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Schweiger J, Edelhoff D, Schubert O. 3D printing of ultra-thin veneers made of lithium disilicate using the LCM method in a digital workflow: A feasibility study. J ESTHET RESTOR DENT 2024; 36:588-594. [PMID: 37962058 DOI: 10.1111/jerd.13155] [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: 06/19/2023] [Revised: 08/26/2023] [Accepted: 10/07/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE This article highlights the feasibility of the additive fabrication of ultra-thin veneers made of lithium disilicate using the lithography-based ceramic manufacturing (LCM) method. CLINICAL CONSIDERATIONS An esthetical appealing restoration of anterior teeth with thin ceramic veneers is considered one of the ultimate challenges in restorative dental prosthetics. These sophisticated restorations can be fabricated in different ways. Both analog and digital subtractive manufacturing processes have been used to date. Either of the methods is highly demanding for the dental technician and dental engineering due to the required low ceramic layer thickness. CONCLUSION Modern additive manufacturing methods, for example LCM technology, enable the production of ultra-thin lithium disilicate veneers with layer thicknesses of down to 0.2 mm and could therefore represent a viable alternative for this indication in the future. CLINICAL SIGNIFICANCE Digital technologies can help streamline workflows, make the outcome more predictable and reproducible, and even further optimize therapeutic restorative options such as highly esthetic veneers for anterior teeth. The reduced material thickness allows for a true non-prep solution or minimally invasive preparation.
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Affiliation(s)
- J Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - D Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - O Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
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Rizk A, El-Guindy J, Abdou A, Ashraf R, Kusumasari C, Eldin FE. Marginal adaptation and fracture resistance of virgilite-based occlusal veneers with varying thickness. BMC Oral Health 2024; 24:307. [PMID: 38443910 PMCID: PMC10913281 DOI: 10.1186/s12903-024-04071-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/25/2024] [Indexed: 03/07/2024] Open
Abstract
STATEMENT OF PROBLEM CAD/CAM occlusal veneers have been developed for minimally invasive prosthetic restoration of eroded teeth. Marginal adaptation and fracture resistance are crucial for the long-term survivability and clinical success of such restorations. Virgilite-based lithium disilicate glass-ceramic is a newly introduced material with claims of high strength. However, constructing occlusal veneers from this material of varying thickness has not been investigated. PURPOSE The current study aimed to assess the impact of CAD/CAM occlusal veneer thickness and materials on marginal adaptation and fracture resistance. MATERIALS AND METHODS Thirty-two occlusal veneers were constructed and divided into two groups (n = 16) based on the CAD/CAM material into Brilliant Crios and CEREC Tessera. Each group was further subdivided into two subgroups (n = 8) according to the thickness: 0.6 and 0.9 mm. Occlusal veneers were bonded to epoxy resin dies. The marginal gap was evaluated before and after thermodynamic aging. Fracture resistance and failure mode were evaluated for the same samples after aging. Marginal adaptation was analyzed using the Mann-Whitney U test. Fracture resistance was analyzed using Weibull analysis (α = 0.05). RESULTS The marginal gap was significantly increased following thermodynamic aging for tested groups (P < 0.001). CEREC Tessera showed a significantly higher marginal gap than Brilliant Crios before and after aging for both thicknesses (P < 0.05). CEREC Tessera recorded lower significant fracture load values compared to Brilliant Crios (P < 0.05). CONCLUSIONS Both CEREC Tessera and Brilliant Crios demonstrated clinically accepted marginal gap values. All groups showed fracture resistance values higher than the average masticatory forces in the premolar region except for 0.6 mm CEREC Tessera. CLINICAL IMPLICATIONS Reinforced composite occlusal veneers demonstrated more favorable outcomes in terms of marginal gap and fracture resistance at both tested thicknesses compared to virgilite-based lithium disilicate glass-ceramic. Additionally, caution should be exercised during the construction of occlusal veneers from virgilite-based lithium disilicate glass-ceramic with reduced thickness.
