scholarly journals Fracture Resistance of Partial Indirect Restorations Made With CAD/CAM Technology. A Systematic Review and Meta-analysis

2019 ◽  
Vol 8 (11) ◽  
pp. 1932 ◽  
Author(s):  
Amesti-Garaizabal ◽  
Agustín-Panadero ◽  
Verdejo-Solá ◽  
Fons-Font ◽  
Fernández-Estevan ◽  
...  

Background: The aim of this systematic review and meta-analysis was to determine the fracture resistance and survival rate of partial indirect restorations inlays, onlays, and overlays fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology from ceramics, composite resin, resin nanoceramic, or hybrid ceramic and to analyze the influence of proximal box elevation on fracture resistance. Materials and methods: This systematic review was based on guidelines proposed by the preferred reporting items for systematic reviews and meta-analyses (PRISMA). An electronic search was conducted in databases US National Library of Medicine National Institutes of Health (PubMed), Scopus, Web of Science (WOS), and Embase. In vitro trials published during the last 10 years were included in the review. Results: Applying inclusion criteria based on the review’s population, intervention, comparison, outcome (PICO) question, 13 articles were selected. Meta-analysis by restoration type estimated the fracture resistance of inlays to be 1923.45 Newtons (N); of onlays 1644 N and of overlays 1383.6 N. Meta-analysis by restoration material obtained an estimated fracture resistance for ceramic of 1529.5 N, for composite resin of 1600 Ne, for resin nanoceramic 2478.7 N, and hybrid ceramic 2108 N. Conclusions: Resin nanoceramic inlays present significantly higher fracture resistance values. Proximal box elevation does not exert any influence on the fracture resistance of indirect restorations.

Author(s):  
Abdulrahman Alhaddad ◽  
Samar Abuzinadah ◽  
Abdullah Al-Otaibi ◽  
Abrar Alotaibi ◽  
Mohsen Alfkih ◽  
...  

Background: Zirconia-based restorations have become more popular in dentistry during the last two decades. Patients choose metal-free restorations, preferring materials with similar attributes to natural teeth and similar light scattering characteristics, resulting in a nice esthetic appearance. Restoring a root canal treated teeth is one of the hot topics today. endo crown materials can be either; feldspathic, glass-ceramic, monolithic hybrid ceramic or composite material. Considering the marginal gap of endocrown, an important cause of failure of treatment, the current study evaluated the marginal gap of CAD‐CAM concocted endo-crowns. Materials and Methods: This research is an analysis systemic review study was conducted between January 2020 and October 2021. We followed the PRISMA principles and recorded this systematic review using the PROSPERO database to find and identify published literature related to the marginal adaptation of CAD-CAM-fabricated endocrown. The search will include all relevant articles through the end of 2021. Finally, 24 papers on marginal clearance and fracture resistance in coronary arteries were reviewed. Results: The electronic database search yielded 98 studies that were relevant. After cross-referencing, further seven studies were added. After a full-text analysis and duplicate reduction, 74 of the 98 articles were eliminated. 5 clinical (prospective) studies, 19 in vitro studies were found. Conclusion: This analysis of the recent literature on the marginal seating integrity and fracture resistance of CAD/CAM made-up endo-crowns showed that the endo-crown had superior marginal seating integrity than classical full crown. CAM/CAM showed statistically significant higher mean fracture resistance than MAD/MAM.


2019 ◽  
Vol 17 (1) ◽  
pp. 228080001880710 ◽  
Author(s):  
İbrahim Duran ◽  
Necati Kaleli ◽  
Çağrı Ural ◽  
İdris Kavut

Background: This in vitro study aimed to evaluate the amount of polymerizing light passing through hybrid ceramic specimens in different shades and thicknesses. Methods: Rectangular-shaped feldspathic ceramic computer aided design and computer aided manufacturing (CAD-CAM) blocks and translucent and high translucent polymer infiltrated hybrid ceramic CAD-CAM blocks in four different shades (1M1, 1M2, 2M2, and 3M2) were sectioned in four different thicknesses (0.8, 1.5, 2, and 3 mm), and a total of 48 groups ( n = 10) were obtained. Feldspathic ceramic specimens served as the control group. The light transmission of each ceramic specimen was measured three times by using a light-emitting diode and a radiometer. Data were statistically analyzed by using univariate analysis of variance (ANOVA) followed by one-way ANOVA, Tukey honest significant difference, and Tamhane T2 tests (α = 0.05). Results: Translucent polymer infiltrated hybrid ceramic specimens exhibited significantly ( p < 0.001) lower light transmission values than high translucent polymer infiltrated hybrid ceramic and feldspathic ceramic specimens, whereas feldspathic ceramic specimens exhibited significantly ( p < 0.001) higher light transmission than translucent and high translucent polymer infiltrated hybrid ceramic specimens. The amount of light transmission significantly ( p < 0.05) decreased when the shade value decreased and the thickness increased. Conclusions: Polymer infiltrated hybrid ceramic specimens showed lower light transmission values than feldspathic ceramic specimens, and the amount of light transmission was affected by the ceramic shade and thickness.


