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Chou YC, Chuang SF, Lin JC, Li CL, Liu BY, Lee CL. Application of near-infrared-to-blue upconversion luminescence for the polymerization of resin cements through zirconia discs. Dent Mater 2024:S0109-5641(24)00137-4. [PMID: 38851964 DOI: 10.1016/j.dental.2024.06.005] [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: 01/18/2024] [Revised: 06/02/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVES To investigate a near-infrared-to-blue luminescence upconversion curing method for polymerizing resin cements under zirconia discs. METHODS Lava zirconia discs of different thicknesses (0.5-2.0 mm) were manufactured. First, the transmittances of the NIR and two blue lights (BLs) (LED and halogen lights) through these discs were measured. Second, NaYF4:Yb3+/Tm3+ upconversion phosphor (UP) powder was milled into 0.5-μm particle sizes. A light-curable resin cement VariolinkII base was chosen as the control (UP0), and an experimental cement (UP5) was prepared by adding 5 % UPs. These two cements were examined using multiphoton excitation microscopy for particle distribution. UP5 and UP0 were polymerized with or without zirconia shielding then subjected to a microhardness test. A multifold analysis was performed to examine the effects of zirconia thickness, curing protocols (pure BL or combined BL and NIR curing), and cement type. RESULTS The transmittance of NIR was superior to that of BL through zirconia discs of all thicknesses. UP particles were homogeneously distributed in UP5 and emitted blue luminescence under 980-nm NIR excitation. UP5 showed higher microhardness values than UP0 under any curing protocol or zirconia shielding condition. The combination of 20-s BL and 40-s NIR curing yielded the highest microhardness in uncovered UP5. However, combining 40-s BL and 20-s NIR curing surpassed the other groups when the zirconia discs were thicker than 0.5 mm. SIGNIFICANCE NIR exhibits higher transmission through zirconia than BL. UP particles work as strengthen fillers and photosensitizers in cements. NIR upconversion curing could be a new strategy for polymerizing resin cements under thick zirconia restorations.
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Affiliation(s)
- Yu-Cheng Chou
- School of Dentistry and Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Shu-Fen Chuang
- School of Dentistry and Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan.
| | - Jui-Che Lin
- Department of Chemical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Ling Li
- School of Dentistry and Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bang-Yan Liu
- School of Dentistry and Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Lin Lee
- Department of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan
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Juntavee N, Juntavee A, Jaralpong C. Flexural Strength of Two Multilayered and Monochromatic High Yttria Containing Zirconia Materials Following Different Sintering Parameters. Eur J Dent 2024; 18:551-562. [PMID: 37729931 PMCID: PMC11132776 DOI: 10.1055/s-0043-1772569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES Sintering parameters influence the properties of zirconia. This study examined the effect of altering sintering temperature and time of monochrome and multilayer 5 mol% yttria-partially stabilized zirconia (5Y-PSZ) on flexural strength. MATERIALS AND METHODS Three hundred specimens (width × length × thickness = 10 × 20 × 2 mm) were prepared from monolayer (ZX) and multilayer (ZM) 5Y-PSZ and randomly sintered at decreasing (TD: 1,450°C), regular (TR: 1,500°C), and increasing (TI: 1,550°C) sintering temperature, with extremely short (HE: 10 minutes), ultrashort (HU: 15 minutes), short (HS: 30 minutes), and regular (HR: 135 minutes) sintering time (n = 15/group). The precrack was induced on the tension side before testing for flexural strength (σ). STATISTICAL ANALYSIS Analysis of variance and Tukey's test were used for significant differences of σ at p < 0.05. The microstructure and crystalline (monoclinic; m, tetragonal; t, cubic; c) phase were evaluated by scanning electron microscope (SEM) and X-ray diffractometer (XRD). RESULTS ZXTIHS indicated the highest σ for ZX (315.81 ± 18.91 MPa), whereas ZMTIHS indicated the highest σ for ZM (335.21 ± 36.18 MPa). There was no significant difference for σ between ZX and ZM (p > 0.05). Sintering zirconia at TI or HR indicated significantly higher σ than sintering at TD or TR or with HS, HE, or HU for both ZX and ZM (p < 0.05). There was no significant difference for σ between TRHR and TIHS, TIHU, and TIHE (p > 0.05). SEM indicated intergranular and transgranular fractures. XRD revealed predominately c- and t-phases and minor amounts of m-phase. CONCLUSION Increasing sintered temperature with decreasing time offers acceptable strength to regular sintering. Raising sintering temperature with decreasing time is suggested to facilitate chairside restorative reconstruction.
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Affiliation(s)
- Niwut Juntavee
- Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Apa Juntavee
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Chutikarn Jaralpong
- Division of Biomaterials and Prosthodontics Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Yousry M, Hammad I, El Halawani M, Aboushelib M. Preparation of ultrathin translucent zirconia laminate veneers using 3D printing reduction guides. J Prosthet Dent 2024; 131:548-553. [PMID: 38480012 DOI: 10.1016/j.prosdent.2024.01.040] [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: 10/25/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 04/05/2024]
Abstract
Minimizing and controlling the amount of tooth reduction during the preparation of ultrathin laminate veneers is a challenge for minimally invasive dentistry. The use of reduction guides is advised to reach the optimal space required for the definitive restoration without excessive reduction. The digital production of a reduction guide used to control tooth preparation for ultrathin laminate veneers is described.
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Affiliation(s)
- Mahinour Yousry
- PhD Researcher, Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ihab Hammad
- Professor, Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed El Halawani
- Lecturer, Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Moustafa Aboushelib
- Professor, Department of Dental Materials Science, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Stoilov M, Boehmer T, Stoilov L, Stark H, Marder M, Enkling N, Kraus D. Influence of Cementation Mode and Ferrule Design on the Fatigue Resistance of Monolithic Zirconia Endocrowns. J Clin Med 2024; 13:1165. [PMID: 38398475 PMCID: PMC10889707 DOI: 10.3390/jcm13041165] [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: 01/30/2024] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Classic endocrowns made of dental ceramics are considered a promising alternative to traditional post-endodontic restorations. The use of circular ferrules in endocrowns is a topic of controversial discussion. Therefore, the present study aims to evaluate the effect of ferrule design and cementation mode on the fatigue resistance of zirconia endocrowns. Methods: Eighty human molars were divided into four groups (n = 20): NFC (no-ferrule, conventional cementation), NFA (no-ferrule, adhesive luting), FC (ferrule, conventional cementation) and FA (ferrule, adhesive luting). Both the classic and the modified endocrown preparation with a two-millimeter ferrule design were carried out. Endocrowns were fabricated from zirconia using the CEREC system. After thermocycling, specimens were loaded according to the step-stress test up to 1500 N. Results: Failure rate was low; 88.8% of total specimens passed the step-stress test. Fractures were distributed between all groups; no significant differences in fatigue resistance were detected for preparation design and cementation mode. Conclusions: Endocrowns appear to be a promising concept for endodontically treated molars. Ferrule and also cementation mode have only a minor influence on fatigue resistance of zirconia endocrowns. However, at very high forces, the marginal area of the ferrule represents a weak point.
