scholarly journals Fracture Resistance of New Metal-Free Materials Used for CAD-CAM Fabrication of Partial Posterior Restorations

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 132
Author(s):  
Georgina García-Engra ◽  
Lucia Fernandez-Estevan ◽  
Javier Casas-Terrón ◽  
Antonio Fons-Font ◽  
Pablo Castelo-Baz ◽  
...  

Background and Objectives: To evaluate in vitro the fracture resistance and fracture type of computer-aided design and computer-aided manufacturing (CAD-CAM) materials. Materials and Methods: Discs were fabricated (10 × 1.5 mm) from four test groups (N = 80; N = 20 per group): lithium disilicate (LDS) group (control group): IPS e.max CAD®; zirconium-reinforced lithium silicate (ZRLS) group: VITA SUPRINITY®; polymer-infiltrated ceramic networks (PICN) group: VITA ENAMIC®; resin nanoceramics (RNC) group: LAVA™ ULTIMATE. Each disc was cemented (following the manufacturers’ instructions) onto previously prepared molar dentin. Samples underwent until fracture using a Shimadzu® test machine. The stress suffered by each material was calculated with the Hertzian model, and its behavior was analyzed using the Weibull modulus. Data were analyzed with ANOVA parametric statistical tests. Results: The LDS group obtained higher fracture resistance (4588.6 MPa), followed by the ZRLS group (4476.3 MPa) and PICN group (4014.2 MPa) without statistically significant differences (p < 0.05). Hybrid materials presented lower strength than ceramic materials, the RNC group obtaining the lowest values (3110 MPa) with significant difference (p < 0.001). Groups PICN and RNC showed greater occlusal wear on the restoration surface prior to star-shaped fracture on the surface, while other materials presented radial fracture patterns. Conclusion: The strength of CAD-CAM materials depended on their composition, lithium disilicate being stronger than hybrid materials.

2020 ◽  
Vol 45 (1) ◽  
pp. 52-61 ◽  
Author(s):  
TD Grubbs ◽  
M Vargas ◽  
J Kolker ◽  
EC Teixeira

SUMMARY Purpose: The purpose of this study was to investigate the effect of four direct restorative materials that can be used in the proximal box elevation (PBE) technique. Methods and Materials: Seventy-five molar teeth were randomly assigned to one of five groups (n=15): type II glass ionomer (GI), type II resin-modified glass ionomer (RMGI), resin-based composite (RBC), bulk-fill (BF) resin-based composite, and a control with no box elevation procedure. Specimens were prepared for a standard mesio-occlusal-distal, computer-aided design/computer-aided manufactured (CAD-CAM) resin, nanoceramic onlay with mesial cervical margins located 1 mm above the cementoenamel junction (CEJ) and distal cervical margins located 2 mm below the CEJ. PBE was used to elevate the distal margins to 1 mm above the CEJ in all groups except the control group. For the control group the onlay margin was placed directly on the prepared distal tooth structure without PBE. A Lava Ultimate CAD/CAM resin, nanoceramic onlay restorative was manufactured and bonded on all specimens with RelyX Ultimate adhesive resin cement. The quality of the tooth-PBE material and PBE material-onlay interface was evaluated with scanning electron microscopy using epoxy resin replicas before and after cyclic loading (100,000 cycles, 1.2 Hz at 65N and 37°C). In addition to margin quality, the fracture resistance of each group was measured using a universal testing machine. Fracture pattern was recorded by visual examination. The Levene test for homogeneity and the Welch analysis of variance were completed for fracture resistance and margin quality. A χ2 test was completed for break mode. Results: For dentin margins, a statistically significant difference was detected between the RMGI and control groups at baseline (p=0.0442). All other groups—GI, RBC, and BF—showed no difference from the control at baseline (p&gt;0.05). No statistical significance was observed among groups for post-cyclic fatigue (p=0.8735). For onlay margins, no statistical significance was observed among groups for pre-cyclic fatigue, post-cyclic fatigue, or change (p=0.9713, p=0.528, p=0.4385, respectively). No significant difference was observed for the fracture resistance among groups or for the type of break by material used (p=0.1593, p=0.77, respectively). Conclusion: Within the parameters of this study, after mechanical fatigue, the materials used for PBE: RMGI, RBC, and BF, did not influence results in terms of margin quality and fracture resistance. Therefore, collective findings suggest that these materials might be suitable for PBE procedures. Nevertheless, clinical caution is recommended with any PBE procedure and further testing of GI materials is needed.


