PEKKTON endocrowns with anatomical preparations revealed most appropriate restoration. The tested new endocrown systems enhanced the biomechanical performance of the tooth. CLINICAL SIGNIFICANCE The innovative endocrown systems (PEKK, Nacera Hyprid) can be seen as a promising choice for restoration of severely-destructed endodontic treated premolars, with less stress transmit to the residual tooth structure. Although the traditional endocrown technology might increase the longevity of tooth bonding, it shouldn't be used for clenching cases since the risk of failure is too great overall.
Collapse
Affiliation(s)
- Mahy Hassouna Abbas
- Fixed Prosthodontics Dept, Faculty of Dentistry, Mansoura University and Delta University for Science and Technology, Mansoura, Egypt.
| | - Fatma Abdallah Elerian
- Department of Mechanical Engineering, College of Engineering, University of Bisha, P.O. Box 001, Bisha, 67714, Saudi Arabia
- Mansoura University, Mansoura, Egypt
| | - Abdallah Ahmed Elsherbiny
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | | | - Abeer Atout
- Department of prosthetic dental sciences , College of Dentistry, Jazan University, KSA and Fixed Prosthodontics Dept, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| |
Collapse
|
21
|
Pontevedra P, Lopez-Suarez C, Rodriguez V, Tobar C, Pelaez J, Suarez MJ. Digital workflow for monolithic and veneered zirconia and metal-ceramic posterior fixed partial dentures: A five-year prospective randomized clinical trial. J Prosthodont Res 2024; 68:78-84. [PMID: 36990752 DOI: 10.2186/jpr.jpr_d_22_00237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Purpose To evaluate and compare the survival, success rates, and biological and technical complications of three-unit posterior monolithic and veneered zirconia and metal-ceramic (MC) posterior fixed partial dentures (FPDs) fabricated using a digital workflow and computer-aided design and computer-aided manufacturing (CAD/CAM) over a 5-year follow-up.Methods Ninety patients in need of three-unit posterior FPDs were randomized to receive monolithic zirconia (MZ), veneered zirconia (VZ), and MC restorations (n = 30 each). Teeth preparations were scanned using an intraoral scanner, and restorations were milled and cemented with resin cement. Clinical performance and periodontal parameters were assessed at baseline and yearly up to 5 years after insertion. Data analysis was performed using the Kaplan-Meier method, Friedman test, and Wilcoxon signed-rank test with Bonferroni correction and Mann-Whitney U test.Results The 5-year survival rates of the MZ, VZ, and MC FPDs were 87%, 97%, and 100%, respectively (P = 0.04). Most complications were biological in nature. Only one MZ FPD fractured 58 months after placement. All the restorations were assessed as satisfactory at each recall. Differences were found in the gingival index score over time in the VZ and MC groups. The margin index remained stable throughout the follow-up period in both zirconia groups.Conclusions The results of this study suggest that using a digital workflow to fabricate posterior FPDs is an adequate treatment option and that monolithic zirconia could be a viable alternative to metal-ceramic or veneered zirconia. However, further long-term studies are necessary to provide stronger evidence in patients with bruxism.
Collapse
Affiliation(s)
- Paula Pontevedra
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Carlos Lopez-Suarez
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Veronica Rodriguez
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Celia Tobar
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Jesus Pelaez
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Maria J Suarez
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| |
Collapse
|
22
|
Bömicke W, Boisserée P, Rammelsberg P, Rues S. Initial damage and failure load of zirconia-ceramic and metal-ceramic posterior cantilever fixed partial dentures. Clin Oral Investig 2024; 28:94. [PMID: 38221600 PMCID: PMC10788321 DOI: 10.1007/s00784-024-05501-z] [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: 10/16/2023] [Accepted: 01/07/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVES The aim of this study was to compare failure load and initial damage in monolithic, partially veneered, and completely veneered (translucent) zirconia cantilevered fixed partial dentures (CFPDs), as well as completely veneered metal-ceramic CFPDs under different support and loading configurations. MATERIALS AND METHODS Eight test groups with anatomically congruent CFPDs (n = 8/group) were fabricated, differing in CFPD material/support structure/loading direction (load applied via steel ball (Ø 6 mm) 3 mm from the distal end of the pontic for axial loading with a 2-point contact on the inner cusp ridges of the buccal and oral cusps and 1.3 mm below the oral cusp tip for 30° oblique loading): (1) monolithic zirconia/CoCr abutment teeth/axial, (2) monolithic zirconia/CoCr abutment teeth/oblique, (3) partially veneered zirconia/CoCr abutment teeth/axial, (4) partially veneered zirconia/CoCr abutment teeth/oblique, (5) completely veneered zirconia/CoCr abutment teeth/axial, (6) completely veneered CoCr/CoCr abutment teeth/axial (control group), (7) partially veneered zirconia/implants/axial, and (8) partially veneered zirconia/natural teeth/axial. Restorations were artificially aged before failure testing. Statistical analysis was conducted using one-way ANOVA and Tukey post hoc tests. RESULTS Mean failure loads ranged from 392 N (group 8) to 1181 N (group 1). Axially loaded monolithic zirconia CFPDs (group 1) and controls (group 6) showed significantly higher failure loads. Oblique loading significantly reduced failure loads for monolithic zirconia CFPDs (group 2). Initial damage was observed in all groups except monolithic zirconia groups, and fractography revealed design flaws (sharp edges at the occlusal boundary of the veneering window) in partially veneered zirconia CFPDs. CONCLUSIONS Monolithic zirconia CFPDs might be a viable alternative to completely veneered CoCr CFPDs in terms of fracture load. However, oblique loading of monolithic zirconia CFPDs should be avoided in clinical scenarios. Design improvements are required for partially veneered zirconia CFPDs to enhance their load-bearing capacity. CLINICAL RELEVANCE Monolithic zirconia may represent a viable all-ceramic alternative to the established metal-ceramic option for CFPD fabrication. However, in daily clinical practice, careful occlusal adjustment and regular monitoring should ensure that oblique loading of the cantilever is avoided.
Collapse
Affiliation(s)
- Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | | | - Peter Rammelsberg
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
23
|
Soares PM, da Rosa LS, Pilecco RO, Pereira GKR, Dal Piva AMDO, Tribst JPM, Valandro LF, Kleverlaan CJ, Rippe MP. Cyclic fatigue of a repaired 4 YSZ ceramic: Effect of the repair protocol on the adhesive and mechanical behavior. Heliyon 2024; 10:e23709. [PMID: 38187296 PMCID: PMC10767202 DOI: 10.1016/j.heliyon.2023.e23709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/17/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
Objective To evaluate the effect of different surface treatments on the morphology, shear bond, and flexural fatigue strength of a repaired translucent zirconia. Methods Monolithic disc-shaped specimens of translucent zirconia were prepared and ground to simulate repair areas. Four groups underwent different treatments: Air-MDP (air-abrasion with alumina particles and 10-MDP primer), Si-Sil (silica-coated alumina particles with MDP-containing silane), Si-MDP (silica coating with 10-MDP primer), and Uni adhe (universal adhesive). After roughness measurements and treatments, repairs were done using resin composite. Shear bond and flexural (n = 15) fatigue tests were performed. Surface topography, interfacial analysis, fractographic, and finite element analysis were conducted. Results The zirconia roughness was similar between the groups, however, the surface topography was modified according to the surface treatments. Si-Sil generated higher and more stable bond strength values (20.69 MPa) between translucent zirconia and resin composite when compared to Uni adhe (15.75 MPa) considering the fatigue bond strength scenario, while it was similar to Si-MDP (17.70 MPa) and Air-MDP (18.97 MPa). Regarding the mechanical behavior, Si-Sil (680.83 MPa) also showed higher and significantly different fatigue strength when compared to Uni adhe (584.55 MPa), while both were similar to Si-MDP (634.22 MPa) and Air-MDP (641.86 MPa). Conclusion The association of mechanical and chemical approaches is essential for long-term bond strength and optimized mechanical behavior, being air-abrasion protocols and the use of silane and/or MDP-based primers suitable for zirconia repair protocols. It was found that relying solely on a universal adhesive was not as effective as other options available. Clinical significance The surface treatment of repair protocols affects translucent zirconia's morphology. To enhance fatigue behavior in repaired monolithic zirconia, air abrasion is crucial. Exclusive use of a universal adhesive is less effective than other choices. A primer containing silane/MDP holds the potential for stable bond strength and optimized mechanical performance.
