Surface deterioration of monolithic CAD/CAM restorative materials after artificial abrasive toothbrushing

Effects of two dentifrices on the surface properties and staining susceptibility of polymer-based materials

PURPOSE

This study examined the effect of whitening and abrasive regular dentifrices on the surface characteristics and stain susceptibility of polymer-based CAD-CAM blocks subjected to artificial toothbrushing abrasion (TB).

MATERIALS AND METHODS

Two resin composite blocks [CeraSmart (CS) and Grandio Blocs (GB)], one polymer-infiltrated ceramic [Vita Enamic (VE)], and one direct resin composite [GrandioSO (RC)] were used to produce 60 specimens. The baseline mass, gloss, roughness, Vickers hardness (Hv), and color were measured after 7 days of water storage. The specimens were then separated into three TB treatment groups (n = 5): water control (C), regular daily dentifrice (R), and whitening dentifrice (W). Measurements were repeated post-TB (20,000 cycles). All specimens were immersed in coffee, and the CIE ΔE00 was measured after 1, 7, and 14 days. Two-way, one-way ANOVA, and Tukey's post hoc tests were performed to determine any significant differences between the materials and TB groups. To determine the stain resistance, repeated measures of ANOVA, one-way ANOVA, and Tukey's post hoc tests were used (α = 0.05).

RESULTS

The R and W mass changes were minimal (-3.77 to 3.16 g%). W reduced the gloss of all the materials by 12.6%-65%. All materials in W were slightly rougher (Ra, 0.107-0.144 μm) than those in R (Ra, 0.049-0.072 μm). The ΔE00 ranged from 0.6 to 1.6 in W and 0.4 to 1.4 in R. VE was the hardest material at baseline (Hv = 362), whereas brushing and staining lowered Hv in all TB groups (282.8-300.6). After brushing in W, VE, and RC were more susceptible to coffee stains than were CS and GB.

CONCLUSIONS

The whitening dentifrice roughened CAD-CAM specimens, reducing gloss, yet lightened some materials. Polymer-infiltrated ceramic and direct resin composite specimens brushed with abrasive regular or whitening dentifrice resulted in more intense staining than the CAD-CAM resin composites.

Surface roughness, optical properties, and microhardness of additively and subtractively manufactured CAD-CAM materials after brushing and coffee thermal cycling

PURPOSE

To evaluate the surface roughness, optical properties, and microhardness of additively or subtractively manufactured CAD-CAM materials after simulated brushing and coffee thermal cycling.

MATERIAL AND METHODS

Two additively manufactured resins (Crowntec, CT and VarseoSmile Crown Plus, VS) and 3 subtractively manufactured materials (a reinforced composite (Brilliant Crios, BC), a polymer-infiltrated ceramic network (Enamic, VE), and a feldspathic ceramic (Mark II, VM)) were used to fabricate disk-shaped specimens (Ø10×1-mm) (n = 10). Surface roughness, Vickers microhardness, and color coordinates were measured after polishing, while surface roughness was also measured before polishing. Specimens were then subjected to 25000 cycles of brushing and 10000 cycles of coffee thermal cycling, and measurements were repeated after each time interval. Color difference (ΔE00 ) and relative translucency parameter (RTP) were calculated. Robust analysis of variance test was used to evaluate surface roughness, ΔE00 , and RTP data, while generalized linear model analysis was used for microhardness data (α = 0.05).

RESULTS

Material type and time interval interaction affected tested parameters (p ≤ 0.002). In addition, material type affected all parameters (p < 0.001) other than surface roughness (p = 0.051), and time interval affected surface roughness and microhardness values (p < 0.001). Tested materials mostly had their highest surface roughness before polishing (p ≤ 0.026); however, there was no clear trend regarding the roughness of materials within different time intervals along with ΔE00 and RTP values within materials or time intervals. VS and CT had the lowest microhardness regardless of the time interval, while the remaining materials were listed as VM, VE, and BC in decreasing order (p < 0.001). Coffee thermal cycling only reduced the microhardness of VM (p < 0.001).

