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Bresser RA, Hofsteenge JW, Buijs GJ, van den Breemer CRG, Özcan M, Cune MS, Gresnigt MMM. Partial glass-ceramic posterior restorations with margins beyond or above the cemento-enamel junction: An observational retrospective clinical study. J Prosthodont Res 2024:JPR_D_23_00219. [PMID: 38684406 DOI: 10.2186/jpr.jpr_d_23_00219] [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: 05/02/2024]
Abstract
PURPOSE This observational retrospective clinical study aimed to investigate the survival and success rates of partial indirect lithium disilicate restorations with margins extending above or beyond the cementoenamel junction (CEJ). METHODS The study included patients who underwent partial indirect lithium disilicate restorations with immediate dentin sealing (IDS) between January 2008 and October 2018. All the restorations were placed in a single general dental practice following a standardized protocol. The impact of various predictive variables on the survival rates was assessed. Moreover, modified United States Public Health Service (USPHS) criteria were used to evaluate the survival quality. RESULTS Totally 1146 partial indirect lithium disilicate restorations in 260 patients were evaluated over an average period of 7.5 years. The cumulative survival and success rates were 97.3% and 95.3%, respectively. Margins extending beyond the cemento-enamel junction did not increase the risk of success or survival failure (P > 0.05). Patients with a high risk of caries, male sex, or non-vital teeth had a significantly higher risk of restoration failure (P < 0.05). Restorations with longer clinical service times exhibited marginally lower clinical quality (P < 0.001). CONCLUSIONS Partial indirect glass-ceramic restorations demonstrated survival and success rates of 97.3% and 95.3%, respectively, over an extended period. However, a higher risk of restoration failure existed in patients with a high caries risk for (pre)molars that had undergone endodontic treatment and in males. In terms of the risk of success or survival failure, comparable results were obtained for the positions of the restoration margin in relation to the cemento-enamel junction.
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Affiliation(s)
- Rijkje A Bresser
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
| | - Jelte W Hofsteenge
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
| | - Gerrit J Buijs
- Buijs Tandartsen, Clinic for General Dentistry, Groningen, The Netherlands
| | - Carline R G van den Breemer
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
| | - Mutlu Özcan
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
- University of Zurich, Center of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Zurich, Switzerland
| | - Marco S Cune
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
- St. Antonius Hospital, Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, The Netherlands
| | - Marco M M Gresnigt
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
- Martini Hospital, Department of Special Dental Care, Groningen, The Netherlands
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Bresser RA, Carvalho MA, Naves LZ, Melma H, Cune MS, Gresnigt MMM. Biomechanical behavior of molars restored with direct and indirect restorations in combination with deep margin elevation. J Mech Behav Biomed Mater 2024; 152:106459. [PMID: 38394767 DOI: 10.1016/j.jmbbm.2024.106459] [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: 12/19/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
STATEMENT OF PROBLEM The existing knowledge is insufficient for comprehending the fatigue survival and fracture resistance of molars that have deep approximal direct and indirect restorations, whether with or without deep margin elevation (DME). PURPOSE The aim of this laboratory and in silico study is to investigate the fatigue survival, fracture strength, failure pattern and tooth deformation of molars restored with DME in combination with a direct or indirect restoration. MATERIAL AND METHODS This study utilized 45 extracted sound human molars, divided into three groups (n = 15). Standardized 100% inter-cuspal inlay preparations were performed, extending 2 mm below the CEJ and immediate dentin sealing (IDS) was applied. Group 1 (Co_1) was restored with direct composite; Group 2 (Hyb_2) with a 2 mm DME of direct composite and a glass-ceramic lithium disilicate restoration; Group 3 (Cer_3) a glass-ceramic lithium disilicate restoration. All specimens were exposed to a fatigue process involving thermal-cyclic loading (50N for 1.2 × 106 cycles at 1.7 Hz, between 5 and 55 °C), if teeth survived, they were fractured using a load-to-failure test and failure types were analyzed. Finite element analysis (FEA) was conducted to assess tooth deformation and tensile stress in the restorations. Statistical evaluation of fracture strength was conducted using the Kruskal-Wallis test. Fisher's exact test was utilized to analyze the fracture types and repairability. A statistical significance level of α < 0.05 was set for all analyses. RESULTS All specimens successfully withstood the fatigue testing procedure, and no statistically significant differences in fracture strength were observed among the three groups (P > 0.05). The Fisher's exact test indicated a significant association between the restorative material and fracture type (F2 = 18.315, df = 2, P = 0.004), but also for repairability (F2 = 13.725, df = 2, P = 0.001). Crown-root fractures were significantly more common in the Cer_3 group compared to the Co_1 group (P = 0.001) and the Co_1 group had significantly more repairable fractures (F2 = 13.197, df = 2, P = 0.001). FEA revealed comparable outcomes of deformation among models and higher maximum tensile stress on models with higher frequency of catastrophic failures. CONCLUSIONS All tested restoration materials exhibited comparable fatigue survival and fracture strength in this laboratory and in silico study. However, it is important to recognize the potential for more severe and irreparable fractures when opting for deeply luted glass-ceramic inlay restorations in clinical practice. In such cases, it would be prudent to consider the alternative option being a direct composite approach, because of its more forgiving fracture types and repairability. CLINICAL IMPLICATIONS Molars with deep approximal direct and indirect restorations, whether with or without DME, are comparable in their fatigue survival and fracture resistance to withstand intra-oral forces. Deep direct restorations exhibit more repairable fractures compared to deeply luted glass-ceramics.
