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Li X, Liang S, Inokoshi M, Zhao S, Hong G, Yao C, Huang C. Different surface treatments and adhesive monomers for zirconia-resin bonds: A systematic review and network meta-analysis. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:175-189. [PMID: 38938474 PMCID: PMC11208804 DOI: 10.1016/j.jdsr.2024.05.004] [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: 01/06/2024] [Revised: 05/03/2024] [Accepted: 05/15/2024] [Indexed: 06/29/2024] Open
Abstract
This review examined the efficacy of surface treatments and adhesive monomers for enhancing zirconia-resin bond strength. A comprehensive literature search in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library yielded relevant in vitro studies. Employing pairwise and Bayesian network meta-analyses, 77 articles meeting inclusion criteria were analyzed. Gas plasma was found to be ineffective, while treatments including air abrasion, silica coating, laser, selective infiltration etching, hot etching showed varied effectiveness. Air abrasion with finer particles (25-53 µm) showed higher immediate bond strength than larger particles (110-150 µm), with no significant difference post-aging. The Rocatec silica coating system outperformed the CoJet system in both immediate and long-term bond strength. Adhesives containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) were superior to other acidic monomers. The application of 2-hydroxyethyl methacrylate and silane did not improve bonding performance. Notably, 91.2 % of bonds weakened after aging, but this effect was less pronounced with air abrasion or silica coating. The findings highlight the effectiveness of air abrasion, silica coating, selective infiltration etching, hot etching, and laser treatment in improving bond strength, with 10-MDP in bonding agents enhancing zirconia bonding efficacy.
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Affiliation(s)
- Xinyang Li
- 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 430079, China
| | - Shengjie Liang
- 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 430079, China
| | - Masanao Inokoshi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1–5-45 Yushima, Bunkyo-ku, Tokyo 113–8549, Japan
| | - Shikai Zhao
- 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 430079, China
| | - Guang Hong
- Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Chenmin Yao
- 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 430079, 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 430079, China
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Kang CM, Hsu WC, Chen MS, Wu HY, Mine Y, Peng TY. Fracture characteristics and translucency of multilayer monolithic zirconia crowns of various thicknesses. J Dent 2024; 145:105023. [PMID: 38670331 DOI: 10.1016/j.jdent.2024.105023] [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: 02/08/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVES Multilayer monolithic zirconia (M-Zr) crowns can be engineered to achieve gradational translucency and color intensity. However, this modification may compromise the mechanical strength, raising concerns regarding the ability of M-Zr crowns to withstand occlusal stresses. The effects of M-Zr crown thickness on translucency and ability to endure occlusal forces were investigated at different tooth positions (incisors, premolars, and molars). The objective was to determine the minimal thickness of M-Zr crowns used in tooth preparation to meet aesthetic and functional demands. METHODS M-Zr samples (Vita A1) with four thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were prepared and subjected to translucency testing using a digital colorimeter by 3-third and 9-square division methods. Crown-shaped M-Zr samples with three thicknesses (1.0, 1.5, and 2.0 mm) and three tooth positions (incisor, premolar, and molar) were digitally designed, and 2.0 mm metal abutments were fabricated. The samples were bonded to the abutments; their fracture characteristics were evaluated using a universal testing machine, and their fracture surfaces examined using an optical microscope. Statistical analyses included the Shapiro-Wilk test, Pearson correlation, and one-way and two-way ANOVA with a post hoc Tukey HSD test (α = 0.05). RESULTS Color analysis results revealed a significant negative correlation between thickness and translucency (r < -0.96, P < 0.01), with the highest values in the incisal region. Cross-sectional profiles confirmed the uniform thickness and morphology of the digitally designed M-Zr crowns. The results of fracture strength analysis showed position-dependent variability, a strong positive correlation with thickness (r > 0.96, P < 0.01), and fracture strengths consistently exceeding 1200 N across all tooth positions. Fracture patterns indicated that thinner crowns at the incisors and molars were more prone to cracking, whereas those at the premolars demonstrated significantly higher strength (4872.51 N, P < 0.05), only with crack or even no fracture occurring at 2.0 mm. CONCLUSIONS Thickness significantly influenced both the translucency and fracture strength of M-Zr, with the tooth position playing an additional role, albeit to a lesser extent. Although thinner crowns exhibited lower strength at each tooth position, even at a thickness of 1.0 mm, fracture strength exceeding 1200 N was maintained, surpassing the typical occlusal forces. Thus, it can be asserted that M-Zr crowns with a minimum thickness of 1.0 mm can meet both aesthetic and functional requirements.
