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Pilecco RO, Machry RV, Baldi A, Tribst JPM, Sarkis-Onofre R, Valandro LF, Kleverlaan CJ, Scotti N, Pereira GKR. Influence of CAD-CAM milling strategies on the outcome of indirect restorations: A scoping review. J Prosthet Dent 2024; 131:811.e1-811.e10. [PMID: 38480018 DOI: 10.1016/j.prosdent.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 05/13/2024]
Abstract
STATEMENT OF PROBLEM The influence of computer-aided manufacturing (CAM) parameters and settings on the outcomes of milled indirect restorations is poorly understood. PURPOSE The purpose of this scoping review was to summarize the current CAM systems, parameters, and setting changes, and their effects on different outcomes of milled indirect restorations and aspects related to their manufacture. MATERIAL AND METHODS The protocol of this review is available online (https://osf.io/x28ps/). Studies that used at least 2 different parameters (CAM units, number of axes, digital spacers, or protocols with different rotatory instruments, grit-sizes, milling speed, or others) for milling indirect restorations were included. A structured search up to July 2023 was performed by 2 independent reviewers for articles written in English in LILACS, MEDLINE via PubMed, EMBASE, Web of Science, and Scopus. RESULTS Of 1546 studies identified, 22 were included in the review. Discrepancies were found between the planned and actual measured cement space, with a decreasing linear relationship impacting restoration adaptation at different points. The CEREC MC XL milling machine was the most used system in the included studies, with variations in bur types, milling modes, and number of burs uses affecting internal fit and surface trueness. The results demonstrated the better adaptation of restorations made with 5-axis over 3-axis milling machines. Lithium disilicate and zirconia were the most commonly used materials, and crowns and inlays were popular designs. Marginal and internal adaptation were the primary outcomes assessed using the various techniques. CONCLUSIONS The study presented a comprehensive exploration of CAM systems and parameters, and their influence on indirect restorations. The planned cement space was not properly reproduced by the milling. Bur characteristics can affect restoration fit and trueness. The 5-axis units seem to result in better-adapted restorations compared with 3- and 4-axis units.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Postgraduate student, Postgraduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Renan Vaz Machry
- Postdoctoral student, Postgraduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Andrea Baldi
- Postdoctoral student, Department of Surgical Sciences, Dental School, Turin, Italy
| | - João Paulo Mendes Tribst
- Assistant Professor, Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands.
| | - Rafael Sarkis-Onofre
- Associate Professor, Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Brazil
| | - Luiz Felipe Valandro
- Full Professor, Postgraduate Program in Oral Sciences (Prosthodontics Unit), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Cornelis Johannes Kleverlaan
- Full Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands
| | - Nicola Scotti
- Associate Professor, Department of Surgical Sciences, Dental School, Turin, Italy
| | - Gabriel Kalil Rocha Pereira
- Adjunct Professor, Postgraduate Program in Oral Sciences (Prosthodontics Unit), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Pilecco RO, da Rosa LS, Baldi A, Machry RV, Tribst JPM, Valandro LF, Kleverlaan CJ, Scotti N, Pereira GKR. How do different intraoral scanners and milling machines affect the fit and fatigue behavior of lithium disilicate and resin composite endocrowns? J Mech Behav Biomed Mater 2024; 155:106557. [PMID: 38657286 DOI: 10.1016/j.jmbbm.2024.106557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
The aim of this in vitro study was to evaluate the effect of the combinations of two different intraoral scanners (IOS), two milling machines, and two restorative materials on the marginal/internal fit and fatigue behavior of endocrowns produced by CAD-CAM. Eight groups (n= 10) were considered through the combination of TRIOS 3 (TR) or Primescan (PS) IOS; 4-axes (CR; CEREC MC XL) or 5-axes (PM; PrograMill PM7) milling machines; and lithium disilicate (LD; IPS e.max CAD) or resin composite (RC; Tetric CAD) restorative materials. Specific surface treatments were applied to each material, and the bonding to its corresponding Endocrown-shaped fiberglass-reinforced epoxy resin preparations was performed (Variolink Esthetic DC). Computed microtomography (μCT) was performed to assess the marginal/internal fit, as well as a mechanical fatigue test (20 Hz, initial load = 100 N/5000 cycles; step-size = 50 N/10,000 cycles until a threshold of 1500 N, then, the step-size was increased if needed to 100 N/10,000 cycles until failure or a threshold of 2800 N) to evaluate the restorations long-term behavior. Complementary analysis of the fracture features and surface topography in scanning electron microscopy was performed. Three-way ANOVA and Kaplan-Meier test (α = 0.05) were performed for marginal/internal fit, and fatigue behavior data, respectively. PS scanner, CR milling machine, and RC endocrowns resulted in a better marginal fit compared to their counterparts. Still, the PM machine resulted in a better pulpal space fit compared to the CR milling machine. Regardless of the scanner and milling machine, RC endocrowns exhibited superior fatigue behavior than LD ones. LD endocrowns presented margin chipping regardless of the milling machine used. Despite minor differences in terms of fit, the 'IOS' and 'milling machine' factors did not impair the fatigue behavior of endocrowns. Resin-composite restorations resulted in a higher survival rate compared to glass-ceramic ones, independently of the digital devices used in the workflow.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School, University of Turin (UNITO), Turin, Piedmont, Italy.