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Affiliation(s)
- Rijkje A Bresser
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands.
| | - Marco A Carvalho
- Dental School, Evangelical University of Goias, Anapolis, Brazil
| | - Lucas Z Naves
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands
| | - H Melma
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands
| | - Marco S Cune
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; St. Antonius Hospital Nieuwegein, Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, the Netherlands
| | - Marco M M Gresnigt
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; Martini Hospital, Department of Special Dental Care, Groningen, the Netherlands
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Gresnigt MMM, Jonker JA, van der Made SAM. The cantilever contact-point resin bonded bridge; adhesion 2.0. J ESTHET RESTOR DENT 2024; 36:37-46. [PMID: 38084818 DOI: 10.1111/jerd.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
AIM When young patients are congenitally missing anterior teeth, different treatment modalities can be used to complement the dental arch. This article proposes a new treatment modality for the replacement of anterior teeth, the cantilever contact-point resin bonded bridge (CCP-RBB). MATERIALS AND METHODS In this proof of principle study, CCP-RBB's delivered by one operator were clinically assessed. Patients who were missing maxillary incisors and had suitable intra-oral conditions for a contact-point cantilever RBB were included. Three cases are presented to describe all adhesive steps. This proof of principle clinical study is presented with up to 60 months follow-up of the cantilever contact resin bonded bridges. RESULTS A total of 19 CCP-RBB's were evaluated after a mean period of 29.8 months. None of the restorations exhibited failure, carious lesions or fractures during the follow-up periods, demonstrating an absence of restoration debonding or the need for repair. CONCLUSION The new cantilever contact-point resin bonded bridge exhibited an excellent treatment modality without failure or debonding up to 5 years. More and extended duration in vivo studies are needed to evaluate this new treatment modality. CLINICAL SIGNIFICANCE In this proof of principle the new cantilever contact-point resin bonded bridge obtained excellent results up to 5 years of clinical follow-up.
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Affiliation(s)
- Marco M M Gresnigt
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Special Dental Care, Martini Hospital, Groningen, the Netherlands
| | - Joyce A Jonker
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Cheng PJ, Liu SM, Huang SM, Wang JC, Hung CC, Chen WC. Survival assessment of fractured porcelain-fused-to-metal crowns surface roughened by sandblasted and repaired by composite resin after in vitro thermal fatigue. J Dent Sci 2023; 18:1706-1715. [PMID: 37799887 PMCID: PMC10547947 DOI: 10.1016/j.jds.2023.01.003] [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: 12/19/2022] [Revised: 01/02/2023] [Indexed: 01/15/2023] Open
Abstract
Background/purpose Intraoral repair usually takes the convenience of the patient's daily life as the starting point, taking into account the bonding strength, operational feasibility, and safety. This study aimed to evaluate the survival of composite resin by simulating cavity fracture repair in porcelain-fused-to-metal (PFM) crowns and referring to the G.V. Black classification of caries as ceramic- and metal-site exposure. Materials and methods Mechanical sandblast experimental and a nonsandblast control groups comprised 120 samples, and interfacial locking was enhanced through acid etching, bonding, and light-curing composite resin restoration. Classes of VI buccal (B), III mesial (M), and IV mesiobuccal (MB) types, were investigated. Load tests were performed on two sets, with one set at room temperature for 24 h and the other via thermal cycling at 5 °C/50 °C 720 times. Loading was gradually applied to the samples until a maximum of 450 N was reached. Results Results showed that 24 h survival rates of B-, M - , and MB-repaired PFM crowns were 88%, 84%, and 88%, respectively. The repaired PFM survival rates for B, M, and MB were 52%, 44%, and 28%, respectively, after thermal cycling and loading tests. Multiple logistic regression and chi-square test (α = 0.05) showed that the regression results of factors affecting survival assessment were only significant between groups after thermal fatigue (P < 0.05). Survival rate of repairing metal-site in the MB model was significantly higher than that of ceramic-sites repairing in non-blasted samples. For the MB cavity model, sandblasting can significantly improve the survival rate of the repair of ceramic parts in the MB model (P < 0.05). Conclusion Our results suggest that sandblasting can be further considered, especially for MB cavity fractures when ceramic-site restorations are required.