2021 ◽  
Vol 32 (3) ◽  
pp. 44-55
Author(s):  
Julia Magalhães Costa Lima ◽  
Anna Karina Figueiredo Costa ◽  
Lilian Costa Anami ◽  
Karina Barbosa Souza ◽  
Nathalia Ramos da Silva ◽  
...  

Abstract In the RLT (Rapid Layer Technology), veneering ceramic and framework are fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) and then cemented to obtain the restoration. This study aimed to evaluate the effect of the thickness of veneering ceramic manufactured by the RLT technique on the fracture resistance (FR) of bilayer crowns with zirconia frameworks. Twenty zirconia frameworks and twenty feldspathic posterior crowns with two different veneering ceramic occlusal thicknesses (1mm=TF1; 2mm=TF2) were manufactured using CAD/CAM system. The specimens were luted to an epoxy resin abutment with resin cement and mechanically cycled (200N and 4.5×105 Pa, 37°C, 2×106 cycles, 3Hz). The FR test was performed (10kN, 0.5mm/min), and the specimens were analyzed in a stereomicroscope. For the stress analysis (finite element analysis, FEA), a 10kN load was equal to the in vitro test, and the principal stress was evaluated. The FR data were analyzed by Student’s t-test and Weibull's analysis. The thickness influenced the FR of bilayer crowns. The FR was higher in the TF2 than in the TF1 group. The TF2 group presented the highest characteristic strength compared to the group TF1. The predominant type of failure was delamination. The FEA showed higher stress concentrations below the loading application point at the veneering cement interface in the 1-mm-thick model. The bilayer crowns manufactured using the approach of 2mm of veneering ceramic promoted higher FR compared to the group with 1mm veneering ceramic. Also, the FEA showed that the veneer ceramic thickness has an effect on stress distribution in zirconia-based bilayer crowns.


2018 ◽  
Vol 43 (5) ◽  
pp. 539-548 ◽  
Author(s):  
JP Andrade ◽  
D Stona ◽  
HR Bittencourt ◽  
GA Borges ◽  
LH Burnett ◽  
...  

SUMMARY The aim was to evaluate, in vitro, the influence of different computer-aided design/computer-aided manufacturing (CAD/CAM) materials (IPS e.max CAD, Vita Enamic, and Lava Ultimate) and thicknesses (0.6 mm and 1.5 mm) on the fracture resistance of occlusal veneers. Sixty human third molars were prepared to simulate advanced erosion of the occlusal surface, and the teeth were randomly divided into six experimental groups (n=10) according to the material and thickness used to build the veneers. Ten sound teeth formed the control group. The veneers were adhesively luted and submitted to mechanical cyclic loading (1 million cycles at 200-N load). The fracture resistance test was performed in a universal testing machine. The failures were classified as “reparable” and “irreparable.” According to two-way analysis of variance and the Tukey test, the interaction (material × thickness) was significant (p=0.013). The highest fracture resistance was obtained for IPS e.max CAD at a 1.5-mm thickness (4995 N) and was significantly higher compared to the other experimental groups (p&lt;0.05). The lowest fracture resistance was obtained for Vita Enamic at 0.6 mm (2973 N), although this resistance was not significantly different from those for IPS e.max CAD at 0.6 mm (3067 N), Lava Ultimate at 0.6 mm (3384 N), Vita Enamic at 1.5 mm (3540 N), and Lava Ultimate at 1.5 mm (3584 N) (p&gt;0.05). The experimental groups did not differ significantly from the sound teeth (3991 N) (p&gt;0.05). The failures were predominantly repairable. The occlusal veneers of IPS e.max CAD, Vita Enamic, and Lava Ultimate, with thicknesses of 0.6 mm and 1.5 mm, obtained fracture resistances similar to those associated with sound teeth.


Polymers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 2251
Author(s):  
Maciej Zarow ◽  
Marzena Dominiak ◽  
Katarzyna Szczeklik ◽  
Louis Hardan ◽  
Rim Bourgi ◽  
...  