Collapse
Affiliation(s)
- Pablo Machado Soares
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - Marilia Pivetta Rippe
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| |
Collapse
|
24
|
Klotz AL, Halfmann J, Rues S, Bömicke W, Rammelsberg P, Zenthöfer A. Fracture Resistance of Posterior Tooth-Supported Cantilever Fixed Dental Prostheses of Different Zirconia Generations and Framework Thicknesses: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2024; 17:263. [PMID: 38204115 PMCID: PMC10779861 DOI: 10.3390/ma17010263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
The rehabilitation of free-end situations is a frequent indication in prosthetic dentistry. Cantilever fixed dental prostheses (cFDPs) made of 1st and 2nd generation zirconia are one treatment option. Due to a unique gradient technology, combinations of different zirconium dioxide generations are thus feasible in one restoration. However, data about these materials are rare. The purpose of this study was therefore to investigate the fracture resistance and fracture modes of tooth-supported cFDPs fabricated from different zirconia materials (gradient technology) and different framework thicknesses. A total of 40 cFDPs were fabricated using the CAD/CAM approach and belonged to five test groups. The different groups differed in the yttria content, the proportion of the tetragonal/cubic phases, or in wall thickness (0.7 mm or 1 mm). After completion, the cFDPs were subjected to thermal cycling and chewing simulation (1.2 × 106 load cycles, 108 N load). Afterwards, cFDPs were statically loaded until fracture in a universal testing machine. A non-parametric ANOVA was compiled to determine the possible effects of group membership on fracture resistance. In addition, post-hoc Tukey tests were used for bivariate comparisons. The mean fracture loads under axial load application ranged from 288 to 577 N. ANOVA detected a significant impact of the used material on the fracture resistances (p < 0.001). Therefore, the use of cFDPs fabricated by gradient technology zirconia may not be unreservedly recommended for clinical use, whereas cFPDs made from 3Y-TZP exhibit fracture resistance above possible masticatory loads in the posterior region.
Collapse
Affiliation(s)
- Anna-Luisa Klotz
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (J.H.); (S.R.); (W.B.); (P.R.); (A.Z.)
| | | | | | | | | | | |
Collapse
|
25
|
Alves LMM, Campos TMB, Bergamo ETP, Benalcazar Jalkh EB, Gierthmuehlen PC, Sailer I, Thim GP, Strazzi-Sahyon HB, Celestrino M, Guimarães CCL, Bonfante EA. Hydrofluoric acid concentration and etching time affect differently the microstructure and surface properties of pressed lithium disilicate glass ceramics. J ESTHET RESTOR DENT 2024; 36:47-55. [PMID: 37772362 DOI: 10.1111/jerd.13140] [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: 05/11/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE To evaluate the effect of different hydrofluoric acid concentrations and etching times on the surface, chemical composition and microstructure of lithium disilicate. MATERIAL AND METHODS Ninety specimens of pressed lithium disilicate (LDS) were obtained (IPS e.max Press, Rosetta SP and LiSi Press). The specimens of each material were divided in two groups according to the hydrofluoric acid concentration: 5% and 10% (n = 15/group), and subdivided according to the etching time: 20, 40 and 60 s (n = 5/group). Crystalline evaluations and chemical composition were performed through x-ray diffraction (XRD) and energy-dispersive x-ray spectroscopy (EDS), respectively. Microstructural analyses were performed by scanning electron microscope (SEM), surface roughness (Ra), and material thickness removal evaluation. Thickness removal and Ra data were analyzed by ANOVA and Tukey test (p < 0.05). RESULTS XRD demonstrated characteristic peaks of lithium disilicate crystals, lithium phosphate and of a vitreous phase for all materials. EDS identified different compositions and SEM confirmed different surface responses to acid etching protocols. Material and etching time influenced Ra and material thickness removal (p < 0.05). CONCLUSION Hydrofluoric acid concentration and etching time affect the surface characteristics of LDS differently. LiSi Press presented higher resistance to hydrofluoric acid etching compared to e.max Press and Rosetta SP. CLINICAL SIGNIFICANCE Applying the appropriate etching protocol is pivotal to avoid excessive material removal and to prevent jeopardize the mechanical and optical properties of the material.
Collapse
Affiliation(s)
- Larissa M M Alves
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Tiago M B Campos
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
- Biomaterials Division, New York University College of Dentistry, New York, New York, USA
| | - Ernesto B Benalcazar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Petra C Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Gilmar P Thim
- Department of Physics, Aeronautics Technological Institute, São José dos Campos, SP, Brazil
| | - Henrico B Strazzi-Sahyon
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | | | - Carolina C L Guimarães
- Department of Physics, Aeronautics Technological Institute, São José dos Campos, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| |
Collapse
|
26
|
Hammoudeh H, Carracho L, Beard C, Razzoog M. Effect of different surface and heat treatments on the surface roughness, crystallography, and phase composition of high translucency zirconia for monolithic restorations. J Prosthet Dent 2024; 131:164.e1-164.e11. [PMID: 37945513 DOI: 10.1016/j.prosdent.2023.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 11/12/2023]
Abstract
STATEMENT OF PROBLEM High translucency zirconia (HTZ) has gained popularity as an esthetic computer-aided design and computer-aided manufacturing (CAD-CAM) material for monolithic restorations. A detailed comparison between different common surface and heat treatments with a non-treated HTZ control to explain the behavior of the material under stress is lacking. PURPOSE The purpose of this in vitro study was to evaluate the effect of different surface and heat treatments on the surface roughness parameters (SRPs), topography, crystallography, and phase composition of HTZ used for monolithic restorations. MATERIAL AND METHODS Ninety Ø11.9×1.18-mm HTZ disks (Prettau Anterior) were milled, sintered, and distributed into 9 groups (n=10); 8 experimental (coarse diamond grinding GC, fine diamond grinding GF, fine diamond grinding and 3-step polishing kit GF+P1, fine diamond grinding and 3-step polishing kit and diamond paste GF+P1+DP, fine diamond grinding and 2-step polishing kit GF+P2, fine diamond grinding and GF+Gl, fine diamond grinding and 3-step polishing and glazing GF+P1+Gl, airborne-particle abrasion with 50-µm alumina), and a control group (C, as-sintered). SRPs (AveSa, AveSv, AveSz) and 3-dimensional (3D) images were obtained using a noncontact 3D-optic-profilometer. The crystal structure was determined with scanning electron microscopy. Phase composition was analyzed by X-ray diffraction (XRD). Surface roughness parameters data were statistically analyzed by 1-way ANOVA and the Tukey HSD test (α=.05). RESULTS The applied surface and heat treatment resulted in significantly different SRP mean values (P<.001) with different topographies. GC had the highest AveSa, AveSv, and AveSz mean values (0.95, 8.8, 17.4 µm, respectively) with significant microcracks. GF had significantly lower SRP with finer microcracks. GF+P1 had a significantly smoother surface, but GF+P2 resulted in SRP comparable with the GF group. GF+P1+DP had the smoothest homogenous surface (mean Sa: 0.08 µm). GF+P1 and GF+GL were equally effective, while GF+P1+GL was not superior. Airborne-particle abrasion produced a low Sa mean value (0.11 µm) with relatively high Sv and Sz mean values (5.9, 9.2 µm, respectively) and microcracks. A monoclinic phase was detected in all groups. All experimental groups had broadened XRD-peaks with lower intensity, suggesting the presence of the rhombohedral phase. CONCLUSIONS The different surface and heat treatments altered the HTZ crystals and their surface roughness with distinct topographies. Cubic crystal changes take place under stress as shown by the scanning electron microscope and the XRD diffraction pattern and may transform to the rhombohedral phase.
Collapse
Affiliation(s)
- Hanin Hammoudeh
- Assistant Professor, Restorative and Prosthodontics Department, The Ohio State University College of Dentistry, Columbus, Ohio; and Scholar, University of Jordan School of Dentistry, Amman, Jordan.
| | - Luis Carracho
- Assistant Professor, Department of Fixed Prosthodontics, University of Lisbon, Portugal; and Private Practice, Lisbon, Portugal
| | - Charles Beard
- Assistant Professor and Senior Clinical Lecturer, Biologic and Materials Sciences and Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Michael Razzoog
- Professor Emeritus, Biologic and Materials Sciences and Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, Mich
| |
Collapse
|
27
|
Rigos AE, Sarafidou K, Kontonasaki E. Zirconia bond strength durability following artificial aging: A systematic review and meta-analysis of in vitro studies. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:138-159. [PMID: 37274447 PMCID: PMC10238491 DOI: 10.1016/j.jdsr.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 03/27/2023] [Accepted: 04/19/2023] [Indexed: 06/06/2023] Open
Abstract
The present study systematically reviewed the literature regarding the bond strength durability of zirconia ceramics to resin-based luting cements after application of different bonding protocols and aging conditions. Electronic searches in PubMed, Scopus, and Web of Science databases were performed for relevant literature published between January 1st 2015 and November 15th 2022. Ninety-three (93) English language in-vitro studies were included. The percentage of the mean bond strength change was recorded prior to and after artificial aging, and the weighted mean values and 95% confidence intervals were calculated. Bonding protocols were classified based on the combination of MDP/non-MDP containing cement/primer and surface pretreatment, as well as the level of artificial aging performed. Alumina sandblasting (SA) was identified as the most frequently used surface pre-treatment while an insufficient number of studies was identified for each category of alternative surface treatments. The combination of MDP cement with tribochemical silica coating (TSC) or SA yielded more durable results after aging, while the application of SA and TSC improved bond durability when a non-MDP cement and a non-MDP primer were used. TSC may lead to increased bond durability compared to SA, whereas MDP cements may act similarly when combined with SA or TSC.
