一种通用粘接剂对不同CAD/CAM可切削材料的短期粘接成绩

[摘要] 目的 评估一种通用粘接剂对于三种不同类型的CAD/CAM可切削材料的短期粘接成绩。方法 制作氧化钇稳定四方相氧化锆陶瓷,纳米复合陶瓷和二硅酸锂玻璃陶瓷试件各20枚,其中前两者进行喷砂处理,后者进行HF酸蚀处理。各组陶瓷再分为2亚组,分别使用（SBU）或不使用（Ctr）通用粘接剂Single Bond Universal。以上表面处理瓷片与复合树脂柱通过树脂水门汀粘接,制作粘接试件,37℃水储24ｈ后测试剪切粘接强度并记录断裂模式。喷砂处理的氧化锆陶瓷和纳米复合陶瓷,以及酸蚀处理的二硅酸锂玻璃陶瓷通过扫描电镜（SEM）观察表面微观形态。结果SEM观察显示酸蚀处理的二硅酸锂玻璃陶瓷,喷砂处理的氧化锆陶瓷和纳米复合陶瓷相对于粗化处理前呈现出粗糙的表面形态。三种经粗化处理的材料使用通用粘接剂表面处理后,剪切强度较未使用者显著增强。结论 通用粘接剂Single Bond Universal能够增强氧化钇稳定四方相氧化锆陶瓷,纳米复合陶瓷和二硅酸锂玻璃陶瓷三种类型CAD/CAM可切削材料的短期粘接强度。     

二硅酸锂玻璃陶瓷与牛牙釉质磨损性能的体外实验研究

目的:研究模拟口腔环境下牛牙釉质与二硅酸锂玻璃陶瓷的磨损特性.方法:将18个长8 mm、直径3 mm的二硅酸锂玻璃陶瓷圆柱作为上颌磨头,分别与下颌二硅酸锂玻璃陶瓷或牛牙釉质试件配副,每组9个样本,利用摩擦磨损试验机,在人工唾液、室温环境、10 N载荷、转速100 r/min、回转半径2.5 mm、匀速圆周运动的条件下进行54万次循环磨损实验.在整个磨损周期中选取10个循环节点,用三维形貌仪测量每个节点下颌试件的磨损高度损失量并绘制相应磨损曲线,扫描电镜观察相应磨损阶段对应的磨损面微观形貌.结果:各循环节点牛牙釉质的磨损量均大于二硅酸锂玻璃陶瓷的磨损量(P＜0.05);实验循环周期内,牛牙釉质的磨损曲线呈现出“跑合期”、“稳定磨损期”、“剧烈磨损期”3个磨损阶段,而二硅酸锂玻璃陶瓷的磨损曲线呈现“跑合期”和“稳定磨损期”两个磨损阶段.2组的微观形貌也呈现出与磨损曲线相对应的阶段性动态衍化规律.结论:在模拟口腔环境下,牛牙釉质和二硅酸锂玻璃陶瓷的磨损行为均呈现出阶段性动态衍化规律;牛牙釉质的磨损量显著高于二硅酸锂的磨损量,提示应注意防止二硅酸锂玻璃陶瓷修复体对对颌天然牙的过度磨损.     

烧结次数对椅旁计算机辅助设计与制作二硅酸锂玻璃陶瓷贴面不同部位颜色的影响

目的 评价烧结次数和渐变厚度及其交互性对椅旁计算机辅助设计与制作（CAD/CAM）二硅酸锂玻璃陶瓷贴面不同部位颜色的影响。方法 在标准中切牙模型上制备贴面修复模型,用椅旁扫描仪采集光学印模,椅旁CAD/CAM系统制作24个二硅酸锂玻璃陶瓷贴面样本共4组（n=6）,初次结晶组为对照组S0,其余按上釉烧结次数依次为S1、S2、S3组。使用Vita easyshade电子比色仪测定每个贴面的色彩参数L、C、H、a、b,用SAS 9.1.3统计软件采用重复测量多因素方差方法分析不同烧结次数以及不同部位厚度间各颜色指标的差异性。最后扫描电镜（SEM）观察每组贴面的晶体排列和致密度。结果 随着烧结次数增加,试件的L值总体呈减小趋势（P<0.05）。C和b的烧结次数有统计学意义（P<0.05）,其中,除S2组与S3组之间差异无统计学意义外（P>0.05）,其余各组之间的两两比较差异均有统计学意义（P<0.05）。SEM观察发现二硅酸锂晶体随着烧结次数增加,晶体变大,晶体间的孔隙变小,晶体间的锁结变得更为紧密。结论 上釉次数和厚度及其交互性对二硅酸锂玻璃陶瓷的色相、明度、彩度均存在影响。     