Various material properties are involved in the success of endodontically treated restorations. At present, restorative composites are commonly employed as core build-up materials. This study aimed to systematically review the literature to assess the effect of using composite core materials on the in vitro fracture of endodontically treated teeth. Two different reviewers screened the literature, up to June 2021, in five distinct electronic databases: PubMed (MedLine), Scopus, Scielo, ISI Web of Science, and EMBASE. Only in vitro studies reporting the effect of the use of composite core materials on the fracture resistance of endodontically treated teeth were included. A meta-analysis was carried out using a software program (Review Manager v5.4.1; The Cochrane Collaboration, Copenhagen, Denmark). The risk of bias in each study was assessed following the parameters of another systematic review. A total of 5016 relevant papers were retrieved from all databases. After assessing the title and abstract, five publications remained for qualitative analysis. From these, only three studies remained for meta-analysis. The fracture strength of endodontically treated teeth where a core build-up composite was used was statistically significantly higher than the control (p = 0.04). Most of the analyses showed a high heterogenicity. The in vitro evidence suggests that the composite core build-up with higher filler content tended to improve the fracture resistance of the endodontically treated teeth, in comparison with conventional composite resins. This research received no external funding. Considering that this systematic review was only carried out on in vitro papers, registration was not performed. Furthermore, there were no identified clinical studies assessing core build-up materials; therefore, more well-designed research on these materials is needed.


2019 ◽  
Vol 18 (4) ◽  
pp. 764-772
Author(s):  
Asa Yazdani Fard ◽  
Zuryati Ab Ghani ◽  
Zaihan Ariffin ◽  
Dasmawati Mohamad

Background: Studies on microleakage of Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) crowns are abundant. However many of them are inconclusive, especially those using self adhesive cements. Aims: To compare the microleakage between CAD/CAM crowns milled out of feldspathic ceramic and resin nano ceramics, cemented with three resin cements. Materials and Methods: Crown preparation was made on 54 extracted human premolars. Impressions were captured optically using CEREC 3D machine intraoral camera, and crowns were milled from feldspathic ceramic (CEREC® Blocs PC, VITA) and resin nano ceramic (Lava™ Ultimate CAD/CAM Restorative, 3M ESPE) blocks. The crowns were then cemented with three cements (n = 9); RelyX™ U200 Self-Adhesive Resin Cement (3M ESPE); NX3 Nexus ® cement with two-step etch-and-rinse adhesive (Kerr Corporation) or three/multistep etch-and-rinse resin cement, Variolink® II/Syntac Classic (Ivoclar Vivadent). The specimens were kept in water for 24 hours, thermocycled, and then soaked in methylene blue dye for 24 hours, before being sectioned mesiodistally. Microleakage was assessed using a fivepoint scale using stereomicroscope. Statistical analysis of the data was carried out using ONEWay ANOVA. Results: CEREC® Blocs PC crowns showed significantly less microleakage (p< 0.001) compared to Lava™ Ultimate. RelyX™ U200 showed significantly lower microleakage (p< 0.001) compared to other cements. Combination of Lava™ Ultimate crown cemented with RelyX™ U200 showed the least microleakage (p< 0.001). Conclusions: The microleakage scores were affected by the types of crown and cements. Bangladesh Journal of Medical Science Vol.18(4) 2019 p.764-772


Author(s):  
Fariborz Vafaei ◽  
Alireza Izadi ◽  
Samaneh Abbasi ◽  
Maryam Farhadian ◽  
Zahra Bagheri

Objectives: This study aimed to compare the optical properties of Zolid FX, Katana UTML, and lithium disilicate laminate veneers. Materials and Methods: In this in-vitro experimental study, the maxillary left lateral incisor of a phantom received a laminate veneer preparation. An impression was made, and a die was fabricated using dental stone. The die was scanned using a computer-aided design/computer-aided manufacturing scanner. Ten dies were fabricated from each of the A1, A2, and A3 shades of composite resin. Laminate veneers were fabricated using A1 shade of Katana UTML, Zolid FX, and IPS e.max CAD ceramics (n=10) and placed on composite abutments using bleach and white colors of trial insertion paste (TIP). The optical properties were measured at the incisal, middle, and cervical thirds using a spectrophotometer. Data were analyzed using three-way analysis of variance and Tukey’s test. Results: The effect of laminate material on the L*, a*, and b* parameters was significant in all areas (P<0.001), except for the L* parameter in the middle and cervical thirds. All color parameters were affected by TIP color in all three regions in most samples (P<0.05). The effect of composite abutment shade was also significant in most cases (P<0.05). The effect of laminate material, abutment shade, and TIP color on the b* parameter was significant (P<0.001). The L* parameter was almost the same in the two zirconia and lithium disilicate ceramic groups. Conclusion: The composite abutment shade, TIP color, and laminate material should be carefully selected to achieve optimal aesthetics in laminate veneers.