| | - Renan Vaz Machry
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin (UNITO), Turin, Piedmont, Italy.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
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Pilecco RO, Machry RV, Ribeiro VF, Dal Piva AMDO, Tribst JPM, Kleverlaan CJ, Moraes RR, Pereira GKR. Impact of try-in paste removal on the fatigue behavior of bonded lithium disilicate ceramics. J Mech Behav Biomed Mater 2024; 151:106394. [PMID: 38218045 DOI: 10.1016/j.jmbbm.2024.106394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/06/2024] [Accepted: 01/07/2024] [Indexed: 01/15/2024]
Abstract
This in vitro study assessed the effectiveness of three cleaning protocols (air-water spray, 37% phosphoric acid, or Ivoclean) on lithium disilicate restorations' fatigue behavior after try-in paste application, compared to a clean condition. Lithium disilicate discs (IPS e.max CAD, Ivoclar) with Ø-= 12 mm and 1 mm thickness were prepared from prefabricated CAD-CAM blocks, polished, subjected to CAD-CAM milling topography simulation and crystallization. After, etching with 5% hydrofluoric acid and the application of try-in paste (Variolink try-in paste shade white; load of 2.5 N for 5 min) was performed. Discs that received try-in paste were divided into three groups according to the removal protocol: SPRAY - air-water spray for 30 s; HPO - active application of 37% phosphoric acid for 60 s; IVOC - application of Ivoclean for 20 s. Control group (CTRL group) did not receive the try-in paste application. Half of the specimens (n= 15) were tested in the baseline condition (24 h up to 7 days), and the others underwent 25,000 thermal cycles (5 - 55 °C) + 210 days of distilled water storage (37 °C). Additional specimens (n= 3) underwent monotonic testing (1 mm/min). Fatigue testing involved a cyclic fatigue approach (20 Hz, initial load = 100 N - 5000 cycles, step size = 50 N - 10,000 cycles) until a visible crack appeared. Fractographic and topographic analyses were performed. Fatigue data were statistically analyzed with two-way ANOVA, Kaplan-Meier log-rank (Mantel-Cox), and independent t-test (α= 0.05). In the baseline condition, the IVOC group resulted in a superior fatigue behavior compared to the CTRL and SPRAY groups, but similar to the HPO group. The HPO and SPRAY presented a similar fatigue behavior to the CTRL group. It was noticed a decrease in fatigue behavior after aging, which resulted in all the cleaning protocols leading to similar fatigue behavior compared to the CTRL group. On the SPRAY group surface, try-in pastes remnants were noticed. In summary, despite a detrimental impact at baseline conditions, all tested cleaning protocols seem proper to remove the try-in paste from the ceramic's surface in the long-term evaluation.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Renan Vaz Machry
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | | | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands.
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands.
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands.
| | - Rafael R Moraes
- Graduate Program in Dentistry, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
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da Rosa LS, Pilecco RO, Soares PM, Rippe MP, Pereira GKR, Valandro LF, Kleverlaan CJ, Feilzer AJ, Tribst JPM. Repair protocols for indirect monolithic restorations: a literature review. PeerJ 2024; 12:e16942. [PMID: 38406292 PMCID: PMC10893862 DOI: 10.7717/peerj.16942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Despite the advancements in indirect monolithic restorations, technical complications may occur during function. To overcome this issues, intraoral repair using resin composite is a practical and low-cost procedure, being able to increase the restoration's longevity. This review aimed to evaluate the need for repair and suggest a standardized repair protocol to the main indirect restorative materials. For this, studies were surveyed from PubMed with no language or date restriction, to investigate the scientific evidence of indirect monolithic restoration repair with direct resin composite. A classification to guide clinical decisions was made based on the FDI World Dental Federation criteria about defective indirect restorations considering esthetic and functional standards, along with the patient's view, to decide when polishing, repairing or replacing a defective restoration. Based on 38 surveyed studies, different resin composite intraoral repair protocols, that included mechanical and chemical aspects, were defined depending on the substrate considering resin-based, glass-ceramic or zirconia restorations. The presented criteria and protocols were developed to guide the clinician's decision-making process regarding defective indirect monolithic restorations, prolonging longevity and increasing clinical success.
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Affiliation(s)
| | | | | | | | | | | | - Cornelis Johannes Kleverlaan
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - Albert J. Feilzer
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - João Paulo Mendes Tribst
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
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Soares PM, da Rosa LS, Pilecco RO, Dal Piva AMDO, Tribst JPM, Werner A, Valandro LF, Pereira GKR, Kleverlaan CJ, Rippe MP. Repair of monolithic zirconia restorations with different direct resin composites: effect on the fatigue bonding and mechanical performance. Clin Oral Investig 2024; 28:149. [PMID: 38355823 PMCID: PMC10866771 DOI: 10.1007/s00784-024-05542-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/02/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE The study aims to evaluate the shear bond and flexural strength fatigue behavior of yttrium-stabilized zirconia (4YSZ) repaired using different resin composites. MATERIALS AND METHODS Cylindric specimens of 4YSZ were obtained for the bond strength (Ø = 6 mm, 1.5 mm of thickness) and biaxial flexural strength (Ø = 15 mm, 1 mm of thickness) fatigue tests and divided into 3 groups according to the repair resin composite: EVO (nanohybrid), BULK (bulk-fill), and FLOW (flowable). The zirconia surface was air-abraded with alumina particles, a 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) primer was applied, and the resin composite was build-up over the zirconia. Fatigue shear bond strength and flexural fatigue strength tests were performed (n = 15). One-way ANOVA and Tukey post hoc tests were carried out for both outcomes, besides scanning electron microscopy and finite element analysis. RESULTS The repair material affected the fatigue shear bond strength of zirconia ceramic. The BULK group (18.9 MPa) depicted higher bond strength values than FLOW (14.8 MPa) (p = 0.04), while EVO (18.0 MPa) showed similar results to both groups. No effect was observed for the mechanical behavior (p = 0.53). The stress distribution was similar for all groups. CONCLUSION The repair of yttrium-stabilized zirconia (4YSZ) ceramics with bulk-fill resin composites was the best option for high fatigue bond strength. However, the fatigue mechanical performance was similar regardless of the applied repair material. CLINICAL RELEVANCE The repair of yttrium-stabilized zirconia (4YSZ) monolithic restorations may be performed with nanohybrid and bulk-fill resin composites in order to promote longevity in the treatment.