3种树脂水门汀对CAD/CAM全瓷-牙本质剪切强度的比较

目的:评价3种树脂水门汀对CAD/CAM全瓷-牙本质剪切强度的影响。方法:选取新鲜拔除的人磨牙30颗,制备牙本质黏结面,随机分为3组(n=10),分别选用全酸蚀树脂水门汀RelyX ARC、自酸蚀树脂水门汀Clearfil DCBond和自黏结树脂水门汀RelyX Unicem对CAD/CAM硅酸锂玻璃全瓷进行黏结,测试3种树脂水门汀对CAD/CAM全瓷-牙本质的剪切强度,并通过立体显微镜观察牙本质的黏结界面。采用SPSS11.0软件包对数据进行统计学分析。结果:RelyX ARC组的剪切强度为(15.90±6.15)MPa,Clearfil DC Bond组的剪切强度为(14.41±5.07)MPa,而RelyXUnicem组的剪切强度为(23.29±7.39)MPa,与前2组相比有显著性差异(P<0.05)。立体显微镜观察显示,3组黏结断面均位于牙本质与树脂水门汀之间。结论:自酸蚀树脂水门汀及自黏结树脂水门汀与CAD/CAM硅酸锂玻璃陶瓷修复体的黏结强度不低于传统全酸蚀树脂水门汀,且临床操作简便,为临床全瓷黏结提供了更多便利与选择。     

陶瓷厚度与基牙底色对4种常用CAD/CAM瓷修复体颜色的影响

目的 研究4种不同厚度和半透明度CAD/CAM陶瓷在不同基牙底色上的遮色效果，为临床的陶瓷材料选择提供参考。方法 4种CAD/CAM陶瓷分别是：IPS e.max CAD（硅酸锂玻璃）, VITA SUPRINITYPC（氧化锆增强玻璃）, VITABLOCS MarkⅡ（长石基玻璃）和Vita Enamic（聚合物渗透陶瓷），制作成不同厚度(1 mm、1.5 mm、2 mm)的瓷块试样，在7种基牙底色(A1、A2、ND7色调复合树脂、白色(White)、黑色(Black)、钴铬合金(CC)、贵金属合金(PMA)下使用分光光度计检测Lab值，同一种瓷块2 mm厚度在A2色上的表现作为对照组，横向比较各种瓷块在不同基牙底色上的色差值以及半透明度。结果 ΔL、Δa、Δb值随着陶瓷厚度的增加逐渐减小，且在4种陶瓷间存在明显差异；半透明性参数均值按半透明度递减顺序依次为长石基玻璃>硅酸锂玻璃>氧化锆增强玻璃>聚合物渗透陶瓷；其中半透明度越大，其陶瓷的遮色效果反而越差；当厚度达到2 mm时，4种陶瓷在各种基牙底色下的ΔE（临床可接受颜色阈值）均<3.7;4种陶瓷中ΔE与厚...     

氧化锆对二硅酸锂玻璃陶瓷力学性能的影响

目的:测定牙科氧化锆-二硅酸锂玻璃陶瓷复合材料(ZTCLDC)的力学性能,探讨氧化锆质量分数变化对ZTCLDC力学性能的影响及机制。方法:向制备好的二硅酸锂基础玻璃粉体中分别添加不同质量分数的ZrO(21%,2%,3%,4%),静压成型晶化热处理,每组中的半数试件进行牙科热压铸处理,分别测试热压铸前后的三点弯曲强度及断裂韧性;扫描电镜观察晶体微观结构;X射线衍射分析其晶相组成。结果:热压铸前,ZTCLDC抗弯强度和断裂韧性随ZrO2含量的增加而升高;热压铸后,ZTCLDC抗弯强度随ZrO2含量的增加而降低,ZrO2加入量为4%时,压铸后的断裂韧性最高为4.3 MPa.m1/2。结论:ZrO2对实验二硅酸锂玻璃陶瓷存在增韧效果,能够提高复合材料的断裂韧性。     

