Effect of cleaning protocol on silica deposition and silica-mediated bonding to Y-TZP

ObjectivesTo evaluate the effect of cleaning methods on the deposition of silica on yttria-stabilized zirconium dioxide (Y-TZP) surface and on the silane-silica mediated bond strength between Y-TZP and resin cement.MethodsY-TZP slabs were air-abraded with 30 μm silica-coated alumina particles and distributed in three groups: no cleaning, cleaning with a stream of oil-free air/water spray for 5 s and cleaning with an ultrasonic bath in water for 10 min. The distribution of Si on the Y-TZP surfaces was recorded using energy dispersive spectroscopy (EDS). After the treatment was applied, Y-TZP slabs (n = 20) received a primer application and resin cement cylinders were built on the surface. After storage (24 h) in water storage or 3 months plus thermocycling; n = 10), microshear bond strength test (μSBS) was performed. X- ray Photoelectron Spectroscopy (XPS) characterized the chemical bonds between the silica layer and the silane-containing primer. Data were analyzed using ANOVA and Tukey test, as well as Weibull analysis (α = 0.05).ResultsCleaning method had a significant effect on the amount of Si deposited on zirconia surface (p < 0.001) and, consequently, on bond strength (p < 0.001). Storage/aging also had a significant effect on bond strength (p < 0.001). Low values of Weibull moduli for bond strength were observed for all groups after aging. XPS showed silane-silica chemical interaction for all groups.SignificanceThe silica deposited by tribochemical coating to Y-TZP was removed by the cleaning methods evaluated, compromising bond strength. Stability of the bonding is also a concern when no cleaning method is applied.     

Translucency,flexural strength,fracture toughness,fracture load of 3-unit FDPs,Martens hardness parameter and grain size of 3Y-TZP materials

ObjectiveThis investigation tested pre-shaded 3Y-TZP materials on optical, mechanical and structural properties and calculated correlations between these properties.MethodsSeven A2-shaded 3Y-TZP zirconia materials were investigated on translucency (T) via UV–vis-spectrophotometer, fracture load of 3-unit FDPs (FL), biaxial flexural strength (FS), Chevron-Notch Beam (CNB), fracture toughness (K_IC) and Martens parameter (hardness: HM and indentation modulus: E_IT). FL, FS and K_IC were measured in a universal testing machine. The grain size was evaluated by scanning electron microscopy (SEM). Data was analyzed using one-way ANOVA followed by post hoc Scheffé, Kruskal–Wallis-, Mann–Whitney-U- and Pearson-test (p < 0.05).ResultsFor translucency, negative correlations were found with results of facture load (R = −0.444, p < 0.001) and K_IC (R = −0.503, p < 0.001). While a positive correlation was found between translucency and flexural strength (R = 0.238, p = 0.019), between fracture load and E_IT (R = 0.227, p < 0.029), between fracture load and K_IC (R = 0.362, p < 0.001) as well as between fracture load and the grain size (R = 0.598, p = 0.007). While the grain size positively correlated with E_IT (R = 0.534, p = 0.017) as well as E_IT with HM (R = 0.720, p < 0.001).SignificanceDespite of being based on the same raw material, tested zirconia materials significantly differed regarding optical, mechanical (except biaxial flexural strength and Martens hardness) and structural properties. Materials with highest optical properties were those with lowest mechanical properties (CER, COP).     

Thermo and mechanical cycling and veneering method do not influence Y-TZP core/veneer interface bond strength

ObjectivesThe purpose of this study was to evaluate the influence of thermal and mechanical cycling and veneering technique on the shear bond strength of Y-TZP (yttrium oxide partially stabilized tetragonal zirconia polycrystal) core–veneer interfaces.Materials and methodsCylindrical Y-TZP specimens were veneered either by layering (n = 20) or by pressing technique (n = 20). A metal ceramic group (CoCr) was used as control (n = 20). Ten specimens for each group were thermal and mechanical cycled and then all samples were subjected to shear bond strength in a universal testing machine with a 0.5 mm/min crosshead speed. Mean shear bond strength (MPa) was analysed with a 2-way analysis of variance and Tukey's test (p < 0.05). Failure mode was determined using stereomicroscopy and scanning electron microscopy (SEM).ResultsThermal and mechanical cycling had no influence on the shear bond strength for all groups. The CoCr group presented the highest bond strength value (p < 0.05) (34.72 ± 7.05 MPa). There was no significant difference between Y-TZP veneered by layering (22.46 ± 2.08 MPa) or pressing (23.58 ± 2.1 MPa) technique. Failure modes were predominantly adhesive for CoCr group, and cohesive within veneer for Y-TZP groups.ConclusionsThermal and mechanical cycling, as well as the veneering technique does not affect Y-TZP core–veneer bond strength.Clinical significanceDifferent methods of veneering Y-TZP restorations would not influence the clinical performance of the core/veneer interfaces.     