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Affiliation(s)
- Pablo Machado Soares
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit Van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit Van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
| | - Arie Werner
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit Van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit Van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - Marilia Pivetta Rippe
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Soares PM, da Rosa LS, Pilecco RO, Pereira GKR, Dal Piva AMDO, Tribst JPM, Valandro LF, Kleverlaan CJ, Rippe MP. Cyclic fatigue of a repaired 4 YSZ ceramic: Effect of the repair protocol on the adhesive and mechanical behavior. Heliyon 2024; 10:e23709. [PMID: 38187296 PMCID: PMC10767202 DOI: 10.1016/j.heliyon.2023.e23709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/17/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
Objective To evaluate the effect of different surface treatments on the morphology, shear bond, and flexural fatigue strength of a repaired translucent zirconia. Methods Monolithic disc-shaped specimens of translucent zirconia were prepared and ground to simulate repair areas. Four groups underwent different treatments: Air-MDP (air-abrasion with alumina particles and 10-MDP primer), Si-Sil (silica-coated alumina particles with MDP-containing silane), Si-MDP (silica coating with 10-MDP primer), and Uni adhe (universal adhesive). After roughness measurements and treatments, repairs were done using resin composite. Shear bond and flexural (n = 15) fatigue tests were performed. Surface topography, interfacial analysis, fractographic, and finite element analysis were conducted. Results The zirconia roughness was similar between the groups, however, the surface topography was modified according to the surface treatments. Si-Sil generated higher and more stable bond strength values (20.69 MPa) between translucent zirconia and resin composite when compared to Uni adhe (15.75 MPa) considering the fatigue bond strength scenario, while it was similar to Si-MDP (17.70 MPa) and Air-MDP (18.97 MPa). Regarding the mechanical behavior, Si-Sil (680.83 MPa) also showed higher and significantly different fatigue strength when compared to Uni adhe (584.55 MPa), while both were similar to Si-MDP (634.22 MPa) and Air-MDP (641.86 MPa). Conclusion The association of mechanical and chemical approaches is essential for long-term bond strength and optimized mechanical behavior, being air-abrasion protocols and the use of silane and/or MDP-based primers suitable for zirconia repair protocols. It was found that relying solely on a universal adhesive was not as effective as other options available. Clinical significance The surface treatment of repair protocols affects translucent zirconia's morphology. To enhance fatigue behavior in repaired monolithic zirconia, air abrasion is crucial. Exclusive use of a universal adhesive is less effective than other choices. A primer containing silane/MDP holds the potential for stable bond strength and optimized mechanical performance.
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Affiliation(s)
- Pablo Machado Soares
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
| | - Marilia Pivetta Rippe
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Pilecco RO, da Rosa LS, Pereira GKR, Tribst JPM, May LG, Valandro LF. The loss of resin cement adhesion to ceramic influences the fatigue behavior of bonded lithium disilicate restorations. J Mech Behav Biomed Mater 2023; 148:106169. [PMID: 37837872 DOI: 10.1016/j.jmbbm.2023.106169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023]
Abstract
When partial and/or non-retentive preparation, such as those for occlusal veneers, is indicated, a proper and stable adhesion is essential. Therefore, the aim of this in vitro study was to evaluate the effect of loss of adhesion in different regions of the bonding interface on the fatigue behavior of simplified lithium disilicate restorations. For this, lithium disilicate (IPS e.max CAD) discs (1 mm thick and Ø = 10 mm) were fabricated, polished with #400-, #600-, #1200-grit silicon carbide (SiC) papers, and crystallized. As substrate, fiber-reinforced resin epoxy discs (2.5 mm thick and Ø = 10 mm) were fabricated and polished with #600-grit SiC paper. The ceramic bonding surface was treated with 5% hydrofluoric acid and a silane-containing primer (Monobond N), while the substrate was etched with 10% hydrofluoric acid followed by the application of the bonding system primers (Primer A + B). A lacquer (nail polish) was used to simulate the loss of adhesion in specific areas according to the study design to compose the testing groups: bonded (control; did not received nail polish application); - non-bonded (loss of adhesion in the whole specimen area); - margin (loss of adhesion in the ceramic margin); - center (loss of adhesion in the ceramic central area). The adhesive area of partially bonded groups was 50% of the adhesive surface. Then, the discs (n = 12) were bonded to the respective substrate using a resin cement (Multilink N), light-cured, water-stored for 90 days, and subjected to thermocycling (25,000 cycles, 5° to 55 °C) before testing. A cyclic fatigue test was run (20 Hz, initial load of 200 N for 5000 cycles, 50 N step size for 10,000 cycles each until specimen failure), and the fatigue failure load and number of cycles for failure were recorded. As complementary analysis, finite element analysis (FEA) and scanning electron microscopy analysis were performed. Kaplan-Meier log-rank (Mantel-Cox) was conducted for survival analysis. The results showed that as the loss of adhesion reaches the central area, the worse is the fatigue behavior and the higher is the stress peak concentration in the ceramic bonding surface. The bonded specimens presented better fatigue behavior and stress distribution compared to the others. In conclusion in a non-retentive preparation situation, proper adhesion is a must for the restoration fatigue behavior even after aging; while the loss of adhesion reaches central areas the mechanical functioning is compromised.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, the Netherlands.
