Effect of laser etching on surface characteristics of and porcelain bond to soft milled and direct metal laser sintered cobalt chromium alloys

STATEMENT OF PROBLEM

The surface topography of metal substrate can affect its bond to porcelain. A neodynium-doped yttrium aluminum garnet (Nd:YAG) laser has been introduced to modify the metal surface topography and improve porcelain bond strength. However, studies on the effect of laser etching on metal to porcelain bond strength are lacking.

PURPOSE

The purpose of this in vitro study was to determine the effect of Nd:YAG laser etching on the surface roughness and wettability of and the porcelain bond strength to cobalt chromium (Co-Cr) substrate fabricated by milling and direct metal laser sintering (DMLS).

MATERIAL AND METHODS

Thirty-two 0.5×3×25-mm Co-Cr specimens were fabricated by milling soft Co-Cr (M group) and DMLS Co-Cr metal powder (DML group). The surface topography of representative specimens from each study group was assessed under a scanning electron microscope (SEM) and an atomic force microscope (AFM). All specimens were assessed for surface roughness using a contact profilometer, and for wettability with a contact angle goniometer. Half of the specimens of each study group (n=8) were subjected to surface laser etching by using a Nd:YAG laser. The specimens subjected to etching were assessed again for surface topography and wettability. All specimens in both study groups were veneered with porcelain. The porcelain bond strength was tested with a 3-point bend test in a universal testing machine. The results were statistically analyzed with 2-way ANOVA test followed by the post hoc Tukey test for pairwise comparisons (α=.05).

RESULTS

After etching, the M group had a higher mean ±standard deviation Ra and Rz of 2.9 ±0.6 and 17.7 ±3.2 µm and significantly better wettability and bond strength of 79 ±6 and 52 ±13 MPa. In contrast, after etching, the DMLS group had a significantly lower Ra and Rz of 7.9 ±2.4 and 41.8 ±9.3 µm and significantly lower wettability and bond strength of 87 ±4 and 70 ±10 MPa. The DMLS group had a significantly higher roughness and bond strength than the M group before and after laser etching. The SEM and AFM showed different surface topography in the study groups.

CONCLUSIONS

The manufacturing process of Co-Cr substrate had a significant effect on surface characteristics and porcelain bond strength. Laser etching improved the surface topography and bond strength of milled Co-Cr but not of DMLS Co-Cr.

Effect of modifying occlusal cement spacer on the fit accuracy of digitally manufactured zirconia crowns

STATEMENT OF PROBLEM

Cement spacer has a crucial influence on the adaptation of fixed restorations. Recently, digitally fabricated zirconia crowns have become more popular, but studies on the effect of occlusal cement spacer on the fit accuracy of digitally designed and milled zirconia crowns are lacking.

PURPOSE

The purpose of this in vitro study was to investigate the effect of modifying digital occlusal spacer on the marginal and internal fit of digitally manufactured zirconia crowns.

MATERIAL AND METHODS

A maxillary molar typodont tooth was prepared for a zirconia crown, scanned with the Medit i700 intraoral scanner (IOS), and the standard tessellation language (STL) file was used to produce 3-dimensionally (3D) printed definitive dies assigned to 3 groups (n=12). All dies were scanned with the IOS, and the obtained STL files were exported to a computer-aided design (CAD) software program for the designing and milling of 36 complete contour zirconia crowns. The zirconia crown design was identical in the 3 groups for all parameters (default parameters in the CAD software program) with a 80-µm radial spacer 1 mm from the finish lines. The occlusal cement spacer was adjusted to 80 µm, 40 µm, and 0 µm for group 80-80, group 40-80, and group 0-80 respectively. The internal and marginal fit of the crowns were measured on their corresponding definitive dies with the replica technique. The Kruskal-Wallis test followed by the Dunn test with the Bonferroni correction was used for statistical analysis of the results (α=.05).

RESULTS

The modification of occlusal cement spacer significantly affected the marginal and internal fit of digitally manufactured crowns (P<.05). Group 0-80 and group 40-80 had similar marginal gap values, which were significantly lower than those of group 80-80 (P<.017). For internal fit accuracy, group 0-80 displayed significantly lower gap values than group 40-80 and group 80-80 for all measured areas. Group 40-80 had significantly lower gap values than group 80-80 at the mid-occlusal and axio-occlusal areas (P<.017).

CONCLUSIONS

Modifying occlusal cement spacer significantly affected the fit of digitally fabricated zirconia crowns. Reducing or eliminating occlusal spacer resulted in significantly improved fit accuracy.

Color difference for shade determination with visual and instrumental methods: a systematic review and meta-analysis

BACKGROUND

Shade determination is a critical step for the fabrication of a satisfactory restoration. Visual shade selection with conventional shade guides is subjective and influenced by variables related to light, observer, and object. Shade selection devices have been introduced to provide subjective and quantitative shade values. This systematic review and meta-analysis aimed to compare the color difference for shade selection with visual and instrumental methods.