烧结温度对二硅酸锂玻璃陶瓷析晶和微结构的影响

目的:观察烧结温度改变对二硅酸锂玻璃陶瓷的析晶行为和微结构的影响.方法:采用两段式烧结法烧结陶瓷,改变烧结终温度,XRD和SEM分别观察烧结前后陶瓷物相和表面微结构的变化.结果:经不同温度烧结后陶瓷呈现不同的析晶行为和微结构改变,以800 ℃时的改变最为显著,经840 ℃烧结后的陶瓷具有较高结晶度(P<0.05)和均匀致密的表面微结构.结论:二硅酸锂玻璃陶瓷烧结中的温度控制至关重要,800 ℃ 和840 ℃为陶瓷晶相和微结构改变的关键温度.     

三种二硅酸锂玻璃陶瓷冠抗折强度研究

目的    通过抗折破坏实验分析3种牙科二硅酸锂玻璃陶瓷抗折强度的差异,为国产二硅酸锂玻璃陶瓷临床应用提供依据。方法    将30个下颌第一磨牙标准预备体代型随机分为3组,每组10个,分别制作国产二硅酸锂玻璃陶瓷冠试件（DID组）、IPS e.max CAD冠试件（IPC组）和IPS e.max Press冠试件（IPP组）。3组全瓷冠试件粘接后,分别放置于电子万能试验机上,用直径6 mm圆形加载头,以0.5 mm/min速度垂直加载于全瓷冠面中央至瓷层碎裂,记录最大载荷,即二硅酸锂玻璃陶瓷冠抗折强度。用扫描电镜（SEM）观察表面形态。采用SPSS21.0 统计软件对3组全瓷冠试件抗折强度值进行单因素方差分析和组间两两比较的q检验,检验水准取双侧α = 0.05。结果    3组全瓷冠试件抗折强度结果：DID组为（949.7 ± 119. 4）N,IPC组为（1746.9 ± 244.8）N,IPP组为（2161.8 ± 239.0）N 。3组间总的比较,差异有统计学意义（F = 86.685,P < 0.05）;各组间两两比较,差异亦均有统计学意义（均P < 0.05）。3组全瓷冠试件的断裂模式无显著差异,大部分试件断裂类型均为Ⅰ型。SEM观察,DID组可见晶体在样本中分布不均匀,大小不一,表面有细小裂隙;IPC组可见析出晶体在样本中分布较均匀,晶体较为长大;IPP组可见析出的棒状二硅酸锂晶体均匀分布于玻璃相中,互相嵌合,并形成一种互锁微结构。结论    研究条件下,不同二硅酸锂玻璃陶瓷对抗折强度及断裂类型均有影响,国产二硅酸锂玻璃陶瓷可以满足临床要求,对于其在临床应用有一定指导意义。     

二硅酸锂和白榴石基玻璃陶瓷在模拟咀嚼循环下的耐磨性研究

目的：比较二硅酸锂和白榴石基玻璃陶瓷在模拟咀嚼循环的条件下磨损行为的演变。方法：采用热压铸造技术制备白榴石基玻璃陶瓷（IPS Empress Esthetic ETC1型铸瓷）和二硅酸锂玻璃陶瓷（IPS e．max Press HT型铸瓷）试件,分别与滑石瓷配副,磨损条件为加载力10 N、转速200 r／min,磨损进行100万转次,使用三维形貌扫描仪在每10转万次循环节点测量磨损体积量,扫描电镜观测表面微观形貌。结果：10万转次白榴石基陶瓷磨损量多于二硅酸锂陶瓷,20万至100万转次后两者没有统计学差异。白榴石基陶瓷表面犁沟与碎片剥脱后的粗糙面交错分布,二硅酸锂陶瓷表面以深且宽大的犁沟为主。随着时间的演变,两种陶瓷的犁沟状磨痕逐渐表浅。结论：白榴石基玻璃陶瓷在磨损初期磨损量多于二硅酸锂陶瓷,磨损中后期的磨损量没有显著性差异。     