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Affiliation(s)
- Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Tobias Boehmer
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Lea Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
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Bolaca A, Erdoğan Y. Fracture resistance evaluation of CAD/CAM zirconia and composite primary molar crowns with different occlusal thicknesses. J Appl Biomater Funct Mater 2024; 22:22808000241235994. [PMID: 38420920 DOI: 10.1177/22808000241235994] [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] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE To evaluate the effect of different CAD/CAM materials and occlusal thicknesses on the fracture resistance of primary molar crowns. METHODS Sixty extracted primary molar teeth were prepared and randomly divided into six experimental groups according to the material and thickness. Primary molar crowns with a central groove thickness of 0.3 and 0.5 mm were fabricated from CAD/CAM zirconia (group Z), zirconia-reinforced lithium silicate (group ZLS), and pre-polymerized composite resin blocks (group C). Each crown was cemented with self-adhesive resin cement on the prepared tooth. All specimens were subjected to fracture tests until fracture. Fracture load values were recorded in Newtons (N). Data were statistically analyzed using a two-way analysis of variance (ANOVA) followed by Tukey multiple comparison test. RESULTS The highest fracture load values were obtained in group Z at 0.5 mm occlusal thickness and were significantly higher compared with the other experimental groups (p < 0.05). Although the lowest fracture load values were obtained in group ZLS at 0.3 mm occlusal thickness, all the tested CAD/CAM primary molar crowns at both thicknesses demonstrated fracture load values exceeding reported chewing force in pediatric patients. CONCLUSION CAD/CAM primary molar crowns with reduced occlusal thickness may be used for the full-coverage restoration of primary molar teeth.
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Affiliation(s)
- Arif Bolaca
- Department of Pediatric Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Yıldırım Erdoğan
- Department of Pediatric Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
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Edelhoff D, Schubert O, Stimmelmayr M, Schweiger J. CAD/CAM full-mouth rehabilitation of an elderly patient: One-piece digital complete denture meets multilayered zirconia with gradient technology. J ESTHET RESTOR DENT 2024; 36:174-185. [PMID: 36866726 DOI: 10.1111/jerd.13031] [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: 12/20/2022] [Revised: 02/02/2023] [Accepted: 02/11/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE This article highlights a CAD/CAM complete-mouth rehabilitation in an 82-year-old patient by means of a complete maxillary prosthesis and mandibular implant- and tooth-supported fixed restorations made from multilayered zirconia. CLINICAL CONSIDERATIONS Comprehensive complete-mouth rehabilitations in elderly patients with adaptation of the occlusal vertical dimension (OVD) often present particular challenges. This applies especially when exacting functional and esthetic requirements are to be met and the treatment should not cause the patient too much effort, still ensuring the highest level of quality and efficiency and a low intervention rate. CONCLUSION The digital approach used for the present patient allowed for an efficient treatment procedure, facilitated virtual evaluations using a face-scan, and enhanced the predictability of the prosthodontic outcome. The approach enabled some steps required in the conventional protocol to be omitted, resulting in a straightforward clinical treatment with minimal strain on the patient. CLINICAL SIGNIFICANCE Because of the comprehensive recording of extraoral and intraoral data, for example with a facial scanner, it was possible to transfer a digital replica of the patient to the dental laboratory technician. With this protocol, many steps can be performed in the absence of the real patient.
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Affiliation(s)
- Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
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Bataineh K, Al Janaideh M. Fatigue behavior of three thin CAD/CAM all-ceramic crown materials. Int Biomech 2023; 10:1-8. [PMID: 38205926 PMCID: PMC10786422 DOI: 10.1080/23335432.2024.2303121] [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: 03/23/2020] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
The purpose of this study was to study the effect of crown thickness on the fatigue life of CAD/CAM ceramic materials. CAD/CAM ceramic materials for the crown were virtually designed with three thickness designs of (a) ultra-thin occlusal crown average 0.7 mm thick (group A), (b) thin occlusal crown 1.1 mm average thick (group B), (c) thick occlusal crown 1.5 mm thick. The materials are: zirconia Cercon ZC and IPS e.max CAD (LD). Finite Element Analysis (FEA) simulations were carried out to estimate the fatigue lives of restorative materials. The lives for groups B and C under fatigue load were not significantly different from each other for Zirconia. The predicted lives for group A zirconia crowns, under fatigue load 50 N, 100 N, 120 N is 24 years, 4.3 years, 1.9 years, respectively. Results for crowns made of LD can be summarized as follows: under load 50 N, all groups have survived longer than 5 respectively, while under the load of 100 N, only group C survived longer than 5 years. 0.7 mm thick full contour Zirconia crowns possessed adequate endurance strength to survive under physiologic conditions. On the other hand, the crown made of LD should have at least 1.5 mm thickness to survive longer than 5 years.
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Affiliation(s)
- Khaled Bataineh
- Department of Mechanical Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Al Janaideh
- Department of Mechanical Engineering, Jordan University of Science and Technology, Irbid, Jordan
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Alghauli MA, Wille S, Lehmann F, Kern M. Survival and debonding resistance of posterior cantilever resin-bonded fixed dental prostheses for moderately and severely worn dentition during thermomechanical loading. Dent Mater 2023; 39:634-639. [PMID: 37183157 DOI: 10.1016/j.dental.2023.05.006] [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: 07/25/2022] [Revised: 04/06/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the survival rate, the debonding resistance, and the failure modes of different occlusal veneer designs when used as a retainer for posterior cantilever, resin-bonded fixed dental prostheses (RBFDPs) at two tooth wear levels. METHODS Four test groups were assigned: two groups with occlusal-proximal preparation (PT1 and PT2 for grade 2 and 3 wear), and two groups for occlusal-proximal and lingual preparation (PLT1 and PLT2 for grade 2 and 3 wear) Monolithic zirconia ceramic (3Y-TZP) RBFDPs were luted with an adhesive bonding system (Panavia V5). The specimens underwent a chewing simulation for 1.200.000 cycles with a load of 5 kg and thermocycling for 7500 cycles between 5 °C and 55 °C. The surviving restorations were debonded under quasi-static conditions. The results were analyzed with ANOVA. RESULTS The specimens exhibited a 100 % survival rate after thermomechanical fatigue loading. The debonding resistance was statistically significant higher for group PLT1 than for group PT1 (P = 0.004), and higher for group PT2 than group PT1 (P ≤ 0.001). However, the debonding resistance showed no statistically significant difference between groups PT2 and PLT2 (P = 0.343), and groups PLT1 and PLT2 (P = 0.222). Groups PT1 and PT2 showed favorable failure modes in 62.5 % and 0.00 % of the specimens, respectively. While groups PLT1 and PLT2 presented 25 % favorable failure modes. SIGNIFICANCE Occlusal veneers showed promising results as a retainer for cantilever RBFDPs. The lingual extension might increase debonding resistance. Nevertheless, conservative designs with lingual and proximal bevels are to be recommended, irrespective of the level of tooth wear.
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Affiliation(s)
- Mohammed Ahmed Alghauli
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany; Department of Prosthodontics, College of Dentistry, Ibb University, Yemen.
| | - Sebastian Wille
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Frank Lehmann
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
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Adabo GL, Longhini D, Baldochi MR, Bergamo ETP, Bonfante EA. Reliability and lifetime of lithium disilicate, 3Y-TZP, and 5Y-TZP zirconia crowns with different occlusal thicknesses. Clin Oral Investig 2023:10.1007/s00784-023-05001-6. [PMID: 37022529 DOI: 10.1007/s00784-023-05001-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVES To assess the probability of survival of crowns made with a 3Y-TZP, a 5Y-TZP, and a lithium disilicate. MATERIALS AND METHODS CAD-CAM premolar crowns with occlusal thicknesses of 1.0 mm or 1.5 mm and cemented on a metal dye. Step-stress accelerated life testing (SSALT) was performed to access the use level probability Weibull curves and reliability were calculated for the completion of a mission of 100,000 cycles at 300 to 1200 N. RESULTS All ceramics showed a high probability of survival (87-99%) at 300 N, irrespective of thickness. 3Y-TZP shows no significant decrease in the probability of survival up to 1200 N (83-96%). Lithium disilicate presented lower reliability than zirconia under the 600 N mission. 5Y-TZP showed lower reliability than 3Y-TZP at 1200 N. There was no significant difference in the Weibull modulus (3.23-7.12). 3Y-TZP had the highest characteristic strength (2483-2972 N), followed by 5Y-TZP (1512-1547 N) and lithium disilicate (971-1154 N). CONCLUSION Zirconia ceramics have a high probability of survival (up to 900 N-load), while lithium disilicate survives up to 300 N load only, irrespective of the thickness (1.0 mm or 1.5 mm). CLINICAL RELEVANCE The probability of survival of posterior crowns made with zirconia ceramics resists extreme loads while glass ceramics resist normal chewing loads. In addition, crowns with thinner occlusal face showed sufficient mechanical behavior.