CONCLUSIONS

Tested additively manufactured resins can be considered more susceptible to simulated brushing and coffee thermal cycling than the other materials, given the fact that their surface roughness and ΔE00 values were higher than previously reported acceptability thresholds and because they had the lowest microhardness after all procedures were complete.

The Toothbrushing Effects on Surface Properties and Color Stability of CAD/CAM and Pressable Ceramic Fixed Restorations-An In Vitro Study

Pressable ceramic restorations have been introduced and investigated, and found comparable to CAD/CAM ceramic in terms of mechanical properties; however, the effect of toothbrushing on the pressable ceramic has not been thoroughly investigated. The objective of the current study was to assess the effect of artificial toothbrushing simulation on the surface roughness, microhardness, and color stability of different ceramic materials. Three lithium disilicate-based ceramics (IPS Emax CAD [EC], IPS Emax Press [EP]; (Ivoclar Vivadent AG), and LiSi Press [LP] (GC Corp, Tokyo, Japan)) were examined. For each ceramic material, eight bar-shaped specimens were prepared and subjected to 10,000 brushing cycles. Surface roughness, microhardness, and color stability (∆E) were measured before and after brushing. Scanning electron microscopy (SEM) was used for surface profile analysis. The results were analyzed using one-way ANOVA, Tukey's post hoc test, and paired sample t-test α = 0.05. The findings revealed a non-significant decrease in the surface roughness of EC, EP, and LP groups (p > 0.05), and both LP and EP have the lowest surface roughness values (0.64 ± 0.13, 0.64 ± 0.08 µm) after brushing, respectively. Toothbrushing showed a decrease in the microhardness of the three groups: EC and LP, p < 0.001; EP, p = 0.012). EP showed the lowest hardness value after brushing (862.45 ± 273.83). No significant changes (∆E) were observed in all groups (p > 0.05); however, the EC group was found to be considerably affected by color changes, in comparison to the EC and LP groups. Toothbrushing had no effect on surface roughness and color stability of all tested materials, but it decreased the microhardness. Material type, surface treatments, and glazing of ceramic materials contributed to the surface changes in the ceramic materials, necessitating further investigations in terms of the toothbrushing effect with different glazing as variables.

Effect of aging on color, gloss and surface roughness of CAD/CAM composite materials

OBJECTIVES

To assess the effect of aging procedures on color, gloss and surface roughness of CAD/CAM composite materials.

METHODS

6 CAD/CAM composite materials (Brilliant CRIOS, Cerasmart, Lava Ultimate, Tetric CAD, Shofu Block HC, Grandio Blocs) were tested. 10 CAD/CAM fabricated specimens of each material polished according to manufacturers' recommendations, were subjected to one of the following aging procedures; immersion in coffee (30 days, 37^οC), water thermocycling (5000 cycles, 5-55 °C) and photoaging (150,000 kJ/m²). Color, gloss and surface roughness measurements were performed before and after aging and the respective changes were calculated. Kruskal-Wallis tests, paired t-tests, one-way ANOVA and Bonferroni post-hoc tests were used for statistical analysis (a = 0.05).

RESULTS

Color changes ranged from 3.03 to 4.13 after coffee immersion, from 1.33 to 2.55 after thermocycling and from 1.02 to 2.75 after photoaging. No statistically significant differences for ΔE*_ab were found among materials after coffee immersion and thermocycling (p>0.05). Gloss changes ranged from -5.7 to -1.6 GU after coffee immersion, from -2.3 to 0.1 GU after thermocycling and from -4.4 to 0.5 GU after photoaging. No significant differences in gloss changes were found among materials after aging (p>0.05). Tetric CAD demonstrated the significantly lower gloss and the higher surface roughness after polishing. Except for gloss after thermocycling, aging procedures caused significant alteration of gloss and surface roughness parameters from baseline levels.

CONCLUSIONS

Aging procedures caused perceptible but acceptable color changes and small but visible gloss changes, while surface roughness parameters of the tested CAD/CAM composite materials were significantly affected by aging.