Materials ◽  
2019 ◽  
Vol 12 (16) ◽  
pp. 2528 ◽  
Author(s):  
Ouqba Ghajghouj ◽  
Simge Taşar-Faruk

The aim of this study was to determine the effect of restoration design on the fracture resistance of different computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics and investigate the marginal leakage of endocrowns according to different types of cement. In total, 96 extracted mandibular first premolars were used for fabrication of endocrowns; 48 of the endocrowns were divided into 6 groups (n = 8) according to intracoronal cavity depth (2 and 3 mm) and CAD/CAM ceramics (lithium disilicate IPS e.max-CAD, zirconia-reinforced glass-ceramic Vita Suprinity, and poly-ether-ether-ketone (PEEK)). Teeth were subjected to a fracture resistance test with a universal test machine following thermo-cycling. Failure modes were determined by stereomicroscope after the load test. The rest of the endocrowns (n = 48) were produced by Vita Suprinity ceramic and divided into 6 groups (n = 8) according to the cement used (Panavia V5, Relyx Ultimate, and GC cement) with intracoronal cavity depths of 2 and 3 mm. Microleakage tests were performed using methylene blue with stereomicroscope after thermo-cycling. Numerical data for both fracture resistance and microleakage tests were obtained and evaluated by three-way ANOVA. PEEK endocrowns had higher fracture resistance compared to lithium disilicate and Vita Suprinity. Panavia V5 cement had the lowest degree of microleakage, while GC cement had the highest. Different intracoronal cavity depths had no correlation with fracture resistance and microleakage.


2021 ◽  
Author(s):  
CA Jurado ◽  
A Tsujimoto ◽  
H Watanabe ◽  
NG Fischer ◽  
JA Hasslen ◽  
...  

SUMMARY Objective: The purpose of this study was to evaluate the effectiveness of five different polishing systems on a computer-aided design and computer-aided manufacturing (CAD/CAM) polymer-infiltrated ceramic-network restoration with nanoscale assessment using atomic force microscopy (AFM) and visual assessment performed by dental school senior students and faculty members. Method: Forty-eight full coverage crowns were milled out of polymer-infiltrated ceramic-network CAD/CAM blocks (Vita Enamic) for polishing with one company proprietary, two ceramic and two composite polishing systems. The prepared crowns were divided into six groups: (1) no polishing (control); (2) polishing with Vita Enamic Polishing Kit (VEna); (3) polishing with Shofu Porcelain Laminate Polishing Kit (SCer); (4) polishing with Brasseler Dialite Feather lite All- Ceramic Adjusting & Polishing System (BCer); (5) polishing with Shofu Composite Polishing Kit (SCom); and (6) polishing with Brasseler Composite Polishing Kit (BCom). The polished crown surface topography was observed, and surface roughness and area were measured with AFM. In addition, polished crowns were visually assessed by 15 senior dental students and 15 dental school faculty members. Results: All polishing treatments significantly reduced the surface roughness and area of the crown compared with the control. SCom and BCom showed significantly higher surface area than VEna, and the SCer and BCer groups were intermediate, showing no significant difference from either VEna or SCom and BCom. There were no significant differences in surface roughness between any of the systems. Dental students and faculty members classified the groups polished with VEna, SCer, and BCer groups as clinically acceptable, and they selected BCer group as the best polished restorations and the control group as the least polished restorations. Conclusions: Ceramic and composite polishing systems produced similar polishing results as that observed using a company proprietary polishing system. However, effectiveness for polishing using a company proprietary and ceramic polishing system tends to be higher than composite polishing systems.