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Grants
- 2016/09640-0, 2012/19078-7, 2021/06730-7, EMU 2016/18818-8, 2019/08693-1 Fundação de Amparo à Pesquisa do Estado de São Paulo
- 2016/09640-0, 2012/19078-7, 2021/06730-7, EMU 2016/18818-8, 2019/08693-1 Fundação de Amparo à Pesquisa do Estado de São Paulo
- 2016/09640-0, 2012/19078-7, 2021/06730-7, EMU 2016/18818-8, 2019/08693-1 Fundação de Amparo à Pesquisa do Estado de São Paulo
- Finance Code 001 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Finance Code 001 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- 307255/2021-2 Conselho Nacional de Desenvolvimento Científico e Tecnológico
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Affiliation(s)
- Gelson Luis Adabo
- School of Dentistry, Sao Paulo State University (Unesp), Araraquara, Sao Paulo, Brazil.
| | - Diogo Longhini
- School of Dentistry, Sao Paulo State University (Unesp), Araraquara, Sao Paulo, Brazil
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Influence of thermo-mechanical aging on fracture resistance and wear of digitally standardized chairside computer-aided-designed/computer-assisted-manufactured restorations. J Dent 2023; 130:104450. [PMID: 36773741 DOI: 10.1016/j.jdent.2023.104450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVES To investigate the influence of thermal cycling and mechanical loading (TCML) aging on fracture resistance and wear behavior of various chairside computer-aided-designed/computer-assisted-manufactured (CAD/CAM) premolar crowns cemented on standardized tooth abutments. METHODS Eighty chairside CAD/CAM crowns were prepared using lithium disilicate (IPS e.max CAD; EM), zirconia-infiltrated lithium silicate (Celtra Duo; CD), polymer-infiltrated ceramic network (Vita Enamic; VE), and resin nanoceramics (Cerasmart; CS) (n = 20). The specimens were divided into two groups (n = 10). In one group, they were subjected to TCML: thermocycling (6000 cycles in distilled water at 5-55 °C) and mechanical loading (50 N for 1.2 × 106 cycles), while in control group they were stored in distilled water (37 °C for 24 h). The fracture load, height loss, and volume wear of the crowns were measured after TCML. Fractography was performed on fractured specimens. Data were analyzed using analysis of variance and multiple comparison tests (α=0.05). RESULTS The mean fracture loads of EM and CD were significantly higher than those of EC and CS (p<0.05). There was no significant change in the fracture load of any CAD/CAM crowns after TCML (p>0.05). CS exhibited a significantly higher volume wear than the other materials investigated. The wear tracts of all TCML crowns acted as failure origins during the fracture test. CONCLUSIONS The fracture resistance of glass-ceramic CAD/CAM crowns was significantly higher than that of resin composite crowns. A 5-year TCML aging did not affect the fracture resistance of CAD/CAM crowns investigated. However, TCML treatment produces a larger wear track in CS than in other materials. CLINICAL SIGNIFICANCE Appropriate chairside CAD/CAM restorative material should be selected for successful clinical practice after considering the fracture and wear resistance of the crowns.
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Alsadon O, Moorehead R, Almansour H, Bangalore D, Alageel O, Wood D. Surface Characteristics and Adhesion of Veneering Composite Resin to PAEK-Based Substructure Restorative Materials. J Prosthodont 2023; 32:147-153. [PMID: 35340086 DOI: 10.1111/jopr.13511] [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: 11/04/2021] [Accepted: 03/20/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate and compare the shear bond strength (SBS) of composite veneering material to polyetherketoneketone (PEKK), polyetheretherketone (PEEK), zirconia (YZ), and nickel-chromium alloy (NiCr) substructure restorative materials. MATERIALS AND METHODS Forty samples (12 × 2 mm) were prepared from four materials: PEKK, PEEK, zirconia, and NiCr alloy (n = 10). The Vickers hardness was evaluated before preparing the surface for bonding by shot-blasting using 110 μm Al2 O3 particles. The surface roughness (Ra) of each sample was determined using a noncontact optical profilometer. The veneering resin was bonded onto each sample following primer application. The prepared samples were then subjected to an SBS test using a universal testing machine at 0.5 mm/min crosshead speed. Failure modes and surface topography following debonding were assessed. The data were statistically analyzed using ANOVA and Tukey's post-hoc comparison test (p < 0.05). RESULTS: The highest and lowest mean surface roughness was observed in PEEK (3.45 ±0.13 μm) and NiCr (1.87 ±0.07 μm) materials, respectively. A significant difference in roughness values was observed between the materials except for NiCr and YZ (p = 0.547). Concerning SBS, PEEK and NiCr exhibited the highest (16.23 ±0.96 MPa) and lowest (10.1 ±0.63 MPa) values. The mean difference in SBS indicated a statistically significant difference between the material groups (p < 0.01). CONCLUSIONS PEKK materials demonstrated significantly lower SBS than PEEK and significantly higher SBS values than conventional zirconia and alloy materials. A positive and significant correlation between mean roughness and SBS was observed, but the causality could be either intrinsic to the material or the roughness.
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Affiliation(s)
- Omar Alsadon
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Robert Moorehead
- The Henry Royce Institute and Department of Materials Science and Engineering, University of Sheffield, Sheffield, UK
| | - Haitham Almansour
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Durgesh Bangalore
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Omar Alageel
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Duncan Wood
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Schnitzhofer K, Rauch A, Schmidt M, Rosentritt M. Impact of the occlusal contact pattern and occlusal adjustment on the wear and stability of crowns. J Dent 2023; 128:104364. [PMID: 36403693 DOI: 10.1016/j.jdent.2022.104364] [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: 08/31/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate the impact of the occlusal contact situation and occlusal adjustment on wear, roughness, and fracture force of molar crowns. MATERIALS AND METHODS CAD/CAM crowns (lower right first molar, n = 64; 4 groups à 8, 3Y-TZP zirconia and resin composite) and corresponding antagonists (upper right first molar; 3Y-TZP zirconia) were manufactured. Crowns were constructed according to two principles of occlusion (group "T": Peter K. Thomas' "point-centric" cusp-to-fossa tripodization concept, with 15 contact points; group "RA" Sigurd P. Ramfjord and Major M. Ash, "freedom in centric" concept with four contacts). On one half of the crowns, occlusal adjustment was performed (groups "T adjusted" and "RA adjusted"). All crowns underwent combined thermal cycling (TC) and mechanical loading (ML) (ML: 1.2 × 106 cycles, 50 N, 2 Hz, mouth opening 1 mm; TC: 2 × 3000 cycles, 5/55°C). Wear area and depth of each contact point on the occlusal surfaces of crowns and antagonists were determined using a digital microscope. Surface roughness (Ra, Rz) was measured in and besides (reference) the worn area (3D laser-scanning microscope). Fracture force of the crowns was determined (statistics: Levene-test, one-way-ANOVA; Bonferroni-post-hoc-test; between-subjects effects, Pearson correlation, α=0.05). RESULTS The resin composite crowns yielded significantly higher mean values for wear area and depth (p < 0.001) and lower fracture forces (p < 0.001). Resin composite surfaces showed increased roughness after TCML while zirconia exhibited smoothened surfaces. The occlusal design significantly impacted wear depth (p = 0.012) and fracture force (p < 0.001). Resin composite crowns with fewer contact points (group RA) showed more wear and lower fracture force. Adjusted resin composite crowns showed increased wear areas and depths (p = 0.009-0.013). For zirconia crowns, the adjustment impacted wear area (p = 0.013), wear depth (p = 0.008), and fracture force (p = 0.006), with adjusted zirconia crowns exhibiting more wear and lower maximum forces until fracture. Zirconia wear depth was also impacted by the occlusal design (p = 0.012). Antagonistic wear was influenced by the restorative material, the occlusal contact pattern, and the adjustment. CONCLUSIONS The investigated materials show strongly varying performances with zirconia being significantly influenced by the adjustment, while for resin composites, contact design and adjustment had a major impact. CLINICAL RELEVANCE The results show the necessity of adapting occlusal design and adjustment in order to improve roughness, wear, and stability of zirconia and resin composite crowns.
