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Cantelli V, Meirelles MT, Della Bona A. Fatigue methods for evaluating translucent dental zirconia. J Dent 2024; 148:105242. [PMID: 39009334 DOI: 10.1016/j.jdent.2024.105242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024] Open
Abstract
OBJECTIVE To investigate fatigue methods for the evaluation of translucent zirconia and to associate in vitro failures with clinically reported ones. DATA Studies published in English that used fatigue tests on dental translucent zirconia. SOURCES Two databases (MEDLINE/PubMed and Scopus) were electronically searched without any restriction on year of publication. STUDY SELECTION A total of 4555 studies were identified. After removal of duplicates (78) and irrelevant articles (4316) that did not meet the inclusion criteria, 161 articles were considered eligible based on their titles and abstracts. These articles were fully read, leading to the inclusion of 41 studies in the review. RESULTS The most widely used fatigue method for evaluation of translucent zirconia was step-stress (18 articles), followed by staircase (seven articles), and step-wise (two articles). Most studies had been conducted in a wet environment with the use of a stainless steel piston to apply load to cemented structures on a dentin-like substrate. Most fracture analyses indicated the fracture originated on the cementation or contact surface where the load was applied. Moreover, studies that utilized anatomical structures (dental crowns) reported fractures starting at the cervical margin of the crowns. CONCLUSION Most studies used the step-stress method. Only three studies reported failures similar to those found in clinical trials that used translucent zirconia restorations. CLINICAL SIGNIFICANCE The study findings can assist on correlating clinical failures to the ones observed in vitro.
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Affiliation(s)
- Viviane Cantelli
- Post-graduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Marcelo Tapparo Meirelles
- Graduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Alvaro Della Bona
- Post-graduate Program in Dentistry, School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil.
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Huang B, Chen M, Wang J, Zhang X. Advances in zirconia-based dental materials: Properties, classification, applications, and future prospects. J Dent 2024; 147:105111. [PMID: 38866229 DOI: 10.1016/j.jdent.2024.105111] [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: 03/14/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVES Zirconia (ZrO2) ceramics are widely used in dental restorations due to their superior mechanical properties, durability, and ever-improving translucency. This review aims to explore the properties, classification, applications, and recent advancements of zirconia-based dental materials, highlighting their potential to revolutionize dental restoration techniques. STUDY SELECTION, DATA AND SOURCES The most recent literature available in scientific databases (PubMed and Web of Science) reporting advances of zirconia-based materials within the dental field is thoroughly examined and summarized, covering the major keywords "dental zirconia, classification, aesthetic, LTD, applications, manufacturing, surface treatments". CONCLUSIONS An exhaustive overview of the properties, classifications, and applications of dental zirconia was presented, alongside an exploration of future prospects and potential advances. This review highlighted the importance of addressing challenges such as low-temperature degradation resistance and optimizing the balance between mechanical strength and translucency. Also, innovative approaches to improve the performances of zirconia as dental material was discussed. CLINICAL SIGNIFICANCE This review provides a better understanding of zirconia-based dental biomaterials for dentists, helping them to make better choice when choosing a specific material to fabricate the restorations or to place the implant. Moreover, new generations of zirconia are still expected to make progress on key issues such as the long-term applications in dental materials while maintaining both damage resistance and aesthetic appeal, defining the directions for future research.
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Affiliation(s)
- Bo Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Mengbing Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xin Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Vijan K. Emerging trends and clinical recommendations for zirconia ceramic crowns: a concise review. Br Dent J 2024; 237:28-32. [PMID: 38997367 PMCID: PMC11245382 DOI: 10.1038/s41415-024-7616-0] [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: 07/06/2023] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 07/14/2024]
Abstract
Introduction A little over ten years ago, zirconia crowns made their debut in the field of dentistry. Despite early problems with the chipping of veneering porcelain, clinical studies have demonstrated excellent performance. It is essential for a ceramic crown to have good aesthetic qualities, in addition to having good mechanical characteristics. The exceptional mechanical qualities of zirconia crowns and the simplicity with which they may be machined, employing computer-aided design and computer-aided manufacturing schemes, are primarily responsible for the widespread use of these materials in clinical settings. New ceramic-based materials, including monolithic zirconia, zirconia-containing lithium disilicate ceramics, and graded glass/zirconia/glass, have recently been launched in the field of dentistry. These newly discovered zirconia crown materials stem from varied technological approaches, each likely to lead to additional clinical advancements. At this point, it seems imperative to offer a concentrated report on the newer developments, along with essential clinical recommendations for best clinical outcomes with zirconia crowns.Types of studies This review article is a consolidation of several case studies, cohort studies and systematic reviews, as well as experimental and observational randomised control trials and other peer-reviewed articles.Results On reviewing, a concise list of clinical recommendations is generated, demonstrating that monolithic zirconia offers some clinical advantages over veneered zirconia crowns.Conclusion This review article discloses various clinical revelations and in-office recommendations for favourable usage of zirconia ceramic crowns that can lead to better patient outcomes and long-term clinical success rates.
