Effect of overglazed and polished surface finishes on the compressive fracture strength of machinable ceramic materials

Efficacy of two polishing systems in reestablishing the surface smoothness of posterior monolithic lithium disilicate restorations: One-year results of a split-mouth randomized controlled clinical trial

STATEMENT OF PROBLEM

Selecting the optimal polishing procedure to reestablish surface smoothness after occlusal adjustment is essential for the long-term success of glass-ceramic restorations. While in vitro studies have shown different effective polishing protocols, clinical trials are lacking.

PURPOSE

The purpose of this split-mouth controlled clinical trial was to evaluate the effectiveness of 2 polishing systems in reestablishing the surface smoothness of posterior monolithic lithium disilicate ceramic restorations.

MATERIAL AND METHODS

Ninety-six restorations that required occlusal adjustment after bonding were randomized into 2 groups: Forty-eight restorations were polished by using the Exa Cerapol polishing kit, and the other 48 restorations were polished by using the Shofu polishing kit. The restorations were replicated with epoxy resin at 3 study times-after bonding (t1), after occlusal adjustment (t2), and after polishing (t3)-for quantitative roughness analysis (Ra). Representative specimens from each group were qualitatively analyzed by using a confocal laser microscope. Clinical analyses were performed after the polishing procedure and at 30, 180, and 365 days after the polishing procedure by following the United States Public Health Service (USPHS) criteria. ANOVA and the Tukey multiple comparisons parametric tests were computed (α=.05). The Kaplan-Meier test was used to analyze the survival rate of restorations.

RESULTS

No statistically significant difference was found between the Exa Cerapol and Shofu groups (P=.086). A statistically significant difference was found between study times t1 and t2 and between t2 and t3 (both P<.001) in both experimental groups. No statistically significant difference was found between study times t1 and t3 (P=.181) in either experimental group. For the clinical criterion "integrity of restorations," all the elements analyzed indicated an alfa grade at all study times. The survival rate of the restorations was 100%.

CONCLUSIONS

Both polishing kits were effective in reestablishing the surface smoothness of restorations after occlusal adjustment.

Overview of Several Typical Ceramic Materials for Restorative Dentistry

With the development of ceramic technology, prosthodontic ceramics are becoming a useful option for improving esthetic outcomes in dentistry. In this paper, various ceramic materials were reviewed and evaluated, and their advantages and disadvantages and indications in oral prosthodontics were analyzed objectively. The properties of resin-based ceramics, polycrystalline ceramics, and silicate ceramics were compared and analyzed. Resin-based ceramics may replace other ceramic materials in the CAD/CAM field.

Comparative Evaluation of Marginal Adaptation and Fracture Strength of Different Ceramic Inlays Produced by CEREC Omnicam and Heat-Pressed Technique

Objective

The aim of this in vitro study was to evaluate marginal adaptation and fracture strength of inlays produced by CEREC Omnicam using different types of blocs and heat-pressed technique. Methods: Seventy-five extracted human mandibular molars were divided randomly into 5 groups (n=15). 60 molars in four groups received MOD inlay preparations. Experimental groups were CO: Intact teeth, EC: IPS e.max CAD and CEREC, LU: Lava Ultimate and CEREC, EL: IPS Empress CAD and CEREC, EP: IPS Empress Esthetic ingots and heat-pressed technique. Marginal gap measurements were taken with a stereomicroscope. Restorations were cemented with Variolink N and stored in distilled water at 37°C for 24 hours. All samples were subjected to thermocycling. The fracture strength of specimens was determined at a 0.5 mm/min crosshead speed until fracture. Fracture modes were determined. Statistical analyses were performed using one-way analysis of variance for fracture strength data and Kruskal–Wallis for marginal gap data (p=0.05).

Results

The mean marginal gap size of EC, LU, EL, and EP were 33.54 µm, 33.77 µm, 34.23 µm, and 85.34 µm, respectively. EP had statistically higher values than other groups. The fracture strength values were significantly higher in the intact teeth group (3959,00 ± 1279,79 N) than those of restored groups EC (2408,00 ± 607,97 N), LU (2206,73 ± 675,16), EL (2573.27 ± 644,73) ve EP (2879,53 ± 897,30).

Conclusion

Inlays fabricated using CEREC Omnicam demonstrated better marginal adaptation than inlays produced with heat-pressed technique, whereas fracture strength values of inlays fabricated with different type of blocks using CEREC Omnicam exhibited similarity to those fabricated with heat-pressed technique.

Effect of Finishing and Polishing on Roughness and Gloss of Lithium Disilicate and Lithium Silicate Zirconia Reinforced Glass Ceramic for CAD/CAM Systems

Objective:

To assess the efficacy of dedicated finishing/polishing systems on roughness and gloss of VITA Suprinity and IPS e.max CAD.

Method:

A total of 24 blocks of Suprinity and 24 of e.max were cut into a wedge shape using an InLab MC-XL milling unit. After crystallization, the 24 Suprinity wedges were divided into four subgroups: group A.1: Suprinity Polishing Set Clinical used for 30 seconds and group A.2: for 60 seconds; group A.3: VITA Akzent Plus Paste; and group A.4: spray. The 24 e.max wedges (group B) were divided into four subgroups according to the finishing procedure: group B.1: Optrafine Ceramic Polishing System for 30 seconds and group B.2: for 60 seconds; group B.3: IPS e.max CAD Crystall/Glaze paste; and group B.4: spray. After finishing/polishing, gloss was assessed with a glossmeter and roughness evaluated with a profilometer. Results were analyzed by applying a two-way analysis of variance for gloss and another for roughness (α=0.05). One specimen per each subgroup was observed with a scanning electron microscope.