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Affiliation(s)
- Karin Schnitzhofer
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg 93042, Germany
| | - Angelika Rauch
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg 93042, Germany
| | - Michael Schmidt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg 93042, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg 93042, Germany.
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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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Skjold A, Schriwer C, Gjerdet NR, Øilo M. Fractographic analysis of 35 clinically fractured bi-layered and monolithic zirconia crowns. J Dent 2022; 125:104271. [PMID: 36041673 DOI: 10.1016/j.jdent.2022.104271] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/12/2022] [Accepted: 08/25/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVES The aim of this retrieval study was to analyze the fracture features and identify the fracture origin of zirconia-based single crowns that failed during clinical use. METHODS Thirty-five fractured single crowns were retrieved from dental practices (bi-layered, n=15; monolithic, n=20). These were analyzed according to fractographic procedures by optical and scanning electron microscopy to identify fracture patterns and fracture origins. The fracture origins were closely examined. The crown margin thickness and axial wall height were measured. RESULTS Three types of failure modes were observed: total fractures, marginal semilunar fractures, and incisal chippings. Most of the crowns (23) had fracture origins at the crown margin and seven of them had defects in the fracture origin area. The exact fracture origin was not possible to identify due to missing parts in four crowns. The crown wall thickness was 20% thinner and wall height 30% shorter in the fracture origin area compared to the opposite side. CONCLUSIONS The findings in this study show that fractography can reveal fracture origins and fracture modes of both monolithic and bi-layered dental zirconia. The findings indicate that the crown margin on the shortest axial wall is the most common fracture origin site. CLINICAL SIGNIFICANCE Crown design factors such as material thickness at the margin, axial wall height and preparation type affects the risk of fracture. It is important to ensure that the crown margins are even and flawless.
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Affiliation(s)
- Anneli Skjold
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19. N-5009 Bergen, Norway.
| | - Christian Schriwer
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19. N-5009 Bergen, Norway.
| | - Nils Roar Gjerdet
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19. N-5009 Bergen, Norway.
| | - Marit Øilo
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19. N-5009 Bergen, Norway.
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Fracture Load and Fracture Patterns of Monolithic Three-Unit Anterior Fixed Dental Prostheses after In Vitro Artificial Aging-A Comparison between Color-Gradient and Strength-Gradient Multilayer Zirconia Materials with Varying Yttria Content. J Clin Med 2022; 11:jcm11174982. [PMID: 36078912 PMCID: PMC9457031 DOI: 10.3390/jcm11174982] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 12/02/2022] Open
Abstract
(1) Background: Due to advantages such as avoidance of chipping, pulp-friendly tooth preparation and cost reduction, zirconia is increasingly being used monolithically without veneering. Nevertheless, to enable good aesthetics, various multilayer systems have been developed. The aim of this study was to investigate the impact of different zirconia multilayer strategies and yttria levels on fracture load, fracture pattern, stress distribution and surface roughness. (2) Methods: Monolithic three-unit anterior FDPs were made from three different color-gradient zirconia multilayer materials with different yttria levels corresponding to varying strength and degrees of translucency grades (Katana HTML, STML, UTML, Kuraray) and one strength-gradient zirconia multilayer material (Katana YML, Kuraray) and artificially aged in a chewing simulator (1.2 × 106 load cycles, 50 N, 2 × 3000 thermocycles, 5−55 °C). Analyses of fracture load, fracture pattern, fracture surfaces, stress distribution and roughness were performed after the fracture load test. Shapiro−Wilk, Kruskal−Wallis, Mann−Whitney U-tests and one-way ANOVA were used (p < 0.05). (3) Results: Fracture loads of the high strength color-gradient material HTML and the strength-gradient material YML were comparable after 5 years of aging (p = 0.645). Increasing yttria levels resulted in a decrease in fracture resistance of 42−57% (p < 0.05). Surface roughness of different zirconia generations is comparable after polishing and aging. (4) Conclusions: Color-gradient multilayer zirconia materials and new strength-gradient zirconia materials with similar yttria levels in the basal layers show comparable mechanical properties and are suitable for anterior FDPs.
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Messer-Hannemann P, Samadi M, Böttcher H, Duy S, Duy D, Albrecht N, Schwendicke F, Effenberger S. Evaluation of a Method to Determine Wear Resistance of Class I Tooth Restorations during Cyclic Loading. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5440. [PMID: 35955375 PMCID: PMC9369466 DOI: 10.3390/ma15155440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/08/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was the development of a test regime to determine the wear resistance and predict the clinical performance of conventional glass ionomer cement (GIC) restorations in Class I tooth cavities. Cavities were prepared in excised human teeth and restored using three conventional glass ionomer restorative materials: DeltaFil, Fuji IX GP and Ketac Universal. The restored teeth were mechanically and thermally stressed using a chewing simulator with a maximum number of 1,200,000 load cycles. Besides determining the number of cycles achieved, the abrasion volume after termination of the chewing simulation was calculated using µCT images. All teeth restored with DeltaFil reached 1,200,000 cycles without any restoration failure. Only 37.5% of the restorations each with Ketac Universal and Fuji IX GP were able to achieve the maximum cycle number. A significant lower abrasion volume for restorations with DeltaFil compared to Ketac Universal (p = 0.0099) and Fuji IX GP (p = 0.0005) was found. Laboratory chewing simulations are a useful tool to study basic wear mechanisms in a controlled setting with in-vivo related parameters. DeltaFil shows an improved wear resistance compared to other conventional GICs, indicating the high potential of this material for long-lasting Class I restorations.