Collapse
Affiliation(s)
- Athanasios E. Rigos
- Resident, Graduate Prosthodontics, Texas A&M School of Dentistry, Dallas, TX, USA
| | - Katia Sarafidou
- Postdoctoral Researcher, Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Eleana Kontonasaki
- Associate Professor, Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| |
Collapse
|
28
|
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.
Collapse
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
| |
Collapse
|
29
|
Di Fiore A, Monaco C, Stellini E. Retrospective clinical study of 1472-unit monolithic zirconia restorations with feather-edge margins realized with digital workflow. Clin Oral Investig 2023; 27:6567-6575. [PMID: 37749286 DOI: 10.1007/s00784-023-05262-1] [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: 05/05/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To evaluate the clinical performance of monolithic zirconia restorations with feather-edge margins fabricated by digital impressions. MATERIALS AND METHODS All participants that present monolithic zirconia restorations with feather-edge margins realized with digital workflow were evaluated during scheduled periodontal maintenance between February and September 2022 according to predetermined inclusion criteria. Clinical performance was assessed using the modified USPHS and periodontal parameters. Overall survival was calculated for monolithic zirconia restorations. Technical and biologic complications were reported. Descriptive statistical analysis and life-table analyses were performed for all data. RESULTS A total of 1472 monolithic zirconia FDPs (1279 on abutments and 193 on pontics) placed in 1189 patients (982 males and 490 females) from February 2017 to September 2020 were analyzed. The mean follow-up was 44 months (range 36-61 months), and the overall survival rate was 98.5%. There were 931 single crowns, 96 were 3-unit FDPs, 33 were 4-unit FDPs, 11 were 5-unit FDPs, and 6-unit FDPs. Three single crowns had irreparable cracks, and 6 single crowns and one 4-unit FDP were fractured. One 3-unit FDP failed due to tooth fracture and 5 single crowns failed due to endodontic failure. The loss of retention was noted in 25 monolithic zirconia FDPs and hypersensitivity in 44 single crowns. Biologic complications were uncommon. CONCLUSIONS Based on the results and its limitations, the monolithic zirconia FPDs and digital impressions represent a favorable prosthetic treatment similar to that reported with other margin designs CLINICAL RELEVANCE: Monolithic zirconia restorations on vertical-margin abutments fabricated using a digital workflow demonstrate excellent clinical performance. The digital clinical workflow without the use of a cast means a reduction in costs, steps, and operating time.
Collapse
Affiliation(s)
- Adolfo Di Fiore
- Department of Neuroscience, School of Dentistry, Division of Prosthodontics and Digital Dentistry, University of Padova, Padova, Italy.
| | - Carlo Monaco
- Department of Surgery, Medicine, and Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | - Edoardo Stellini
- Department of Neuroscience, School of Dentistry, Division of Prosthodontics and Digital Dentistry, University of Padova, Padova, Italy
| |
Collapse
|
30
|
Soares PM, da Rosa LS, Pereira GKR, Valandro LF, Rippe MP, Dal Piva AMDO, Feilzer AJ, Kleverlaan CJ, Tribst JPM. Mechanical Behavior of Repaired Monolithic Crowns: A 3D Finite Element Analysis. Dent J (Basel) 2023; 11:254. [PMID: 37999018 PMCID: PMC10670502 DOI: 10.3390/dj11110254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
This study evaluated the mechanical behavior and risk of failure of three CAD-CAM crowns repaired with different resin composites through a three-dimensional (3D) finite element analysis. Three-dimensional models of different cusp-repaired (conventional nanohybrid, bulk-fill, and flowable resin composites) crowns made of zirconia, lithium disilicate, and CAD-CAM resin composite were designed, fixed at the cervical level, and loaded in 100 N at the working cusps, including the repaired one. The models were analyzed to determine the Maximum Principal and Maximum Shear stresses (MPa). Complementary, an in vitro shear bond strength test (n = 10) was performed to calculate the risk of failure for each experimental group. The stress distribution among the models was similar when considering the same restorative material. The crown material affected the stress concentration, which was higher for the ceramic models (±9 MPa for shear stress; ±3 MPa for tensile stress) than for the CAD-CAM composite (±7 MPa for shear stress; ±2 MPa for tensile stress). The shear bond strength was higher for the repaired CAD-CAM resin composite (±17 MPa) when compared to the ceramics (below 12 MPa for all groups), while the repair materials showed similar behavior for each substrate. The stress distribution is more homogenous for repaired resin composite crowns, and a flowable direct resin composite seems suitable to repair ceramic crowns with less risk of failure.
Collapse
Affiliation(s)
- Pablo Machado Soares
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Marilia Pivetta Rippe
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.M.d.O.D.P.)
| | - Albert J. Feilzer
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands;
| | - Cornelis J. Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.M.d.O.D.P.)
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands;
| |
Collapse
|
31
|
Al-Bermani ASA, Quigley NP, Ha WN. Do zirconia single-retainer resin-bonded fixed dental prostheses present a viable treatment option for the replacement of missing anterior teeth? A systematic review and meta-analysis. J Prosthet Dent 2023; 130:533-542. [PMID: 34893319 DOI: 10.1016/j.prosdent.2021.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Zirconia has been widely used in restorative dentistry because of its favorable strength and esthetics. However, its polycrystalline structure presents a challenge for resin bonding. Significant research into surface treatments of zirconia to improve bonding has been reported, yet a universally accepted protocol remains elusive. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the performance of anterior single-retainer zirconia resin-bonded fixed dental prostheses (RBFDPs) and review the bonding protocols used in the published data. MATERIAL AND METHODS An electronic search of English language literature was conducted in the PubMed and Ovid (MEDLINE) databases. Following the application of inclusion and exclusion criteria, the research was evaluated to assess the quantitative data. RESULTS Of the included studies, 1 randomized controlled trial, 3 prospective cohort studies, and 2 retrospective cohort studies reporting on anterior single-retainer zirconia RBFDPs were evaluated. Over a 3- to 10-year period, the success rate of anterior single-retainer zirconia RBFDPs was over 80%. Although there were reports of debonds, this is a minor complication as rebonding is usually possible. Furthermore, catastrophic fractures of the entire prosthesis were rare. CONCLUSIONS Evidence for the use of single-retainer zirconia RBFDPs as a suitable treatment option for the replacement of anterior missing teeth is considerable. Based on the findings of this systematic review and meta-analysis, a 2-step process comprising micromechanical retention using airborne-particle abrasion and subsequent resin-zirconia adhesion by the application of 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) can be recommended.
Collapse
Affiliation(s)
| | | | - William N Ha
- Lecturer, The University of Queensland, School of Dentistry, Brisbane, QLD, Australia
| |
Collapse
|
32
|
Luna-Domínguez CR, Luna-Domínguez JH, Blatz M. Full-mouth rehabilitation in a completely digital workflow using partially adhesive monolithic zirconia restorations. J ESTHET RESTOR DENT 2023; 35:1050-1057. [PMID: 37026815 DOI: 10.1111/jerd.13048] [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: 08/09/2022] [Revised: 03/17/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE This clinical case describes a completely digital workflow using current digital technologies for a full-mouth adhesive rehabilitation with ultra-translucent multilayer zirconia restorations. CLINICAL CONSIDERATIONS A healthy 60-year-old man with abfractions on all upper and lower molars and severe tooth wear underwent a full-mouth rehabilitation with laminate veneers and partial adhesive restorations. A proper zirconia bonding protocol was realized to provide a durable bond between the ultra-translucent zirconia and the resin cement. Furthermore, the implementation of a digital workflow enables the clinician to have an effective communication during treatment planning and simplify the clinical and laboratory procedures, providing the patient with long-term esthetic treatment and functional results. CONCLUSION The implementation of a completely digital workflow and the use of ultra-translucent multilayer zirconia for indirect adhesive restorations can be an alternative with simplified and predictable procedures for patients with dental wear and teeth discolorations. CLINICAL SIGNIFICANCE The digital workflow described is intended to facilitate the planning and execution of a full-mouth adhesive rehabilitation and demonstrates to clinicians a reliable zirconia bonding concept for minimally invasive anterior and posterior restorations.