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Affiliation(s)
- Amr Rizk
- Fixed Prosthodontics division, Department of Prosthetic Dentistry, Faculty of Dentistry, King Salman International University, South Sinai, Egypt.
| | - Jylan El-Guindy
- Fixed Prosthodontics division, Department of Prosthetic Dentistry, Faculty of Dentistry, King Salman International University, South Sinai, Egypt
- Fixed Prosthodontics department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ahmed Abdou
- Faculty of Dentistry, Al-Ayen University, Thi‑Qar, Iraq
| | - Reem Ashraf
- Biomaterials Division, Department of Prosthetic Dentistry, Faculty of Dentistry, King Salman International University, South Sinai, Egypt
| | - Citra Kusumasari
- Conservative Dentistry department, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Farid Emad Eldin
- Fixed Prosthodontics department, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
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Ferrando Cascales Á, Sauro S, Hirata R, Astudillo-Rubio D, Ferrando Cascales R, Agustín-Panadero R, Delgado-Gaete A. Total Rehabilitation Using Adhesive Dental Restorations in Patients with Severe Tooth Wear: A 5-Year Retrospective Case Series Study. J Clin Med 2023; 12:5222. [PMID: 37629264 PMCID: PMC10455517 DOI: 10.3390/jcm12165222] [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: 05/14/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION Currently, there is little clinical evidence to support the medium- and long-term survival and clinical performance of ultraconservative approaches using adhesive restorations in full-mouth restorations. The aim of this case series study was to evaluate the medium-term clinical performance of anterior and posterior adhesive restorations applied with direct and indirect techniques using resin composites and glass-ceramic-based materials. MATERIALS AND METHODS The inclusion criteria were an esthetic problem as the main reason for consultation and severe generalized wear of grade 2 to 4 according to the Tooth Wear Evaluation System (TWES 2.0). In addition, at each follow-up appointment, patients were required to submit a clinical-parameter-monitoring record according to the modified United States Public Health Service (USPHS) criteria. RESULTS Eight patients with severe tooth wear were treated through full rehabilitation in a private dental clinic in Spain by a single operator (AFC). A total of 212 restorations were performed, which were distributed as follows: 66 occlusal veneers, 26 palatal veneers and 120 vestibular veneers. No signs of marginal microleakage or postoperative sensitivity were observed in any occlusal, vestibular and/or palatal restoration after the follow-up period. The estimated survival rate of the 212 restorations was 90.1% over 60 months of observation, with a survival time of 57.6 months. Only 21 restorations had complications, which were mostly resolved with a direct composite resin. The dichotomous variables of the restoration type (posterior veneer, anterior veneer) and the type of restored tooth (anterior, posterior) were the risk predictors with statistically significant influences (p < 0.005) on the survival of the restorations. CONCLUSION According to the results of this study, there is a significantly higher risk of restorative complications in posterior teeth compared to anterior teeth. Also, it can be concluded that the indication of adhesive anterior and posterior restorations is justified in the total oral rehabilitation of patients with severe multifactorial tooth wear, as they are associated with a low risk of failure.
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Affiliation(s)
- Álvaro Ferrando Cascales
- Department of Biomaterials Engineering, Faculty of Medicine, UCAM, Universidad Católica de Murcia, Campus Los Jerónimos, 135 Guadalupe, 30107 Murcia, Spain; (Á.F.C.); (R.F.C.)
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, University CEU Cardenal Herrera, C/Santiago Ramón y Cajal, s/n, Alfara del Patriarca, 46115 Valencia, Spain;
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Ronaldo Hirata
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY 10010, USA;
| | - Daniela Astudillo-Rubio
- Division of Prosthodontics, School of Dentistry, Universidad Católica de Cuenca, Cuenca 010107, Ecuador; (D.A.-R.); (A.D.-G.)
| | - Raúl Ferrando Cascales
- Department of Biomaterials Engineering, Faculty of Medicine, UCAM, Universidad Católica de Murcia, Campus Los Jerónimos, 135 Guadalupe, 30107 Murcia, Spain; (Á.F.C.); (R.F.C.)
| | - Rubén Agustín-Panadero
- Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
| | - Andrés Delgado-Gaete
- Division of Prosthodontics, School of Dentistry, Universidad Católica de Cuenca, Cuenca 010107, Ecuador; (D.A.-R.); (A.D.-G.)