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Affiliation(s)
| | - Mariam Samadi
- DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
| | - Henrik Böttcher
- DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
| | - Sebastian Duy
- SD Mechatronik GmbH, 83620 Feldkirchen-Westerham, Germany
| | - Daniela Duy
- SD Mechatronik GmbH, 83620 Feldkirchen-Westerham, Germany
| | | | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, 14197 Berlin, Germany
| | - Susanne Effenberger
- DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, 14197 Berlin, Germany
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17
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Treatment of Tooth Wear Using Direct or Indirect Restorations: A Systematic Review of Clinical Studies. Bioengineering (Basel) 2022; 9:bioengineering9080346. [PMID: 36004871 PMCID: PMC9404995 DOI: 10.3390/bioengineering9080346] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/17/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Tooth wear is considered a well-developed issue in daily clinical practice; however, there is no standard protocol for treatment. The aim of this manuscript was to systematically review the literature to evaluate the clinical outcomes of direct or indirect restorations for treating tooth wear. A literature search was conducted through the PubMed MedLine, Scopus, ISI Web of Science, Scielo, and EMBASE databases up to 29 April 2022. Clinical studies evaluating the clinical performance of direct or indirect restorations for treating tooth wear for a minimum follow-up of 6 months were included in the review. A total of 2776 records were obtained from the search databases. After full-text reading, 16 studies were included in the qualitative analysis. Considering the high heterogenicity of the studies included, a meta-analysis could not be performed. All studies included the rehabilitation of anterior and posterior teeth with extensive wear, using both indirect and direct restorations for a maximum follow-up of 10 years. Restoration materials included ceramo-metal crowns, full gold crowns, lithium disilicate ceramic, zirconia, polymer infiltrated ceramic networks, and resin composites. Most of the reports assessed the survival rate of the restorations and the clinical features using the United States Public Health Service (USPHS) Evaluation System criteria. Contradictory discoveries were perceived concerning the type of restoration with better clinical performance. Considering the current literature available, there is no evidence in the superiority of any restoration technique to ensure the highest clinical performance for treating tooth wear.
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18
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Do you know your ceramics? Part 5: zirconia. Br Dent J 2022; 232:311-316. [DOI: 10.1038/s41415-022-3997-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/07/2021] [Indexed: 11/08/2022]
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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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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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Assessment of Tooth Preparations Submitted to Dental Laboratories for Fabrication of Monolithic Zirconia Crowns. Dent J (Basel) 2021; 9:dj9100112. [PMID: 34677174 PMCID: PMC8534446 DOI: 10.3390/dj9100112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose: The objective of this study was to assess the quality of posterior teeth prepared for monolithic zirconia crowns. Materials and Methods: A total of 392 STL-files of posterior preparations for monolithic zirconia crowns were evaluated in this study. Three-dimensional (3D) images were evaluated using a software (3D Viewer; 3Shape A/S, Copenhagen, Denmark) for finish line design, finish line width, occluso-cervical dimension, total occlusal convergence (TOC), intercuspal angulation, finish line quality, line angle form, and presence or absence of undercut at the axial wall and unsupported lip of enamel. The assessment was performed by two calibrated evaluators. Then, data were descriptively analyzed. Data for occluso-cervical dimension and TOC were descriptively analyzed according to their location. Results: Thirty-nine percent of premolars, 77% of first molars, and 91% of second molars had an average occluso-cervical dimension of less than 3 mm (premolars) and 4 mm (molars), with most of the preparations having a TOC of more than 20 degrees. More than 50% of preparations had undercut, unsupported enamel and/or unacceptable finish line quality. Conclusions: The quality of tooth preparation including finish line quality, absence of unsupported enamel and undercut at the axial wall should be evaluated when preparing monolithic zirconia crowns.
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22
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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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Schriwer C, Gjerdet NR, Arola D, Øilo M. The effect of preparation taper on the resistance to fracture of monolithic zirconia crowns. Dent Mater 2021; 37:e427-e434. [PMID: 33910755 DOI: 10.1016/j.dental.2021.03.012] [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] [Received: 11/09/2020] [Revised: 03/15/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Monolithic zirconia crowns have become a viable alternative to conventional layered restorations. The aim of this study was to evaluate whether the taper, and thus wall thickness, of the abutment or pre-defined cement space affect the fracture resistance or fracture mode of monolithic zirconia crowns. METHODS A model tooth was prepared with a taper of 15° and a shallow circumferential chamfer preparation (0.5 mm). Two additional models were made based on the master model with a taper of 10° and 30° using computer-aided design software. Twenty monolithic 3rd generation translucent zirconia crowns were produced for each model with pre-defined cement space set to either 30 μm or 60 μm (n = 60). The estimated cement thickness was assessed by the replica method. The cemented crowns were loaded centrally in the occlusal fossa at 0.5 mm/min until fracture. Fractographic analyses were performed on all fractured crowns. RESULTS The load at fracture was statistically significant different between the groups (p < 0.05). The crowns with 30° taper fractured at lower loads than those with 10° and 15° taper, regardless of the cement space (p < 0.05). The fracture origin for 47/60 crowns (78%) was in the cervical area, close to the top of the curvature in the mesial or distal crown margin. The remaining fractures started at the internal surface of the occlusal area and propagated cervically. SIGNIFICANCE The fracture resistance of the monolithic zirconia crowns was lower for crowns with very large taper compared to 10 and 15° taper even though the crown walls were thicker.
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Affiliation(s)
- Christian Schriwer
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway.
| | - Nils Roar Gjerdet
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway
| | - Dwayne Arola
- Materials Science and Engineering, University of Washington, USA; Department of Restorative Dentistry, Dental School, University of Washington, USA
| | - Marit Øilo
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway
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Schönhoff LM, Lümkemann N, Buser R, Hampe R, Stawarczyk B. Fatigue resistance of monolithic strength-gradient zirconia materials. J Mech Behav Biomed Mater 2021; 119:104504. [PMID: 33845296 DOI: 10.1016/j.jmbbm.2021.104504] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Evaluation of the effect of three different dynamic fatigue protocols on the fracture resistance of two monolithic strength-gradient zirconia materials. MATERIALS AND METHODS A total of 240 specimens (3 × 4 × 45 mm) was milled from two different layers (incisal and middle) of two types of strength-gradient zirconia blanks (IPS e. max ZirCAD MT Multi A2 vs. IPS e. max ZirCAD Prime A2), resulting in 60 specimens per material and layer group (IPS e. max ZirCAD MT Multi A2: incisal (MI), middle (MM); IPS e. max ZirCAD Prime A2: incisal (PI), middle (PM)). Each group was divided into one static (n = 15) and three dynamic fatigue protocols (N = 45, n = 15): i. 50 N increase every 5000 cycles ii. Increase by 5% of static fracture load every 5000 cycles iii. 10 N increase every 1000 cycles until facture. All specimens were loaded until facture in CeraTest 2 k. Kaplan-Meier, Log-Rank and Chi-squared-test as well as Weibull statistics were performed. A fractographic analysis was performed. The specimens were classified according to the number of crack origins and evaluated using the Ciba-Geigy table. RESULTS With regard to the fracture load, in the static loading MI and PI showed a higher fracture load and in dynamic fatigue protocol 2 PI showed a lower fracture load. The number of cycles until fracture only differed within three groups: MM and MI survived a higher number of cycles in dynamic fatigue protocol 2; PI survived a higher number of cycles in dynamic fatigue protocol 2 than in protocol 1. Within dynamic fatigue protocols, PM resisted the highest number of cycles in protocol 1 and 3 and MI in protocol 2. Comparing groups, Weibull modulus differed only within the static loading, with PI showing lower values than MM and MI. Within the material groups, MI showed higher values in static loading than in dynamic fatigue protocol 1 and 2, and PI showed higher values in the dynamic fatigue protocol 3 than in static loading. With regard to fracture patterns, no differences were found between the groups. CONCLUSIONS Dynamic fatigue protocols provide clinically relevant information on the long-term stability and reliability of monolithic strength-gradient zirconia materials. However, no definitive instructions for dynamic testing can be provided from this investigation.
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Affiliation(s)
- Lisa Marie Schönhoff
- Dental Material Unit, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Nina Lümkemann
- Dental Material Unit, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Ramona Buser
- Dental Material Unit, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Rüdiger Hampe
- Dental Material Unit, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Bogna Stawarczyk
- Dental Material Unit, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany.