| | - Liliana Gressler May
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
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Pilecco RO, Machry RV, Ribeiro VF, Moraes RR, Pereira GKR. Evaluation paste removal method and bond strength between resin cement and lithium disilicate ceramic: An in vitro study. J Prosthet Dent 2023:S0022-3913(23)00346-3. [PMID: 37357087 DOI: 10.1016/j.prosdent.2023.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/27/2023]
Abstract
STATEMENT OF PROBLEM After the use of evaluation paste, residue can remain on the bonding surface. However, how adhesion to lithium disilicate ceramic is affected is unclear. PURPOSE The purpose of this in vitro study was to determine the effectiveness of lithium disilicate cleaning after contamination with an evaluation paste and before the application of a resin cement. MATERIAL AND METHODS Rectangular lithium disilicate (IPS e.max CAD) specimens were obtained with a simulated milled surface, crystallized, etched with 5% hydrofluoric (HF) acid, and contaminated with an evaluation paste. The cleaning methods tested were air-water spray (SPRAY), 37% phosphoric acid (HPO), ultrasonic bath (ULT), cleaning paste (IVOC), and a conventional surface treatment (HF + silane-HF+SIL). The control (CTRL) group was not contaminated. After silane had been applied, resin cement cylinders were fabricated and light polymerized. Half of the cylinders (n=56) were tested for microshear bond strength at baseline (24 hours), and the other half after 210 days of water storage and 25 000 thermal cycles. Surface roughness, failure analysis, scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS) were performed. Statistical analysis was performed with the Kruskal-Wallis and Mann-Whitney tests for surface roughness and the 2-way ANOVA and Bonferroni post hoc tests for bond strength (α=.05). RESULTS At baseline, only SPRAY did not restore the bond strength compared with CTRL. After aging, the bond strengths of SPRAY and IVOC were lower than of CTRL (P<.05); no significant difference was found between CTRL, HPO, ULT, and HF+SIL (P>.05). EDS demonstrated the presence of carbon in the SPRAY and ULT groups, probably remnants of the evaluation paste. SEM analysis identified such remnants in the SPRAY group only. CONCLUSIONS For optimal bond strength between lithium disilicate and resin cement after evaluation paste use, cleaning the ceramic surface with 37% phosphoric acid, ultrasonic bath, or with hydrofluoric acid worked best.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Postgraduate student, Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Renan Vaz Machry
- Postdoctoral student, Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Vinícius Fogliato Ribeiro
- Graduate student, Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Rafael R Moraes
- Associate Professor, Faculty of Dentistry, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Gabriel Kalil Rocha Pereira
- Adjunct Professor, Post-Graduate Program in Oral Sciences (Prosthodontics Unit), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
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Pilecco RO, Dapieve KS, Baldi A, Valandro LF, Scotti N, Pereira GKR. Comparing the accuracy of distinct scanning systems and their impact on marginal/internal adaptation of tooth-supported indirect restorations. A scoping review. J Mech Behav Biomed Mater 2023; 144:105975. [PMID: 37379673 DOI: 10.1016/j.jmbbm.2023.105975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE To summarize the existing scientific evidence on the effect of distinct intraoral (IOS) and extraoral (EOS) scanners in terms of their accuracy for image acquisition and the marginal/internal adaptation of indirect restorations. METHODS The protocol of this scoping review is available online (https://osf.io/cwua7/). A structured search, with no date restriction, was performed in LILACS, MEDLINE via Pubmed, EMBASE, Web of Science, and Scopus, for articles written in English. The inclusion criteria were studies that considered at least two scanners, regardless of method (intra or extraoral), for the production of tooth-supported restorations. Two independent and blinded researchers screened the studies, collected and analyzed the data descriptively. RESULTS 103 studies were included (55 on marginal/internal adaptation, 33 on accuracy, 5 on both outcomes, and 10 reviews). Most of them, shown clinically acceptable adaptation (<120 μm). Factors commonly related to the performance of scanners are: use of anti-reflection powders, method of image acquisition, and restoration/tooth characteristics. The need of anti-reflection powders was controversial. Different scanning principles seems to result on similar performance; IOS that combine them could be promising. The most explored systems were Omnicam - IOS, and inEos X5 - EOS, which showed similar performance on marginal/internal adaptation. Scarce studies explored the performance of EOS systems, especially in terms of accuracy. Different restoration designs as single-unit seemed not to modify the performance of scanners. Limited information is available regarding the planned cement space, restorative material and design (multi-unit restorations), as also techniques to measure adaptation. CONCLUSIONS Digital scanners are valid approaches to obtain accurate impressions resulting in clinically acceptable restorations. Systems that uses combined principles of image acquisition seems promising for optimal performance. Based on high discrepancy, the quality of evaluated evidence is low, and well-designed studies are still encouraged, especially considering validated IOS/EOS as a control comparison condition.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences, Division of Prosthodontics, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Kiara Serafini Dapieve
- Post-Graduate Program in Oral Sciences, Division of Prosthodontics, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Andrea Baldi
- Department of Surgical Sciences, Endodontics and Operative Dentistry. Dental School, University of Turin (UNITO), Piemonte State, Italy.