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Kondo D, Komada W, Oishi S, Fueki K. Surface strain at the cervical area and fracture strength of flared root canals reinforced using a zirconia tube and glass-fiber post. J Dent Sci 2024; 19:1571-1577. [PMID: 39035343 PMCID: PMC11259610 DOI: 10.1016/j.jds.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/19/2023] [Indexed: 07/23/2024] Open
Abstract
Background/purpose Recently, an effective core build-up system for teeth with flared root canals is needed. This research aimed to evaluate the effect of foundation restorations using a composite resin core with a fiber post reinforced with a zirconia tube for the surface strain at the cervical area and the fracture load of teeth with flared root canals. Materials and methods Bovine teeth were shaped to mimic human premolars with flared root canals and restored using three types of composite resin foundation restorations with each materials described below: a fiber post (FC), a zirconia tube (ZC), a fiber post and zirconia tube (ZFC). Each specimen was restored with a zirconia crown. The surface strains of the specimens at the cervical area and fracture loads were analyzed using a one-way analysis of variance (ANOVA), followed by Tukey's honest significant difference test. Results The surface strains of Groups ZFC and ZC were significantly lower than that of Group FC in the buccal root. The fracture strengths of Groups ZFC and ZC were significantly higher than that of Group FC. The strength of Group ZFC was significantly higher than that of Group ZC. Conclusion The use of a composite resin core with a zirconia tube for the simulated premolar with flared root canals reduced surface strain at the cervical area and provided higher fracture strength compared to using a composite resin core with a fiber post. And the zirconia tubes provided even higher fracture strength when used with a fiber post.
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Affiliation(s)
- Daiki Kondo
- Division of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Komada
- Division of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinya Oishi
- Division of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenji Fueki
- Division of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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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.
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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
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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.
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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
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Naffah N, Ounsi H, Ozcan M, Salameh Z. Evaluation of the Color Stability of Three Resin-Ceramic Materials Using a Spectrophotometer and a Digital Photography Software. Contemp Clin Dent 2024; 15:44-50. [PMID: 38707666 PMCID: PMC11068248 DOI: 10.4103/ccd.ccd_656_18] [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: 08/27/2018] [Revised: 11/15/2018] [Accepted: 11/26/2018] [Indexed: 05/07/2024] Open
Abstract
Background Computer-aided design/computer-aided manufacturing (CAD/CAM) resin ceramics allow easier milling than glass ceramics but are suspected to be more stainable. Although Photoshop® is widely used for picture analysis, its potential for shade selection has not been properly assessed. Aim Purpose primary: To evaluate the color stability of three CAD/CAM resin ceramics and Lithium Disilicate. Secondary: to compare the color evaluation between a spectrophotometer (Vita Easyshade compact) and Photoshop software. Materials and Methods Three CAD/CAM resin ceramic materials (n = 10) and a fourth group of lithium disilicate were used. Half of each group were thermocycled (5°C and 55°C; 3000 cycles). All samples were immersed in colored beverages (coffee, tea and red wine) for 30 days. Values were obtained by spectrophotometry and photographs analyzed using Photoshop software. The parameters measured were CIEL*a*b, and the color difference (ΔE) was analyzed. A mixed model test was used to compare the results through time and materials (α = 0.05). The comparison between the spectrophotometer and Photoshop results was performed using the bivariate Pearson's correlation test. Results Lithium disilicate glass ceramic exhibited less color change (ΔE = 14) than resin ceramics (15.7 < ΔE < 18.7). The least change was noted with GC Cerasmart (ΔE = 15.7) followed by Vita Enamic (ΔE = 17*) and Brilliant Crios (ΔE = 18.7*). Spectrophotometer and Photoshop values showed low correlations. Conclusions Resin ceramics may suffer from color change in clinical use. Photoshop is technique sensitive; pictures are easily affected by the light conditions and camera settings.
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Affiliation(s)
- Nicolas Naffah
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Hani Ounsi
- Department of Endodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
- Faculty of Dental Medicine, Siena University, Siena, Italy
| | - Mutlu Ozcan
- University of Zurich, Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, Zurich, Switzerland
| | - Ziad Salameh
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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Dewan H. Clinical Effectiveness of 3D-Milled and 3D-Printed Zirconia Prosthesis-A Systematic Review and Meta-Analysis. Biomimetics (Basel) 2023; 8:394. [PMID: 37754145 PMCID: PMC10526775 DOI: 10.3390/biomimetics8050394] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/05/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Additive manufacturing (three-dimensional (3D) printing) has become a leading manufacturing technique in dentistry due to its various advantages. However, its potential applications for dental ceramics are still being explored. Zirconia, among ceramics, has increasing popularity and applications in dentistry mostly due to its excellent properties. Although subtractive manufacturing (3D milling) is considered the most advanced technology for the fabrication of zirconia restorations, certain disadvantages are associated with it. METHODS A systematic review was piloted to compare the clinical performance of zirconium crowns that were fabricated using three-dimensional (3D) milling and 3D printing. A meta-analysis was performed, and studies published up to November 2022 were identified. The terms searched were "Zirconium crowns", "3D printing", "CAD/CAM" (Computer-Aided Design and Computer-Aided Manufacturing), "Milling", "dental crowns", and "3D milling". The characteristics that were compared were the year in which the study was published, study design, age of the patient, country, the number of crowns, the type of crown fabrication, marginal integrity, caries status, and outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to structure this systematic review. Out of eleven hundred and fifty titles identified after a primary search, nine articles were included in the quantitative analysis. The research question based on PICO/PECO (Participant, Intervention/exposure, Comparison, and Outcome) was "Do 3D-printed and milled (P) zirconia crowns and FDPs (I) have a better survival rate (O) when conventional prosthesis is also an option (C)"? The data collected were tabulated and compared, and the risk of bias and meta-analysis were later performed. Only nine articles (clinical research) were selected for the study. Since there were no clinical studies on the 3D printing of zirconium crowns, six in vitro studies were considered for the comparison. Zirconium crowns in the milling group had an average minimum follow-up of 6 months. RESULTS A moderate risk of bias was found, and survival was significant. A high heterogeneity level was noted among the studies. Marginal integrity, periodontal status, and survival rate were high. Linear regression depicted no statistical correlation between the type of cement used and the survival rate. CONCLUSIONS It can be concluded that the milled crowns had a higher performance and satisfactory clinical survival.
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Affiliation(s)
- Harisha Dewan
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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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.