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杨 欣, 李 榕, 叶 红, 陈 虎, 王 勇, 周 永, 孙 玉. [Evaluation of fracture strength of two kinds of zirconia all-ceramic crowns with different edge compensation angles]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:402-405. [PMID: 33879918 PMCID: PMC8072427 DOI: 10.19723/j.issn.1671-167x.2021.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate the effects of different edge compensation angles on the fracture strength of multilayer zirconia all-ceramic crowns and traditional uniform zirconia all-ceramic crowns. METHODS The resin tooth preparation specimen of the mandibular first molar with a knife-edge was fabricated. A 3D digital model of the specimen was obtained by scanning it with a 3D dental model scanner. The 3D digital model was imported into computer aided design (CAD) software, and three 3D digital models of the full crown with the same surface shape are designed with the edge compensation angles of 30°, 45° and 60°, respectively. Then, the designed 3D digital model is imported into computer aided manufacturing (CAM) software. Three kinds of multilayer and homogeneous zirconia all-porcelain crowns with different edge compensation angles were fabricated, 10 each for a total of 60. The fracture load of each crown was measured under the electronic universal testing machine. RESULTS Fracture load of multilayer and uniform zirconia all-ceramic crowns, (4 322.86±610.07) N and (5 914.12±596.80) N in the 30° group, (5 264.82±883.76) N and (5 220.83±563.38) N in the 45° group and (4 900.42±345.41) N and (5 050.22±560.24) N in the 60° group, respectively. The fracture load of multi-layer zirconia all-ceramic crowns in the 30° group was significantly lower than that of homogeneous zirconia all-ceramic crowns(P < 0.05); there was no statistical significance in 45° group and 60° group(P>0.05). In the multi-layer zirconia all-ceramic crowns: the fracture load of the 30° group was significantly lower than that of the 45° group (P < 0.05); there was no significant difference between the 30° group and the 60° group, the 45° group and the 60° group (P>0.05).In uniform zirconia full crown group: the 30° group was higher than the 45° group, the 30° group was higher than the 60° group (P < 0.05), and there was no significant difference between the 45° group and the 60° group (P>0.05). CONCLUSION The fracture loads of three kinds of uniform and multilayer zirconia all ceramic crowns with different edge compensation angles can meet the clinical requirements. A smaller edge compensation angle is recommended when using traditional zirconia all-ceramic crowns, while 45° is recommended when using multi-layer zirconia all-ceramic crowns.
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Affiliation(s)
- 欣 杨
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 榕 李
- 北京大学口腔医学院·口腔医院,口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 红强 叶
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 虎 陈
- 北京大学口腔医学院·口腔医院,口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 勇 王
- 北京大学口腔医学院·口腔医院,口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 永胜 周
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 玉春 孙
- 北京大学口腔医学院·口腔医院,口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Kim SH, Choi YS, Kang KH, Att W. Effects of thermal and mechanical cycling on the mechanical strength and surface properties of dental CAD-CAM restorative materials. J Prosthet Dent 2021; 128:79-88. [PMID: 33546857 DOI: 10.1016/j.prosdent.2020.11.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM The properties of dental computer-aided design and computer-aided manufacturing (CAD-CAM) materials vary. Studies regarding the effects of aging on the properties of these materials are lacking. PURPOSE The purpose of this in vitro study was to evaluate the changes in the mechanical and surface properties of different CAD-CAM materials after thermocycling and mechanical loading. MATERIAL AND METHODS In total, 150 bar-shaped specimens (17.0×4.0×2.0 mm) were prepared from feldspathic glass-ceramic (VM; Vitablocs Mark II), lithium disilicate glass-ceramic (EX; IPS e.max CAD), zirconia-reinforced lithium silicate glass-ceramic (CD; Celtra Duo), polymer-infiltrated ceramic network (VE; Vita Enamic), and resin-nanoceramic (CS; Cerasmart). Each type was divided into 2 groups (n=15; each). One group was subjected to thermocycling in distilled water at 5 °C to 55 °C for 6000 cycles and 50 N mechanical loading for 1.2×106 cycles. The other group was stored in 37 °C water for 24 hours. Nanoindentation hardness, Young modulus, and 3-point flexural strength were measured for the analyses of the mechanical properties. Surface roughness, surface microstructure, and elemental composition were measured to analyze the surface characteristics. Statistical analyses were performed with 1-way ANOVA with the Tukey HSD post hoc test, independent samples t test, Kruskal-Wallis test with Bonferroni post hoc test, Mann-Whitney U test, and 2-way ANOVA (α=.05). RESULTS Before and after aging, CS exhibited the lowest hardness (1.20 to 1.04 GPa) and Young modulus (13.76 to 13.48 GPa) values (P<.05). EX exhibited the highest flexural strengths (393.43 to 391.86 MPa), and VM exhibited the lowest (109.98 to 112.73 MPa) values (P<.05). CS exhibited the highest surface roughness (Sa and Sq; 10.60 to 28.82, 14.21 to 38.27 nm) values (P<.05). After aging, the hardness and Young modulus of VM, EX, and VE decreased significantly (P<.001). No significant difference was observed in the flexural strengths of the CAD-CAM materials (P>.05). Significant increases were observed in the surface roughness of all the materials (P<.05), with altered microstructures. Except for the flexural strength, the mechanical properties and surface characteristics of the CAD-CAM materials were significantly affected by the material type after aging. CONCLUSIONS Before and after aging, resin-nanoceramic exhibited the lowest hardness and Young modulus, and the highest surface roughness. Lithium disilicate glass-ceramic exhibited the highest flexural strength and feldspathic glass-ceramic exhibited the lowest value. After aging, increased surface roughness and microstructure alterations were observed. Significant interactions between aging process and material type were found for the mechanical properties and surface characteristics except for the flexural strength.
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Affiliation(s)
- Sung-Ho Kim
- Graduate student, Graduate Prosthodontics, Department of Prosthodontics, College of Dentistry, Dankook University, Cheonan, Republic of Korea
| | - Yu-Sung Choi
- Associate Professor, Department of Prosthodontics, College of Dentistry, Dankook University, Cheonan, Republic of Korea; Visiting Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.
| | - Ki-Ho Kang
- Professor and Advanced Education Program Director, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Wael Att
- Professor and Chairman, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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Al Mortadi N, Bataineh K, Al Janaideh M. <p>Fatigue Failure Load of Molars with Thin-Walled Prosthetic Crowns Made of Various Materials: A 3D-FEA Theoretical Study</p>. Clin Cosmet Investig Dent 2020; 12:581-593. [PMID: 33376410 PMCID: PMC7759726 DOI: 10.2147/ccide.s286826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 11/21/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
- Noor Al Mortadi
- Department of Applied Dental Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Correspondence: Noor Al Mortadi Department of Applied Dental Sciences, Jordan University of Science and Technology, P.O. Box (3030), Irbid22110, JordanTel +9627201000 Email
| | - Khaled Bataineh
- Department of Mechanical Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Al Janaideh
- Department of Mechanical Engineering, Jordan University of Science and Technology, Irbid, Jordan
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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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Rosentritt M, Preis V, Behr M, Strasser T. Fatigue and wear behaviour of zirconia materials. J Mech Behav Biomed Mater 2020; 110:103970. [DOI: 10.1016/j.jmbbm.2020.103970] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 01/10/2023]
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Wiedenmann F, Pfefferle R, Reichert A, Jerman E, Stawarczyk B. Impact of high-speed sintering, layer thickness and artificial aging on the fracture load and two-body wear of zirconia crowns. Dent Mater 2020; 36:846-853. [PMID: 32414506 DOI: 10.1016/j.dental.2020.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/18/2020] [Accepted: 04/13/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the impact of high-speed sintering, layer thickness and artificial aging in a chewing simulator on the fracture load (FL) and two-body wear (2BW) of 4Y-TZP crowns. METHODS 4Y-TZP crowns (Ceramill Zolid HT+, Amann Girrbach AG) in three different layer thicknesses (0.5, 1.0, 1.5; N=192, n=64/group) were manufactured using CAD/CAM technology and sintered at 1580°C (high-speed sintering) or 1450°C (control group). Specimens were polished in two-steps and bonded to standardized CoCr abutments with Multilink Automix (Ivoclar Vivadent). 2BW after 6000 thermo- and 1,200,000 chewing-cycles employing enamel antagonists was determined using best fit machining. FL was tested before and after artificial aging. Univariate ANOVAs, post hoc Scheffé, unpaired t-, Kruskal-Wallis- and Mann-Whitney-U-test were computed (p<0.05). RESULTS High-speed sintering resulted in less 2BW of the zirconia than the control group (p=0.013). High-speed sintering (p=0.001-0.006) and an increase in layer thickness (p<0.001-0.012) resulted in higher FL values, while artificial aging led to a reduction of FL (p<0.001). SIGNIFICANCE As high-speed sintering resulted in less two-body wear of the zirconia and comparable or even higher fracture load results than the control group, this cost- and time efficient alternative presents promising mechanical results.