Collapse
Affiliation(s)
- Carlos Roberto Luna-Domínguez
- Department of Prosthodontics, Autonomous University of Tamaulipas, School of Dentistry, Tampico-Madero University Center, Tampico, Tamaulipas, Mexico
- Private Practice, Odontología Avanzada, Tampico, Tamaulipas, Mexico
| | - Jorge Humberto Luna-Domínguez
- Private Practice, Odontología Avanzada, Tampico, Tamaulipas, Mexico
- Research Center, Autonomous University of Tamaulipas, School of Dentistry, Tampico-Madero University Center, Tampico, Tamaulipas, Mexico
| | - Markus Blatz
- Department of Preventive and Restorative Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
33
|
Sevilla P, Gseibat M, Peláez J, Suárez MJ, López-Suárez C. Effect of Surface Treatments with Low-Pressure Plasma on the Adhesion of Zirconia. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6055. [PMID: 37687747 PMCID: PMC10488541 DOI: 10.3390/ma16176055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
The purpose of this study was to investigate the effect of low-pressure plasma on the contact angle, shear bond strength (SBS), and the failure mode of zirconia ceramic. Zirconia specimens were divided into three groups according to the surface treatment methods as follows: sandblasting with aluminum oxide (ZR-C), sandblasting with aluminum oxide and oxygen plasma (ZR-CP), and argon plasma (ZR-P). The contact angle, SBS, and surface characteristics were tested after thermocycling. Data analysis was made using the Kruskal-Wallis test and one-way analysis of variance. Plasma treatment significantly reduced the contact angle (p < 0.001) with the lowest value for the Zr-P group. An increase in oxygen and a decrease in carbon was observed on the zirconia surface in both plasma groups. For the SBS, there were significant differences among the groups (p < 0.018), the Zr-CP group showing the highest bond strength. Mixed failures were the most frequent. Plasma treatment was effective in increasing the wettability, increasing the oxygen/carbon ratio without changing zirconia surface morphology. The sandblasting plus plasma with oxygen group exhibited the highest bond strength.
Collapse
Affiliation(s)
| | | | - Jesús Peláez
- Department of Conservative Dentistry and Buco-facial Prosthesis, Faculty of Odontology, University Complutense of Madrid, 28040 Madrid, Spain; (P.S.); (M.G.); (C.L.-S.)
| | - María J. Suárez
- Department of Conservative Dentistry and Buco-facial Prosthesis, Faculty of Odontology, University Complutense of Madrid, 28040 Madrid, Spain; (P.S.); (M.G.); (C.L.-S.)
| | | |
Collapse
|
34
|
Bresser RA, Hofsteenge JW, Wieringa TH, Braun PG, Cune MS, Özcan M, Gresnigt MMM. Clinical longevity of intracoronal restorations made of gold, lithium disilicate, leucite, and indirect resin composite: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:4877-4896. [PMID: 37597003 PMCID: PMC10492736 DOI: 10.1007/s00784-023-05050-x] [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: 02/15/2023] [Accepted: 04/28/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the comparative clinical success and survival of intracoronal indirect restorations using gold, lithium disilicate, leucite, and indirect composite materials. MATERIAL AND METHODS This systematic review and meta-analysis were conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. The protocol for this study was registered in PROSPERO (registration number: CRD42021233185). A comprehensive literature search was conducted across various databases and sources, including PubMed/Medline, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and gray literature. A total of 7826 articles were screened on title and abstract. Articles were not excluded based on the vitality of teeth, the language of the study, or the observation period. The risk difference was utilized for the analyses, and a random-effects model was applied. All analyses were conducted with a 95% confidence interval (95% CI). The calculated risk differences were derived from the combined data on restoration survival and failures obtained from each individual article. The presence of heterogeneity was assessed using the I2 statistic, and if present, the heterogeneity of the data in the articles was evaluated using the non-parametric chi-squared statistic (p < 0.05). RESULTS A total of 12 eligible studies were selected, which included 946 restorations evaluated over a minimum observation period of 1 year and a maximum observation period of 7 years. Results of the meta-analysis indicated that intracoronal indirect resin composite restorations have an 18% higher rate of failure when compared to intracoronal gold restorations over 5-7 years of clinical service (risk difference = - 0.18 [95% CI: - 0.27, - 0.09]; p = .0002; I2 = 0%). The meta-analysis examining the disparity in survival rates between intracoronal gold and leucite restorations could not be carried out due to methodological differences in the studies. CONCLUSIONS According to the currently available evidence, medium-quality data indicates that lithium disilicate and indirect composite materials demonstrate comparable survival rates in short-term follow-up. Furthermore, intracoronal gold restorations showed significantly higher survival rates, making them a preferred option over intracoronal indirect resin-composite restorations. Besides that, the analysis revealed no statistically significant difference in survival rates between leucite and indirect composite restorations. The short observation period, limited number of eligible articles, and low sample size of the included studies were significant limitations. CLINICAL SIGNIFICANCE Bearing in mind the limitations of the reviewed literature, this systematic review and meta-analysis help clinicians make evidence-based decisions on how to restore biomechanically compromised posterior teeth.
Collapse
Affiliation(s)
- R A Bresser
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - J W Hofsteenge
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - T H Wieringa
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - P G Braun
- Central Medical Library, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M S Cune
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Prosthodontics and Special Dental Care, Department of Oral Maxillofacial Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - M Özcan
- Clinic for Reconstructive Dentistry, Division of Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - M M M Gresnigt
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Department of Special Dental Care, Martini Hospital, Groningen, The Netherlands
| |
Collapse
|
35
|
Moralez PF, Kantovitz KR, Martinez EF, Teixeira LN, Demasi AP. In vitro cytotoxicity of resin cement and its influence on the expression of antioxidant genes. ACTA ODONTOLOGICA LATINOAMERICANA : AOL 2023; 36:120-127. [PMID: 37776509 PMCID: PMC10557080 DOI: 10.54589/aol.36/2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/01/2023] [Indexed: 10/02/2023]
Abstract
AIM This study evaluated cytotoxicity and antioxidant gene expression of resin cements on human gingival fibroblasts (hGF). MATERIALS AND METHOD RelyX Ultimate™(RXU), Variolink™II(VLII), and RelyXU200™(RXU200) resin cements were incubated with culture medium for 24 h to obtain eluates. Then, the eluates were applied over hGF to assess cell viability at 24 h, 48 h, and 72 h and antioxidant gene expression at 24 h. hGF cultures non-exposed to the eluates were used as Control. Data were submitted to ANOVA and Bonferroni tests (α≤0.05). RESULTS RXU and RXU200 reduced the number of viable cells in 24 h. Longer exposure to cement extracts caused cell death. Gene expression showed peroxiredoxin 1 (PRDX1) induction by all resin cement types, and superoxide dismutase 1 (SOD1) induction by RXU200 and VLII. Moreover, RXU200 induced not only PRDX1 and SOD1, but also glutathione peroxidase 1 (GPX1), catalase (CAT), and glutathione synthetase (GSS). CONCLUSIONS All resin cements showed toxicity, and induced antioxidant genes in hGF. Antioxidant gene induction is at least partly associated with cytotoxicity of tested cements to oxidative stress experience.