CLINICAL SIGNIFICANCE

Aging procedures affected CAD/CAM composite materials indicating that these materials may be prone to color and surface alterations in the oral environment that could compromise the esthetics and the performance of the restorations. Clinical studies are needed to investigate the long-term behavior of the newly introduced CAD/CAM materials.

Influences of Different CAD/CAM Ceramic Compositions and Thicknesses on the Mechanical Properties of Ceramic Restorations: An In Vitro Study

The aim of this study was to assess the influences of different CAD/CAM ceramic compositions and thicknesses on the surface roughness and hardness of ceramic restorations. Four different ceramics were used in the current study: lithium disilicate (LD), leucite reinforced (LE), advanced lithium disilicate (ALD), and zirconia-reinforced lithium silicate (ZLS). Each group included 30 specimens subdivided into three different ceramic thicknesses (0.5, 1 and 1.5 mm thicknesses). The microhardness was measured for all the specimens using a microhardness testing machine, while the surface roughness was measured using a non-contact optical profilometer at three intervals (before toothbrushing and after toothbrushing, with and without toothpaste). Three-way and two-way ANOVA were used to determine the factors influencing the surface roughness and microhardness. There was a significant difference in the surface roughness between the studied groups for all the thicknesses. The findings showed that ALD had the lowest surface roughness, while ZLS showed the highest surface roughness. Moreover, ALD, followed by ZLS, had the highest hardness, while LD and LE had the lowest hardness values. Regarding the thicknesses, both the 0.5 and 1 mm ceramic thicknesses showed a significantly lower surface roughness than the 1.5 mm thickness, while the 1.5 mm thickness showed a significantly higher microhardness than the 0.5 mm thickness. The surface roughness and hardness were significantly affected by the ceramic composition and type of filler. It is recommended to use 1.5 mm-thick ceramic materials for the fabrication of definitive full-coverage ceramic restorations, while veneers require 0.5 mm-thick materials. ALD is a promising CAD/CAM material that can be used for the fabrication of restorations with a proper strength in both anterior and posterior regions.

Effect of Successive In-office Bleaching Sessions on the Surface Properties, Substance Loss, Biaxial Flexural Strength, and Reliability of CAD-CAM Monolithic Materials

Little is known about the effects of in-office bleaching on the surface properties and on other aspects of CAD-CAM monolithic materials, especially when successive bleaching sessions are conducted. This study evaluated the effect of up to three successive in-office bleaching sessions on the microhardness, roughness, topography, substance loss, biaxial flexural strength (BFS), and reliability of CAD-CAM monolithic materials. Disks from Lava Ultimate (LU), Vita Enamic (VE), and IPS Empress CAD (EMP) were fabricated and submitted to one, two, and three bleaching sessions. In-office bleaching was performed with 40% hydrogen peroxide and each session consisted of three applications of 20 minutes each. The analyses regarding the aforementioned parameters were assessed before and after the first, second, and third bleaching sessions, except for BFS, which was evaluated at the baseline and after the third session. Weibull modulus was calculated from the BFS data. Bleaching decreased the microhardness of LU and VE from the third and second sessions, respectively, and affected neither the roughness nor the BFS of the three materials. However, in LU, it decreased the reliability and caused topographic changes, which were accentuated by the increase in the number of sessions. In general, LU and EMP showed, respectively, the highest and the lowest substance losses. Successive in-office bleaching sessions with the use of the protocol of the present study should be avoided in LU and VE.

Digital Volumetric Analysis of CAD/CAM Polymeric Materials after Tooth Brushing

The objective of the study was to evaluate the volumetric wear of four composite materials for CAD/CAM (computer-aided design/computer-aided manufacturing) systems. The materials evaluated were: Cerasmart (CER), Shofu Block HC (SBH), Tetric CAD (TEC) and Brava (BRA). All the samples (n = 40) were subjected to simulated brushing (100,000 cycles). Wear was evaluated by superimposing pre-and post-brushing scans obtained with an intraoral optical scanner (CEREC Primescan; Dentsply Sirona, Germany), which were subsequently imported into the OraCheck software 5.0 (Dentsply Sirona, Germany). The data were analyzed by ANOVA test and Tukey’s HSD test was used for multiple comparisons. Cerasmart showed the least wear after brushing. All the tested materials exhibited mass loss.