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Affiliation(s)
- Felicitas Wiedenmann
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336 Munich, Germany.
| | - Regina Pfefferle
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336 Munich, Germany
| | - Axel Reichert
- Research & Development, Amann Girrbach GmbH, Herrschaftswiesen 1, 6842 Koblach, Austria
| | - Eva Jerman
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336 Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336 Munich, Germany
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Schlenz MA, Fiege C, Schmidt A, Wöstmann B. Microleakage of thin-walled monolithic zirconia and polymer-containing CAD-CAM crowns. J Prosthet Dent 2020; 125:316-322. [PMID: 32151385 DOI: 10.1016/j.prosdent.2019.11.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 01/14/2023]
Abstract
STATEMENT OF PROBLEM Monolithic restorations facilitate computer-aided design and computer-aided manufacturing (CAD-CAM) processability and provide thin-walled restorations, which require less tooth reduction. For the long-term success of these restorations, their durable sealing is important. However, data in this regard are sparse. PURPOSE The purpose of this in vitro study was to investigate the microleakage of monolithic complete crowns made from current CAD-CAM materials after mastication simulation. MATERIAL AND METHODS Sixty-four identical test specimens (crown and tooth) were milled based on corresponding standard tessellation language data sets: one for the crowns and another for the human molar teeth. Four CAD-CAM restoration materials were investigated: 2 polymer-containing materials, Brilliant Crios (BC) and Vita Enamic (VE), and 2 zirconia materials, ultra-high-translucent Nacera Pearl Q³ Multi-Shade (ultraHT) and high-translucent Nacera Pearl Multi-Shade (HT). The crowns were adhesively luted to the CAD-CAM milled human molars with 1 of 3 luting systems: OneCoat7Universal and DuoCem (BC); A.R.T.Bond and DuoCement (VE); or EDPrimer/Panavia F2.0 (ultraHT and HT). The specimens were divided in 2 subgroups, and 2 different mastication simulations were applied: normal function (NF) and bruxism (B). A dye penetration test was used to detect microleakage, and the specimens were sectioned. A digital microscope (Zeiss) was used for analysis and to calculate the percentage of leakage in relation to the height of the tooth. Data were subjected to the Mann-Whitney and Kruskal-Wallis tests (α=.05). RESULTS Microleakage was identified in all groups. VE reported the highest leakage with a mean of 13.0%, followed by ultraHT (4.8%), HT (3.6%), and BC (3.0%). No significant difference was detected between the 2 simulation programs (normal function and bruxism). However, VE and the zirconia group HT exhibited a significant difference (P<.014), whereas no significant difference was noted among the zirconia groups or the polymer-containing groups BC and VE. CONCLUSIONS Thin-walled restorations made of CAD-CAM composite resin and zirconia exhibited reduced microleakage compared with the polymer-containing ceramic. Thus, from the specific viewpoint of microleakage, CAD-CAM composite resins and zirconia seem to be suitable materials for thin-walled complete crowns.
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Affiliation(s)
- Maximiliane A Schlenz
- Postdoctoral Researcher, Department of Prosthodontics, Dental Clinic, Justus-Liebig-University, Giessen, Germany.
| | - Carsten Fiege
- Doctoral Researcher, Department of Prosthodontics, Dental Clinic, Justus-Liebig-University, Giessen, Germany
| | - Alexander Schmidt
- Postdoctoral Researcher, Department of Prosthodontics, Dental Clinic, Justus-Liebig-University, Giessen, Germany
| | - Bernd Wöstmann
- Professor and Head, Department of Prosthodontics, Dental Clinic, Justus-Liebig-University, Giessen, Germany
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Garcia PP, Cappoani A, Schelbauer RS, Correr GM, Gonzaga CC. Retrospective clinical and radiographic evaluation of restored endodontically treated teeth. Restor Dent Endod 2020; 45:e49. [PMID: 33294414 PMCID: PMC7691265 DOI: 10.5395/rde.2020.45.e49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 11/11/2022] Open
Abstract
Objectives The aim of this study was to perform a clinical and radiographic analysis of endodontically treated teeth (ETT) restored with cast metal posts (CMPs) or prefabricated glass fiber posts (GFPs) and crowns. Materials and Methods Fifty ETT were restored with 25 CMPs and 25 GFPs at a private dental clinic between 2001 and 2016. The restorations consisted of 12 all-ceramic crowns, 31 metal-ceramic crowns, and 7 composite resin crowns. Demographic data, type of teeth, type of post-and-core system, time of placement, crown restorations, the number of proximal contacts, the type of antagonist, and reports of any complications after post-and-core placement were recorded for each patient. Assessments were performed at baseline (radiographic) and follow-up (radiographic and clinical). Data were analyzed by the McNemar test, the Pearson χ2 test, and Kaplan-Meier survival curves (α = 0.05). The mean follow-up was 67.6 months. Results No significant difference was observed for any of the radiographic parameters when the baseline and final radiographs were compared. In the clinical evaluation, anatomical form (p = 0.009) and occlusion (p = 0.001) showed significant differences according to the type of crown restoration; specifically, metal-ceramic and all-ceramic crowns outperformed composite resin crowns. Conclusions CMPs and GFPs showed favorable results for restoring ETT after 6 years of follow-up. All-ceramic and metal-ceramic crowns showed higher survival rates and better clinical outcomes.
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Affiliation(s)
- Paula Pontes Garcia
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Aline Cappoani
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Ricardo Susin Schelbauer
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Gisele Maria Correr
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Carla Castiglia Gonzaga
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
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Ozdogan M, Gokce H. Investigation of the effects of cement in different thicknesses and mechanical properties on implant with zirconia crown: A finite element analysis. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_348_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kurtulmus-Yilmaz S, Önöral Ö, Aktore H, Ozan O. Does the application of surface treatments in different sintering stages affect flexural strength and optical properties of zirconia? J ESTHET RESTOR DENT 2019; 32:81-90. [PMID: 31774243 DOI: 10.1111/jerd.12552] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/07/2019] [Accepted: 11/11/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the influence of surface treatments conducted in presintering and postsintering stages on flexural strength and optical properties of zirconia. MATERIALS AND METHODS Specimens were milled from partially sintered zirconia blocks in different geometries and divided into three main groups as presintered, postsintered, and control groups. Test groups were further divided into three subgroups (n = 10) according to the surface treatments conducted (grinding, Er,Cr:YSGG laser irradiation, air-borne particle abrasion [APA]). Four-point flexural strength (σ) test and Weibull analysis were conducted. Color differences (ΔE00 ) and translucency parameter (TPab ) were calculated with a spectrophotometer. Surfaces of specimens were scrutinized under FESEM. Data were statistically analyzed. RESULTS Postsintered groups exhibited higher σ values (P < .05). Within all groups, highest and lowest σ values were detected at postsintered and presintered APA groups, respectively (P < .05). All ΔE00 values were above the perceptibility threshold (ΔE00 > 0.8). Higher TPab values were obtained and deeper scratches were observed in presintered groups. CONCLUSIONS Surface treatments performed at postsintering stage had a favorable effect on the flexural strength of all specimens. Surface treatments performed before sintering increased translucency and caused higher ΔE00 values. CLINICAL SIGNIFICANCE Surface treatments performed at different sintering stages can alter mechanical and optical properties of zirconia.