Collapse
|
36
|
Abd Alraheam I, Al-Asmar A, Hasan N, Asoleihat F, Alkayed A. Clinical evaluation of cemented and adhesively resin-bonded monolithic and partially layered zirconia and lithium disilicate crowns. Saudi Dent J 2023; 35:508-514. [PMID: 37520593 PMCID: PMC10373076 DOI: 10.1016/j.sdentj.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose Zirconia and lithium disilicate crowns are very popular dental restorations. The cement type and layering technique used can profoundly affect the clinical performance of these crowns.This retrospective study is designed to investigate the success rate of cemented and adhesively bonded monolithic and partially layered zirconia and lithium disilicate crowns placed in faculty practice settings. Materials and Methods Patients who had received zirconia or lithium disilicate crowns at the faculty practice were invited for clinical examination. The examiner used the modified United States Public Health Service (MUSPHS) evaluation criteria to evaluate the crowns. The crowns were either glass ionomer cemented zirconia (GIC-Zr), resin-bonded zirconia (Adh-Zr), or resin-bonded lithium disilicate (Adh-LD). The crowns were also divided into monolithic and layered groups. Inferential analysis was used to examine the differences through bivariate analysis using t-testing and one-way ANOVA. Results Thirty-five patients, with a combined total of 218 single crowns, agreed to participate in the study. No statistically significant differences in the quality outcome variables considered were found between the groups, except for marginal adaptation, where Adh-Zr achieved significantly higher scores compared to GIC-Zr and Adh-LD. Layered zirconia and lithium disilicate crowns have significantly higher quality outcomes in terms of anatomic form, marginal adaptation, and color match compared to monolithic zirconia and lithium disilicate crowns. Conclusions Conventionally cemented zirconia and adhesively bonded zirconia and lithium disilicate crowns are reliable treatment options with high short-term success rates. Clinical studies with longer follow-up times are needed to investigate their long-term success rates.
Collapse
Affiliation(s)
- Islam Abd Alraheam
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Aya Al-Asmar
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Noor Hasan
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Firas Asoleihat
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Awni Alkayed
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| |
Collapse
|
37
|
Calamita RS, Oliveira AAD, Pizzanelli GG, Salvador MVO, Mesquita AMM, Pecorari VGA, Lima AF. Interaction of different concentrations of 10-MDP and GPDM on the zirconia bonding. Dent Mater 2023; 39:665-668. [PMID: 37225538 DOI: 10.1016/j.dental.2023.05.003] [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: 02/03/2023] [Revised: 04/12/2023] [Accepted: 05/02/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To analyze the influence of different concentrations of 10-MDP and GPDM used, combined or not, on the bonding to zirconia. METHODS Specimens of zirconia and a resin-composite (7 mm length, 1 mm width, and 1 mm thick) were obtained. The experimental groups were obtained according to the functional monomer (10-MDP and GPDM) and the concentrations (3 %, 5 %, and 8 %). For the groups with combined 10-MDP and GPDM, the agents were used with a proportion of 50 %/50 % wt until reaching the 3 %, 5 % and 8 % concentrations. All monomers were diluted in ethanol to obtain the primers. Two control groups were established: ethanol (negative control) and a commercial reference Monobond N (positive control). The zirconia surface treatment was performed with the primer application followed by the bonding to a resin-composite sample with a light-curing resin cement. Twenty-four hours after the adhesive procedure, a microtensile test was performed and the failure pattern of each sample was analysed with a stereoscopic magnifying glass. Data were analysed by a two-way ANOVA and Dunnet test. RESULTS All experimental primers presented a higher bond strength than the negative control (ethanol). Excepting the 8 % GPDM primer, all groups presented statistically similar bond strength compared to the positive control, with a predominance of adhesive failure. SIGNIFICANCE 10-MDP, GPDM, and the combination of both for the concentrations tested promote an effective chemical bonding to zirconia. However, using 10-MDP and GPDM in the same primer has no synergistic effect.
Collapse
Affiliation(s)
- Rafael Soares Calamita
- Dental Research Division, Paulista University, Rua Doutor Bacelar, 1212, 04026-002 Sao Paulo, Brazil
| | | | - Giulia Gamero Pizzanelli
- Dental Research Division, Paulista University, Rua Doutor Bacelar, 1212, 04026-002 Sao Paulo, Brazil
| | | | | | | | - Adriano F Lima
- Dental Research Division, Paulista University, Rua Doutor Bacelar, 1212, 04026-002 Sao Paulo, Brazil.
| |
Collapse
|
38
|
El-Farag SAA, Elerian FA, Elsherbiny AA, Abbas MH. Impact of different CAD/CAM materials on internal and marginal adaptations and fracture resistance of endocrown restorations with: 3D finite element analysis. BMC Oral Health 2023; 23:421. [PMID: 37357307 DOI: 10.1186/s12903-023-03114-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 06/06/2023] [Indexed: 06/27/2023] Open
Abstract
PURPOSE To assess and compare the impact of various computers aided design/manufacturing (CAD/CAM) materials on internal and marginal discrepancies, fracture resistance and failure probability of Endocrown restorations with 3D Finite Element analysis. MATERIAL AND METHODS Forty devitalized human maxillary first molars were collected. After endodontic treatment, they classified into 4 groups (n = 10) based on the materials used for endocrown fabrication. Group V (Vita-Enamic), Group N (Nacera Hybrid), Group T (Translucent Prettau Zirconia) and Group P (Pekkton ivory). All samples were exposed to artificial aging method simulating one year of clinical service. Silicone replica technique and stereomicroscope (25X) utilized to evaluate the marginal and internal gaps of endocrowns at different areas. Fracture resistance test used for cemented specimens followed by qualitative investigation utilizing Stereomicroscopy. Four models representing four endocrown systems used for restoration of severely-damaged endodontically treated upper first molar were generated for finite element analysis (FEA). Axially and centrally static occlusal compressive load was applied. Modified Von Mises and maximum principal stress values on the remaining tooth structure, cement lines and restorative materials were assessed independently. Resulted data were statistically analyzed at P-value ≤ 0.05. RESULTS In the current study, the highest mean values of internal and marginal discrepancies (μm) among studied groups were reported for Zirconia group (100.300 and 102.650) respectively, while the lowest mean value of internal discrepancy (μm) was observed for Nacera group (69.275) and the lowest mean value of marginal discrepancy (μm) was observed for PEKK group (78.4750). Regarding internal discrepancy, Vita-Enamic and PEKK groups did not exhibit any statistically significant differences (P = 0.293), however zirconia and the other tested groups exhibited statistically significant differences in the mean values of the marginal gap region (p 0.05).On the other hand, PEKK group showed the highest mean value of fracture resistance (1845.20 N) and the lowest value was observed for Vita-Enamic group (946.50 N). Regarding to stress distributions through 3D FEA, and according to modified von Mises (mvM) analysis, the greatest possible stress values were noticed in PEKK model in relation to tooth structure, cement line, and flowable composite as the following: (93.1, 64.5, 58.4 MPa) respectively, while Zirconia revealed lower maximum stress values (11.4, 13.6, 11.6 MPa) respectively. CONCLUSIONS Statistically excellent marginal and internal fit was observed for PEKK in relation to other used endocrown materials. Also, PEKK material explained fracture resistance comparable to zirconia value while the lowest value was detected for Vita Enamic material.
Collapse
Affiliation(s)
- Shaimaa Ahmed Abo El-Farag
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University and Horus University (HUE), Mansoura, Egypt
| | - Fatma Abdallah Elerian
- Production and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, 35516, Egypt
| | - Abdallah Ahmed Elsherbiny
- Production and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, 35516, Egypt
| | - Mahy Hassouna Abbas
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University and Delta University for Science and Technology, Mansoura, Egypt.
| |
Collapse
|
39
|
Pilecco RO, Machry RV, Ribeiro VF, Moraes RR, Pereira GKR. Evaluation paste removal method and bond strength between resin cement and lithium disilicate ceramic: An in vitro study. J Prosthet Dent 2023:S0022-3913(23)00346-3. [PMID: 37357087 DOI: 10.1016/j.prosdent.2023.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/27/2023]
Abstract
STATEMENT OF PROBLEM After the use of evaluation paste, residue can remain on the bonding surface. However, how adhesion to lithium disilicate ceramic is affected is unclear. PURPOSE The purpose of this in vitro study was to determine the effectiveness of lithium disilicate cleaning after contamination with an evaluation paste and before the application of a resin cement. MATERIAL AND METHODS Rectangular lithium disilicate (IPS e.max CAD) specimens were obtained with a simulated milled surface, crystallized, etched with 5% hydrofluoric (HF) acid, and contaminated with an evaluation paste. The cleaning methods tested were air-water spray (SPRAY), 37% phosphoric acid (HPO), ultrasonic bath (ULT), cleaning paste (IVOC), and a conventional surface treatment (HF + silane-HF+SIL). The control (CTRL) group was not contaminated. After silane had been applied, resin cement cylinders were fabricated and light polymerized. Half of the cylinders (n=56) were tested for microshear bond strength at baseline (24 hours), and the other half after 210 days of water storage and 25 000 thermal cycles. Surface roughness, failure analysis, scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS) were performed. Statistical analysis was performed with the Kruskal-Wallis and Mann-Whitney tests for surface roughness and the 2-way ANOVA and Bonferroni post hoc tests for bond strength (α=.05). RESULTS At baseline, only SPRAY did not restore the bond strength compared with CTRL. After aging, the bond strengths of SPRAY and IVOC were lower than of CTRL (P<.05); no significant difference was found between CTRL, HPO, ULT, and HF+SIL (P>.05). EDS demonstrated the presence of carbon in the SPRAY and ULT groups, probably remnants of the evaluation paste. SEM analysis identified such remnants in the SPRAY group only. CONCLUSIONS For optimal bond strength between lithium disilicate and resin cement after evaluation paste use, cleaning the ceramic surface with 37% phosphoric acid, ultrasonic bath, or with hydrofluoric acid worked best.