Effects of aging procedures on the topographic surface,structural stability,and mechanical strength of a ZrO2-based dental ceramic

ObjectiveTo determine the effects of different aging methods on the degradation and flexural strength of yttria-stabilized tetragonal zirconia (Y-TZP)MethodsSixty disc-shaped specimens (∅, 12 mm; thickness, 1.6 mm) of zirconia (Vita InCeram 2000 YZ Cubes, VITA Zahnfabrik) were prepared (ISO 6872) and randomly divided into five groups, according to the aging procedures (n = 10): (C) control; (M) mechanical cycling (15,000,000 cycles/3.8 Hz/200 N); (T) thermal cycling (6,000 cycles/5–55 °C/30 s); (TM) thermomechanical cycling (1,200,000 cycles/3.8 Hz/200 N with temperature range from 5 °C to 55 °C for 60 s each); (AUT) 12 h in autoclave at 134 °C/2 bars; and (STO) storage in distilled water (37 °C/400 days). After the aging procedures, the monoclinic phase percentages were evaluated by X-ray diffraction (XRD), and topographic surface analysis was performed by 3D profilometry. The specimens were then subjected to biaxial flexure testing (1 mm/min, load 100 kgf, in water). The biaxial flexural strength data (MPa) were analyzed by 1-way ANOVA and Tukey's test (α = 0.05). The data for monoclinic phase percentage and profilometry (Ra) were analyzed by Kruskal–Wallis and Dunn's tests.ResultsANOVA revealed that flexural strength was affected by the aging procedures (p = 0.002). The M (781.6 MPa) and TM (771.3 MPa) groups presented lower values of flexural strength than did C (955 MPa), AUT (955.8 MPa), T (960.8 MPa) and STO (910.4 MPa). The monoclinic phase percentage was significantly higher only for STO (12.22%) and AUT (29.97%) when compared with that of the control group (Kruskal–Wallis test, p = 0.004). In addition, the surface roughnesses were similar among the groups (p = 0.165).SignificanceWater storage for 400 days and autoclave aging procedures induced higher phase transformation from tetragonal to monoclinic; however, they did not affect the flexural strength of Y-TZP ceramic, which decreased only after mechanical and thermomechanical cycling.     

Effect of sintering time on biaxial strength of zirconium dioxide

ObjectivesAim of this study was to evaluate effect of sintering time on mechanical properties of yttrium partially stabilized zirconia (Y-TZP) (ICE Zirkon, ZirkonZahn, Italy).MethodsFifty-six zirconia discs were divided into two groups. Discs of the first group were sintered in sintering oven (ZirkonZahn) at 20–1500 °C temperature using rise time of 3 h and kept at 1500 °C for 2 h. Discs of the second group were sintered at 20–1500 °C using rise time of 1 h 40 min and kept at 1500 °C for 1 h. Half of the discs (n = 15) from both groups were thermocycled in distilled water for 20 000 cycles (5–55 °C). Biaxial flexural strength of the discs (diameter 19.0 mm, thickness 1.6 mm) were measured dry at room temperature. Surface microhardness (VHN) was also measured. X-Ray diffraction analysis was performed to evaluate the ratio of tetragonal to monoclinic phase in thermocycled discs. The data was calculated using Weibull and ANOVA analysis.ResultsNo statistically significant difference (p > 0.05) was found between the groups in terms of sintering time or thermocycling. The biaxial flexural strength of the groups varied from 995 MPa to 1127 MPa. Surface microhardness varied from 1478 to 1532. The relative amount of the monoclinic phase was higher when zirconia was thermocycled and stored in water compared to control discs, which had no monoclinic phase at all.SignificanceVariation in the sintering time from 1.6 h to 3.0 h did not influence mechanical properties of Y-TZP zirconia.     