Effect of erosive media on microhardness and fracture toughness of CAD-CAM dental materials

Background

Erosive acids might create surface flaws and deteriorate the mechanical properties of CAD-CAM materials. This invitro study aimed to investigate the effect of simulated gastric HCl and extrinsic erosive acids on surface microhardness and fracture toughness of CAD-CAM materials.

Methods

400 bar-shaped specimens (17×4×2 mm³) were prepared from 4 different CAD-CAM dental materials (n = 100/group); monolithic zirconia (Ceramill Zolid HT+, Amanngirbach, Austria), lithium disilicate ceramic (IPS e.max CAD, Ivoclar Vivadent, Liechtenstein), nanohybrid resin composite (Grandio Blocs, VOCO) and polymer-infiltrated glass network (Vita Enamic, VITA Zahnfabrik). Specimens from each material type were further subdivided into 5 groups (n = 20) according to the erosive media applied (simulated gastric HCl, white wine, Coca-Cola®, orange juice, and artificial saliva that served as a control). Specimens were immersed for 24 h in an incubator at 37 ℃, then ultrasonically cleaned in distilled water and air-dried. Half of the specimens were tested for Vickers microhardness (VHN) at parameters of 500 gf for 10 s, while the rest of the specimens underwent 3-point flexure till fracture. Fractured surfaces were examined under a scanning electron microscope (SEM) for fracture toughness (K_IC) calculation using the quantitative fractographic analysis method. Data collected were statistically analyzed using two-way analysis of variance (α = 0.05) after verification of data normality and homogeneity of variances.

Results

Erosive media created surface flaws that lowered the surface microhardness of the material and initiated the fracture pattern under different loads according to material type. The material type was a more predominant factor than erosive media that affected either the microhardness or the fracture toughness of CAD-CAM dental materials. The highest VHN and K_IC values were found among Ceramill Zolid HT+ groups followed by IPS e.max CAD and Grandio Blocs regardless of the erosive media employed. Erosive media significantly reduced the VHN and K_IC in Vita Enamic specimens compared to the rest of the material types.

Conclusion

All CAD-CAM materials used, except Vita Enamic, showed high resistance against the erosive acids indicating higher longevity of the material in patients frequently exposed to either extrinsic or intrinsic acid.

Long-term effects of simulated gastric juice alternated with brushing on hardness, substance loss, flexural strength and reliability of CAD-CAM monolithic materials

OBJECTIVES

The purpose of this study is to evaluate, over a simulated 5-year period, the effect of simulated gastric juice alternated with brushing on CAD-CAM monolithic materials considering microhardness, substance loss, flexural strength, and reliability of the materials.

METHODOLOGY

Blocks from Lava Ultimate (LU), Vita Enamic (VE), IPS Empress CAD (EMP), IPS e.max CAD (EMAX), and Vita Suprinity (VS) were milled into cylinders and sliced into disks. The EMAX and VS were crystallized, and all specimens were polished with silicon carbide papers and allocated as follows: 1) artificial saliva + brushing or 2) simulated gastric juice (0.113% hydrochloric acid (HCl) solution in deionized water, pH 1.2) + brushing, simulating 1, 3, and 5 years of clinical function. Each year of clinical function was simulated by three repetitions of immersion for 3 hours in artificial saliva or simulated gastric juice followed by 1,217 brushing cycles. The microhardness and substance loss were evaluated at baseline (T0) and at each year by using a Vickers hardness tester and an analytical balance. The biaxial flexural strength (BFS) test was performed in a mechanical testing machine at the end of the 5th year. Weibull modulus was calculated from the BFS data.