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Affiliation(s)
- Chien-Ming Kang
- Huayi Dental Laboratory, Taipei, Taiwan; School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Chieh Hsu
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Oral Hygiene, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan; Research Center of Precision Biomedical Implants, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - May-Show Chen
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsuan-Yu Wu
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yuichi Mine
- Department of Medical Systems Engineering, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Project Research Center for Integrating Digital Dentistry, Hiroshima University, Hiroshima, Japan
| | - Tzu-Yu Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
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Ushijima K, Hiraishi N, Ikeda M, Tsuji Y, Tsuchida Y, Shimada Y. Effect of water glass treatment for zirconia and silane coupling on bond strength of resin cement. Clin Oral Investig 2024; 28:305. [PMID: 38722356 DOI: 10.1007/s00784-024-05680-9] [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: 03/09/2024] [Accepted: 04/22/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE To evaluate the ability of the water glass treatment to penetrate zirconia and improve the bond strength of resin cement. MATERIAL AND METHODS Water glass was applied to zirconia specimens, which were then sintered. The specimens were divided into water-glass-treated and untreated zirconia (control) groups. The surface properties of the water-glass-treated specimens were evaluated using surface roughness and electron probe micro-analyser (EPMA) analysis. A resin cement was used to evaluate the tensile bond strength, with2 and without a silane-containing primer. After 24 h in water storage at 37 °C and thermal cycling, the bond strengths were statistically evaluated with t-test, and the fracture surfaces were observed using SEM. RESULTS The water glass treatment slightly increased the surface roughness of the zirconia specimens, and the EPMA analysis detected the water glass penetration to be 50 μm below the zirconia surface. The application of primer improved the tensile bond strength in all groups. After 24 h, the water-glass-treated zirconia exhibited a tensile strength of 24.8 ± 5.5 MPa, which was significantly higher than that of the control zirconia (17.6 ± 3.5 MPa) (p < 0.05). After thermal cycling, the water-glass-treated zirconia showed significantly higher tensile strength than the control zirconia. The fracture surface morphology was mainly an adhesive pattern, whereas resin cement residue was occasionally detected on the water-glass-treated zirconia surfaces. CONCLUSION The water glass treatment resulted in the formation of a stable silica phase on the zirconia surface. This process enabled silane coupling to the zirconia and improved the adhesion of the resin cement.
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Affiliation(s)
- Kei Ushijima
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8549, Japan
| | - Noriko Hiraishi
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8549, Japan.
| | - Masaomi Ikeda
- Oral Biomedical Engineering, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8549, Japan.
| | - Yukiko Tsuji
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8549, Japan
| | - Yumi Tsuchida
- Department of Digital Dentistry, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8549, Japan
| | - Yasushi Shimada
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8549, Japan
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Ahmed N, Adil H, Batool U, Sakrani H, Heboyan A. Transforming smiles: Aesthetic rehabilitation with layered zirconia veneers and crowns for spaced dentition and faulty crowns-A case report. SAGE Open Med Case Rep 2024; 12:2050313X241248385. [PMID: 38680597 PMCID: PMC11047240 DOI: 10.1177/2050313x241248385] [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: 07/03/2023] [Accepted: 04/03/2024] [Indexed: 05/01/2024] Open
Abstract
The objective of this case report was to provide a plan for aesthetic rehabilitation of a patient utilizing layered zirconia restorations to produce a homogeneous, pleasing smile. In this case, a female patient, aged 38 years, presented in dental clinic with a spaced dentition and faulty crowns that were causing functional and aesthetic concerns. She was a banker by profession and socially active. The treatment plan involved layered zirconia indirect restorations to enhance her natural teeth appearance. The aim of this case report was to propose an effective strategy for addressing her concerns, with the potential to achieve a desired aesthetic outcome. Additionally, the implementation of this treatment approach had a positive influence on self-esteem and confidence of the patient.