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Affiliation(s)
- Sevcan Kurtulmus-Yilmaz
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Lefkosa, Mersin 10, Turkey
| | - Özay Önöral
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Lefkosa, Mersin 10, Turkey
| | | | - Oguz Ozan
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Lefkosa, Mersin 10, Turkey
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Kontonasaki E, Giasimakopoulos P, Rigos AE. Strength and aging resistance of monolithic zirconia: an update to current knowledge. JAPANESE DENTAL SCIENCE REVIEW 2019; 56:1-23. [PMID: 31768195 PMCID: PMC6872834 DOI: 10.1016/j.jdsr.2019.09.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/02/2019] [Accepted: 09/17/2019] [Indexed: 01/01/2023] Open
Abstract
New zirconia compositions with optimized esthetic properties have emerged due to the fast-growing technology in zirconia manufacturing. However, the large variety of commercial products and synthesis routes, make impossible to include all of them under the general term of “monolithic zirconia ceramics”. Ultra- or high translucent monolithic formulations contain 3–8 mol% yttria, which results in materials with completely different structure, optical and mechanical properties. The purpose of this study was to provide an update to the current knowledge concerning monolithic zirconia and to review factors related to strength and aging resistance. Factors such as composition, coloring procedures, sintering method and temperature, may affect both strength and aging resistance to a more or less extend. A significant reduction of mechanical properties has been correlated to high translucent zirconia formualtions while regarding aging resistance, the findings are contradictory, necessitating more and thorough investigation. Despite the obvious advantages of contemporary monolithic zirconia ceramics, further scientific evidence is required that will eventually lead to the appropriate laboratory and clinical guidelines for their use. Until then, a safe suggestion should be to utilize high-strength partially-stabilized zirconia for posterior or long span restorations and fully-stabilized ultra-translucent zirconia for anterior single crowns and short span fixed partial dentures.
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Affiliation(s)
- Eleana Kontonasaki
- Department of Prosthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Greece
- Corresponding author at: Laboratory of Prosthodontics, Department of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki GR-54124, Greece.
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Clinical factors affecting the translucency of monolithic Y-TZP ceramics. Odontology 2019; 108:526-531. [DOI: 10.1007/s10266-019-00446-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
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A Comparative Study of the Fitness and Trueness of a Three-Unit Fixed Dental Prosthesis Fabricated Using Two Digital Workflows. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9142778] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to measure and correlate the fitness and trueness of a 3-unit fixed dental prosthesis (FDP) fabricated using two digital workflows. The 3-unit FDPs were fabricated using two digital workflows (N = 15). The digital workflows were divided into chairside (closed type) and in-lab (open type) groups. The scanning, computer-aided design (CAD), and computer-aided manufacturing (CAM) processes were conducted with 3shape E1 scanner, exocad CAD software, and DDS EZIS HM, respectively, in the in-lab group; and with CEREC omnicam intraoral scanner, CEREC CAD software, and CEREC MC XL, respectively, in the chairside group. The fitness of the fabricated 3-unit FDPs was evaluated by scanning the silicone replica of the cement space and analyzing the thickness of the silicone replica in the three-dimensional (3D) inspection software (Geomagic control X). The trueness of the milling unit was analyzed by 3D analysis of the CAD reference model, which is the design file of the 3-unit FDP, and the CAD test model, which is the scanned file of the 3-unit FDP. In the statistical analysis, comparison of the two groups was conducted by Mann–Whitney U test, and the correlation between the fitness and trueness was conducted by Pearson correlation test (α = 0.05). The marginal and internal fit were significantly lower in the in-lab group at all measurement positions (p < 0.001). The trueness of the milling unit was significantly higher in the in-lab group compared to the chairside group (p < 0.001). There was a positive correlation between the trueness and internal fit (correlation coefficient = 0.621) in the in-lab group (p = 0.013). The use of appropriate equipment in an in-lab (open type) digital workflow enables a better fabrication of 3-unit FDPs than a chairside (closed type) digital workflow, and poor trueness on the inner surface of the crown adversely affects the internal fit.
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Fracture Resistance of Monolithic Zirconia Crowns on Four Occlusal Convergent Abutments in Implant Prosthesis. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9132585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adjusting implant abutment for crown delivery is a common practice during implant installation. The purpose of this study was to compare the fracture resistance and stress distribution of zirconia specimens on four occlusal surface areas of implant abutment. Four implant abutment designs [occlusal surface area (SA) SA100, SA75, SA50, and SA25] with 15 zirconia prostheses over the molar area per group were prepared for cyclic loading with 5 Hz, 300 N in a servo-hydraulic testing machine until fracture or automatic stoppage after 30,000 counts. The minimum occlusal thickness of all specimens was 0.5 mm. Four finite element models were simulated under vertical or oblique 10-degree loading to analyze the stress distribution and peak value of zirconia specimens. Data were statistically analyzed, and fracture patterns were observed under a scanning electron microscope. Cyclic loading tests revealed that specimen breakage had moderately strong correlation with the abutment occlusal area (r = 0.475). Specimen breakage differed significantly among the four groups (P = 0.001). The lowest von Mises stress value was measured for prosthesis with a smallest abutment occlusal surface area (SA25) and the thickest zirconia crown. Thicker zirconia specimens (SA25) had higher fracture resistance and lowest stress values under 300 N loading.
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Degirmenci K, Kocak-Buyukdere A, Ekici B. Evaluation of reliability of zirconia materials to be used in implant-retained restoration on the atrophic bone of the posterior maxilla: A finite element study. J Adv Prosthodont 2019; 11:112-119. [PMID: 31080572 PMCID: PMC6491356 DOI: 10.4047/jap.2019.11.2.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Zirconia materials have been used for implant-retained restorations, but the stress distribution of zirconia is not entirely clear. The aim of this study is to evaluate the stress distribution and risky areas caused by the different design of zirconia restorations on the atrophic bone of the posterior maxilla. MATERIALS AND METHODS An edentulous D4-type bone model was prepared from radiography of an atrophic posterior maxilla. Monolithic zirconia and zirconia-fused porcelain implant-retained restorations were designed as splinted or non-splinted. 300-N occlusal forces were applied obliquely. Stress analyses were performed using a 3D FEA program. RESULTS According to stress analysis, the bone between the 1) molar implant and the 2) premolar in the non-splinted monolithic zirconia restoration model was stated as the riskiest area. Similarly, the maximum von Mises stress value was detected on the bone of the non-splinted monolithic zirconia models. CONCLUSION Splinting of implant-retained restorations can be more critical for monolithic zirconia than zirconia fused to porcelain for the longevity of the bone.
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Affiliation(s)
- Kubra Degirmenci
- Department of Prosthodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Ayse Kocak-Buyukdere
- Department of Prosthodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Bulent Ekici
- Department of Mechanical Engineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
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