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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
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Oishi S, Komada W, Tsukahara R, Yoshimatsu S, Kondo D, Omori S, Nozaki K, Miura H, Fueki K. A composite resin core with a new zirconia tube reduces the surface strain at the cervical area of a mandibular molar: A model tooth study. J Prosthodont Res 2023; 67:70-76. [PMID: 35249930 DOI: 10.2186/jpr.jpr_d_21_00243] [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: 01/12/2023]
Abstract
PURPOSE This study aimed to evaluate the surface strain at the cervical area of endodontically treated molars with a large pulp chamber restored using a composite resin core with three different types of core build-up systems. METHODS Reproduction models of human mandibular molars with prepared post spaces were used in this study. Roots duplicated with a composite resin were used as the experimental teeth. Three types of core build-up systems were used: composite resin core(RC), composite resin core with fiber posts (FC), and composite resin core with a prefabricated zirconia tube (ZC). Each group comprised eight specimens. Crowns made of yttria partially stabilized zirconia were cemented with dual-cure resin cement. Four strain gauges were attached to the surfaces of each specimen: the cervical area of the root and crown, on the buccal and lingual sides. The surface strain at each cervical area was measured using a static loading test and statistically analyzed. RESULTS In the case of static loading to the buccal cusp inner slope, ZC showed a significantly lower strain than RC in the crown on the buccal side and in the root and FC in the root. In the central fossa, ZC showed a significantly lower strain than FC in the root on the lingual side. CONCLUSIONS The prefabricated zirconia tube reduced the surface strain at the cervical area of the buccal/lingual root in molars; however, the effect was small in the cervical area of the crown.
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Affiliation(s)
- Shinya Oishi
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Wataru Komada
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Ruri Tsukahara
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shu Yoshimatsu
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Daiki Kondo
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satoshi Omori
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kosuke Nozaki
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroyuki Miura
- Department of Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kenji Fueki
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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11
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Miura S, Shinya A, Koizumi H, Fujisawa M. Effect of speed sintering of monolithic zirconia with different yttria contents on color and crystal phase. Eur J Oral Sci 2022; 130:e12898. [PMID: 36335285 DOI: 10.1111/eos.12898] [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: 06/18/2022] [Accepted: 09/28/2022] [Indexed: 11/09/2022]
Abstract
This study evaluated the color and microstructure of monolithic zirconia crowns with different yttrium oxide (Y2 O3 ) contents treated by conventional or speed sintering. Four types of zirconia ceramics were assessed: two monolayer zirconia, and two multilayer zirconia. The monolithic zirconia crowns were fabricated using a dental computer-aided design/computer-aided manufacturing (CAD/CAM) system and in two shades (A2 and BL). After milling, the zirconia crowns were sintered using either speed sintering or conventional sintering. For each combination of zirconia (4), shade (2), and sintering condition (2), the color parameters were determined at three positions of each of nine crowns using a non-contact dental spectrophotometer. In addition, the zirconia phases in the specimens were quantified using X-ray diffractometry. Significant differences in the ΔE00 values at different measurement positions were observed for the Multi2 crown of the BL shade group. The color difference resulting from conventional and speed sintering programs was not affected by the difference in yttria content of Mono1, Mono2, and Multi1. However, in Multi2, containing 3Y-TZP and 5Y-PSZ, a color change was caused by the use of speed sintering. Therefore, when performing speed sintering with Multi2, it is necessary to select the color in consideration of these results or take measures for staining.
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Affiliation(s)
- Shoko Miura
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Saitama, Japan
| | - Akikazu Shinya
- Department of Dental Materials Sciences, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan.,Department of Prosthetic Dentistry and Biomaterials Science, Institute of Dentistry, University of Turku, Turku, Finland
| | - Hiroyasu Koizumi
- Department of Dental Materials, Nihon University School of Dentistry, Tokyo, Japan
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Saitama, Japan
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12
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Goto M, Oki K, Koyano K, Ayukawa Y. The 3-year cumulative survival rates of posterior monolithic zirconia crowns and their antagonist teeth, and their influencing factors. J Oral Sci 2022; 64:286-289. [PMID: 36104182 DOI: 10.2334/josnusd.22-0221] [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: 11/01/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the 3-year cumulative survival rates of posterior single monolithic zirconia crowns (MZCs) and their antagonists, and to analyze the influencing factors. METHODS The clinical outcomes of posterior single MZCs and their abutment teeth with antagonists, and the antagonists between April 2014 and September 2020 were evaluated retrospectively. The 3-year cumulative survival rates were calculated and associations between the survival time and predictor variables ("Jaw", "Tooth", and "Pulpal condition") were also verified using Cox proportional hazards models and hazard ratios (HRs). RESULTS The 3-year cumulative survival rate of single MZCs was 89.8% (9 of 177 MZCs, 95% confidence interval (CI): 80.0-95.1%). Cox proportional hazards models showed non-vital teeth were significantly associated with failure (HR: 2.76e + 9, P = 0.012). The 3-year cumulative survival rate of antagonists was 94.8% (7 of 171 antagonists, 95% CI: 89.3-97.6%). Non-vital antagonists were also identified as an independent predictor for failure in Cox proportional hazards models (HR: 7.83, P = 0.03). CONCLUSION Although posterior single MZCs were clinically acceptable, non-vital pulpal condition could be a potential risk factor for failures in the abutment and antagonist teeth of MZCs.