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Affiliation(s)
- Naseer Ahmed
- Department of Prosthodontics Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Huda Adil
- Department of Prosthodontics Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Uzma Batool
- Department of Prosthodontics Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Hasnain Sakrani
- Department of Orthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
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Abdou A, Hussein N, Abd El-Sattar NEA, Takagaki T, Kusumasari C, Rizk A, Abo-Alazm EA. MDP-salts as an adhesion promoter with MDP-primers and self-adhesive resin cement for zirconia cementation. BMC Oral Health 2023; 23:907. [PMID: 37993834 PMCID: PMC10666379 DOI: 10.1186/s12903-023-03663-y] [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: 08/10/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
PURPOSE To evaluate the effect of zirconia priming with MDP-Salt before MDP containing primers and self-adhesive cement on the shear bond strength. MATERIALS AND METHODS Fully sintered high translucent zirconia specimens (n = 120) were assigned into 2 groups (n = 60 each): Control (No Pretreatment) and Methacryloyloxydecyl dihydrogen phosphate salt (MDP-Salt) pretreated. Each group was divided into 3 subgroups (n = 20) according to cementation protocol: 1) MDP + Silane primer and conventional resin cement, 2) MDP+ Bisphenyl dimethacrylate (BPDM) primer and conventional resin cement, and 3) MDP containing self-adhesive resin cement. Shear bond strength (SBS) was measured after 10,000 thermocycling. Contact angle was measured for tested groups. Surface topography was assessed using a 3D confocal laser scanning microscope (CLSM). Weibull analysis was performed for SBS and one-way ANOVA for contact angle and surface topography measurements (α = 0.05). RESULTS The use of MDP-Salt significantly improved the SBS (p < .05) for all tested subgroups. Self-adhesive cement showed an insignificant difference with MDP + Silane group for both groups (p > .05). MDP + BPDM showed a significantly lower characteristic strength compared to self-adhesive resin cement when both were pretreated with MDP-Salt. No difference between all tested groups in the surface topographic measurements while MDP-Salt showed the highest contact angle. CONCLUSION MDP-Salt pretreatment can improve bonding performance between zirconia and MDP containing products.
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Affiliation(s)
- Ahmed Abdou
- Faculty of Dentistry, Al-Ayen University, Thi-Qar, Nasiriyah, Iraq
| | - Nasser Hussein
- Fixed Prosthodontics Department, Faculty of Dentistry, Modern University for Technology, and Information, Mokatam, Cairo, Egypt
| | - Nour E A Abd El-Sattar
- Department of Chemistry, Organic Labs, Faculty of Science, Ain Shams University, Abbasiya, Cairo, 11566, Egypt
- Basic & Medical Sciences Department, Faculty of Dentistry, Alryada University for Science & Technology, Menoufia, Egypt
| | - Tomohiro Takagaki
- Department of Operative Dentistry, Oral Functional Science and Rehabilitation Division, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Citra Kusumasari
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
| | - Amr Rizk
- Prosthetic Dentistry Department, Fixed Prosthodontic Division, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt
| | - Emad A Abo-Alazm
- Restorative Dentistry Department, Faculty of Dentistry, Egyptian Russian University, Badr City, Cairo, Egypt
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Abdou A, Hussein N, Kusumasari C, Abo-Alazm EA, Rizk A. Alumina and glass-bead blasting effect on bond strength of zirconia using 10-methacryloyloxydecyl dihydrogen phosphate (MDP) containing self-adhesive resin cement and primers. Sci Rep 2023; 13:19127. [PMID: 37926736 PMCID: PMC10625984 DOI: 10.1038/s41598-023-46548-4] [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: 09/16/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023] Open
Abstract
In fact, bonding of zirconia restorations is still a big challenge in clinical situations and many bonding protocols discussed in literature might be still controversial. The aim of this was to study assess the bond strength of zirconia after alumina and glass-bead pre-treatments with two different primers in combination with conventional resin cement and 10-methacryloyloxydecyl dihydrogen phosphate (MDP) containing self-adhesive resin cement without priming. Fully sintered high translucent zirconia samples (n = 160) were assigned into 2 groups of pre-treatments (n = 80): Alumina-sandblasting (AB) and Glass-bead (GB). Then, each group was divided into 4 sub-groups according to priming and cement used (n = 20 each): conventional self-adhesive resin cement, MDP-silane Primer, MDP primer both with conventional self-adhesive resin cement, and MDP contained cement. Shear bond strength (SBS) was measured after thermocycling. Failure mode was analyzed using stereomicroscope. Contact angle and surface topography were investigated using other fully sintered samples (n = 30) constructed for that sole purpose, divided into control (no pre-treatment [unmodified], alumina-, and glass-bead sandblasted groups). Two-way ANOVA was performed for SBS and failure mode was analyzed. The use of Alumina-sandblasting showed higher SBS compared to Glass-bead pre-treatment for MDP-silane primer (p = 0.034) and MDP primer (p < 0.001). While MDP contained cement showed higher but insignificant SBS when pre-treated with glass-beads. Alumina-sandblasting and glass-bead pre-treatments improve bond strength of zirconia combined using primers before cementation with conventional resin cement. Also, self-adhesive MDP contained cement along with surface pre-treatment showed the highest achievable bond strength. It was concluded that both alumina-sandblasting and glass-bead blasting improved SBS combined with MDP containing self-adhesive resin cement reducing the required clinical steps during cementation of zirconia restorations.