Collapse
Affiliation(s)
- Rafaela Oliveira Pilecco
- Postgraduate student, Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Renan Vaz Machry
- Postdoctoral student, Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Vinícius Fogliato Ribeiro
- Graduate student, Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Rafael R Moraes
- Associate Professor, Faculty of Dentistry, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Gabriel Kalil Rocha Pereira
- Adjunct Professor, Post-Graduate Program in Oral Sciences (Prosthodontics Unit), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
| |
Collapse
|
40
|
Martins RG, Castro TSD, Dib LL, Gehrke SA, Mesquita AMM. Influence of Restorative Material on the Distribution of Loads to the Bone in Hybrid Abutment Crowns-In Vitro Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1188. [PMID: 37512000 PMCID: PMC10384236 DOI: 10.3390/medicina59071188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 07/30/2023]
Abstract
Background: The objective of this study was to evaluate the load transmitted to the peri-implant bone by seven different restorative materials in single-unit rehabilitations with morse taper implants using a strain gauge. Materials: In a polyurethane block that simulated type III bone, a morse taper platform implant was installed (3.5 × 11 mm) in the center and 1 mm below the test base surface, and four strain gauges were installed around the implant, simulating the mesial, distal, buccal and lingual positions. Seven similar hybrid abutment crowns were crafted to simulate a lower premolar using different materials: 1-PMMA; 2-glass ceramic over resin matrix; 3-PEEK + lithium disilicate; 4-metal-ceramic; 5-lithium disilicate; 6-zirconia + feldspathic; 7-monolithic zirconia. All groups underwent axial and oblique loads (45 degrees) of 150 N from a universal testing machine. Five measurements (n = 5) were performed with each material and for each load type; the microdeformation data underwent statistical analysis. The data were obtained in microdeformation (με), and the significance level was set at p ≤ 0.05. Results: There was no statistically significant difference in the evaluation among the materials under either the axial load or the oblique load at 45 degrees. In turn, in the comparison between axial load and oblique load, there was a difference in load for all materials. Conclusion: The restorative material did not influence the load transmitted to the bone. Furthermore, the load transmitted to the bone was greater when it occurred obliquely at 45° regardless of the material used. In conclusion, it appeared that the different elastic modulus of each material did not influence the load transmission to the peri-implant bone.
Collapse
Affiliation(s)
| | | | - Luciano Lauria Dib
- Department of Implantology, Paulista University-UNIP, São Paulo 04026-002, Brazil
| | | | | |
Collapse
|
41
|
Fuchs F, Westerhove SM, Schmohl L, Koenig A, Suharbiansah RSR, Hahnel S, Rauch A. Influence of the Application Time of Silane for the Bonding Performance between Feldspar or Lithium Disilicate Ceramics and Luting Resin Composites. J Funct Biomater 2023; 14:jfb14040231. [PMID: 37103321 PMCID: PMC10143910 DOI: 10.3390/jfb14040231] [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: 03/06/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023] Open
Abstract
A correct silanization time is essential for successful surface functionalization and sufficient bonding to dental ceramics. The shear bond strength (SBS) of lithium disilicate (LDS) and feldspar (FSC) ceramics and luting resin composite was investigated with respect to different silanization times, taking into account the physical properties of the individual surfaces. The SBS test was performed with a universal testing machine, and the fracture surfaces were evaluated by stereomicroscopy. The surface roughness of the prepared specimens was analyzed after etching. Changes in surface properties due to surface functionalization were evaluated by surface free energy (SFE) via contact angle measurement. Fourier transform infrared spectroscopy (FTIR) was used to determine the chemical binding. The roughness and SBS of the control group (no silane, etched) were higher for FSC than for LDS. Regarding the SFE, the dispersive fraction increased and the polar fraction decreased after silanization. FTIR confirmed the presence of silane on the surfaces. The SBS of LDS showed a significant increase from 5 to 15 s, depending on the silane and luting resin composite. For FSC, cohesive failure was observed for all samples. For LDS specimens, a silane application time of 15 to 60 s is recommended. Based on clinical conditions, no difference between the silanization times was observed for FSC specimens, indicating that etching alone produces sufficient bonding.
Collapse
Affiliation(s)
- Florian Fuchs
- Department of Prosthetic Dentistry and Material Science, Leipzig University, 04109 Leipzig, Germany
| | - Sina Maria Westerhove
- Department of Prosthetic Dentistry and Material Science, Leipzig University, 04109 Leipzig, Germany
| | - Leonie Schmohl
- Department of Prosthetic Dentistry and Material Science, Leipzig University, 04109 Leipzig, Germany
| | - Andreas Koenig
- Department of Prosthetic Dentistry and Material Science, Leipzig University, 04109 Leipzig, Germany
| | | | - Sebastian Hahnel
- Department of Prosthetic Dentistry and Material Science, Leipzig University, 04109 Leipzig, Germany
- Department of Dental Prosthetics, UKR University Hospital Regensburg, 93053 Regensburg, Germany
| | - Angelika Rauch
- Department of Prosthetic Dentistry and Material Science, Leipzig University, 04109 Leipzig, Germany
- Department of Dental Prosthetics, UKR University Hospital Regensburg, 93053 Regensburg, Germany
| |
Collapse
|
42
|
Packaeser MG, Aragonez GC, Machado PS, Borges ALS, Pereira GKR, Valandro LF, Rippe MP. High-versus low-viscosity resin cements: Its effect on the load-bearing capacity under fatigue of a translucent zirconia. J Mech Behav Biomed Mater 2023; 142:105829. [PMID: 37068429 DOI: 10.1016/j.jmbbm.2023.105829] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/28/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
The purpose of the present study was to characterize the elastic modulus and Poisson's ratio of a resin cement with distinct viscosities, and to evaluate their impact on the static and fatigue strength of a translucent zirconia (4Y-PSZ) after air-abrasion surface treatment. Bar-shaped specimens of two different viscosities of resin cement (high and low) were obtained (25 × 10 × 3 mm). Sonelastic and Maxwell principles tests were performed to determine the elastic modulus and Poisson's ratio of each resin cement. Disc-shaped specimens of 4Y-PSZ were made (Ø = 15 mm, 1.2 mm in thickness) for the mechanical tests and allocated into groups according to two factors: surface treatment (presence or absence of air-abrasion with alumina particles; 45 μm grain-size); cement (absence, low or high viscosity). The static (n = 10) and cyclical (n = 15) biaxial flexural strength tests were performed by piston-on-three-balls geometry. A fatigue strength test was executed (20 Hz, initial stress of 60 MPa [12% of the mean static biaxial flexural strength], followed by increments of 25 MPa [5% of the mean static biaxial flexural strength] at each step of 10,000 cycles until the failure). The obtained data were analyzed by Weibull analysis. Survival rates were tabulated by the Kaplan-Meier test. Complementary analyses of surface roughness, topography, cross-sectional interfacial zone, fractography, and zirconia crystalline content (X-ray diffraction) were also performed. The evaluated resin cements with high and low viscosity presented similar elastic modulus (13.63 GPa; 12.74 GPa) and Poisson's ratio (0.32; 0.30), respectively. The air-abraded groups depicted higher mechanical strength of the zirconia ceramics than non-abraded groups (p˂ 0.05), regardless of the resin cement. 4Y-PSZ adhesively bonded to a high or low viscosity resin cement have statistically similar behavior (p˃ 0.05). The mechanical structural reliability of the 4Y-PSZ was not affected by the factors. Therefore, resin cement with high and low viscosity presented similar properties and potential to fill the zirconia surface, and did not affect the mechanical behavior of 4Y-PSZ. However, the air-abrasion surface treatment increased the static and fatigue flexural strength of the translucent zirconia.