2019 ◽  
Vol 45 (4) ◽  
pp. 442-452 ◽  
Author(s):  
N Ilie ◽  
G Furtos

Clinical Relevance Light transmission through dental materials and tooth structure has direct clinical implication on such factors as selecting an appropriate curing technique during a restorative process. SUMMARY Introduction: This study aims to quantify and compare the amount of light that passes through seven different types of direct and indirect restorative materials comprising light-cured resin based composites (regular and bulk-fill), computer-aided design/computer-aided manufacturing (CAD/CAM) restoratives such as resin based composites, poly(methyl methacrylate) (PMMA) resin, leucite glass-ceramic, lithium silicate glass-ceramic, feldspar ceramic, and the natural tooth structure. Methods and Materials: Individual sets (n=6) of plane-parallel test specimens (2 mm) of 32 restorative materials belonging to the aforementioned seven material types and the tooth structure were prepared. Within the analyzed materials, one leucite glass-ceramic and one lithium disilicate glass-ceramic were considered in two different translucencies. In addition, two light-cured resin composites, one CAD/CAM resin composite, and one lithium disilicate glass-ceramic were considered in two different shades. Optical properties (transmittance, T; absorbance, A; and opacity, O) of each material were calculated from the relationship between incident and transmitted irradiance [I(d)] using a violet-blue light-curing unit. Incident and transmitted irradiance were assessed in real time on a spectrophotometer. A multivariate analysis (general linear model) assessed the effects of various parameters on the optical properties. Results: A very strong influence of the parameter material was identified on I(d) (p&lt;0.001; partial eta squared, ηP2=0.953), T (p&lt;0.001; ηP2=0.951), A (p&lt;0.001; ηP2=0.925), and O (p&lt;0.001; ηP2=0.886), while the effect of the parameter material type was not significant (p=0.079, p=0.05, p=0.05, and p=0.051, respectively). Light attenuation differed significantly by material within each shade category and by shade category within the analyzed material. Conclusions: Attenuation of light through restorative materials and tooth structure is high (59.9% to 94.9%); thus, deficits in polymerization are difficult to compensate for by additional light exposure at the end of the restorative process.


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.


2021 ◽  
Author(s):  
W Moon ◽  
SH Chung ◽  
J Chang

SUMMARY The aim of this study was to evaluate interfacial gap formation of CAD/CAM lithium disilicate inlay margins before and after thermomechanical loading. Methods and Materials: Mesio-occlusal-distal cavities were prepared on 12 extracted mandibular molars. The gingival margin of one proximal box was elevated with resin modified glass ionomer (RMGI) by a height of 2 mm (Group E [elevation]), and the margin of the other side served as a control (Group NE [no elevation]). Lithium disilicate computer-aided design and computer-aided manufacturing (CAD/CAM) inlays were fabricated and bonded with a self-adhesive resin cement. An aging process was simulated on the specimens under thermomechanical cycling by using a chewing simulator. Marginal integration was evaluated under scanning electron miscroscopy (SEM) using epoxy resin replicas before and after cycling. Marginal areas were stained with silver nitrate solution, and the volumetric gap was measured at the bonded interfaces using microcomputed tomography (CT) before and after cycling. Statistical analyses were performed using paired t-tests, the Wilcoxon signed rank test, and the Mann–Whitney test (a&lt;0.05). Results: SEM showed marginal discontinuities in Group NE that increased after thermomechanical cycling. Micro-computed tomography exhibited three-dimensional dye-penetrating patterns at the interfaces before and after cycling. Interfacial disintegration was larger in Group NE before cycling (p&lt;0.05). Thermomechanical cycling increased the gaps in both Groups NE and E (p&lt;0.05). The gap increment from thermomechanical cycling was larger in Group NE (p&lt;0.05). Conclusions: Thermomechanical cycling induced interfacial disintegration at the lithium disilicate CAD/CAM inlays, with deep proximal margins. Margin elevation with RMGI placement reduced the extent of the interfacial gap formation before and after the aging simulation.


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.


Author(s):  
Tugba Serin-Kalay ◽  
Beyza Zaim

Surface changes of restorative materials after bleaching have clinical importance in terms of the durability and survival of restorations. This study aimed to evaluate the effect of home bleaching on the surface roughness, microhardness, and surface analysis of four different types of chairside computer-aided design and computer-aided manufacturing (CAD/CAM) materials. Specimens were prepared from composite resin (Brilliant Crios: BC), resin nanoceramic (Lava Ultimate: LU), polymer-infiltrated ceramic-network (Vita Enamic: VE), and zirconia-reinforced lithium silicate glass-ceramic (Vita Suprinity: VS) CAD/CAM materials. Specimens were polished using 800, 1000, 1200, and 2000 grit SiC papers. Each restorative material was randomly divided into two groups; control and bleaching (n=10). The 16% carbamide peroxide bleaching agent (Whiteness Perfect 16%, FGM) was applied to the specimens for 4 h/day for 14 days. Surface roughness values (Ra) were obtained using a profilometer, and microhardness values (VHN) were obtained using a Vickers microhardness test. Surface analysis of specimens was evaluated by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). Data were analyzed Two-way ANOVA and Fisher’s Least Significant Difference (LSD) test (p<0.05). After bleaching, the surface roughness of BC (p<0.001) and VE (p<0.032) significantly increased. Bleaching did not significantly affect the microhardness of CAD/CAM materials. SEM evaluation showed material-dependent surface damages after bleaching procedures. The effect of 16% carbamide peroxide home bleaching agent on surface roughness and microhardness of chairside CAD/CAM materials is material-dependent. Before bleaching, restorative materials should be protected by applying a protective barrier and contact with the bleaching agent should be minimized. Also, after bleaching, the restoration surface should be carefully inspected, and re-polishing might be beneficial.