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Noronha MDS, Carvalho MAD, Do AQ, Neto VGDA, Campos CH, Giannini M, Magne P. Effect of thickness and CAD-CAM material on fatigue resistance of endodontically treated molars restored with occlusal veneers. J Prosthodont 2023; 32:e19-e29. [PMID: 36087111 DOI: 10.1111/jopr.13606] [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: 08/27/2021] [Accepted: 09/06/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the influence of the thickness and type of computer-aided design and computer-aided manufacturing (CAD-CAM) material on the fatigue resistance and failure mode of endodontically treated teeth (ETT) restored with occlusal veneers (OV). MATERIALS AND METHODS Seventy-five (N = 75) ETT were restored with Herculite XRV in the endodontic access. Five experimental groups (n = 15) were tested. Four groups had two different thicknesses (0.6-0.7 mm or 1.4-1.6 mm) and two different CAD-CAM materials: zirconia-reinforced lithium-silicate (LS/Celtra Duo) and composite resin (RC/Cerasmart). The fifth group (control) did not have occlusal veneers. All the specimens were subjected to accelerated fatigue (5 Hz frequency) with an occlusal load increasing up to 1800 N and 131,000 cycles. The number of cycles was recorded when the machine stopped or at the completion of the test. Fatigue resistance was analyzed using the Kaplan-Meier survival test (95% significance level, log-rank post hoc pairwise comparisons). The samples were categorized according to failure mode. The CAD-CAM materials were examined through scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). RESULTS No differences were found between the thicknesses, regardless of the type of the CAD-CAM material. The thick LS OV outperformed the RC and control groups. The thin RC OV and control groups showed a higher percentage of repairable and possibly repairable failures than the other groups. LS was more homogeneous under SEM, and the EDS analysis detected Si and Zr, but not Li. CONCLUSIONS A larger thickness did not improve the resistance of the CAD-CAM materials. Thick LS showed a higher cumulative survival rate to fatigue than the RC and control groups. The direct composite alone (control) survived similarly to the experimental groups, except for the thick LS.
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Affiliation(s)
- Mayara Dos Santos Noronha
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Anh Quynh Do
- Advanced Endodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA
| | | | - Camila Heitor Campos
- Department of Oral Rehabilitation, School of Dentistry, Federal Fluminense University, Nova Friburgo, Brazil
| | - Marcelo Giannini
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Pascal Magne
- Division of Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA
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Alghauli M, Alqutaibi AY, Wille S, Kern M. Clinical outcomes and influence of material parameters on the behavior and survival rate of thin and ultrathin occlusal veneers: A systematic review. J Prosthodont Res 2023; 67:45-54. [PMID: 35545532 DOI: 10.2186/jpr.jpr_d_21_00270] [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] [Indexed: 01/12/2023]
Abstract
PURPOSE Various oral rehabilitation approaches are available for severely worn dentition. However, evidence-based guidelines for permanent treatment are limited. This review aims to investigate clinical observational findings and compare in-vitro outcomes of thin and ultrathin occlusal veneers using different materials and approaches. METHODS An electronic search of online databases, such as PubMed (MEDLINE), BioMed Central (BMC), Cochrane, and Scopus, was performed for the 2009 - Jun 2021 period, following the PRISMA 2020 criteria. The reports sought for retrieval were all the articles evaluating the clinical outcomes of permanent full-mouth rehabilitation, and all in-vitro records that investigated and compared fracture strength, survival rate, and modes of failure of ultrathin (0.3 - 0.6 mm), thin (0.5 - 0.8 mm), and thick (0.8-1.5 mm) occlusal veneer restorations, with regard to the available indirect restorative materials. The Newcastle Ottawa risk of bias criteria was used to judge the clinical studies and a modified consort statement was used for the evaluation of in-vitro studies. The data of the included studies were extracted and grouped based on the similarity of the outcomes and study protocols. Data heterogeneity determined the qualitative and quantitative grouping of the results. RESULTS Two clinical and 17 in-vitro studies were included. Data exhibited heterogeneity within the materials, variables, testing protocols and observation periods. Therefore, only qualitative synthesis of the results was feasible. Clinically used 1 mm lithium disilicate overlays and ultrathin one-step no-prep polymer infiltrated ceramic network (PICN) occlusal veneers exhibited very high success and survival rates. The analysis of in-vitro studies exhibited variable survival rates and fracture load values, based on materials, thickness, and restorative approaches used. CONCLUSIONS Within the limitations of this systematic review, it can be concluded that the clinical outcomes of thin and ultrathin occlusal veneers/overlays are auspicious. In-vitro experimental results support the usage of the thin and ultrathin occlusal veneers.