Collapse
|
43
|
Poca A, De Peretti Della Rocca K, Nasr K, Ducassé R, Canceill T. Effects of Translucency and Thickness of Lithium Disilicate-Reinforced Glass-Ceramic Veneers on the Degree of Conversion of a Purely Light-Curing Bonding Resin: An In Vitro Study. Polymers (Basel) 2023; 15:polym15071617. [PMID: 37050231 PMCID: PMC10097364 DOI: 10.3390/polym15071617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/11/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
The objective of this study was to evaluate the variations in the degree of conversion (DC) of a light-curing composite resin when the thickness or the translucency of lithium disilicate-enriched glass-ceramic veneers are modified. IPS e. max® CAD blocks of the MT-A2, LT-A2 and MO1 types were cut to obtain four slices with thicknesses ranging from 0.6 mm to 1 mm. A strictly light-curing composite resin (G-aenial Universal Injectable) was injected in the empty part of a silicone mold so that the veneer could then be inserted under digital pressure to the stop. A 40 s light cure (1400 mW/cm2) was then performed. Resin samples were analyzed using Fourier transform infrared (FTIR) spectroscopy. When the degree of translucency of the ceramic was modified, a decrease in the resin conversion rate was noted, but with a non-significant global p-value (p = 0.062). Interestingly, the degree of conversion of the light-curing composite resin was also modified when the ceramic’s thickness increased, especially when it was over 1 mm (DC0.6 > DC0.7 > DC0.8 > DC1; p < 0.0001). This confirms that the degree of conversion of a bonding material is very dependent on the ceramic’s thickness. Contradictory data are, however, found in the literature, where there are reports of an absence of a difference between the DC obtained with thicknesses of ceramics of 0.7 and 2 mm.
Collapse
|
44
|
Magalhães T, Fidalgo-Pereira R, Torres O, Carvalho Ó, Silva FS, Henriques B, Özcan M, Souza JCM. Microscopic Inspection of the Adhesive Interface of Composite Onlays after Cementation on Low Loading: An In Vitro Study. J Funct Biomater 2023; 14:jfb14030148. [PMID: 36976072 PMCID: PMC10058625 DOI: 10.3390/jfb14030148] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Abstract
Purpose: This study aimed to assess the layer thickness and microstructure of traditional resin-matrix cements and flowable resin-matrix composites at dentin and enamel to composite onlay interfaces after cementation on low loading magnitude. Materials and Methods: Twenty teeth were prepared and conditioned with an adhesive system for restoration with resin-matrix composite onlays manufactured by CAD-CAM. On cementation, tooth-to-onlay assemblies were distributed into four groups, including two traditional resin-matrix cements (groups M and B), one flowable resin-matrix composite (group G), and one thermally induced flowable composite (group V). After the cementation procedure, assemblies were cross-sectioned for inspection by optical microscopy at different magnification up to ×1000. Results: The layer thickness of resin-matrix cementation showed the highest mean values at around 405 µm for a traditional resin-matrix cement (group B). The thermally induced flowable resin-matrix composites showed the lowest layer thickness values. The resin-matrix layer thickness revealed statistical differences between traditional resin cement (groups M and B) and flowable resin-matrix composites (groups V and G) (p < 0.05). However, the groups of flowable resin-matrix composites did not reveal statistical differences (p < 0.05). The thickness of the adhesive system layer at around 7 µm and 12 µm was lower at the interfaces with flowable resin-matrix composites when compared to the adhesive layer at resin-matrix cements, which ranged from 12 µm up to 40 µm. Conclusions: The flowable resin-matrix composites showed adequate flowing even though the loading on cementation was performed at low magnitude. Nevertheless, significant variation in thickness of the cementation layer was noticed for flowable resin-matrix composites and traditional resin-matrix cements that can occur in chair-side procedures due to the clinical sensitivity and differences in rheological properties of the materials.
Collapse
Affiliation(s)
- Tiago Magalhães
- University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra PRD, Portugal
| | - Rita Fidalgo-Pereira
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa (UCP), 3504-505 Viseu, Portugal
| | - Orlanda Torres
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra PRD, Portugal
| | - Óscar Carvalho
- Centre for MicroElectromechanical Systems (CMEMS-UMINHO), Campus Azurém, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS Associate Laboratory, University of Minho, 4710-057 Braga, Portugal
| | - Filipe S. Silva
- Centre for MicroElectromechanical Systems (CMEMS-UMINHO), Campus Azurém, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS Associate Laboratory, University of Minho, 4710-057 Braga, Portugal
| | - Bruno Henriques
- Centre for MicroElectromechanical Systems (CMEMS-UMINHO), Campus Azurém, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS Associate Laboratory, University of Minho, 4710-057 Braga, Portugal
- Ceramic and Composite Materials Research Group (CERMAT), Department of Mechanical Engineering (EMC), Federal University of Santa Catarina (UFSC), Florianopolis 88040-900, Brazil
| | - Mutlu Özcan
- Division of Dental Biomaterials, Center of Dental Medicine, Clinic of Reconstructive Dentistry, University of Zurich, 8032 Zurich, Switzerland
| | - Júlio C. M. Souza
- University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra PRD, Portugal
- Centre for MicroElectromechanical Systems (CMEMS-UMINHO), Campus Azurém, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS Associate Laboratory, University of Minho, 4710-057 Braga, Portugal
- Correspondence:
| |
Collapse
|
45
|
Kles P, Bar-On H, Zabrovsky A, Kles K, Eldad S, Ben-Gal G. Number of consecutive procedures after endodontic treatment to extraction: A 28-year retrospective study. J Prosthet Dent 2023:S0022-3913(23)00006-9. [PMID: 36890001 DOI: 10.1016/j.prosdent.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 03/08/2023]
Abstract
STATEMENT OF PROBLEM After endodontic treatment, teeth may require additional treatment. Data regarding the number of treatments up to extraction after endodontic treatment are lacking. PURPOSE The purpose of this retrospective study was to evaluate the number of consecutive restorative procedures performed on a specific tooth starting from endodontic treatment up to extraction. A comparison was made between crowned and uncrowned teeth. MATERIAL AND METHODS A retrospective study was conducted using 28 years of data from a private clinic. The total number of patients was 18 082 and included 88 388 treated teeth. The data were collected for permanent teeth that received at least 2 consecutive retreatments. The data included tooth number, procedure type, date of procedure, total number of procedures conducted during the study period, extraction date, time from endodontic treatment to extraction, and whether the tooth had been crowned or not. Endodontically treated teeth were divided into 2 groups: extracted and nonextracted. In each group, a comparison was made between crowned and uncrowned teeth and between anterior and posterior teeth by using the Student t test (α=.05). RESULTS In the non extracted group, teeth that were crowned required significantly (P<.05) fewer restorative treatments (mean ±standard deviation 2.9 ±2.1) than uncrowned teeth (5.01 ±2.98). For extracted teeth, the mean time from endodontic treatment until extraction was 10.39 years. Crowned teeth were extracted after a mean of 11.06 years and 3.98 treatments, while uncrowned teeth were extracted after a mean of 9.96 years and 7.22 treatments (P<.05). CONCLUSIONS Endodontically treated teeth that were crowned required significantly fewer subsequent restorative procedures than uncrowned teeth and exhibited higher survival rates up to extraction.
Collapse
Affiliation(s)
- Paz Kles
- Researcher, Department of Prosthodontics, The Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Hilit Bar-On
- Clinical Instructor, Department of Prosthodontics, The Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Asher Zabrovsky
- Lecturer, Department of Prosthodontics, The Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Keren Kles
- Researcher, Institute of Biochemistry Food Science and Nutrition, Faculty of Agricultural, Food and Environmental Sciences, The Hebrew University, Jerusalem, Israel
| | - Sharon Eldad
- Clinical Lecturer, Department of Prosthodontics, The Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Gilad Ben-Gal
- Clinical Lecturer, Department of Prosthodontics, The Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel.
| |
Collapse
|
46
|
Hassall D. The use of the monolithic ceramic and direct monolithic composite in the aesthetic rehabilitation of tooth wear. Br Dent J 2023; 234:406-412. [PMID: 36964362 DOI: 10.1038/s41415-023-5621-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 03/26/2023]
Abstract
Traditional cold layering composite techniques can have limitations in the aesthetic rehabilitation of advanced tooth wear, with potentially high maintenance/failure rates and compromised aesthetics. This article explores advances in materials and clinical techniques involving monolithic ceramics and direct monolithic composites. These restorations satisfy the most aesthetically demanding patient, providing good to excellent aesthetics and long-term predictability.