数控切削成形复合材料的进展

随着CAD/CAM技术在口腔医学的广泛应用,通过数控切削(digital milling)成形方法制作修复体成为受欢迎的方法,特别是椅旁数控切削方法具有速度快、精度高等优点.早期的椅旁数控切削材料主要是可切削陶瓷材料,代表性的材料是长石质切削瓷和玻璃陶瓷(例如白榴石增强玻璃陶瓷和二硅酸锂玻璃陶瓷).由于陶瓷材料固有的脆性缺点,且多数切削瓷切削后需要终烧结或者上饰瓷,制作时间长,尺寸准确性较低.而复合材料切削后经过抛光即可使用,且尺寸准确性高 [2].基于此,人们多年前就开始研究应用陶瓷与聚合物的复合材料作为上述瓷材料的替代物,用于单个牙的永久性修复,以改善修复体的韧性,减小脆性,缩短制作步骤.近年来已经出现不少市售的切削复合材料,用于永久修复体的制作.本文针对这些材料的种类、性能特点及应用进行介绍和分析,并与相应的陶瓷类材料进行比较,以期为临床选择使用材料提供参考.     

Biaxial flexural strength and translucent characteristics of dental lithium disilicate glass ceramics with different translucencies

PurposeThe aim of this study was to evaluate the biaxial flexural strength and translucent characteristics of dental lithium disilicate glass ceramics with different translucencies.MethodsTwo heat pressed lithium disilicate glass ceramics (IPS e.max Press and an experimental ceramic) and one computer aided design/ computer aided manufacture (CAD/CAM) lithium disilicate glass ceramic (IPS e.max CAD) with different translucencies were evaluated. Disk-shaped specimens of each group were subjected to a biaxial flexural strength (BFS) test. Translucent parameters (TP) were also tested at 0.5 mm and 1.0 mm thickness, respectively. X-ray diffraction (XRD) and SEM were used for crystalline and microstructural analysis.ResultsBFS values of two heat pressed lithium disilicate glass ceramics were significantly higher than the CAD/CAM counterpart. No difference in BFS between two heat pressed glass ceramic was found. There were significant differences in BFS and TP values among the tested subgroups with different translucencies for IPS e.max Press and IPS e.max CAD. No difference in crystalline composition was found among the tested glass ceramics, but microstructure with shorter and wider crystal was revealed for IPS e.max CAD ceramics.ConclusionsLithium disilicate glass ceramics with different translucencies demonstrated different BFS and TP values.     

Strength and fracture pattern of monolithic CAD/CAM-generated posterior crowns.

OBJECTIVES: This study evaluated the strength and fracture pattern of monolithic posterior CAD/CAM crowns hypothesizing that zinc-phosphate cemented lithium disilicate crowns might show the same fracture strength as adhesively cemented crowns. METHODS: Two sets of monolithic posterior crowns each with uniform occlusal and lateral wall thickness of 1.5mm were fabricated from three types of block ceramic (1) lithium disilicate glass, (2) leucite glass and (3) feldspathic ceramic using CEREC 3 CAD/CAM. Crowns (n = 15) of ceramics (1), (2) and (3) each were (A) zinc-phosphate cemented, (B) adhesively cemented on resin-based composite dies and loaded until fracture. Load data was analyzed using ANOVA and Scheffé tests. Crack pattern was evaluated on an additional three sample cross-sections for each group at start of fracture. RESULTS: Radial cracks originated early at the cementation interfaces and cone cracks were observed finally at the loading sites. Mean load values (SD) of A-crowns at fracture start/end (1) 807 (91) N/2082 (192) N; (2) 915 (193) N/1130 (166) N; (3) 985 (199) N/1270 (301) N were all significantly (P < 0.001) lower when compared to their B-crown analogs (1) 1456 (205) N/2389 (84) N; (2) 1684 (395) N/2469 (171) N; (3) 1548 (304) N/2392 (75) N, rejecting the authors hypothesis. A-1 crowns had significantly (P < 0.001) higher fracture load than A-2 and A-3 crowns. The A-1 crown fracture load data, even if significantly (P < 0.001) lower, came close to the B-1 values. SIGNIFICANCE: Adhesive cementation balanced the strength of weak ceramics with that of strong ceramic and recommended itself for leucite glass ceramic and feldspathic ceramic crowns. Zinc-phosphate cementation appeared feasible for lithium disilicate crowns.     

Effect of Crystallization Firing on Marginal Gap of CAD/CAM Fabricated Lithium Disilicate Crowns

Purpose

To evaluate the marginal gaps of CAD/CAM (CEREC 3) produced crowns made from leucite‐reinforced glass‐ceramic (IPS Empress CAD) blocks (LG), and lithium‐disilicate (IPS e.max CAD) blocks before (LD‐B), and after (LD‐A) crystallization firing.