Effect of high-speed sintering on the flexural strength of hydrothermal and thermo-mechanically aged zirconia materials

ObjectiveTo investigate the influence of high-speed and conventional sintering on the flexural strength (FS) of three zirconia materials initial and after artificial aging.MethodsMilled zirconia specimens (3Y-TZP: ZI and Zolid; 4Y-TZP: Zolid HT+; Amann Girrbach AG; N = 288, n = 96/group) were sintered in a high-speed sintering protocol (final temperature 1580 °C, n = 48/subgroup) or a conventional sintering protocol (control group, final temperature 1450 °C, n = 48/subgroup). FS was tested initially and after artificial aging (10 h in an autoclave or 1,200,000 chewing cycles; n = 16/subgroup). Univariate ANOVAs, post-hoc Scheffé, partial eta-squared, Kolmogorov–Smirnov-, Kruskal–Wallis- and Mann–Whitney-U-test were performed (p < 0.05).ResultsZI showed the highest and HT+ the lowest FS, regardless of the sintering protocols and aging regimens (p < 0.001). High-speed sintered HT+ showed higher initial FS than the control group (p < 0.001). ZI (p < 0.001–0.004) and Zolid (p < 0.001–0.007) showed higher FS after thermo-mechanical aging. High-speed sintered HT+ showed higher FS in the initial stage (p < 0.001). The Weibull modulus of the three thermo-mechanically aged materials was negatively influenced by high-speed sintering.SignificanceAs shorter sintering times represent a cost and time efficient alternative, high-speed sintering is a valid alternative to conventional sintering protocols.     

Three-dimensional trueness analysis of ceramic crowns fabricated using a chairside computer-aided design/manufacturing system: An in vitro study

PurposeThis study analyzed the trueness of polymer-infiltrated ceramic and glass ceramic crowns manufactured using the chairside computer-aided design/manufacturing (CAD/CAM) system.MethodsThe master model designs crowns using a CAD program after acquiring a digital impression with an intraoral scanner. Vita Enamic (VE), Vita Suprinity (VS), and IPS e.max CAD (IPS) were used to manufacture 10 crowns each (total: 30 crowns), using the chairside CAD/CAM system (inLab MC XL). Trueness was evaluated by superimposing the CAD data on the scan data using a three-dimensional program. The Kruskal–Wallis H test, a nonparametric test, and the Mann–Whitney U test were performed by applying the significance level (0.05/3 = 0.016), which was adjusted by post-analysis Bonferroni testing.ResultsThere was a significant difference in the trueness between the samples (p < 0.05). However, there was no statistically significant difference in the outer surface trueness between the samples (p > 0.05).ConclusionsThese findings show that the milling accuracy of VE is better than that of VS and IPS.     

Effect of silane and MDP-based primers on physico-chemical properties of zirconia and its bond strength to resin cement

ObjectiveTo evaluate the effect of surface treatments on yttria-tetragonal zirconia polycrystal (Y-TZP) characteristics and on resin-mediated zirconia bond.MethodsY-TZP slabs were grit blasted with 45 μm alumina or with 30 μm silica-coated alumina particles. The chemical treatments were: no-chemical treatment (NC), silane-containing primer (SP), MDP (10-Methacryloyloxydecyl dihydrogen phosphate) and silane-containing primer (MPS), MDP-containing primer (MP) and MDP and silane-containing adhesive (MPA). Contact angle as a function of surface roughness (θ_m) and surface roughness parameter (Sdr) were measured using Fringe Projection Phase Shifting (FPPS). Surface free energy (γ_s^TOT) was calculated with a goniometer. Chemical interaction between primers/adhesive and zirconia was analyzed using time-of-flight secondary ion mass spectrometry (ToF-SIMS). Resin cement microshear bond strength (μSBS) was analyzed at either 24-h or 8-months water storage (37 °C). θ_m values, Sdr values, γ_s^TOT and μSBS values were analyzed using Analysis of variance (ANOVA) and post hoc Tukey test (α = 0.05).ResultsChemical treatment had an effect (p < 0.001) on all surface parameters analyzed: θ_m, γ_s^TOT and Sdr. MP-treated group showed higher incidence of P–O–Zr bonds than the other groups, indicating more chemical linkages. Grit blasting (p < 0.001) and the interaction chemical treatment*storage (p < 0.001) did not affect μSBS; all silane-containing primers showed significant drop in μSBS after aging.SignificanceMDP and/or silane-based solutions affect the physicochemical properties of blasted-zirconia. An MDP-based primer is fundamental to achieve a stable resin-zirconia bonding, but the chemical reactivity of MDP is impaired when this molecule is present in a multicomponent system.     