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Affiliation(s)
- Ahmed Abdou
- Faculty of Dentistry, Al-Ayen University, Thi-Qar, Iraq
| | - Nasser Hussein
- Fixed Prosthodontics Department, Faculty of Dentistry, Modern University for Technology, and Information, Mokatam, Cairo, Egypt
| | - Citra Kusumasari
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
| | - Emad A Abo-Alazm
- Restorative Dentistry Department, Faculty of Dentistry, Egyptian Russian University, Badr City, Cairo, Egypt
| | - Amr Rizk
- Prosthetic Dentistry Department, Fixed Prosthodontics Division, Faculty of Dentistry, King Salman International University, South Sinai, El Tur, 46511, Egypt
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Uğur M, Kavut İ, Tanrıkut ÖO, Cengiz Ö. Effect of ceramic primers with different chemical contents on the shear bond strength of CAD/CAM ceramics with resin cement after thermal ageing. BMC Oral Health 2023; 23:210. [PMID: 37041493 PMCID: PMC10091622 DOI: 10.1186/s12903-023-02909-z] [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: 12/23/2022] [Accepted: 03/24/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND This study evaluated the effect of ceramic primers containing 10-methacryloyloxydecyl phosphate (10-MDP) and γ-methacryloxypropyl trimethoxysilane (γ-MPTS) agents on the shear bond strength (SBS) of CAD/CAM ceramics with different chemical structures and resin cement. METHODS A total of 640 CAD/CAM ceramic specimens were obtained from Vita Mark II (VM), IPS E.max CAD (EM), Vita Suprinity (VS) and Vita Enamic (VE). The specimens were divided into two groups: etched with hydrofluoric acid (HF) and unetched. Each group was treated with a different ceramic primer (Clearfil Ceramic Primer Plus, G-Multi Primer and Monobond S), except for an untreated group (n = 10). After ceramic primers and resin cement were applied to each ceramic surface, half of the specimens were thermally aged at 10,000 cycles, 5-55 ± 1 °C, with a dwell time of 30 s. The SBS was tested with a universal testing machine at a 0.5 mm/min crosshead speed. Data were analysed by using statistical software (SPSS 20). Normal data distribution was checked with the Shapiro‒Wilk test. Three-way ANOVA was used to analyse the difference between the numeric data of the HF etched and thermally aged groups. A post hoc Tukey test was applied in the paired comparison of significant difference. The statistical significance level was accepted as p < 0.05. RESULTS The highest SBS values were obtained in the HF etched G-Multi primer applied nonaged EM group (28.3 ± 2.62 MPa), while the lowest values were obtained in the nonetched and thermally aged EM group that received no treatment (2.86 ± 0.04 Mpa). The SBS significantly increased in all specimens on which the ceramic primer was applied (p < 0.001). Thermal ageing had a significant negative effect on the SBS values in all groups (p < 0.001). CONCLUSION The positive combined effects of the 10-MDP and γ-MPTS agents resulted in a significant increase in the bonding strength of the resin cement to the CAD/CAM ceramics. In addition, the increase in the amount of inorganic filler provided a favourable effect on durable adhesion.
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Affiliation(s)
- Mehmet Uğur
- Department of Prosthodontics, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey
| | - İdris Kavut
- Department of Prosthodontics, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey.