Materials and Methods

A human molar tooth (#19) was mounted with adjacent teeth on a typodont and prepared for a full‐coverage ceramic crown. The typodont was assembled in the mannequin head to simulate clinical conditions. After tooth preparation 15 individual optical impressions were taken by the same operator using titanium dioxide powder and a CEREC 3 camera per manufacturer's instructions. One operator designed and machined the crowns in leucite‐reinforced glass‐ceramic blocks (n = 5) and lithium‐disilicate blocks (n = 10) using the CEREC 3 system. The crowns were rigidly seated on the prepared tooth, and marginal gaps (μm) were measured with an optical microscope (500×) at 12 points, 3 on each of the M, B, D, and L surfaces of the leucite‐reinforced glass‐ceramic crowns and the lithium‐disilicate crowns before and after crystallization firing. Results were analyzed by two‐way ANOVA followed by a Tukey's post hoc multiple comparison test (α = 0.05).

Results

The overall mean marginal gaps (μm) for the crowns evaluated were: LG = 49.2 ± 5.5, LD‐B = 42.9 ± 12.2, and LD‐A = 57.2 ± 16.0. The marginal gaps for LG and LD‐B were not significantly different, but both were significantly less than for LD‐A.

Conclusions

The type of ceramic material did not affect the marginal gap of CAD/CAM crowns. The crystallization firing process required for lithium‐disilicate crowns resulted in a significant increase in marginal gap size, likely due to shrinkage of the ceramic during the crystallization process. Clinical Relevance: The marginal gap of CAD/CAM‐fabricated lithium disilicate crowns increases following crystallization firing. The marginal gap still remains within clinically acceptable parameters.     

氢氟酸质量分数对二硅酸锂玻璃陶瓷表面形貌及树脂粘接的影响

目的 探讨不同质量分数的氢氟酸对二硅酸锂玻璃陶瓷表面形貌及树脂粘接耐久性的影响。方法 制备大小为11 mm×13 mm×2 mm的二硅酸锂玻璃陶瓷片试件72个,经烧结、研磨、清洗后,随机分为3组,每组24个,分别接受质量分数为32%的磷酸、4%的氢氟酸、9.5%的氢氟酸处理20 s,形成酸蚀后试件。每组随机选出4个陶瓷片,1个使用扫描电子显微镜观察陶瓷表面形态,另外3个用表面粗糙度仪测量陶瓷片表面粗糙度参数（Ra、Rz和Rmax）。陶瓷片表面接受硅烷偶联剂/树脂粘接剂/树脂水门汀处理,并与直径3 mm的复合树脂柱粘接形成粘接试件。将每组20个粘接试件分为两组,10个试件直接进行剪切实验,10个试件经20 000次冷热循环后进行剪切实验。结果 氢氟酸处理组试件表面粗糙度参数值均显著高于磷酸处理组;9.5%氢氟酸组除Ra以外的参数值均高于4%氢氟酸组（P<0.05）。冷热循环明显降低了所有实验组的粘接强度（P<0.05）。冷热循环前后,氢氟酸处理组的粘接强度均高于磷酸处理组;尽管4%氢氟酸组的粘接强度高于9.5%氢氟酸组,但9.5%氢氟酸组在冷热循环过程中的粘接强度降低幅度要明显低于4%氢氟酸组（P<0.05）。结论 氢氟酸的质量分数对陶瓷表面形态及与树脂的粘接耐久性有明显影响,9.5%氢氟酸能更有效地保持二硅酸锂玻璃陶瓷的树脂粘接强度。     

Fatigue analysis of computer‐aided design/computer‐aided manufacturing resin‐based composite vs. lithium disilicate glass‐ceramic