Mechanical properties,aging stability and translucency of speed-sintered zirconia for chairside restorations

ObjectiveTo evaluate the performance of zirconia ceramics sintered in a speed sintering induction furnace by comprehensive understanding of their optical and mechanical properties, microstructure, phase composition and aging stability, in comparison to ceramics sintered in a conventional furnace.MethodsSpeed sintered (SS) Katana STML_SS (Kuraray Noritake) (total thermal cycle/sintering time/dwell temperature: 30 min/16 min/1560 °C) and CEREC Zirconia (CEREC Zr_SS) (Dentsply Sirona) (15 min/2 min/1578 °C) were compared to conventionally sintered (CS) Katana STML_CS (6.8 h/2 h/1550 °C) and inCoris TZI_CS (4 h/2 h/1510 °C). The translucency parameter (TP) and contrast ratio (CR) were measured with a spectrophotometer. The chemical composition of the materials was determined by XRF and phase composition was characterized using XRD. Hydrothermal aging behavior was evaluated by measuring the tetragonal-to-monoclinic ZrO₂ phase transformation after accelerated hydrothermal aging in steam at 134 °C. The indentation fracture toughness, Vickers hardness and biaxial strength of the sintered ceramics were assessed.ResultsSpeed and conventionally sintered zirconia revealed similar density, microstructure, average strength and hydrothermal aging stability. Both Katana STML_SS/CS 5Y-PSZ ceramics were characterized with a higher content of cubic phase (≈53 wt%), which resulted in a higher amount of Y₂O₃ in the remaining tetragonal ZrO₂ phases compared to the 3Y-TZP CEREC Zr_SS and inCoris TZI_CS (8 and 20 wt%, respectively). The sintering program did not affect the hydrothermal aging behavior of Katana STML_SS and CEREC Zr_SS. TP of Katana STML_SS (TP ≈ 32) was not affected by speed sintering, while the translucency of CEREC Zr_SS (TP = 14) was significantly reduced. Hardness, fracture toughness and Weibull characteristic strength of Katana STML_SS and CEREC Zr_SS also reached the optimal level, but speed sintering substantially lowered their mechanical reliability.SignificanceSpeed sintering of 3Y-TZP and 5Y-PSZ in a speed sintering induction oven appeared suitable for clinical applications. However, further studies should focus on improving of translucency and mechanical reliability of the speed-sintered zirconia ceramics.     

Graded structures for damage resistant and aesthetic all-ceramic restorations

ObjectivesClinical studies revealed several performance deficiencies with alumina- and zirconia-based all-ceramic restorations: fracture; poor aesthetic properties of ceramic cores (particularly zirconia cores); and difficulty in achieving a strong ceramic–resin-based cement bond. We aim to address these issues by developing a functionally graded glass/zirconia/glass (G/Z/G) structure with improved damage resistance, aesthetics, and cementation properties.MethodsUsing a glass powder composition developed in our laboratory and a commercial fine zirconia powder, we have successfully fabricated functionally graded G/Z/G structures. The microstructures of G/Z/G were examined utilizing a scanning electron microscopy (SEM). The crystalline phases present in G/Z/G were identified by X-ray diffraction (XRD). Young's modulus and hardness of G/Z/G were derived from nanoindentations. Critical loads for cementation radial fracture in G/Z/G plates (20 mm × 20 mm, 1.5 or 0.4 mm thick) bonded to polycarbonate substrates were determined by loading with a spherical indenter. Parallel studies were conducted on homogeneous yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) controls.ResultsThe G/Z/G structure consists of an outer surface aesthetic glass layer, a graded glass–Y-TZP layer, and a dense Y-TZP interior. The Young's modulus and hardness increase from surface to interior following power-law relations. For G/Z/G plates of 1.5 and 0.4 mm thick, critical loads for cementation radial fracture were 1990 ± 107 N (mean ± S.D., n = 6) and 227 ± 20 N (mean ± S.D., n = 6), respectively, which were ～30 and 50% higher than those for their monolithic Y-TZP counterparts (1388 ± 90 N for 1.5 mm and 113 ± 10 N for 0.4 mm thick; mean ± S.D., n = 6 for each thickness). A 1-sample t-test revealed significant difference (p < 0.001) in critical loads for radial fracture of G/Z/G and homogeneous Y-TZP for both specimen thicknesses.SignificanceOur results indicate that functionally graded G/Z/G structures exhibit improved damage resistance, aesthetics, and potentially cementation properties compared to homogeneous Y-TZP.     