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Affiliation(s)
- Midori Goto
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Kyosuke Oki
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Kiyoshi Koyano
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University
| | - Yasunori Ayukawa
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
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The effect of aging on the fracture resistance of different types of screw-cement-retained implant-supported zirconia-based restorations. PLoS One 2022; 17:e0270527. [PMID: 35749553 PMCID: PMC9232153 DOI: 10.1371/journal.pone.0270527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/11/2022] [Indexed: 11/19/2022] Open
Abstract
Structural durability of screw-cement-retained implant-supported zirconia-based restorations is an important factor in choosing the best type of restoration for clinical use. This study aimed to evaluate the effects of thermocycling on the fracture resistance of different types of screw-cement-retained implant-supported zirconia-based restoration. Two experimental groups (monolithic zirconia and porcelain-veneered zirconia) and a control group of porcelain-fused-to-metal restorations were fabricated via CAD-CAM (n = 14 per group). Half of the specimens of each group (n = 7) were subjected to 10000 thermal cycles. The compressive force was applied and the force leading to fracture was measured by using a Universal Testing Machine. The fractured modes were classified under a scanning electron microscope. The data were analyzed through two-way ANOVA, one-way ANOVA, and independent samples t-test (α = 0.05). Among the non-thermocycled subgroups, the monolithic zirconia specimens were significantly more fracture-resistant than the porcelain-veneered zirconia and porcelain-fused-to-metal groups (P<0.05); but it was not the same with aging (P>0.05). Thermocycling decreased the fracture resistance of all groups; however, the difference was not statistically significant (P<0.05). The monolithic zirconia presented higher fracture resistance than the bilayered restorations for screw-cement retained implant-supported restorations. Thermocycling decreased the fracture resistance of all types of restorations insignificantly which can be clinically important.
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Kim M, Kim RH, Lee SC, Lee TK, Hayashi M, Yu B, Jo DW. Evaluation of Tensile Bond Strength between Self-Adhesive Resin Cement and Surface-Pretreated Zirconia. MATERIALS 2022; 15:ma15093089. [PMID: 35591424 PMCID: PMC9101034 DOI: 10.3390/ma15093089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 02/01/2023]
Abstract
The tensile bond strength between zirconia subjected to different surface-pretreatment methods and methacryloyloxydecyl-dihydrogen-phosphate (MDP)-containing self-adhesive resin cement was evaluated herein. Eighty-eight cylindrical zirconia specimens were randomly divided into the following four groups based on the pretreatment method: (1) no treatment, (2) air abrasion, (3) HNO3/HF etching, and (4) zirconia-nanoparticle coating. The tensile bond strength of the zirconia−resin-cement complexes was investigated. One-way ANOVA and post hoc tests were performed at a 95% significance level, and the Weibull modulus was calculated. Fracture patterns were visualized by SEM. The surface roughness of the specimens without resin bonding was evaluated by AFM. The tensile bond strength of the specimens decreased as follows: Groups 3 > 4 > 2 > 1 (28.2 ± 6.6, 26.1 ± 5.7, 16.6 ± 3.3, and 13.9 ± 3.0 MPa, respectively). Groups 3 and 4 had significantly higher tensile bond strengths (p < 0.05) and lower fracture probabilities than those of Groups 1 and 2. They also showed both mixed failure and resin-cement cohesive failure, whereas Groups 1 and 2 showed mixed failure exclusively. The zirconia−resin tensile bond was stronger after HNO3/HF etching or ZrO2-nanoparticle coating than after air abrasion or no treatment. The estimated surface roughness decreased as follows: Groups 3 > 4 > 2 > 1. The combination of zirconia pretreated with HNO3/HF etching or ZrO2-nanoparticle coating and an MDP-containing self-adhesive resin cement can increase the clinical longevity of zirconia restorations by preventing their decementation.
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Affiliation(s)
- Mijoo Kim
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Reuben H. Kim
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Samuel C. Lee
- California Smile Dental Studio, Gardena, CA 90247, USA;
| | - Thomas K. Lee
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Marc Hayashi
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Bo Yu
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Deuk-Won Jo
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam 13620, Korea
- Correspondence: ; Tel.: +82-31-787-7548
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Ordoñez Balladares A, Abad-Coronel C, Ramos JC, Martín Biedma BJ. Fracture Resistance of Sintered Monolithic Zirconia Dioxide in Different Thermal Units. MATERIALS 2022; 15:ma15072478. [PMID: 35407810 PMCID: PMC8999687 DOI: 10.3390/ma15072478] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 01/27/2023]
Abstract
The purpose of this study was to compare the fracture strength of monolithic zirconium dioxide subjected to a sintering process in two different furnaces: InFire HTC Speed and CEREC SpeedFire. Methods: Forty restorations were designed and machined using a computer aided design / computer aidded machine (CAD/CAM) system. The restorations were randomly assigned to two groups of 20 samples each, Group 1 for the SpeedFire furnace (fast sintering) and Group 2 for the InFire furnace (slow sintering). Each of the crowns was subjected to a maximum compression load recorded in Newtons (N) and a displacement control with a speed of 1 mm/min. Results: Group 1 presented an average of 1222.8 N and a standard deviation of 136.91 N. Group 2 obtained a mean of 1068.5 N and a standard deviation of 316.39 N. Conclusions: There were no significant differences between the two groups, and the mechanical strength of the material was not affected, which would imply a saving of clinical and laboratory time when performing rapid sintering on monolithic translucent zirconium dioxide restorations. However, rapidly sintered restorations have limited reliability.