RESULTS

The microhardness of the LU was not influenced by the treatment, whereas that of the other materials, in certain years, was significantly lower in the gastric juice + brushing groups in comparison with artificial saliva + brushing groups. In general, the materials did not present a significant change in microhardness over time, for either of the treatments. The LU alone showed greater substance loss in the gastric juice + brushing groups for every year. In both treatments, the LU, VE, and EMP exhibited a significant increase in the substance loss over time. The treatment did not affect the BFS of the materials. The gastric juice + brushing decreased the reliability of the VE.

CONCLUSIONS

All materials were somehow impaired by the gastric juice + brushing in at least one of the evaluated parameters, except for the BFS. However, in a deeper analysis, the LU would be the least indicated materials, followed by VE, for patients with eating disorders.

Effect of toothbrushing on the optical properties and surface roughness of extrinsically stained high-translucency zirconia

OBJECTIVES

The effect of toothbrushing on the color, relative translucency, and surface roughness of extrinsically stained zirconia dental restorations is still unclear. The purpose of the present study was to evaluate the optical properties and surface textures of extrinsically stained or glazed partially stabilized zirconia with 5 mol% yttria (5Y-PSZ) after toothbrushing by determining changes in the color, translucency parameter (TP), and surface roughness.

MATERIALS AND METHODS

Specimens (2 mm thick; n = 50) were sectioned from 5Y-PSZ blanks. Three brands of powdered stains (namely VI, SH, IV) and a glaze (GL) were used to extrinsically stain the specimen surfaces (n = 10 per group). The specimens were subjected to 10,000-50,000 simulated toothbrushing strokes using a toothpaste slurry (Ora2 PREMIUM Stain clear paste). The color parameters were measured before staining or glazing and before and after simulated brushing. The color changes and TP values can be calculated before and after simulated brushing. The surface roughness was also evaluated.

RESULTS

Significant changes were found in the shade and TP values of 5Y-PSZ after extrinsic staining, but no significant changes were found after toothbrushing, irrespective of the staining brand (p > 0.05). The surface roughness of the characterized 5Y-PSZ specimens decreased after toothbrushing, whereas that of the non-characterized 5Y-PSZ group increased.

CONCLUSIONS

Toothbrushing markedly affects the surface roughness of extrinsically stained or glazed 5Y-PSZ specimens, whereas no impacts on the color or translucency were observed.

CLINICAL RELEVANCE

For esthetic reasons, clinicians and dental technicians prefer to apply extrinsic stains to zirconia restorations, which profoundly affects its appearance. The limited influence of toothbrushing on color and translucency of 5Y-PSZ is promising for clinical applications.

Influence of Toothbrush Abrasion and Surface Treatments on Roughness and Gloss of Polymer-Infiltrated Ceramics

The aim of this study was to compare the surface roughness and gloss of polymer-infiltrated ceramics after simulated in vitro toothbrushing in different storage mediums. Four polymer- infiltrated ceramics were evaluated, Lava ultimate (LU), Vita enamic (EN), Shofu (SH), and Crystal ultra (CU). The control group was a feldspathic ceramic, Vita Mark II (VM). One hundred and twenty specimens (12 × 14 × 2.5 mm) were prepared using a precision saw. For each material (n = 24), the specimens were allocated into two groups, polished and stained. The specimens of each group were stored (for 7 days) in either citric acid (0.2N) or distilled water. Data for surface gloss (ΔE*_SCE-SCI) and roughness (Ra) were evaluated before (baseline) and after simulated toothbrushing. For toothbrushing simulation, a toothpaste slurry containing a toothpaste of 100 relative dentin abrasion (RDA) and 0.3 ml distilled water was used for 3650 cycles (7300 strokes) for each specimen. Data were analyzed using t-test and ANOVA. A p-value of ≤ to 0.05 was considered significant. The highest mean value of surface gloss was identified in CU (stained—water) (4.3 (0.47)) (ΔE*) and EN (stained—acid) (4.3 (1.00)) (ΔE*) specimens, whereas the lowest mean value was shown by SH (stained—acid) (2.04 (0.42)) (ΔE*) samples. The highest mean value of surface roughness was observed in SH (0.40 (0.99)) Ra (stained—acid) whereas the lowest in VM (0.13 (0.039)) Ra (polished— water). A significant difference (p < 0.05) was observed in surface roughness and gloss between the materials with simulated toothbrushing, except in VM and LU, respectively. Therefore, it can be concluded that simulated toothbrushing impacts on surface roughness and gloss, irrespective of the storage medium.