Results:

For roughness, materials and surface were significant factors (p&lt;0.001). Suprinity exhibited significantly lower roughness than e.max. Also the Material-Surface Treatment interaction was statistically significant (p=0.026). For gloss, both material and surface treatment were significant factors (p&lt;0.001). VITA Suprinity showed significantly higher gloss than e.max. Also the Material-Surface Treatment interaction was statistically significant (p&lt;0.001).

Conclusions:

Manual finishing/polishing for 60 seconds and glazing paste are the most effective procedures in lowering the roughness of CAD/CAM silica-based glass ceramics. Manual finishing/polishing for 60 seconds allows milled silica-based glass ceramics to yield a higher gloss. VITA Suprinity displayed higher polishability than IPS e.max CAD.

Luting of CAD/CAM ceramic inlays: direct composite versus dual-cure luting cement

The aim of this study was to investigate bonding effectiveness in direct restorations. A two-step self-etch adhesive and a light-cure resin composite was compared with luting with a conventional dual-cure resin cement and a two-step etch and rinse adhesive. Class-I box-type cavities were prepared. Identical ceramic inlays were designed and fabricated with a computer-aided design/computer-aided manufacturing (CAD/CAM) device. The inlays were seated with Clearfil SE Bond/Clearfil AP-X (Kuraray Medical) or ExciTE F DSC/Variolink II (Ivoclar Vivadent), each by two operators (five teeth per group). The inlays were stored in water for one week at 37°C, whereafter micro-tensile bond strength testing was conducted. The micro-tensile bond strength of the direct composite was significantly higher than that from conventional luting, and was independent of the operator (P<0.0001). Pre-testing failures were only observed with the conventional method. High-power light-curing of a direct composite may be a viable alternative to luting lithium disilicate glass-ceramic CAD/CAM restorations.

Effects of Different Polishing Protocols on Lithium Disilicate Ceramics

The aim of this study was to evaluate the effect of different polishing protocols on surface roughness and morphology of lithium disilicate ceramics (IPS e.max CAD). Fifty ceramic bars (2.0x3.0x2.5 mm) were produced and randomly divided into five groups (n=10), according to surface treatments: C: Control; Cer: Ceramaster (60 s); CW: cloth wheel with large-grit diamond (30 s) + cloth wheel with fine-grit diamond paste (30 s); E: grey Exa-Cerapol (20 s) + pink Exa-Cerapol (20 s) + Cerapol Super (20 s); F: Felt wheel with large-grit diamond paste (30 s) + Felt wheel with fine-grit diamond paste (30 s). The samples were evaluated quantitatively for surface roughness (Ra) and qualitatively by SEM, at different moments: initial (prior to roughening), after roughening and after polishing procedures. Ra means were submitted to two-way ANOVA and Tukey test (p<0.05). After the different polishing protocols, no statistically significant differences were observed between the Cer and E groups (p=0.6347), E and CW groups (p=0.1366), and CW and FW groups (p=0.5433). Comparing different stages in the same group, it was possible to observe that CW (p<0.0001) and FW groups (p<0.0001) showed significant differences. SEM analysis revealed that both Cer and E groups exhibited a surface morphological pattern similar to that of control group. All polishing systems were effective in reducing the surface roughness of the studied ceramic type.

In vitro evaluation of a modified 4-META/MMA-TBB resin for filling access holes of screw-retained implant prostheses

This study evaluates a modified 4-META/MMA-TBB resin (M4M) as a candidate material for filling screw-retained implant access hole. Its characteristics were compared with a conventional composite resin (CR) with or without a bonding agent (BA) or a ceramic primer (CP). Ceramic blocks were divided into five groups, including (A) CR, (B) CR with BA, (C) CR with CP and BA, (D) M4M, and (E) M4M with CP. Shear bond strengths were measured after 5000 times of thermocycling. Groups A, B, and D were excluded from further tests as they showed no adhesion. A cylindrical cavity (2.5 mm diameter, 3 mm depth) simulating access hole was prepared in a ceramic block and glazed to evaluate micro-leakage and wear test of groups C and E. The results were statistically analyzed with Mann-Whitney test (p  <  0.05). Shear bond strength of groups C (7.6 ± 2.2 MPa) and E (8.6 ± 1.0 MPa) was not significantly different. In micro-leakage analysis, average wear depth and wear volume, group E (7.5 ± 3.3%, 59.3 ± 12.9 μm, 0.16 ± 0.04 mm(3) ) showed significantly lower values than those of group C (45.6 ± 24.4%, 76.0 ± 16.4 μm, 0.28 ± 0.03 mm(3) ). It is suggested that the combination of CP and M4M can be one of feasible systems to fill the ceramic access holes of the implant upper structure.

Ceramic dental biomaterials and CAD/CAM technology: state of the art

PURPOSE

Ceramics are widely used as indirect restorative materials in dentistry because of their high biocompatibility and pleasing aesthetics. The objective is to review the state of the arts of CAD/CAM all-ceramic biomaterials.

STUDY SELECTION

CAD/CAM all-ceramic biomaterials are highlighted and a subsequent literature search was conducted for the relevant subjects using PubMed followed by manual search.

RESULTS

Developments in CAD/CAM technology have catalyzed researches in all-ceramic biomaterials and their applications. Feldspathic glass ceramic and glass infiltrated ceramic can be fabricated by traditional laboratory methods or CAD/CAM. The advent of polycrystalline ceramics is a direct result of CAD/CAM technology without which the fabrication would not have been possible.

CONCLUSIONS

The clinical uses of these ceramics have met with variable clinical success. Multiple options are now available to the clinicians for the fabrication of aesthetic all ceramic restorations.