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Affiliation(s)
- Andrea Ordoñez Balladares
- Faculty of Dentistry, Universidad de Guayaquil, Guayaquil 090514, Ecuador;
- Faculty of Dentistry, Universidad de Santiago de Compostela, 15782 Galicia, Spain;
| | - Cristian Abad-Coronel
- Department of Digital Dentistry and CAD/CAM Materials, Faculty of Dentistry, Universidad de Cuenca, Cuenca 010107, Ecuador
- Faculty of Dentistry, Universidad San Francisco de Quito, Quito 170901, Ecuador
- Correspondence:
| | - Joao Carlos Ramos
- Faculty of Medicine, Universidad de Coimbra, 3000-370 Coimbra, Portugal;
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Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up. Clin Oral Investig 2022; 26:4327-4335. [PMID: 35142924 PMCID: PMC9203772 DOI: 10.1007/s00784-022-04396-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022]
Abstract
Objectives To evaluate and to compare the clinical performance and survival rate of posterior monolithic and veneered zirconia fixed partial dentures (FPDs). Material and methods Sixty 3-unit posterior FPDs were included in the study. The patients were randomly distributed into two groups (n = 30 each) to receive either a monolithic (Zenostar T, Wieland Dental) or veneered zirconia (IPS e.max ZirCAD, Ivoclar Vivadent) FPD. Each patient received only 1 FPD. Tooth preparations were scanned (Trios 3, 3Shape), designed (Dental System 2016, 3 Shape), milled (Zenotec CAM 3.2, Wieland Dental), and cemented with a resin cement. Technical and biological outcomes and periodontal parameters were assessed. Data analysis was made using the Friedman and the Wilcoxon signed-rank tests with the Bonferroni correction and the Mann–Whitney U test. Results The survival rate at 3 years was 100% for veneered and 90% for monolithic zirconia restorations. Three monolithic zirconia FPDs were lost because of biologic complications. The main complication in the veneered zirconia FPDs was the fracture of the veneering ceramic in 4 of the veneered zirconia FPDs. No fracture of the frameworks was observed in any of the groups. All restorations were assessed as satisfactory after 3 years. No differences in periodontal parameters were observed between the groups. Conclusions The results of this study suggest that monolithic zirconia and complete digital flow could be a viable alternative to veneered zirconia in the posterior regions. Clinical relevance The monolithic zirconia restorations with a digital workflow can be a viable alternative in posterior fixed partial dentures, with good periodontal outcomes. Clinical trial registration number ClinicalTrials.gov (Identifier NCT 04,879,498).
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Prospective Clinical Evaluation of Posterior Third-Generation Monolithic Zirconia Crowns Fabricated with Complete Digital Workflow: Two-Year Follow-Up. MATERIALS 2022; 15:ma15020672. [PMID: 35057389 PMCID: PMC8780337 DOI: 10.3390/ma15020672] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
Clinical studies on the behavior of posterior translucent monolithic zirconia restorations are lacking. We assessed the clinical outcome and survival rate of posterior third-generation monolithic zirconia crowns over a 2-year period. A total of 24 patients, requiring 30 posterior full-contour restorations were selected. All abutments were scanned, and crowns were milled and cemented with a self-adhesive dual cure cement. Crowns were assessed using the California Dental Association’s criteria. Gingival status was assessed by evaluating the gingival index, plaque index, periodontal probing depth of the abutments and control teeth, and the margin index of the abutment teeth. Statistical analyses were performed using the Friedman and the Wilcoxon signed-rank tests. During the 2-year follow-up, no biological or mechanical complications were observed, and the survival and success rate was 100%. All restorations ranked as satisfactory throughout the follow-up period. The gingival index and plaque index were worse at the end of the 2-year follow-up. The margin index was stable during the 2 years of clinical service. No significant differences were recorded in periodontal parameters between crowns and control teeth. Third-generation monolithic zirconia could be a reliable alternative to posterior metal–ceramic and second-generation monolithic zirconia posterior crowns.
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Prott LS, Spitznagel FA, Bonfante EA, Malassa MA, Gierthmuehlen PC. Monolithic zirconia crowns: effect of thickness reduction on fatigue behavior and failure load. J Adv Prosthodont 2021; 13:269-280. [PMID: 34777717 PMCID: PMC8558575 DOI: 10.4047/jap.2021.13.5.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/30/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The objective of this study was to evaluate the effect of thickness reduction and fatigue on the failure load of monolithic zirconia crowns. MATERIALS AND METHODS 140 CAD-CAM fabricated crowns (3Y-TZP, inCorisTZI, Dentsply-Sirona) with different ceramic thicknesses (2.0, 1.5, 1.0, 0.8, 0.5 mm, respectively, named G2, G1.5, G1, G0.8, and G0.5) were investigated. Dies of a mandibular first molar were made of composite resin. The zirconia crowns were luted with a resin composite cement (RelyX Unicem 2 Automix, 3M ESPE). Half of the specimens (n = 14 per group) were mouth-motion-fatigued (1.2 million cycles, 1.6 Hz, 200 N/ 5 – 55℃, groups named G2-F, G1.5-F, G1-F, G0.8-F, and G0.5-F). Single-load to failure was performed using a universal testing-machine. Fracture modes were analyzed. Data were statistically analyzed using a Weibull 2-parameter distribution (90% CI) to determine the characteristic strength and Weibull modulus differences among the groups. RESULTS Three crowns (21%) of G0.8 and five crowns (36%) of G0.5 showed cracks after fatigue. Characteristic strength was the highest for G2, followed by G1.5. Intermediate values were observed for G1 and G1-F, followed by significantly lower values for G0.8, G0.8-F, and G0.5, and the lowest for G0.5-F. Weibull modulus was the lowest for G0.8, intermediate for G0.8-F and G0.5, and significantly higher for the remaining groups. Fatigue only affected G0.5-F. CONCLUSION Reduced crown thickness lead to reduced characteristic strength, even under failure loads that exceed physiological chewing forces. Fatigue significantly reduced the failure load of 0.5 mm monolithic 3Y-TZP crowns.
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Affiliation(s)
- Lea Sophia Prott
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Frank Akito Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Estevam Augusto Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | | | - Petra Christine Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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Leitão CIMB, Fernandes GVDO, Azevedo LPP, Araújo FM, Donato H, Correia ARM. Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis. J Prosthodont Res 2021; 66:374-384. [PMID: 34615842 DOI: 10.2186/jpr.jpr_d_21_00081] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology. STUDY SELECTION An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search. RESULTS From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672). CONCLUSIONS Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.