Collapse
Affiliation(s)
- Dominic Hassall
- Specialist in Restorative, Prosthodontic, Periodontal and Endodontic Dentistry, Dominic Hassall Training Institute, 91 Lode Lane, Solihull, B91 2HH, UK.
| |
Collapse
|
47
|
Abstract
The purpose of this article is to review current understanding of lithia-based glass-ceramics and to identify future research needs for this class of dental materials in relation to novel compositions and fabrication methods. With rapid advances in material development and digital technology, time efficiency of dental workflow and fit accuracy of ceramic restorations are ever improving. Lithia-based glass-ceramics are at the forefront of this advance-new variants with more efficient fabrication routes are continually being introduced into the marketplace. Base glass composition, crystallization heat treatment, nucleant and coloration additives, and property gradation are some pertinent variables. The trend in fabrication is to move from CAD/CAM grinding of partially crystallized glass-ceramics to fully crystallized materials, thereby circumventing the need for postmachining firing altogether. In these endeavors, a better understanding of mechanical properties and evolving shaping technologies, such as ductile grinding, is paramount. Additive manufacturing and 3-dimensional printing methodologies offer a promising alternative to current CAD/CAM subtractive manufacturing routes. Challenges to the implementation of new technologies in efficient development and production of high-quality dental glass-ceramic prostheses are addressed.
Collapse
Affiliation(s)
- Y. Zhang
- Department of Preventive and
Restorative Sciences, School of Dental Medicine, University of Pennsylvania,
Philadelphia, PA, USA
| | - S. Vardhaman
- Department of Preventive and
Restorative Sciences, School of Dental Medicine, University of Pennsylvania,
Philadelphia, PA, USA
| | - C.S. Rodrigues
- Department of Dental Materials and
Prosthodontics, Institute of Science and Technology, São Paulo State University, São
José dos Campos, Brazil
| | - B.R. Lawn
- Material Measurement Laboratory,
National Institute of Standards and Technology, Gaithersburg, MD, USA
| |
Collapse
|
48
|
Irie M, Okada M, Maruo Y, Nishigawa G, Matsumoto T. Shear Bond Strength of Resin Luting Materials to Lithium Disilicate Ceramic: Correlation between Flexural Strength and Modulus of Elasticity. Polymers (Basel) 2023; 15:polym15051128. [PMID: 36904369 PMCID: PMC10006982 DOI: 10.3390/polym15051128] [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: 01/20/2023] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/26/2023] Open
Abstract
This study investigates the effect of the curing mode (dual-cure vs. self-cure) of resin cements (four self-adhesive and seven conventional cements) on their flexural strength and flexural modulus of elasticity, alongside their shear bond strength to lithium disilicate ceramics (LDS). The study aims to determine the relationship between the bond strength and LDS, and the flexural strength and flexural modulus of elasticity of resin cements. Twelve conventional or adhesive and self-adhesive resin cements were tested. The manufacturer's recommended pretreating agents were used where indicated. The shear bond strengths to LDS and the flexural strength and flexural modulus of elasticity of the cement were measured immediately after setting, after one day of storage in distilled water at 37 °C, and after 20,000 thermocycles (TC 20k). The relationship between the bond strength to LDS, flexural strength, and flexural modulus of elasticity of resin cements was investigated using a multiple linear regression analysis. For all resin cements, the shear bond strength, flexural strength, and flexural modulus of elasticity were lowest immediately after setting. A clear and significant difference between dual-curing and self-curing modes was observed in all resin cements immediately after setting, except for ResiCem EX. Regardless of the difference of the core-mode condition of all resin cements, flexural strengths were correlated with the LDS surface upon shear bond strengths (R2 = 0.24, n = 69, p < 0.001) and the flexural modulus of elasticity was correlated with them (R2 = 0.14, n = 69, p < 0.001). Multiple linear regression analyses revealed that the shear bond strength was 17.877 + 0.166, the flexural strength was 0.643, and the flexural modulus was (R2 = 0.51, n = 69, p < 0.001). The flexural strength or flexural modulus of elasticity may be used to predict the bond strength of resin cements to LDS.
Collapse
Affiliation(s)
- Masao Irie
- Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
- Correspondence: ; Tel.: +81-86-235-6668
| | - Masahiro Okada
- Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
| | - Yukinori Maruo
- Department of Prosthodontics, Division of Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
| | - Goro Nishigawa
- Department of Prosthodontics, Division of Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
| | - Takuya Matsumoto
- Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
| |
Collapse
|
49
|
Barile G, Capodiferro S, Muci G, Carnevale A, Albanese G, Rapone B, Corsalini M. Clinical Outcomes of Monolithic Zirconia Crowns on Posterior Natural Abutments Performed by Final Year Dental Medicine Students: A Prospective Study with a 5-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2943. [PMID: 36833639 PMCID: PMC9966316 DOI: 10.3390/ijerph20042943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
The conventional metal-ceramic is still considered the gold standard in fixed prosthetics especially in terms of longevity. Among alternative materials used, Monolithic Zirconia has shown the capability to reconcile excellent biomechanical properties with acceptable aesthetic performance and to overcome several inconveniences related to veneer restorations. This study aims to clinically evaluate Monolithic Zirconia prosthetic crowns on natural abutments in the posterior sectors, performed by final-year dental medicine students (undoubtedly with less experience in the management of such material) by the standardized California Dental Association score system evaluation, to better understand the viability of Monolithic Zirconia. This prospective study was carried out at the Dental School of the University of Bari "Aldo Moro", Italy. Prosthetic rehabilitation included single crowns or a short pontic prosthesis with maximum one intermediate. Final-year dental students performed tooth reduction under the supervision of three expert tutors. The California Dental Association systematics (based on color, surface, anatomical shape, and marginal integrity) were adopted to evaluate the prosthetic maintenance status over time. Annual follow-up visits were re-evaluated by the same parameters each year. Univariate logistic regression analysis was performed to evaluate outcomes and the Kaplan-Meier plot to report survival. The sample consists of 40 crowns performed on 31 patients, 15 males (48.4%) and 16 females (51.6%) with an average age of 59.3 years. The clinical cases subjected to experimental study were found to be "Excellent" (1a/2a/3a/4a) in 34 cases (85%), "Acceptable" in 4 cases (10%), and "To be re-done" in 2 cases (failures) (5%). Our conclusive data support the predictability of Monolithic Zirconia restorations on natural posterior abutments at a long-term follow-up of five years, even when performed by less-experienced clinicians.
Collapse
Affiliation(s)
- Giuseppe Barile
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giovannino Muci
- Dental School, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Giovanni Albanese
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Massimo Corsalini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| |
Collapse
|
50
|
Guncu MB, Aktas G, Turkyilmaz I, Gavras JN. Performance of high-translucent zirconia CAD/CAM fixed dental prostheses using a digital workflow: A clinical study up to 6 years. J Dent Sci 2023; 18:44-49. [PMID: 36643237 PMCID: PMC9831836 DOI: 10.1016/j.jds.2022.07.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 07/30/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose Zirconia has recently become a popular material for fixed restorations. The purpose of this study was to use a digital workflow to fabricate monolithic zirconia fixed dental prostheses (FDPs) and assess the connection between variable connector sizes compared to their clinical performance. Materials and methods Clinicians evaluated monolithic zirconia FDPs in 58 patients. After definitive impressions were made, stone casts were obtained. The stone casts were scanned to a standard triangle language (STL) file. A digital wax up was fabricated, and corresponding provisional restorations were milled. Final FDPs were fabricated from a high-translucent zirconia material. During digital fabrication, the connector area of each FDP was recorded while meticulous attention was paid to ensure that the connector cross-sectional area was ≥9 mm2 for the 3-unit restorations (pontic to retainer) and ≥12 mm2 for the 4-unit restorations (pontic to pontic). Biological an technical outcomes of the FDPs were performed at 1 week, 6 months and then annually for 6 consecutive years. Results A total of 23 men and 35 women received a total of 63 full-contour zirconia FDPs in the posterior regions and were observed for a time period ranging between 50 and 70 months. No decementation occurred and no caries were detected during the observation period, however signs of gingivitis were detected in 4 patients. The dimension of the connector areas was 12 mm2 in the two broken 4-unit FDPs. Conclusion The results of this study suggest that the use of digital scanning and milling to fabricate monolithic zirconia FDPs of posterior regions may be an acceptable alternative restorative approach to traditional metal-ceramic restorations.
Collapse
Affiliation(s)
- Mustafa Baris Guncu
- Department of Prosthodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Guliz Aktas
- Department of Prosthodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ilser Turkyilmaz
- Department of Prosthodontics, New York University College of Dentistry, New York, NY, USA,Corresponding author. New York University College of Dentistry, Department of Prosthodontics, 380 Second Avenue, Suite 302, New York, NY, 10010, USA.
| | | |
Collapse
|