2015 ◽  
Vol 40 (2) ◽  
pp. 201-210 ◽  
Author(s):  
HM El-Damanhoury ◽  
RN Haj-Ali ◽  
JA Platt

SUMMARY This study assessed marginal leakage and fracture resistance of computer-aided design/computer-aided manufacturing (CAD/CAM) fabricated ceramic crowns with intracoronal extensions into the pulp chambers of endodontically treated teeth (endocrowns) using either feldspathic porcelain (CEREC Blocks [CB], Sirona Dental Systems GmbH, Bensheim, Germany), lithium disilicate (e.max [EX], Ivoclar Vivadent, Schaan, Liechtenstein), or resin nanoceramic (Lava Ultimate [LU], 3M ESPE, St Paul, MN, USA).). Thirty extracted human permanent maxillary molars were endodontically treated. Standardized preparations were done with 2-mm intracoronal extensions of the endocrowns into the pulp chamber. Teeth were divided into three groups (n=10); each group was restored with standardized CAD/CAM fabricated endocrowns using one of the three tested materials. After cementation with resin cement, specimens were stored in distilled water at 37°C for one week, subjected to thermocycling, and immersed in a 5% methylene-blue dye solution for 24 hours. A compressive load was applied at 35 degrees to long axis of the teeth using a universal testing machine until failure. Failure load was recorded, and specimens were examined under a stereomicroscope for modes of failure and microleakage. Results were analyzed using one-way analysis of variance and Bonferroni post hoc multiple comparison tests (α=0.05). LU showed significantly (p&lt;0.05) higher fracture resistance and more favorable fracture mode (ie, fracture of the endocrown without fracture of tooth) as well as higher dye penetration than CB and EX. In conclusion, although using resin nanoceramic blocks for fabrication of endocrowns may result in better fracture resistance and a more favorable fracture mode than other investigated ceramic blocks, more microleakage may be expected with this material.


2018 ◽  
Vol 43 (4) ◽  
pp. 437-446 ◽  
Author(s):  
NG Fischer ◽  
A Tsujimoto ◽  
AG Baruth

SUMMARY Objective: Limited information is available on how to polish and finish zirconia surfaces following computer-aided design/computer-aided manufacturing (CAD/CAM), specifically, how differing application forces and reuse of zirconia polishing systems affect zirconia topography. Purpose: To determine the effect of differing, clinically relevant, polishing application forces and multiple usages of polishing burs on the surface topography of CAD/CAM zirconia. Methods: One hundred twenty 220-grit carbide finished zirconia disks were sintered according to manufacturer's directions and divided into two groups for the study of two coarse polishing bur types. Each group was divided into subgroups for polishing (15,000 rpm) at 15 seconds for 1.0 N, 4.5 N, or 11 N of force using a purpose-built fixture. Subgroups were further divided to study the effects of polishing for the first, fifth, 15th, and 30th bur use, simulating clinical procedures. Unpolished surfaces served as a control group. Surfaces were imaged with noncontact optical profilometry (OP) and atomic force microscopy (AFM) to measure average roughness values (Ra). Polishing burs were optically examined for wear. Scanning electron microscopy (SEM) was performed on burs and zirconia surfaces. One-way ANOVA with post hoc Tukey HSD (honest significant difference) tests (α=0.05) were used for statistical analyses. Results: AFM and OP Ra values of all polished surfaces were significantly lower than those of the unpolished control. Different polishing forces and bur reuse showed no significant differences in AFM Ra. However, significant differences in OP Ra were found due to differing application forces and bur reuse between the first and subsequent uses. SEM and optical micrographs revealed notable bur wear, increasing with increasing reuse. SEM and AFM micrographs clearly showed polished, periodic zirconia surfaces. Nanoscale topography, as analyzed with kurtosis and average groove depth, was found dependent on the specific polishing bur type. Conclusions: These in vitro results suggest changes in OP Ra due to bur reuse and polishing application force. Within the parameters of this study, the resultant topography of zirconia polishing is force-dependent and the reuse of coarse polishing burs is possible without statistically significant differences in Ra values after initial use. Nanoscale and microscale topography were shown to depend on specific polishing bur type.


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