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences, Division of Prosthodontics, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Nicola Scotti
- Department of Surgical Sciences, Endodontics and Operative Dentistry. Dental School, University of Turin (UNITO), Piemonte State, Italy.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Division of Prosthodontics, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
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Dapieve KS, Pilecco RO, Temp RW, Villetti MA, Pereira GKR, Valandro LF. Adhesion to lithium disilicate glass-ceramics after aging: Resin viscosity and ceramic surface treatment effects. J Mech Behav Biomed Mater 2023; 142:105819. [PMID: 37062098 DOI: 10.1016/j.jmbbm.2023.105819] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To evaluate the influence of intaglio ceramic surface treatments, resin cement viscosities, and storage regimens on the microshear bond strength of lithium disilicate ceramic. In addition, to investigate the dynamic viscosity of the resin-based luting agents. MATERIALS AND METHODS Ceramic slices were randomly allocated into eight groups (n = 19) considering three factors: ceramic surface treatment (hydrofluoric acid followed by silane, HF; or self-etching ceramic primer, E&P), resin cement viscosity (high, HIGH; or low, LOW) and storage regimen (baseline or aging). Surface treatments were performed, resin cement cylinders were built and microshear bond strength tests (μSBS, wire-loop method, speed: 1.0 mm/min) were run according to the storage factor. Failure mode, topographic and dynamic viscosity (37 °C; shear rate of 1.0-100 s-1) of resin cement components (base, high and low catalyst) were also performed. RESULTS Resin cement viscosity and the association among ceramic surface treatment, resin cement viscosity, and storage regimen were statistically significant factors (p < 0.05). Worse behavior was identified for the E&P_HIGH group compared to the E&P_LOW and HF_LOW in the baseline condition. After aging, the HF_HIGH group (16.78 MPa) presented the worst result among the aged groups (21.44-25.25 MPa). Most of the failures were adhesive. Surface micrographs revealed a distinct pattern after etching, more aggressive by HF and milder by E&P. High viscosity catalyst is 5.3 and 8.5-fold more viscous than the base and low viscosity catalyst, respectively (high > base > low). CONCLUSION Differences in filler content can impact the resin viscosity of the material (more fillers increase the viscosity), which in turn can influence the bond strength of a lithium disilicate ceramic, depending on the surface treatment and storage regimen.
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Mueller B, Pilecco RO, Valandro LF, Ruschel VC, Pereira GKR, Bernardon JK. Effect of immediate dentin sealing on load-bearing capacity under accelerated fatigue of thin occlusal veneers made of CAD-CAM glass-ceramic and resin composite material. Dent Mater 2023; 39:372-382. [PMID: 36922258 DOI: 10.1016/j.dental.2023.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 02/05/2023] [Accepted: 03/03/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE The objective of this study was to assess the influence of immediate dentin sealing (IDS) on the fatigue behavior of laminate occlusal veneers fabricated with CAD/CAM lithium disilicate ceramic and resin composite. METHODS Forty sound human molars were prepared and randomly divided into 4 groups (n = 10): RC-IDS+ (IDS and resin composite occlusal laminate veneer); RC-IDS- (resin composite occlusal laminate veneer without IDS); LD-IDS+ (IDS and lithium disilicate laminate veneer); LD-IDS- (lithium disilicate occlusal laminate veneer without IDS). The restorations were obtained using a digital workflow. After surface conditioning and bonding, thermocycling and accelerated fatigue tests (20 Hz, 5000 cycles with an initial load of 300 N, step-size of 100 N for 10,000 cycles, up to 1000 N, and then a step-size of 50 N until failure) were conducted. Fatigue data were recorded for both outcomes (crack or fracture) and statistically analyzed. Fractographic and adhesive interface analysis were conducted. RESULTS The indirect resin composite groups showed better fatigue behavior compared to lithium disilicate. IDS only had a positive effect for the survival of resin composite restorations for the 'fracture' outcome. Evident presence of micro-gaps at the adhesive interface in the LD-IDS- group could be noted. SIGNIFICANCE Immediate dentin sealing improved fatigue resistance behavior of resin composite occlusal veneers. However, this effect was not observed in lithium disilicate veneers.
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Affiliation(s)
- Bruna Mueller
- MSciD and PhD Post-Graduate Program in Oral Science, Ontological Clinic, Faculty of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina State, Brazil
| | - Rafaela Oliveira Pilecco
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Vanessa Carla Ruschel
- MSciD and PhD Post-Graduate Program in Oral Science, Ontological Clinic, Faculty of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina State, Brazil
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Jussara Karina Bernardon
- MSciD and PhD Post-Graduate Program in Oral Science, Ontological Clinic, Faculty of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina State, Brazil
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Pilecco RO, Zucuni CP, Carvalho ABGD, Saavedra GDSFA, Marinho RMDM, Rocha Pereira GK, Valandro LF. Polishing the bonding surface, before or after crystallization, does not alter the fatigue behavior of bonded CAD-CAM lithium disilicate. J Mech Behav Biomed Mater 2023; 142:105794. [PMID: 37037152 DOI: 10.1016/j.jmbbm.2023.105794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 04/08/2023]
Abstract
The aim of this study was to assess if the finishing/polishing of the bonding surface of lithium disilicate ceramic, prior to or after crystallization, would affect the fatigue behavior of a bonded restorations. For this, lithium disilicate ceramic (IPS e.max CAD) discs (n = 15) were milled and randomly divided into 3 groups: CAD-CAM group which remained untouched; PRE group which received a finishing/polishing protocol (OptraFine system) prior to its crystallization; and POST group, which received the treatment after its crystallization. After surface treatments, ceramic and glass-fiber reinforced epoxy resin discs were paired and bonded using a resin cement (Multilink N). A cyclical fatigue test was conducted (frequency 20 Hz, initial load 200 N for 5000 cycles, step-size of 100 N for 10,000 cycles/step) until failure occurrence. Surface roughness and topography were analyzed. An initial descriptive analysis of surface roughness, FFL and CFF was performed to obtain the mean, standard deviation and confidence interval values (SPSS v. 21, SPSS Inc.) for statistical analysis. Roughness data was using one-way ANOVA with Tukey's post hoc test (α = 0.05), while the fatigue data was submitted to survival analysis with Kaplan-Meier test (α = 0.05) and Weibull modulus (Weibull++, Reliasoft). Neither the finishing/polishing procedure of the bonding surface, nor the moment (prior to or after crystallization), affected the fatigue behavior of bonded milled lithium disilicate. There were also no differences for mechanical reliability among conditions. Despite this, finishing/polishing reduced surface roughness and led to smoother topography. Finishing/polishing the bonding surface of milled lithium disilicate, before or after crystallization, does not alter the fatigue behavior of the bonded restorative set, although there is some influence on roughness and topography.