| | - Özgür Ozan Tanrıkut
- Department of Prosthodontics, Faculty of Dentistry, Mersin University, Mersin, Turkey
| | - Önder Cengiz
- Gungoren Oral and Dental Health Center, Istanbul, Turkey
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Rues S, Zehender N, Zenthöfer A, Bömicke W, Herpel C, Ilani A, Erber R, Roser C, Lux CJ, Rammelsberg P, Schwindling FS. Fit of anterior restorations made of 3D-printed and milled zirconia: An in-vitro study. J Dent 2023; 130:104415. [PMID: 36640843 DOI: 10.1016/j.jdent.2023.104415] [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: 07/19/2022] [Revised: 12/23/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To evaluate the fit of zirconia veneers made by either 3D printing or milling. METHODS A typodont maxillary central incisor was prepared for a 0.5-mm-thick veneer and was reproduced 36 times from resin. Restorations were designed with a 20-µm-wide marginal and a 60-µm-wide internal cement gap, and were made from 3D-printed zirconia (LithaCon 3Y 210, Lithoz, n = 24) and milled zirconia (Cercon ht, DentsplySirona, n = 12). For milled zirconia, a drill compensation was needed to give the milling bur access to the intaglio surface. The restorations were cemented, cross-sectioned, and the cement gap size was analyzed by two raters. Inter-rater reliability was studied at 12 3D-printed veneers (intraclass correlation coefficient, ICC, mixed model, absolute agreement). Twelve remaining 3D-printed restorations were compared with 12 milled restorations regarding fit at three locations: marginally, labially, and at the incisal edge (Mann-Whitney U-tests, α<0.05). RESULTS Inter-rater reliability was excellent, with an ICC single-measure coefficient of 0.944 (95%-confidence interval: [0.907; 0.966]). Gap sizes (mean ± SD / maximum) were 55 ± 9 / 143 µm at the margins, 68 ± 14 / 130 µm labially, and 78 ± 19 / 176 µm at the incisor edge for 3D-printed veneers. For milled veneers, gap sizes were 44 ± 11 / 141 µm at the margins, 85 ± 19 / 171 µm labially, and 391 ± 26 / 477 µm at the incisor edge. At the margins, the milled veneers outperformed the 3D-printed restorations (p = 0.011). The cement gap at the incisor edge was significantly smaller after 3D printing (p < 0.001). CONCLUSIONS 3D-printed zirconia restorations showed clinically acceptable mean marginal gaps below 100 µm. Because drill compensation could be omitted with 3D printing, the fit at the sharp incisal edge was significantly tighter than with milling. CLINICAL SIGNIFICANCE The fit of 3D-printed ceramic anterior restorations meets clinical standards. In addition, 3D printing is associated with a greater geometrical freedom than milling. With regard to fit this feature allows tighter adaptation even after minimally invasive preparation.
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Affiliation(s)
- Stefan Rues
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Nathalie Zehender
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Zenthöfer
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Bömicke
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher Herpel
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Ilani
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Ralf Erber
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Roser
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
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Recen D, Yildirim B, Çeliksöz Ö. The effects of applying a novel cleaner on the bonding strength of zirconia surfaces. Proc Inst Mech Eng H 2023; 237:385-394. [PMID: 36727619 DOI: 10.1177/09544119231151268] [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: 02/03/2023]
Abstract
This study evaluates how pre-treatment with an MDP-containing cleaning agent (Katana Cleaner, Kuraray) influences the micro-shear bond strength (µSBS) of saliva-contaminated zirconia when used with universal adhesive (UA) systems. Rectangular specimens (2 mm × 12 mm × 15 mm) were obtained (IPS, e.max ZirCAD, MO, B65L17, Ivoclar Vivadent) and divided into three groups; a non-contaminated group (control group)(CON), a contaminated and cleaned with isopropyl alcohol group(ISP), and lastly, a group contaminated and cleaned with an MDP-containing cleaning agent(KAC). Each group was then subdivided into three subgroups according to the UAs used (n = 12). Composite cylinders were prepared and bonded to each surface with Panavia V5 (Kuraray, Noritake Dental). A µSBS test was performed and the data were evaluated with the two-way analysis of variance (two-way ANOVA) and multiple comparisons test (α = 0.05). The highest µSBS values were obtained in the non-contaminated group (p < 0.001), regardless of UAs. All subgroups showed lower µSBS values after saliva contamination, but KAC resulted in significantly higher µSBS values than 99% isopropanol (p < 0.001). Overall, the lowest µSBS value was obtained with 99% isopropanol. The KAC-Clearfil UA subgroup resulted in statistically significantly higher µSBS values than the other UAs (p = 0.035 and 0.007), although all three UAs resulted in sufficient µSBS values. This study revealed that applying KAC followed by a UA containing phosphate monomers produces promising results for improving µSBS values of zirconia, greater than results using 99% isopropanol.Clinical relevance: An MDP-containing cleaning agent followed by a phosphate monomer containing a universal adhesive is a promising method to obtain acceptable bonds with saliva-contaminated zirconia ceramics.
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Affiliation(s)
- Duygu Recen
- Faculty of Dentistry, Department of Restorative Dentistry, İzmir Democracy University, İzmir, Turkey
| | - Bengisu Yildirim
- Faculty of Dentistry, Department of Prosthodontics, Usak University, Uşak, Turkey
| | - Özge Çeliksöz
- Faculty of Dentistry, Department of Restorative Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
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