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Affiliation(s)
- Mohamed Alghauli
- Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen.,Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany
| | - Ahmed Yaseen Alqutaibi
- Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen.,Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
| | - Sebastian Wille
- Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany
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Schlichting LH, Resende TH, Reis KR, Raybolt Dos Santos A, Correa IC, Magne P. Ultrathin CAD-CAM glass ceramic and composite resin occlusal veneers for the treatment of severe dental erosion: An up to 3-year randomized clinical trial. J Prosthet Dent 2022; 128:158.e1-158.e12. [PMID: 35750501 DOI: 10.1016/j.prosdent.2022.02.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Ultrathin bonded posterior occlusal veneers represent a conservative alternative to traditional onlays and complete coverage crowns for the treatment of erosive dental wear. Data regarding the clinical performance of ceramic and composite resin ultrathin occlusal veneers are lacking. PURPOSE The purpose of this prospective randomized clinical trial was to evaluate the influence of computer-aided design and computer-aided manufacturing (CAD-CAM) restorative material (ceramic versus composite resin) on the clinical performance of ultrathin occlusal veneers bonded to worn posterior teeth. MATERIAL AND METHODS Eleven participants (mean age, 30.4 years) had their posterior teeth restored with 24 ceramic (e.max CAD) and 36 composite resin (Lava Ultimate) ultrathin occlusal veneers. The material type was assigned randomly. The tooth preparations were trial restoration driven and included immediate dentin sealing (OptiBond FL). The intaglio surfaces of the ceramic restorations were etched with hydrofluoric acid and silanated, and the composite resins were airborne-particle abraded and silanated. The tooth preparations were airborne-particle abraded and etched with phosphoric acid before restoration insertion. All restorations were adhesively luted with preheated composite resin (Filtek Z100). The participants were evaluated according to the modified United States Public Health Service (USPHS) criteria at baseline and then each year for up to 3 years. Survival rates were estimated with time to failure (primary outcome of interest) as the endpoint (scores 4 or 5). RESULTS No restorations were lost. Five partial failures, in the form of chipping (all scored 4), were observed in the composite resin group (Lava Ultimate). The Kaplan-Meier survival rates were 100% for ceramic and 84.7% (SE 0.065%) for composite resin. Differences between the 2 groups were not statistically significant (P=.124). In the surviving restorations, significant difference (P=.003) was found for surface roughness as restorations in the composite resin group experienced some surface degradation. CONCLUSIONS The findings of this medium-term clinical trial suggest that ceramic (e.max CAD) and composite resin (Lava Ultimate) CAD-CAM ultrathin occlusal veneers presented statistically comparable performance regardless of the minor partial failures (restorable chipping) observed in the composite resin group. Higher surface degradation was observed in the composite resin group.