METHODS

An initial search was conducted on databases (MEDLINE via PubMed, Scopus, and Web of Science) in addition to a manual search through references of identified articles. Studies comparing the accuracy of visual and instrumental shade selection based on ΔΕ were included in data synthesis. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated to estimate the effect size for global and subgroup meta-analysis using the inverse variance weighted method and random-effects model (P ˂ 0.05). Results were presented as forest plots.

RESULTS

The authors identified 1776 articles from the initial search. Seven in vivo studies were included in the qualitative analysis of which six studies were included in the meta-analysis. For the global meta-analysis, the pooled mean (95% CI) was - 1.10 (- 1.92, - 0.27). Test for overall effect showed that instrumental methods were significantly more accurate than visual methods with significantly less ΔΕ (P = 0.009). Test for subgroup difference showed that the type of instrumental shade selection method used had a significant effect on accuracy (P ˂ 0.001). Instrumental methods including spectrophotometer, digital camera, and smartphone showed significantly better accuracy compared with visual shade selection (P ˂ 0.05). The greatest mean difference was found between the smartphone and visual method with a mean (95% CI) of - 2.98 (- 3.37, - 2.59) with P ˂ 0.001 followed by digital camera and spectrophotometer. There was no significant difference in accuracy between IOS and visual shade selection (P = 1.00).

CONCLUSIONS

Instrumental shade selection with a spectrophotometer, digital camera, and smartphone showed significantly better shade matching compared with a conventional shade guide, whereas IOS did not improve the shade matching significantly compared with shade guides.

REVIEW REGISTRATION

PROSPERO CRD42022356545.

In vivo precision of digital static interocclusal registration for full arch and quadrant arch scans: a randomized controlled clinical trial

BACKGROUND

Clinical studies comparing the accuracy of digital and conventional records for static interocclusal registration are lacking. Therefore, the purpose of this clinical study was to assess the precision of digital interocclusal registration compared to conventional registration for full arch and quadrant arch conditions.

METHODS

Nine individuals with complete natural dentition were enrolled in this study. Each participant received digital scans, conventional impressions, and static interocclusal records according to the following groups: group DF, full arch digital scans and bilateral buccal scans with Medit i700 intraoral scanner (IOS); group DQ, quadrant arch digital scans and unilateral buccal scans with Medit i700 IOS; group CF, full arch polyvinyl siloxane (PVS) impressions and PVS interocclusal records; group CQ, quadrant arch PVS impressions and PVS interocclusal records. For group CF and group CQ, the impressions were poured, mounted with the silicone bites, scanned with a laboratory scanner, and articulated virtually with buccal scans with the laboratory scanner. In each group, each participant received three interocclusal records to repeat the virtual articulation three times and the articulated models were saved as STL files. The STL files were imported into a 3D-processing software to calculate the discrepancies between repeated measures using best-fit-alignment method. The significance between the study groups was calculated with two-tailed paired t-test at P < 0.05.

RESULTS

For full arch, group DF showed significantly better precision with a mean value of 31 ± 19 µm compared to 204 ± 81 µm for group CF (P = 0.0003). Similarly, for quadrant arch, group DQ showed significantly better precision with a mean value of 18 ± 6 µm compared to 255 ± 136 µm for group CQ (P = 0.0009). No significant difference in precision was found between quadrant arch and full arch when the digital or the conventional method was used.

CONCLUSIONS

The digital approach had significantly better precision for static interocclusal registration compared to the conventional method in both full and quadrant arch situations. Trial Registry This clinical trial was registered on 06/07/2022 in the Pan African Clinical Trial Registry database, the number for the registry is PACTR202207648490275.

Accuracy of intraoral scanners for static virtual articulation: A systematic review and meta-analysis of multiple outcomes

STATEMENT OF PROBLEM

Static virtual articulation with intraoral scanners (IOSs) can eliminate the human errors related to conventional articulation methods and enhance accuracy. A systematic review and meta-analysis based on multiple accuracy outcomes can combine the available literature and provide an evidence-based conclusion.

PURPOSE

The purpose of this systematic review and meta-analysis was to investigate whether static virtual articulation with IOSs has acceptable accuracy for completely dentate and partially edentulous patients.

MATERIAL AND METHODS

An electronic search was conducted on the PubMed, Web of Science, and Scopus databases. In addition, a manual search through reference lists of selected articles was performed. Clinical and in vitro studies evaluating the accuracy of static virtual articulation with IOSs based on diagnostic accuracy, trueness, precision, and occlusion of fabricated fixed restorations were included. The pooled results included sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratios (DORs), mean values, and 95% confidence intervals (CIs). Results were presented as forest plots. The summary receiver operator characteristic (SROC) was displayed to summarize the diagnostic test performance.