Resin‐based composite molar crowns made by computer‐aided design/computer‐aided manufacturing (CAD/CAM) systems have been proposed as an inexpensive alternative to metal‐ceramic or all‐ceramic crowns. However, there is a lack of scientific information regarding fatigue resistance. This study aimed to analyze the fatigue behavior of CAD/CAM resin‐based composite compared with lithium disilicate glass‐ceramic. One‐hundred and sixty bar‐shaped specimens were fabricated using resin‐based composite blocks [Lava Ultimate (LU); 3M/ESPE] and lithium disilicate glass‐ceramic [IPS e.max press (EMP); Ivoclar/Vivadent]. The specimens were divided into four groups: no treatment (NT); thermal cycling (TC); mechanical cycling (MC); and thermal cycling followed by mechanical cycling (TCMC). Thermal cycling was performed by alternate immersion in water baths of 5°C and 55°C for 5 × 10⁴ cycles. Mechanical cycling was performed in a three‐point bending test, with a maximum load of 40 N, for 1.2 × 10⁶ cycles. In addition, LU and EMP molar crowns were fabricated and subjected to fatigue treatments followed by load‐to‐failure testing. The flexural strength of LU was not severely reduced by the fatigue treatments. The fatigue treatments did not significantly affect the fracture resistance of LU molar crowns. The results demonstrate the potential of clinical application of CAD/CAM‐generated resin‐based composite molar crowns in terms of fatigue resistance.     

数字化口腔修复（23）--激光脱敏后的CAD／CAM全瓷冠修复（附病例报告）

目的：观察二极管激光活髓牙脱敏后的CAD／CAM全瓷冠修复效果。方法：对1例13-23／33-43活髓牙烤瓷联冠修复患者,伴有冷热刺激敏感,牙龈萎缩,边缘不密合及颜色不协调,应用CEREC?椅旁CAD／CAM全瓷冠修复,二极管激光辅助活髓牙牙本质脱敏。3个月后采用改良USPHS标准对其临床疗效进行评价。结果：椅旁CAD／CAM二矽酸锂玻璃陶瓷全冠修复体外形颜色美观,边缘密合,粘接、固位良好,冷热刺激过敏症状消除。牙龈健康,形态正常及探诊无出血。结论：半导体激光可以有效减轻和消除牙本质过敏症状。     

Chipping behaviour of all-ceramic crowns with zirconia framework and CAD/CAM manufactured veneer

Objectives

The aim of this in vitro study was to assess the ultimate load to failure of zirconia based crowns veneered with CAD/CAM manufactured ceramic.

Methods

32 identical, anatoform zirconia (Sirona inCoris ZI, mono L F1) frameworks (thickness 0.6 mm) were constructed (Sirona inLab 3.80). Afterwards, 16 crowns were completed using a CAD/CAM manufactured lithium disilicate ceramic veneer (IPS e.max CAD, Ivoclar Vivadent). The remaining 16 frames were veneered using conventional manual layering technique. For the CAD/CAM manufactured veneers, the connection between framework and veneer was accomplished via a glass fusion ceramics. Before fracture tests, half of the specimens underwent thermocycling and chewing simulation (1.2 million chewing cycles, force magnitude F_max = 108 N). To further investigate the new technique, finite element computations were carried out on the basis of the original geometry.

Results

Nearly all (87.5%) conventionally veneered crowns failed already during chewing simulation, whereas crowns with CAD/CAM manufactured veneers were non-sensitive to artificial ageing. Crowns veneered with lithium disilicate ceramic displayed ultimate loads to failure of about 1600 N.

Conclusion

The CAD/CAM production of veneers for restorations with zirconia framework is a promising way to reduce failures originating from material fatigue.     

The effect of core material, veneering porcelain, and fabrication technique on the biaxial flexural strength and weibull analysis of selected dental ceramics