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Affiliation(s)
- Luís Henrique Schlichting
- Associate Professor, Operative Dentistry, Division of Comprehensive Oral Health, UNC Adams School of Dentistry, Chapel Hill, NC.
| | - Tayane Holz Resende
- Assistant Professor, Department of Prosthodontics and Dental Materials, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Kátia Rodrigues Reis
- Associate Professor, Department of Prosthodontics and Dental Materials, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Aline Raybolt Dos Santos
- Associate Professor, Department of Prosthodontics and Dental Materials, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Ivo Carlos Correa
- Professor, Department of Prosthodontics and Dental Materials, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Pascal Magne
- The Don and Sybil Harrington Professor of Esthetic Dentistry, Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif
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Ladino L, Sanjuan ME, Valdez DJ, Eslava RA. Clinical and Biomechanical Performance of Occlusal Veneers: A Scoping Review. J Contemp Dent Pract 2021; 22:1327-1337. [PMID: 35343461 DOI: 10.5005/jp-journals-10024-3226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
AIM This manuscript aims to evaluate, through a scoping review, current knowledge of the biomechanical behavior, materials, preparations, and limitations of occlusal veneers. BACKGROUND Occlusal veneers are a minimally invasive alternative for the additive restoration of posterior teeth with significant loss of the occlusal structure. This type of restoration has been emerged in recent years as an alternative to invasive treatment, which in the same way seeks to restore the structure of the posterior teeth. All this is because in recent years restorative dentistry has focused a large part of its objectives on conservative therapies. REVIEW RESULTS Five electronic databases-PubMed, Cochrane, LILACS, EMBASE, and Google Scholar-were searched. Title and abstracts were independently screened by three reviewers, followed by a full-text review. A total of 42 articles met our inclusion criteria; most of these studies were in vitro (n = 35) and other studies were clinical studies (n = 7). These in vitro studies included 21 studies that analyzed the type of preparation and 6 studies that evaluated the limitations of occlusal veneers. CONCLUSION Thicknesses between 0.7 and 1.0 mm are recommended for ceramic materials; in addition, thicknesses less than 0.7 mm are recommended to use polymeric materials. The materials used for this type of restoration are plastic- and ceramic-based materials, whose load resistance values were found to exceed 2000 N in most studies. It is recommended to carry out a minimally invasive preparation or not to carry out a dental preparation, as long as there is a peripheral enamel to make an external bevel that redirects the eccentric forces to the axis of the tooth. CLINICAL SIGNIFICANCE Restorative dentistry has moved toward conservative treatments with the least amount of dental tissue being removed. Occlusal veneers appear to be a conservative option in the reconstruction of tooth tissues lost due to tooth wear and in cases where it is necessary to restore or increase the vertical dimension.
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Affiliation(s)
- LuisGabriel Ladino
- LuisGabriel Ladino, Department of Prosthodontics, Institución Universitaria Colegios de Colombia (UNICOC), Bogota, DC, Colombia, Phone: +57 3057979215, e-mail:
| | - Martin Eduardo Sanjuan
- Department of Prosthodontics, Institución Universitaria Colegios de Colombia (UNICOC), Bogota, DC, Colombia
| | - Darell Josué Valdez
- Department of Prosthodontics, Institución Universitaria Colegios de Colombia (UNICOC), Bogota, DC, Colombia
| | - Rosa Angelica Eslava
- Department of Prosthodontics, Institución Universitaria Colegios de Colombia (UNICOC), Bogota, DC, Colombia
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Al-Zordk W, Saudi A, Abdelkader A, Taher M, Ghazy M. Fracture Resistance and Failure Mode of Mandibular Molar Restored by Occlusal Veneer: Effect of Material Type and Dental Bonding Surface. MATERIALS 2021; 14:ma14216476. [PMID: 34772003 PMCID: PMC8585144 DOI: 10.3390/ma14216476] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
This study assesses the effect of the material type (lithium disilicate, zirconia, and polymer-infiltrated ceramic) and dental bonding substrates (dentin, dentin with intra-coronal cavity, and dentin with composite filling) on the fracture resistance and failure mode of molars restored by occlusal veneers. Methods: Ninety occlusal veneers, fabricated from either lithium disilicate, zirconia, or polymer-infiltrated ceramic, were adhesively bonded to teeth prepared with either dentin, dentin with intra-coronal cavity, or dentin with composite filling. All specimens were thermally aged (5000 cycles), then load cycled (120,000 cycles). Each specimen was subjected to a compressive load through fracture, then was examined (×20) to identify the fracture type. Data were statistically analyzed. Results: Material type and dental substrate had no significant effect on the fracture resistance of adhesively retained occlusal veneer restorations. For each material, no significant differences were found between veneers bonded to dentin, dentin with intra-coronal cavity, and dentin with composite filling. Additionally, within each bonding substrate, there were no significant differences between lithium disilicate, zirconia, and polymer-infiltrated ceramic veneers. The adhesive failure was recorded mainly with zirconia occlusal veneer restorations. Conclusions: Considering the fracture results, lithium disilicate, zirconia, and polymer-infiltrated ceramic occlusal veneers perform well whatever the type of dental bonding surface. When the dental bonding surface varies, different occlusal veneer materials should be considered. Occlusal veneers bonded to dentin, dentin with composite filling, or dentin with an intra-coronal cavity exhibited a fracture resistance exceeding the average human masticatory forces in the molar area.