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da Rosa LS, Pilecco RO, Sarkis-Onofre R, Kantorski KZ, Valandro LF, Rocha Pereira GK. Should finishing, polishing or glazing be performed after grinding YSZ ceramics? A systematic review and meta-analysis. J Mech Behav Biomed Mater 2023; 138:105654. [PMID: 36634437 DOI: 10.1016/j.jmbbm.2023.105654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/26/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
The present systematic review and meta-analysis aimed to assess the characteristics and consequences of post-processing methods after grinding procedures in YSZ ceramics on its surface roughness and flexural strength. The protocol of this review was made prospectively and is available online in the PROSPERO database (link). Literature searches on PubMed/MEDLINE, EMBASE, Lilacs, Web of Science and Scopus were conducted on December 2022 to select in vitro studies written in English, without publishing-date restrictions, that considered surface characteristics and mechanical properties of YSZ ceramics submitted to grinding and subsequent post-processing surface treatments as an attempt to revert the effect induced by grinding. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences (Rev-Man 5.1, random effects model, α= 0.05) were obtained by comparing flexural strength and surface roughness values of ground surfaces with at least one post-processing surface treatment (global analysis). Subgroup analyses were performed considering the most prevalent categories of post-processing methods. A total of 33 (out of 4032) studies were eligible and included in the analysis. In the global analysis, ground surfaces showed higher flexural strength than when post-processing methodologies were employed (p< 0.0001). The subgroup analysis showed that only polishing was able to enhance the flexural strength after grinding (p= 0.001); however, when other protocols were used, the ground surface was always superior in terms of flexural strength (p< 0.0001). Post-processing techniques in both the global and sub-group analyses were able to reduce the surface roughness after grinding in YSZ ceramics (p< 0.00001). High heterogeneity was found in all the meta-analyses. Concerning the risk of bias analysis, the included studies had mixed scores for the considered factors. In conclusion, in terms of improving flexural strength and restoring surface roughness after grinding, polishing protocols can be considered the best indication as post-processing treatment after YSZ ceramics adjustments/grinding.
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Affiliation(s)
- Lucas Saldanha da Rosa
- MSciD and PhD Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Rafaela Oliveira Pilecco
- MSciD and PhD Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Rafael Sarkis-Onofre
- Graduate Program in Dentistry, Atitus Educação, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Karla Zanini Kantorski
- MSciD and PhD Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
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Souza LFB, Pilecco RO, Menna Barreto VS, Chiapinotto GF, Daudt NDF, Valandro LF, Pereira GKR. Pre-sintering pigmentation techniques do not affect the fatigue behavior of adhesively luted 4YSZ restorations. J Mech Behav Biomed Mater 2022; 132:105270. [PMID: 35617820 DOI: 10.1016/j.jmbbm.2022.105270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 11/20/2022]
Abstract
This study aims to characterize the effect of shading techniques on the fatigue behavior of a 4YSZ ceramic (4 mol% yttrium stabilized zirconia) adhesively bonded to a dentin analogue (fiber-reinforced epoxy resin). 4YSZ ceramic discs (IPS e.max ZirCAD, Ø = 10 mm and 1 mm of thickness) were allocated according to the factor 'shading technique' into 4 groups: Brush- unshaded ceramic disc (IPS e.max ZirCAD BL) pigmented at the pre-sintered stage with pigment solution applied manually using a round liner brush; Immersion- unshaded ceramic disc pigmented through immersion in the solution for 1 s on only one side of the ceramic disc; Manufacturer- specimens already shaded by the manufacturer (IPS e.max ZirCAD MT A2 - Manufacturer group); Control- a control condition with absence of pigment (i.e. non-pigmented specimens). The specimens were sintered and a spectrophotometer (SP60, EX- Rite) was used to ensure that the same perceived color (i.e. pigment saturation) was achieved in the different shading strategies (Manufacturer, Brush or Immersion groups). To do so, the color differences (ΔE00) were calculated using the CIEDE 2000 equation; and an ΔE00 of up to 1.77 was considered as an acceptability threshold. Dentin analogue discs were obtained (Ø = 10 mm and 2.5 mm of thickness) and randomly allocated into pairs with the 4YSZ ceramic discs. Next, the pairs were adhesively bonded using a resin cement (Multilink N). The bonded assemblies (n = 15) were tested for fatigue using the step-stress test method (frequency of 20 Hz; 10,000 cycles per step, initial load 200 N; step-size of 100 N, up to 700 N; and after, step-size of 50 N, until specimen failure/fracture or radial cracks). Fatigue failure load (FFL) and number of cycles for failure (CFF) were recorded for statistical analysis. Fractographic features were accessed, and complementary roughness, topography, grain size and phase content analyses were performed. No statistical differences were observed in the fatigue behavior among the non-shaded condition (Control group - 880 N) and the shaded specimens (Manufacturer - 887 N, Brush - 820 N, and Immersion - 850 N groups; p > 0.05). However, the use of a brush shading technique induced slightly inferior fatigue mechanical behavior of the restorative set compared to the specimens already shaded by the manufacturer (p = 0.027). No differences in Weibull modulus were observed among the tested groups. The specimens pigmented by the brush technique demonstrated a rougher surface, with statistically higher Rz values, in addition to a larger grain size in comparison to all other conditions (p< 0.05). No m-phase content was identified (only t and c phases were detected). Thus, the shading techniques used to provide a Vita classic A2 shade does not negatively affect the mechanical fatigue properties of a bonded 4YSZ ceramic. However, the brush technique has detrimental effect on the fatigue behavior compared to when the ceramic was already provided in a shaded format by its manufacturer.