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Affiliation(s)
| | | | | | - Filipe Miguel Araújo
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health, Viseu, Portugal
| | - Helena Donato
- Coimbra Hospital and University Centre, Documentation Department, Coimbra, Portugal
| | - André Ricardo Maia Correia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health, Viseu, Portugal
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Waldecker M, Behnisch R, Rammelsberg P, Bömicke W. Five-year clinical performance of monolithic and partially veneered zirconia single crowns-a prospective observational study. J Prosthodont Res 2021; 66:339-345. [PMID: 34556602 DOI: 10.2186/jpr.jpr_d_21_00024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to prospectively evaluate the medium-term clinical performance and esthetics of monolithic and partially (i.e., facially) veneered zirconia single crowns (MZ-SC and PZ-SC, respectively). METHODS Between September 2011 and June 2013, 68 participants received 90 MZ-SC and 72 PZ-SC. Clinical study documentation was performed at crown cementation (baseline), at 6-month follow-up, and then yearly thereafter using standardized report forms. Three participants with four MZ-SC dropped out during clinical follow-up. Thus, 65 participants (n = 31, 47.7% men) fitted with 158 restorations (86 MZ-SC, 72 PZ-SC) were evaluated. The mean observation period of the restorations was 5.8 ±2.5 years; 6.3 ±2.2 for MZ-SC and 5.2 ±2.6 for PZ-SC. RESULTS The 5-year rate of complication-free survival (success) was 87.0% for MZ-SC and 95.8% for PZ-SC (log-rank test, p = 0.026). The 5-year failure-free survival rate was 93.1% for MZ-SC and 96.2% for PZ-SC (log-rank test, p = 0.111), and the 5-year ceramic fracture-free survival rate was 100% for MZ-SC and 98.6% for PZ-SC (log-rank test, p = 0.274). Crowns of both designs were awarded excellent scores for esthetics by participants and dentists. CONCLUSIONS Monolithic and partially veneered zirconia crowns can be used clinically with high medium-term survival and success and uncompromised esthetic results.
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Affiliation(s)
- Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
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Miura S, Tsukada S, Fujita T, Isogai T, Teshigawara D, Saito-Murakami K, Asami K, Fujisawa M. Effects of abutment tooth and luting agent colors on final color of high-translucent zirconia crowns. J Prosthodont Res 2021; 66:243-249. [PMID: 34321374 DOI: 10.2186/jpr.jpr_d_21_00025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aimed to evaluate the effects of the tooth portion evaluated and the colors of the abutment tooth and resin luting agent on the final color of monolithic zirconia crowns. METHODS Monolithic zirconia crowns were fabricated for left maxillary central incisors using two shades (A2 and A3) of highly translucent monolithic zirconia disks. A model of the abutment tooth was fabricated using resin core materials (white: W; dentin: D). The color of the crowns was measured with try-in pastes (clear: C; brown: B) as a resin-luting agent substitute. The measurement was performed after placing the crown on the model with the attached abutment tooth with try-in paste. The color of three labial portions (cervical, body, and incisal) was evaluated using a dental spectrophotometer. The color difference (ΔE) between the CIELab values of the zirconia disks and the final me asurement of zirconia crowns was calculated. RESULTS The ΔE between the crown of the A2 shade and the zirconia disk of the A2 shade had the highest ΔE value in the body portion with W-B (ΔE=3.92). Similarly, the A3 shade had the highest ΔE value in the cervical portion, with W-B (ΔE=4.27). The results of three-way ANOVA showed that the ΔE values were influenced by the tooth portion evaluated and the color of the abutment tooth. CONCLUSIONS The final color of the monolithic zirconia crowns was significantly in fluenced by the tooth portion evaluated and the color of the abutment tooth.
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Affiliation(s)
- Shoko Miura
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Saitama
| | - Shohei Tsukada
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Saitama
| | - Takafumi Fujita
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Saitama
| | - Tomonori Isogai
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Saitama
| | - Daisuke Teshigawara
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Saitama
| | - Konatsu Saito-Murakami
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Saitama
| | - Kazuya Asami
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Saitama
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Saitama
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Solá-Ruiz MF, Baixauli-López M, Roig-Vanaclocha A, Amengual-Lorenzo J, Agustín-Panadero R. Prospective study of monolithic zirconia crowns: clinical behavior and survival rate at a 5-year follow-up. J Prosthodont Res 2020; 65:284-290. [PMID: 33041280 DOI: 10.2186/jpr.jpr_d_20_00034] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose To evaluate the clinical behavior and survival of full coverage monolithic zirconia crowns on posterior teeth over a 5-year follow-up.Methods Fifty patients were recruited and underwent restoration with a Lava Plus monolithic zirconia crown (Lava™ Frame Zirconia, 3M Espe, Germany) on premolars or molars. Patients were monitored over a 5-year follow-up (2014-19), recording any biological and/or mechanical complications; these data were used to estimate the crowns' success rate. Periodontal clinical parameters were recorded (pocket probing depth (PPD), plaque index (PLI), bleeding on probing (BOP), and gingival recession (GR)). Wear to the zirconia crowns and antagonist teeth were also evaluated with Geomagic software (3D Systems, U.S.A.). Patients' satisfaction with treatment was evaluated in a questionnaire.Results For the 50 monolithic zirconia crowns analyzed, the survival rate was 98% after 5 years. Only 6% of the crowns presented some type of complication (two debonding and one root fracture). No fracture or fissures were detected. GR and BOP were the only clinical parameters found to be significantly greater around teeth restored with crowns. The monolithic zirconia crowns suffered less wear than the enamel of antagonist teeth. Patient's general satisfaction with treatment was high.Conclusions Monolithic zirconia crowns on posterior teeth are a highly predictable treatment option, with a high survival rate. The single treatment failure was due to a biological complication arising from root fracture. This treatment may be recommended as a treatment that conserves dental structure, and requires minimal dental preparation.