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Affiliation(s)
- Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; (A.S.); (A.A.); (M.G.)
- Fixed Prosthodontics Department, Faculty of Dentistry, Horus University, Damietta 34511, Egypt
- Correspondence: ; Tel.: +2-010-0890-6074
| | - Alaa Saudi
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; (A.S.); (A.A.); (M.G.)
| | - Abdelraheem Abdelkader
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; (A.S.); (A.A.); (M.G.)
| | - Mansoura Taher
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt;
| | - Mohamed Ghazy
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt; (A.S.); (A.A.); (M.G.)
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Alberto Jurado C, Kaleinikova Z, Tsujimoto A, Alberto Cortés Treviño D, Seghi RR, Lee DJ. Comparison of Fracture Resistance for Chairside CAD/CAM Lithium Disilicate Crowns and Overlays with Different Designs. J Prosthodont 2021; 31:341-347. [PMID: 34297866 DOI: 10.1111/jopr.13411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To determine the fracture resistance of chairside computer-aided design and computer-assisted manufacturing (CAD/CAM) lithium disilicate full coverage crowns and two different designs of overlay restorations for premolars. MATERIALS AND METHODS CAD/CAM lithium disilicate (IPS e.max CAD for CEREC/HT A1 C14, Ivoclar Vivadent) restorations (15 specimens/group) with 1.5 mm occlusal thickness and 1.0 mm chamfer were designed and fabricated with a chairside CAD/CAM system (CEREC, Dentsply Sirona). The restorations were prepared in three different designs: (1) full coverage crowns, (2) overlays with the margin located 2 mm above the gingiva, and (3) overlays with the margin located 4 mm above the gingiva. Restorations were cemented using conventional resin luting cement (Multilink, Ivoclar Vivadent) with primer system (Monobond Plus, Ivoclar Vivadent) to resin printed dies, load cycled (2,000,000 load cycles at 1 Hz with 275 N force), and then finally loaded with a steel indenter until failure. Scanning electron microscopy observations of fractured surfaces were also conducted. Group results were analyzed with one-way analysis of variance, and the medians were evaluated independently with Kruskal-Wallis. RESULTS The fracture force of CAD/CAM lithium disilicate restorations was significantly different (p < 0.001) depending on the design of the restoration. Full coverage crowns showed significantly higher force to fracture (1018.8 N) than both types of overlays (p = 0.002 for overlay 2.0 mm and p < 0.001 for overlay 4.0 mm above gingiva). Among the two overlays, the restoration with the margin located 2 mm above the gingiva showed significantly higher fracture force (813.8 N) than the overlay with margin at 4 mm above the gingiva (436.1 N; p < 0.001). The fracture appearance of the crowns was much more complex than that of the overlay restorations. CONCLUSIONS Full coverage chairside CAD/CAM lithium disilicate premolar crown showed higher fracture resistance than overlay restorations. Overlays with the margin located 2 mm above the margin demonstrated higher resistance than those with the margin located 4 mm above the gingiva.