Characterization of Reinforced and Unreinforced Glass-Ceramic Veneers

This study aimed to characterize the surface topography, effect of polishing on surface roughness, residual stresses, and hardness in two glass-ceramic veneers. Fifty-two (52) upper incisors were collected, prepared, and scanned for ceramic veneers. Half of the teeth were restored with veneers made up of feldspathic ceramic (FE), and the other half with zirconia-reinforced lithium silicate ceramic (SZ). All the veneers were designed and milled using a CAD/CAM system and later cemented following the manufacturer's guideline. An optical microscope analyzed the topography of the specimens before and after polishing. The surface roughness was measured using the roughness meter (n=12) and the topographical analysis was carried out using an atomic force microscope (n=6). The residual stresses and Vickers' hardness were evaluated by the indentation method in a micro-hardness indenter (n=6). The surface roughness was analyzed using a three-way analysis of variance (ANOVA) followed by a post hoc Tukey test. The Student t-test was used to compare the residual stresses and hardness between the two ceramics. The topographical analysis revealed that both glass-ceramic veneers had similar percentages of specimens with cracks, before (34.6%) and after (42.3%) polishing. The surface roughness decreased after polishing (p<0.001), and the polishing smoothed out the surface of the veneers. The zirconia-reinforced lithium silicate veneer had a lower roughness as compared to the feldspathic one after polishing, while the residual stresses (p=0.722) and hardness (p=0.782) were statistically similar for both ceramic veneers.

Awareness and Treatment Decisions on Tooth Wear among Jordanian Dentists and Prosthodontists: A Cross-Sectional Survey Study

Objectives

To assess the awareness, knowledge, and treatment decisions by dentists in Jordan regarding tooth wear.

Materials and Methods

A questionnaire was disseminated to a random sample of 200 general dentists and 100 prosthodontists working in the Ministry of Health, academia, private practices, and military services. Chi square and independent t-tests were performed for statistical analysis.

Results

Hundred and seventy-nine dentists and prosthodontists responded (59.7% response rate), of which 71.5% was females. 83.8% of the dentists reported they see patients with tooth wear. 61.5% registered wear lesions in the patient file, and 68.2% reported they find a probable cause of tooth wear. 87.2% of the dentists reported that bruxism is the most common cause in Jordan. 63.3% dentists treated their patients. 46.4% reported they “always” record a dietary history. 77.7% did not think that tooth wear is linked to caries. Low confidence levels were demonstrated among general practitioners in diagnosing and treating tooth wear. Regarding treatment decisions, most dentists decided to restore worn teeth with composite and to construct a night guard. Minimally affected anterior teeth were mostly treated with fluoride. Restoration of posterior worn teeth with overlay was suggested by one-third of the dentists.

Conclusion

The dentists and prosthodontists in Jordan are aware of tooth wear. However, examination and documentation were given a little priority by general dentists. On the other hand, there was an agreement among the dentists and prosthodontists on applying the minimally invasive approach. Clinical Significance. It is challenging for dentists to make the best treatment decision for tooth wear especially as no standard treatment is available. Therefore, this study investigated the awareness and treatment decisions of a sample of dentists and prosthodontists in Jordan.