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Affiliation(s)
- Mª Fernanda Solá-Ruiz
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Mar Baixauli-López
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Ana Roig-Vanaclocha
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Jose Amengual-Lorenzo
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Rubén Agustín-Panadero
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Pontevedra P, Lopez‐Suarez C, Pelaez J, Garcia‐Serdio S, Suarez MJ. Prospective Clinical Evaluation of Posterior Monolithic Zirconia Fixed Partial Dentures Using a Complete Digital Workflow: Two‐Year Follow‐Up. J Prosthodont 2020; 30:298-304. [DOI: 10.1111/jopr.13251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 02/04/2023] Open
Affiliation(s)
- Paula Pontevedra
- 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
| | - Jesus Pelaez
- Department of Conservative Dentistry and Buccofacial Prostheses Faculty of Odontology, University Complutense of Madrid Madrid Spain
| | - Sara Garcia‐Serdio
- 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
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Miura S, Yamauchi S, Kasahara S, Katsuda Y, Fujisawa M, Egusa H. Clinical evaluation of monolithic zirconia crowns: a failure analysis of clinically obtained cases from a 3.5-year study. J Prosthodont Res 2020; 65:148-154. [PMID: 32938882 DOI: 10.2186/jpr.jpor_2019_643] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The primary purpose of this study was to examine the clinical performance of monolithic zirconia single crowns in terms of short-term failure or complications. The secondary purpose was to detect the originating flaws of clinically failed monolithic zirconia crowns to find the causes of failure. METHODS A short-term prospective cohort study based on record evaluation and clinical examination of patients treated with tooth-supported monolithic zirconia crowns was performed in the Department of Fixed Prosthodontics, Tohoku University Hospital, Japan. The crowns were prepared during the follow-up period from April 2014 to July 2018. The 3.5-year cumulative success and survival rates were set as primary endpoints. Fractures of the crown or fragments were inspected under a scanning electron microscope for descriptive fractography. RESULTS During the study period, 40 monolithic zirconia crowns were placed. Four crowns experienced clinical complications, including: 1) fracture of the crown (two crowns), 2) abrasion of the crown (one crown), and 3) fracture of the antagonist tooth (one crown). The estimated Kaplan-Meier 3.5-year success and survival rates were 90.5% (95% confi dence interval [CI]: 73.1-97.1) and 92.8% (95% CI: 74.1-98.3), respectively. Fractography revealed that all fractures were initiated from the wear phase on the occlusal surface. CONCLUSIONS The results of this study suggest that the molar application of monolithic zirconia crowns requires detailed attention to interocclusal clearance and the restoration of the antagonist tooth.
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Affiliation(s)
- Shoko Miura
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado.,Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Shinobu Yamauchi
- Department of Biomaterials, Nihon University School of Dentistry at Matsudo
| | - Shin Kasahara
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Yusuke Katsuda
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
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Habibi Y, Dawid M, Waldecker M, Rammelsberg P, Bömicke W. Three‐year clinical performance of monolithic and partially veneered zirconia ceramic fixed partial dentures. J ESTHET RESTOR DENT 2020; 32:395-402. [DOI: 10.1111/jerd.12568] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/16/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Yasamin Habibi
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Marie‐Theres Dawid
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Moritz Waldecker
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Peter Rammelsberg
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Wolfgang Bömicke
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
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26
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Honda J, Komine F, Kusaba K, Kitani J, Matsushima K, Matsumura H. Fracture loads of screw-retained implant-supported zirconia prostheses after thermal and mechanical stress. J Prosthodont Res 2019; 64:313-318. [PMID: 31859081 DOI: 10.1016/j.jpor.2019.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/23/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The objective of the present study was to evaluate fracture loads of screw-retained implant-supported zirconia prostheses after artificial aging. METHODS Four types of screw-retained implant-supported prostheses were fabricated (n=11 each); porcelain-veneered zirconia prosthesis (PVZ), indirect composite-veneered zirconia prosthesis (IVZ), porcelain-fused-to-metal prosthesis (PFM), and monolithic zirconia prosthesis (ML). The specimens were subjected to 10,000 thermocycles and cyclic loading for 1.2 million cycles. Fracture loads were measured, and the data were analyzed with the Kruskal-Wallis and Steel-Dwass tests (α=0.05). RESULTS All specimens survived the artificial aging procedures. The fracture loads for the PVZ (1.52kN), IVZ (1.62kN), and PFM groups (1.53kN) did not significantly differ; however, the fracture load for the ML group (6.61kN) was significantly higher than those for the other groups. The fracture load for the IVZ group was comparable to those for the PVZ and PFM groups. CONCLUSIONS The monolithic zirconia prostheses exhibited significantly higher fracture loads than the bilayered prostheses. All the investigated types of screw-retained implant-supported zirconia prostheses appear sufficient to resist posterior masticatory forces during long-term clinical use.