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Affiliation(s)
- Carlos Alberto Jurado
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX
| | - Zinaida Kaleinikova
- Comprehensive Care Unit, A.T. Still University Arizona School of Dentistry & Oral Health, Mesa, AZ
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA
| | | | - Robert R Seghi
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH
| | - Damian J Lee
- Advanced Prosthodontics Program, The Ohio State University College of Dentistry, Columbus, OH
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Valenzuela EBS, Andrade JP, da Cunha PFJS, Bittencourt HR, Spohr AM. Fracture load of CAD/CAM ultrathin occlusal veneers luted to enamel or dentin. J ESTHET RESTOR DENT 2020; 33:516-521. [PMID: 32949221 DOI: 10.1111/jerd.12658] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/30/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate, in vitro, the fracture load of IPS e.max CAD occlusal veneers at thicknesses of either 0.3 or 0.6 mm luted to enamel or dentin. MATERIALS AND METHODS Fifty human molars were randomly distributed into five groups (n = 10): G1 - healthy teeth (control); G2-0.3-mm-thick veneers luted to enamel; G3-0.6-mm-thick veneers luted to enamel; G4-0.3-mm-thick veneers luted to dentin; and G5-0.6-mm-thick veneers luted to dentin. After the luting procedures, the specimens were immersed in distilled water at 37°C for 24 hours and then subjected to mechanical loading (106 cycles at 200 N load). The specimens were subjected to a fracture load test in a universal testing machine. Two-way ANOVA and Tukey's test (α = 0.05) were used to analyze data. RESULTS Only the thickness factor was significant (P = .002). Values of fracture load followed by distinct letters represent significant differences (P < .05): G1 (3204 N ± 730)ab ; G2 (3144 N ± 729)ab ; G3 (2489 N ± 606)b ; G4 (3591 N ± 776)a ; and G5 (2770 N ± 598)ab . CONCLUSION IPS e.max ultrathin occlusal veneers luted to enamel or dentin obtained fracture load comparable to that of the healthy tooth. CLINICAL SIGNIFICANCE IPS e.max CAD ultrathin occlusal veneers at 0.3 or 0.6-mm-thick seem to provide good perspectives in relation to the clinical use.
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Affiliation(s)
| | - Jonas Pereira Andrade
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Hélio Radke Bittencourt
- Department of Statistics, School of Mathematics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ana Maria Spohr
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Villavicencio-Espinoza CA, Giacomini MC, Narimatsu MH, Magalhães AC, Atta MT, Wang L. Adapted Three-step Restorative Technique: Recovering Dental Substrate Compromised by Complex Erosive Wear in a Young Patient. Oper Dent 2020; 45:457b-466. [DOI: 10.2341/18-204-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2019] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
This article presents the dental restoration of a young female patient complaining of erosive dental wear using a three-step restorative technique, an alternative approach with some novel adjustments.
SUMMARY
For successful tooth wear treatment, determining the etiological systemic and local factors is the main priority before deciding on effective and long-term preventive and/or therapeutic restorative approaches. In addition to professional intervention, achieving optimal outcomes requires patients to control their diet and/or gastric issues, thus minimizing the wear process. However, continuous wear constitutes the most challenging scenario, mainly when it affects young patients’ dentitions. This article describes the dental restoration of posterior teeth with reestablishment of occlusal vertical dimension before treating the anterior teeth, while educating the patient and providing medical monitoring. The three-step restorative technique seems to be properly applicable in cases of significant dental compromise due mainly to erosive wear and is based on direct procedures, which can assure a reliable and feasible approach.
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Ferrando-Cascales Á, Astudillo-Rubio D, Pascual-Moscardó A, Delgado-Gaete A. A facially driven complete-mouth rehabilitation with ultrathin CAD-CAM composite resin veneers for a patient with severe tooth wear: A minimally invasive approach. J Prosthet Dent 2020; 123:537-547. [DOI: 10.1016/j.prosdent.2019.04.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/06/2019] [Accepted: 04/08/2019] [Indexed: 11/27/2022]
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