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Affiliation(s)
- Luiza Freitas Brum Souza
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Rafaela Oliveira Pilecco
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | | | | | - Natália de Freitas Daudt
- MSciEng and PhD Post-Graduate Program in Mechanical Engineering, Faculty of Mechanical Engineering, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
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Aragonez GC, Pilecco RO, Dapieve KS, Burgo TAL, Guilardi LF, Prochnow C, Valandro LF, Rippe MP. Simulation of CAD/CAM milling on lithium disilicate: Mechanical and topographic analyses of surface grinding different protocols. J Mech Behav Biomed Mater 2022; 132:105278. [PMID: 35653917 DOI: 10.1016/j.jmbbm.2022.105278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
The aim of this study was to evaluate the topography and the fatigue performance of lithium disilicate glass-ceramic after surface grinding through different laboratory protocols used to simulate the Computer-aided design/Computer-aided manufacturing (CAD/CAM) milling. Ceramic discs (IPS e.max CAD, Ø = 13.5 mm × 1.2 mm of thickness) were produced through different methodologies: milling in CAD/CAM system (CAD/CAM group); produced in-lab with a polished surface (POL group); or produced through in-lab methods and randomly distributed into five groups according to different grinding protocols to simulate the CAD/CAM milling [grinding with a CAD/CAM bur coupled to a mandrel (CAD/CAM Bur group); fine diamond bur using oscillatory movements (DBO group); fine diamond bur in x and y axes of the disc (DBXY group); #60-grit silicon carbide sandpaper (SiC group); and #60-grit wood sandpaper (WS group)]. The specimens were fatigue tested (n = 15) according to the step-stress method (initial load: 60 N; step-size: 20 N; 10,000 cycles/step; 20 Hz frequency). A roughness analysis was performed on all specimens, while fractal dimension (FD) and fractography were performed on representative samples. The Kaplan-Meier analysis showed that the POL (293.3 N) group presented better fatigue performance (higher load and number of cycles for failure) (p < 0.05) than the other groups (CAD/CAM = 222.7 N; CAD/CAM Bur = 181.3 N; DBO = 184.0 N; DBXY = 192.0 N; SiC = 182.6 N; WS = 182.6 N). For roughness, only the SiC (Ra = 1.616; Rz = 10.465) and WS (Ra = 1.673; Rz = 10.655) groups produced statistically similar Ra (μm) and Rz (μm) values to the CAD/CAM (Ra = 1.628; Rz = 9.571) group (p > 0.05). The surface created by CAD/CAM milling and POL group exhibited more complexity (FD) higher values than the experimental groups. For the ceramic surface topography images, the CAD/CAM milling visibly produced a uniform surface compared to the other groups; however, the POL group was the smoothest. The DBO, DBXY, SiC, and WS groups resulted in similar characteristics of surface topography. Therefore, although the SiC and WS groups showed similar roughness to the control group (CAD/CAM), no in-lab simulation method was fully capable to mimic the mechanical performance of the CAD/CAM-milled lithium disilicate glass-ceramic.
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Affiliation(s)
- Gabriela Carrão Aragonez
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Rafaela Oliveira Pilecco
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Kiara Serafini Dapieve
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Thiago Augusto Lima Burgo
- Department of Physics, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Luís Felipe Guilardi
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Catina Prochnow
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Marília Pivetta Rippe
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul State, Brazil.