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Affiliation(s)
- Junichi Honda
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Futoshi Komine
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan.
| | - Kosuke Kusaba
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Jin Kitani
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Keisuke Matsushima
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Hideo Matsumura
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
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JANSEN JU, LÜMKEMANN N, SENER B, STAWARCZYK B. Comparison of fracture toughness measurements for zirconia materials using two test methods. Dent Mater J 2019; 38:806-812. [DOI: 10.4012/dmj.2018-361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jan Ulrich JANSEN
- Department of Prosthetic Dentistry, Dental Material Unit, Ludwig-Maximilians-University Munich
| | - Nina LÜMKEMANN
- Department of Prosthetic Dentistry, Dental Material Unit, Ludwig-Maximilians-University Munich
| | - Beatrice SENER
- Periodontics and Cardiology, Clinic for Preventive Dentistry, University of Zurich
| | - Bogna STAWARCZYK
- Department of Prosthetic Dentistry, Dental Material Unit, Ludwig-Maximilians-University Munich
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Kontonasaki E, Rigos AE, Ilia C, Istantsos T. Monolithic Zirconia: An Update to Current Knowledge. Optical Properties, Wear, and Clinical Performance. Dent J (Basel) 2019; 7:dj7030090. [PMID: 31480688 PMCID: PMC6784470 DOI: 10.3390/dj7030090] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/22/2019] [Accepted: 08/20/2019] [Indexed: 01/09/2023] Open
Abstract
The purpose of this paper was to update the knowledge concerning the wear, translucency, as well as clinical performance of monolithic zirconia ceramics, aiming at highlighting their advantages and weaknesses through data presented in recent literature. New ultra-translucent and multicolor monolithic zirconia ceramics present considerably improved aesthetics and translucency, which, according to the literature reviewed, is similar to those of the more translucent lithium disilicate ceramics. A profound advantage is their high strength at thin geometries preserving their mechanical integrity. Based on the reviewed articles, monolithic zirconia ceramics cause minimal wear of antagonists, especially if appropriately polished, although no evidence still exists regarding the ultra-translucent compositions. Concerning the survival of monolithic zirconia restorations, the present review demonstrates the findings of the existing short-term studies, which reveal promising results after evaluating their performance for up to 5 or 7 years. Although a significant increase in translucency has been achieved, new translucent monolithic zirconia ceramics have to be further evaluated both in vitro and in vivo for their long-term potential to preserve their outstanding properties. Due to limited studies evaluating the wear properties of ultra-translucent material, no sound conclusions can be made, whereas well-designed clinical studies are urgently needed to enlighten issues of prognosis and long-term survival.
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Affiliation(s)
- Eleana Kontonasaki
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
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Fushiki R, Komine F, Kimura F, Kusaba K, Kondo T, Moriya Y, Matsumura H. Bond strengths between gingiva-colored layering resin composite and zirconia frameworks coated with feldspathic porcelain. Dent Mater J 2019; 38:547-554. [PMID: 31105163 DOI: 10.4012/dmj.2018-253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study evaluated shear bond strengths of two gingiva-colored layering resin composites to zirconia frameworks coated with feldspathic porcelain. Airborne-particle abraded porcelain-coated zirconia disks were treated with one of the following primers: Clearfil Photo Bond, Clearfil Photo Bond with Clearfil Porcelain Bond Activator (CPB+Activator), Estenia Opaque Primer, Porcelain Liner M Liquid B (PLB), or no primer. A light-polymerizing (CER) or a photo/heat-polymerizing gingiva-colored indirect resin composite (EST) was bonded to the porcelain-coated zirconia disks in each group (n=11). Shear bond strength was measured. For both CER and EST specimens, bond strengths in CPB+Act group were significantly higher than those in the other groups. In all priming groups, bond strength was significantly higher for EST specimens than for CER specimens. Combined application of a phosphate monomer and silane enhanced initial bond strength of light-polymerized and photo/heat-polymerized gingiva-colored layering resin composites to porcelain-coated zirconia ceramics.
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Affiliation(s)
- Ryosuke Fushiki
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Futoshi Komine
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Fumiaki Kimura
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Kosuke Kusaba
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Tomohide Kondo
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Yuta Moriya
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Hideo Matsumura
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
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Tanner J, Niemi H, Ojala E, Tolvanen M, Närhi T, Hjerppe J. Zirconia single crowns and multiple-unit FDPs—An up to 8 -year retrospective clinical study. J Dent 2018; 79:96-101. [DOI: 10.1016/j.jdent.2018.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 12/20/2022] Open
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Kondo T, Komine F, Honda J, Takata H, Moriya Y. Effect of veneering materials on fracture loads of implant-supported zirconia molar fixed dental prostheses. J Prosthodont Res 2018; 63:140-144. [PMID: 30446411 DOI: 10.1016/j.jpor.2018.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/25/2018] [Accepted: 10/29/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the effect of veneering material and framework design on fracture loads of implant-supported zirconia molar fixed dental prostheses (FDPs). METHODS Sixty-six zirconia FDPs were manufactured onto two implants and classified as uniform thickness (UT) or anatomic design (AD). These framework design groups were then further divided into three subgroups (n=11): feldspathic porcelain-veneered zirconia FDPs (PVZ), indirect composite-veneered zirconia FDPs (IVZ), and metal-ceramic FDPs (MC). The FDPs were luted on the implant abutments and underwent fracture load testing. Significant differences were assessed by the Kruskal-Wallis test and Mann-Whitney U-test (α=0.05). RESULTS For UT group, median fracture load was significantly higher for the IVZ (1.87kN) and MC (1.90kN) specimens than for the PVZ specimens (1.38kN) (p<0.05). In the AD group, the IVZ specimens had the highest median fracture load (4.10kN) of the three groups tested. The AD group exhibited higher median fracture loads than the UT group in all subgroups. CONCLUSIONS Indirect composite appears to be a useful alternative to feldspathic porcelain as the layering material for implant-supported zirconia FDPs. The AD group had higher fracture loads than UT group. In addition, implant-supported indirect composite-veneered zirconia-based FDPs appear to be clinically feasible.
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Affiliation(s)
- Tomohide Kondo
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Futoshi Komine
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan.
| | - Junichi Honda
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Hiroki Takata
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Yuta Moriya
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
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