2021 ◽  
Vol 9 (D) ◽  
pp. 37-42
Author(s):  
Abd El Azeem Mostafa ◽  
Cherif A. Mohsen

BACKGROUND: Ceramic laminate veneer restoring is considered a challenging modality in solving various esthetic dental problems. AIM: The purpose of this study was to investigate the effect of digital internal relief space on the color of ceramic laminate veneer. MATERIALS AND METHODS: An acrylic central incisor model was prepared for ceramic laminate veneer with standard measures. The prepared acrylic resin dentotype model was scanned with intraoral computer-aided design/computer-aided manufacturing (CAD/CAM) optical scanner (CEREC Omnicam|Dentsply Sirona). The laminate veneer design was planned on the optically scanned preparation on CAD/CAM system software (CEREC software|Dentsply Sirona). Thirty ceramic laminate veneer specimens were machined from zirconia-reinforced lithium silicate (Celtra Duo blocks, Dentsply/Sirona) according to standard design by CAD/CAM system with the change of the digital internal relief space settings. The specimens were divided into three groups according to their digital internal relief settings (IRS) (20, 60, and 100 μm) (n = 10). Thirty epoxy dies were duplicated from the prepared acrylic model. The ceramic laminate veneer specimens were cemented to epoxy dies with total etch resin cement system according to the manufacture instructions. The color change (ΔE) of the cemented ceramic laminate veneer specimens was measured by spectrophotometer (Vita Easy shade, Ivoclar Vivadent AG, Schaan, Liechtenstein) using the CIELAB scale and L*, a*, b*. Each specimen was measured two times (before and after cementation). The value of color difference (ΔE) was calculated according to the formula: ΔE = [(L*2 - L*1)2 + (a*2 - a*1)2 + (b*2- b*1) 2]½. RESULTS: The highest mean value of ΔE was recorded in G100 group (1.91 ± 0.33), followed by G60 group (1.83 ± 0.09), with the least value recorded in G20 group (1.49 ± 0.49). Analysis of variance test revealed a statistically significant difference between groups (p = 0.024). CONCLUSION: The change of the digital IRS affects the color of ceramic laminate veneers.


2019 ◽  
Vol 45 (4) ◽  
pp. 416-425
Author(s):  
LH Raposo ◽  
PS Borella ◽  
DC Ferraz ◽  
LM Pereira ◽  
MS Prudente ◽  
...  

Clinical Relevance Marginal misfit of monolithic lithium disilicate ceramic crowns obtained from a chairside computer-aided design/computer-aided manufacturing system is affected after successive millings using a single diamond bur set. This fact can be critical for the longevity of indirect restorations. SUMMARY Objectives: This laboratory study aimed to assess the effect of successive crown millings on the marginal misfit of monolithic full-ceramic restorations obtained from two lithium disilicate systems, with a single diamond bur set used for each material in a chairside computer-aided design/computer-aided manufacturing (CAD/CAM) unit. Methods and Materials: Initially, 36 standardized composite resin dies were produced by additive manufacturing from a three-dimensional model of a right mandibular first molar with full-crown preparation generated in CAD software. Individual ceramic crowns were obtained in a chairside CAD/CAM unit (CEREC MC XL) for each composite resin die according to the ceramic system (IPS e.max CAD and Rosetta SM; n=18). Two new diamond burs were used as a set for obtaining the crowns in each experimental group (ceramic systems), and the milling periods were defined after three crown millings (T0-T6), when the diamond bur set of each system was removed for morphologic characterization using scanning electron microscopy (SEM). The marginal misfit of the crowns was assessed through coronal and sagittal micro-tomographic sectioning, in the vertical and horizontal directions of the ceramic crowns seated on their respective resin dies. The collected data were tabulated and subjected to one-way analysis of variance and Tukey's honestly significant difference test (α=0.05). Results: SEM images showed changes in the superficial morphology of the diamond bur sets, with progressive loss of the diamond granules after the successive millings of crowns for both experimental groups. Significant differences were detected in the marginal misfit of the crowns from both ceramic systems at the different milling periods (p&lt;0.001). Conclusions: Diamond burs deteriorated after successive crown millings for both lithium disilicate ceramic systems. The marginal misfit of the crowns obtained increased with the successive use of the CAD/CAM diamond bur set employed for milling each ceramic material. In addition, new milling of full lithium disilicate ceramic crowns can be inappropriate after 11 successive millings for IPS e.max CAD and 12 for Rosetta SM, due to the increased marginal misfit observed under the parameters tested.


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