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Dapieve KS, Pilecco RO, Pivetta JP, Machry RV, Werner A, Kleverlaan CJ, Pereira GKR, Valandro LF. Is the application of a silane-based coupling agent necessary to stabilize the fatigue performance of bonded simplified lithium disilicate restorations? J Mech Behav Biomed Mater 2021; 126:104989. [PMID: 34864398 DOI: 10.1016/j.jmbbm.2021.104989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/16/2022]
Abstract
This study evaluated the influence of ceramic surface conditioning and storage regimen (baseline vs. aging) on the fatigue performance of simplified lithium disilicate glass-ceramic restorations. A total of 90 ceramic discs (Ø= 10 mm; thickness= 1.0 mm) were allocated into 6 groups (n= 15), considering 2 factors: "ceramic surface treatment" - CA (only silane-based coupling agent, Monobond N), HF (5% hydrofluoric acid etching), or HF+CA (5% HF acid etching plus silane-based coupling agent); and "storage regimen" - baseline (24 hours - 5 days of distilled water at 37 °C), or long-term aging (180 days of distilled water at 37 °C + 25,000 thermal cycles). After intaglio ceramic conditioning, adhesive bonding (Multilink N) was performed onto epoxy resin discs (Ø= 10 mm; thickness= 2.5 mm) and the bonded sets were subjected to step-stress fatigue tests (initial load: 200 N; step-size: 50 N; 10,000 cycles per step; 20 Hz). Fatigue data were analyzed using Kaplan-Meier and Weibull statistical analyses. Fractography and topography analyses were also conducted. The fatigue findings demonstrated that the performance among groups for both baseline and aging conditions maintained a tendency: the CA groups had the worst behavior (baseline: 893 N/143,667 cycles; aging: 639 N/84,179 cycles), while the surface etching with HF (baseline: 1247 N/214,333 cycles; aging: 816.67 N/128,333 cycles) and HF+CA groups (baseline: 1290 N/222,333 cycles; aging: 900 N/145,000 cycles) had no statistically significant difference between them. The aging protocol reduced the performance of all groups. The groups with better fatigue performance (HF and HF+CA) did not have statistical differences regarding structural reliability (Weibull modulus). Most failures were radial cracks from the cementation interface, except for CA aging specimens, with 27% failing from debonding. The HF etching led to noteworthy surface topographical alterations. Micromechanical interlocking resulting from HF acid etching remained prevalent in the fatigue behavior. Thus, the silane-based coupling agent (Monobond N) does not need to be applied after HF etching in terms of fatigue behavior outcomes.
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Affiliation(s)
- Kiara Serafini Dapieve
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Rafaela Oliveira Pilecco
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Jordana Pavanelo Pivetta
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Renan Vaz Machry
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Arie Werner
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, Noord-Holland, the Netherlands.
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, Noord-Holland, the Netherlands.
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Oral Science, Prosthetic Dentistry Unit, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
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Pilecco RO, Dalla-Nora F, Guilardi LF, Pereira GKR, de Andrade GS, de Melo RM, Valandro LF, Rippe MP. In-lab simulation of CAD/CAM milling of lithium disilicate glass-ceramic specimens: Effect on the fatigue behavior of the bonded ceramic. J Mech Behav Biomed Mater 2021; 121:104604. [PMID: 34087550 DOI: 10.1016/j.jmbbm.2021.104604] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
The aim of this study was to evaluate the effect of in-lab simulation procedures performed on a lithium disilicate ceramic luted to a dentin-analogue material regarding the fatigue performance and topographic changes. Lithium disilicate ceramic (IPS e.max CAD) discs (Ø = 13.5 mm and 1.5 mm of thickness) were produced in different ways: milled in a CAD/CAM system (CAD/CAM - control group); mirror-polished (POL group); produced in-lab and ground with #60 silicon carbide paper (SiC group); with #60 wood sandpaper (WS group); with a fine diamond bur (DB group); or with a CAD/CAM bur adapted in a handpiece with a custom mandrel (MANDREL group). The ceramic discs were adhesively luted (Multilink N) onto dentin analogue discs (Ø = 12 mm and 2 mm of thickness) and fatigue testing (n = 19 discs) was performed by step-stress methodology (initial load of 200 N; step-size of 50 N; 10,000 cycles per step; 20 Hz). Surface roughness and contact angle analysis were also performed. According to Kaplan-Meier and post-hoc Mantel-Cox (log-rank), distinct fabrication methods affected the fatigue performance of bonded glass-ceramic discs (p< 0.001). The CAD/CAM group presented the lowest fatigue failure loads (1250 N) and number of cycles for failure (185,000), while the POL groups obtained the highest results (1752 N; 284,444 cycles). The in-lab groups had intermediate values (1355 - 1526 N; 206,052 - 238,684 cycles). Polished specimens presented the lowest roughness values (Ra = 0.041 μm), while the SiC (1.604 μm), WS (1.701 μm), and MANDREL (1.867 μm) groups showed statistically similar roughness values to the CAD/CAM group (1.738 μm). Despite differences before etching, the contact angle was similar among the milled and simulated groups after etching, except for the polished group. Even with some topographic similarities, the tested in-lab simulation methods were not able to mimic the milled specimens in terms of fatigue findings, leading to distinct magnitude of overestimations of the results.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Fernanda Dalla-Nora
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Luís Felipe Guilardi
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Guilherme Schmitt de Andrade
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology ICT/SJC, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Renata Marques de Melo
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology ICT/SJC, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Marília Pivetta Rippe
- MSciD and PhD Graduate Programs in Oral Science - Prosthodontic Units, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
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Dapieve KS, Machry RV, Pilecco RO, Kleverlaan CJ, Rocha Pereira GK, Venturini AB, Valandro LF. One-step ceramic primer as surface conditioner: Effect on the load-bearing capacity under fatigue of bonded lithium disilicate ceramic simplified restorations. J Mech Behav Biomed Mater 2020; 104:103686. [DOI: 10.1016/j.jmbbm.2020.103686] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 10/25/2022]
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Pilecco RO, Godois LDS, Maroneze MC, Ortiz FR, Ardenghi TM. Factors associated with the number of filled teeth in adolescents from public schools: a cohort study. Braz Oral Res 2020; 33:e124. [PMID: 31994597 DOI: 10.1590/1807-3107bor-2019.vol33.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 11/06/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Leonardo da Silva Godois
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Marília Cunha Maroneze
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Fernanda Ruffo Ortiz
- Universidade Federal de Minas Gerais -UFMG, School of Dentistry, Department of children and adolescent's oral health, Belo Horizonte, MG, Brazil
| | - Thiago Machado Ardenghi
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
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