RESULTS

The initial search resulted in a total of 5061 articles, of which 29 articles were included in the analysis. The virtual interocclusal records (VIRs) with IOSs showed acceptable pooled results for diagnostic accuracy (sensitivity: 0.76; specificity: 0.80; DOR: 14.77, area under the SROC (AUC): 0.87; cut off point Q∗: 80; +LR: 3.66; -LR: 0.31). The pooled data for trueness and precision were within the acceptable limits. The pooled mean (95% CI) for trueness based on linear deviations was 243.53 (144.90, 342.17). The pooled mean (95% CI) for precision based on 3D deviation of articulated models was 54.97 (43.49, 66.46). In addition, the included studies reported accurate occlusion for fixed restorations fabricated by using VIRs with IOSs. Moreover, most of the studies on trueness based on virtual occlusal contact area reported acceptable accuracy.

CONCLUSIONS

VIRs with IOSs had acceptable accuracy for static virtual articulation.

Fit of zirconia fixed partial dentures fabricated from conventional impressions and digital scans: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Available studies comparing fit accuracy of zirconia fixed partial dentures (FPDs) fabricated from conventional impressions and digital scans provide contradictory results. In addition, studies have been heterogeneous and of a limited number to provide conclusive evidence.

PURPOSE

The purpose of this systematic review and meta-analysis was to compare the marginal and intaglio fit of tooth-supported zirconia FPDs fabricated from conventional impressions and digital scans and to investigate the effect of different variables on the fit results.

MATERIAL AND METHODS

An electronic search was performed on the National Library of Medicine (NLM), Cochrane Central Register of Controlled Trials, and Scopus databases. In addition, a manual search was carried out. Studies comparing the fit of tooth-supported zirconia FPDs fabricated from conventional impressions and digital scans and reporting sufficient data for qualitative and quantitative analysis were included. Standard mean differences (SMDs) and 95% confidence intervals (CI) were calculated for meta-analysis. Subgroup analysis was performed to study the effect of variables including restoration form (monolithic or framework), units number, intraoral scanner (IOS) type, conventional impression material, spacer thickness, and abutments region.

RESULTS

The initial search resulted in a total of 608 articles. Nine articles were included in the analysis (1 clinical and 8 in vitro) evaluating 118 restorations. Digital scan displayed significantly better marginal fit (P<.001; SMD: -0.68; 95% CI: -0.92, -0.09) and intaglio fit (P=.020; SMD: -0.51; 95% CI: -0.94, -0.42). Test for subgroup difference showed a significant influence of only impression material type (P=.008) and units number (P=.030) on marginal fit. Digital scan showed significantly better marginal accuracy for 3-unit FPDs than 4-unit FPDs (P<.001; SMD: -1.02; 95% CI: -1.41, -0.63). In addition, digital scanning had significantly better marginal fit with polyvinyl siloxane than polyether (P<.001; SMD: -0.98; 95% CI: -1.32, -0.64). A cement spacer ≤50 μm improved both marginal and intaglio fit in the digital group. The TRIOS scanner resulted in the best performance in the digital group for marginal fit.

CONCLUSIONS

Digital scanning provides significantly better marginal and intaglio fit than conventional impression making for fabricating zirconia FPDs up to 4 units, either in monolithic form or frameworks and at any region of the arch. However, further clinical studies are recommended to obtain more substantial results.

Thermal inactivation kinetics of peroxidase and polyphenol oxidase from pomegranate arils (Punica granatum L. cv. Wonderful)

Thermal inactivation of peroxidase (POD) and polyphenol oxidase (PPO) in both pomegranate arils crude enzyme extract and fresh juice was investigated. The optimum conditions for reactions were studied using a mixture of guaiacol and H2 O2 as substrate for POD and pyrogallol for PPO. The experimental work indicated that optimum pH for both enzymes was 7.0; meanwhile optimum temperature was 30°C for POD and 25°C for PPO. Michaelis-Menten constant (Km) values for POD were 8.33 and 8.00 mM for guaiacol and H2 O2, respectively. The Km value was 5.88 mM pyrogallol for PPO. Thermal inactivation results revealed that the inactivation kinetics followed a monophasic first-order model. Activation energies (Ea) were 74.68 and 112.97 kJ/mol for POD and PPO, respectively. Therefore, POD was more heat-stable than PPO. This result is very useful to optimize pomegranate processing (canning or freezing), which represents the most important food industries in many tropical and subtropical regions. PRACTICAL APPLICATIONS: Pomegranate has been attracted more interest due to its antioxidant and nutritional values. For industrial applications, there is a growing interest to obtain pomegranate products such as juice, jams, food supplements, etc. It is well established that the residual activities of endogenous enzymes in either raw materials or processed products may cause loss of quality during storage. Inhibition of enzymatic browning is an important factor to maintain pomegranate quality. This work offers a better insight of characterization of browning enzymes and their thermosatbility, which will be useful to control the possible browning of pomegranate arils during processing and storage. In addition, the results of this study is very important in pomegranate processing where it showed a higher temperature with shortened time can be applied.