Surface Deterioration of Indirect Restorative Materials

The objective of this work was to evaluate the effects of in vitro and in situ biodegradation on the surface characteristics of two resin cements and a hybrid ceramic system. One hundred and eighty specimens (4X1.5mm) of each material (Maxcem Elite, NX3 Nexus and Vita Enamic) were made and randomly distributed in twelve groups (n=15) according to the material and biodegradation method. The specimens were then submitted to the following challenges: storage in distilled water 37 ºC for 24 h or 7 days, storage for 7 days, at 37 ºC, in stimulated saliva or in situ. The in situ stage corresponded to the preparation of 15 intraoral palatal devices, used for 7 days. Each device presented 3 niches, where a sample of each materials was accommodated. Specimens from both saliva and in situ groups suffered a cariogenic challenge, corresponding to the application of a solution of 20% of sucrose, 10 times throughout each day. After each biodegradation method, the surface roughness (Ra), Vickers hardness (VHN) and scanning electron microscopy (SEM) analyzes were performed. The data collected were evaluated by Levene test, two-way ANOVA and Tukey`s test (α=5%). The in situ challenge promoted the greater biodegradation, regardless of the material. Regarding the materials, the Vita Enamic VHN was negatively affected by all biodegradation methods and the Nexus NX3 presented better performance than the self-adhesive cement tested. Therefore, within the conditions of this work, it was concluded that in situ biodegradation can affect negatively the surface characteristics of indirect restorative materials.

Colour stability and surface properties of high-translucency restorative materials for digital dentistry after simulated oral rinsing

High-translucency restorative materials are commonly used in the restoration of anterior teeth where aesthetics is a critical factor. In this in vitro study, the impact of mouthwash on the colour stability and surface characteristics of high-translucency computer-aided design and computer-aided manufacturing (CAD-CAM) dental restorative materials was evaluated. Two-hundred specimens were fabricated from five high-translucency CAD-CAM materials: a resin nano ceramic; a polymer-infiltrated ceramic network; a feldspathic ceramic; a lithium disilicate glass ceramic; and high-translucency zirconia. Each group of ceramic specimens was then divided into four subgroups: conventional mouthwash (LISTERINE); whitening mouthwash (LISTERINE Healthy White); chlorhexidine gluconate; and distilled water. Oral rinsing was simulated at 100 rpm for 180 h, representing 15 yr of clinical simulation. The specimens were then evaluated for colour, translucency, gloss, roughness, and surface morphology. Two-way ANOVA and linear mixed models were used for intergroup comparisons (α = 0.05). The polymer-infiltrated ceramic network and feldspathic ceramic became brighter, more opaque, less glossy, and rougher after rinsing with the whitening mouthwash. The long-term use of specific mouthwashes can cause deterioration of the optical and surface properties of high-translucency CAD-CAM dental restorations.

Optical and Surface Properties of Monolithic Zirconia after Simulated Toothbrushing

This in vitro study investigated the impact of various dentifrices on the shade, translucency, gloss, and surface characteristics of polishing- or glazing-finished monolithic zirconia surfaces after simulated toothbrushing. Eighty square-shaped monolithic zirconia specimens were divided into two major groups based on the finishing methods—polished (P) and glazed (G). Next, specimens from the two major groups were categorized into four subgroups: stored in distilled water (DW, control); brushed with a fluoride-free conventional dentifrice (C); brushed with a fluoride dentifrice (F); and brushed with a whitening dentifrice (W). Overall, eight groups were created—PDW, PC, PF, PW, GDW, GC, GF, and GW (n = 10 each). Shade, translucency, surface gloss, surface roughness, crystalline phase, and superficial topography data were obtained. Repeated-measures ANOVA and two-way ANOVA were used for intergroup comparison (all α = 0.05). The color differences (ΔE₀₀) between pre- and posttreatment were 0.3158 (PDW), 0.7164 (PC), 0.7498 (PF), 0.8106 (PW), 0.1953 (GDW), 0.301 (GC), 0.3051 (GF), and 0.4846 (GW). A statistically significant difference was observed among the ΔE₀₀, surface gloss, and surface roughness of monolithic zirconia. Thus, brushing with several dentifrices markedly affects the optical properties and surface characteristics of monolithic zirconia finished with polishing or glazing methods.