Purpose: The objective of this study was to compare the effect of veneering porcelain (monolithic or bilayer specimens) and core fabrication technique (heat‐pressed or CAD/CAM) on the biaxial flexural strength and Weibull modulus of leucite‐reinforced and lithium‐disilicate glass ceramics. In addition, the effect of veneering technique (heat‐pressed or powder/liquid layering) for zirconia ceramics on the biaxial flexural strength and Weibull modulus was studied. Materials and Methods: Five ceramic core materials (IPS Empress Esthetic, IPS Empress CAD, IPS e.max Press, IPS e.max CAD, IPS e.max ZirCAD) and three corresponding veneering porcelains (IPS Empress Esthetic Veneer, IPS e.max Ceram, IPS e.max ZirPress) were selected for this study. Each core material group contained three subgroups based on the core material thickness and the presence of corresponding veneering porcelain as follows: 1.5 mm core material only (subgroup 1.5C), 0.8 mm core material only (subgroup 0.8C), and 1.5 mm core/veneer group: 0.8 mm core with 0.7 mm corresponding veneering porcelain with a powder/liquid layering technique (subgroup 0.8C‐0.7VL). The ZirCAD group had one additional 1.5 mm core/veneer subgroup with 0.7 mm heat‐pressed veneering porcelain (subgroup 0.8C‐0.7VP). The biaxial flexural strengths were compared for each subgroup (n = 10) according to ISO standard 6872:2008 with ANOVA and Tukey's post hoc multiple comparison test (p≤ 0.05). The reliability of strength was analyzed with the Weibull distribution. Results: For all core materials, the 1.5 mm core/veneer subgroups (0.8C‐0.7VL, 0.8C‐0.7VP) had significantly lower mean biaxial flexural strengths (p < 0.0001) than the other two subgroups (subgroups 1.5C and 0.8C). For the ZirCAD group, the 0.8C‐0.7VL subgroup had significantly lower flexural strength (p= 0.004) than subgroup 0.8C‐0.7VP. Nonetheless, both veneered ZirCAD groups showed greater flexural strength than the monolithic Empress and e.max groups, regardless of core thickness and fabrication techniques. Comparing fabrication techniques, Empress Esthetic/CAD, e.max Press/CAD had similar biaxial flexural strength (p= 0.28 for Empress pair; p= 0.87 for e.max pair); however, e.max CAD/Press groups had significantly higher flexural strength (p < 0.0001) than Empress Esthetic/CAD groups. Monolithic core specimens presented with higher Weibull modulus with all selected core materials. For the ZirCAD group, although the bilayer 0.8C‐0.7VL subgroup exhibited significantly lower flexural strength, it had highest Weibull modulus than the 0.8C‐0.7VP subgroup. Conclusions: The present study suggests that veneering porcelain onto a ceramic core material diminishes the flexural strength and the reliability of the bilayer specimens. Leucite‐reinforced glass‐ceramic cores have lower flexural strength than lithium‐disilicate ones, while fabrication techniques (heat‐pressed or CAD/CAM) and specimen thicknesses do not affect the flexural strength of all glass ceramics. Compared with the heat‐pressed veneering technique, the powder/liquid veneering technique exhibited lower flexural strength but increased reliability with a higher Weibull modulus for zirconia bilayer specimens. Zirconia‐veneered ceramics exhibited greater flexural strength than monolithic leucite‐reinforced and lithium‐disilicate ceramics regardless of zirconia veneering techniques (heat‐pressed or powder/liquid technique).     

Can we use the translucency parameter to predict the CAD/CAM ceramic restoration aesthetic?

ObjectivesTo evaluate the effects of background color, ceramic type and coping thickness on masking ability (ΔE) and translucency parameter (TP) of CAD/CAM lithium disilicate glass-ceramic/monolithic zirconia and, to determine the correlations between coping thickness, TP and ΔE.MethodsA total of 120 ceramic specimens (2 mm, 1 mm and 0.5 mm thickness; n = 10) of four CAD/CAM ceramics: IPS e.max, IPS ZirCAD, Upcera Li CAD and Upcera TT CAD, were studied. Specimens were tested over nine fabricated backgrounds: A1, A2, A3.5, ND2 and ND7 shade resin-based composites, cobalt-chromium alloy (CC), medium precious alloy (MPA), black (B) and white (W). CIELab values (L*, a* and b*), color difference (ΔE) and translucency parameter (TP) were measured and calculated using a digital spectrophotometer (color i7, X-Rite, Pantone®). Data were analyzed using the Shapiro-Wilk test, one-way ANOVA, three-way ANOVA, independent t-tests and Tukey post-hoc tests (p < 0.05).Results2 mm CAD/CAM ceramics showed ideal color matching (ΔE<2.6) over different backgrounds, except for CC, B and W backgrounds. Monolithic zirconia had lower ΔE values than lithium disilicate glass-ceramics. ΔE and TP values significantly reduced with the increased coping thickness (p < 0.05). Regardless of ceramic type and thickness, a strong TP-SD of ΔE correlation was observed.SignificanceCAD/CAM ceramic restoration color was significantly affected by background color, ceramic type and coping thickness. TP is a promising predictor for appropriate ceramic selection to receive an acceptable CAD/CAM ceramic restoration aesthetic.