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Affiliation(s)
- Po-Jen Cheng
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung, Taiwan
- Division of Dental Research, Department of Dentistry, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan
| | - Shih-Ming Liu
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung, Taiwan
| | - Ssu-Meng Huang
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung, Taiwan
| | - Jen-Chyan Wang
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Cheng Hung
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Cheng Chen
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Fragrance and Cosmetic Science, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
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Avram LT, Galațanu SV, Opriș C, Pop C, Jivănescu A. Effect of Different Etching Times with Hydrofluoric Acid on the Bond Strength of CAD/CAM Ceramic Material. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7071. [PMID: 36295139 PMCID: PMC9605186 DOI: 10.3390/ma15207071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
The objective of this study was to evaluate the influence of hydrofluoric acid (HF) and conditioning time on the micro-shear bond strength (µSBS) between dual-cure resin cement and glass-ceramic materials, such as lithium disilicate ceramic (IPS e.max CAD, Ivoclar Vivadent) (EX) and leucite-reinforced ceramic (IPS Empress CAD, Ivoclar Vivadent) (EP), and also a hybrid ceramic (Vita Enamic, Vita Zahnfabrik) (VE). Eighteen sections with 1 mm thickness were cut from each CAD/CAM material and randomly divided into three groups, according to the surface etching time (30 s, 60 s, 90 s). The surface treatment was performed using 9.5% HF acid gel, then resin cement was applied on the prepared ceramic plates and light cured. µSBS values between resin cement and the ceramic material were measured with a universal testing machine at a crosshead speed of 0.5 mm/min until the failure occurred. The fractured surfaces of specimens were microscopically evaluated, and failure modes were classified as: adhesive between resin cement and ceramic, cohesive within ceramic or cement and mixed failure. Surface roughness of etched samples was examined using a scanning electron microscope. Obtained data were statistically analysed using one-way analysis of variance (ANOVA) and Bonferroni post hoc test with a level of significance α = 0.05. The results of the statistical methods applied indicate that µSBS mean difference for leucite-reinforced ceramic (EP) was statistically significant (p < 0.05). However, µSBS values for hybrid ceramic (VE) and lithium disilicate ceramic (EX) were not affected, from a statistical point of view, by the conditioning time (p > 0.05).
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Affiliation(s)
- Liane Tabitha Avram
- Department of Prosthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Victor Babeș” Timișoara, Revoluţiei din 1989 Bd. No. 9, 300070 Timișoara, Romania
| | - Sergiu-Valentin Galațanu
- Department of Mechanics and Strength of Materials, Politehnica University of Timisoara, Mihai Viteazu Bd., 300222 Timisoara, Romania
| | - Carmen Opriș
- Department of Materials and Manufacturing Engineering, Politehnica University of Timisoara, Mihai Viteazu Bd., Timis, 300222 Timisoara, Romania
| | - Cristian Pop
- Department of Mechatronics, Politehnica University of Timisoara, Mihai Viteazu Bd., 300222 Timisoara, Romania
| | - Anca Jivănescu
- Department of Prosthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Victor Babeș” Timișoara, Revoluţiei din 1989 Bd. No. 9, 300070 Timișoara, Romania
- TADERP Research Center, University of Medicine and Pharmacy “Victor Babeș” Timișoara, Revoluţiei din 1989 Bd. No. 9, 300070 Timișoara, Romania
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