Influence of pigments and opacifiers on color stability of silicone maxillofacial elastomer

ObjectivesTo determine the effects of opacifiers and silicone pigments on the color stability of silicone A-2000 maxillofacial prosthetic elastomers subjected to artificial aging.MethodsSeventy-five groups (n = 5) were made by various combinations (5%, 10%, and 15%) of four dry earth opacifiers (Georgia kaolin, Gk; calcined kaolin, Ck; Artskin white, Aw; titanium white dry pigment, Td); and 1 silicone pigment white (Sw) with one of 5 silicone pigments (no pigment (control), red (Pr), yellow (Py), burnt sienna (Po), and a mixture of Pr + Py + Po). A reflection spectrophotometer was used for color measurements. Color differences (ΔE*) between baseline and after an energy exposure of 450 kJ/m² in an artificial aging chamber were calculated. A ΔE* = 3.0 was used as 50:50% acceptability threshold in result interpretation, while ΔE* = 1.1 was used as 50:50% perceptibility threshold. Means were compared by Fisher's PLSD intervals at the 0.05 level of significance. Color differences after aging were subjected to three-way analysis of variance.ResultsYellow ochre mixed with all opacifiers at all intervals had increased ΔE* values significantly from 0.7–2.1 up to 3.8–10.3. When mixed groups were considered, at 5%, Gk exhibited the smallest color changes, followed by Td < Aw = Sw < Ck, respectively. At 10%, Aw < Td < Gk < Sw = Ck. At 15%, Td < Aw < Gk = Sw < Ck (< indicates p < 0.0001 and = indicates p > 0.05). The smallest color differences, observed for opacifier groups, were recorded for Gk at 5%, and Td and Aw at 10% and 15%. Overall, 15% Td exhibited the smallest, whereas 5% Ck exhibited the most pronounced color change after artificial aging. All ΔE* values were below the 50:50% acceptability threshold, indicating acceptable color stability. Color differences for 10% and 15% of Aw and Td were below 50:50% perceptibility thresholds, indicating excellent color stability.ConclusionSilicone pigments mixed with 10% and 15% Artskin white and titanium white dry pigment opacifiers protected silicone A-2000 from color degradation over time. Yellow silicone pigment significantly affected color stability of all opacifiers especially silicone pigment white and calcined kaolin.     

Fracture loads of screw-retained implant-supported zirconia prostheses after thermal and mechanical stress

PurposeThe objective of the present study was to evaluate fracture loads of screw-retained implant-supported zirconia prostheses after artificial aging.MethodsFour types of screw-retained implant-supported prostheses were fabricated (n = 11 each); porcelain-veneered zirconia prosthesis (PVZ), indirect composite-veneered zirconia prosthesis (IVZ), porcelain-fused-to-metal prosthesis (PFM), and monolithic zirconia prosthesis (ML). The specimens were subjected to 10,000 thermocycles and cyclic loading for 1.2 million cycles. Fracture loads were measured, and the data were analyzed with the Kruskal–Wallis and Steel–Dwass tests (α = 0.05).ResultsAll specimens survived the artificial aging procedures. The fracture loads for the PVZ (1.52 kN), IVZ (1.62 kN), and PFM groups (1.53 kN) did not significantly differ; however, the fracture load for the ML group (6.61 kN) was significantly higher than those for the other groups. The fracture load for the IVZ group was comparable to those for the PVZ and PFM groups.ConclusionsThe monolithic zirconia prostheses exhibited significantly higher fracture loads than the bilayered prostheses. All the investigated types of screw-retained implant-supported zirconia prostheses appear sufficient to resist posterior masticatory forces during long-term clinical use.     

Comparison of various 3D printed and milled PAEK materials: Effect of printing direction and artificial aging on Martens parameters

ObjectivesThe aim of this study was to investigate the effect of artificial aging on the Martens parameters of different 3D printed and milled polyaryletherketon (PAEK) materials.MethodsIn total 120 specimens of 4 different polyetheretherketon (PEEK) materials (Essentium PEEK, KetaSpire PEEK MS-NT1, VICTREX PEEK 450 G and VESTAKEEP i4 G) were additively manufactured via fused layer manufacturing (FLM) in either horizontal or vertical directions (n = 15 per group). 75 specimens were milled out of prefabricated PAEK blanks from the materials breCAM.BioHPP, Dentokeep, JUVORA Dental Disc 2 and Ultaire AKP ( = 15 per group). Martens hardness (HM), indentation hardness (H_IT) and indentation modulus (E_IT) were determined initially and longitudinally after thermocycling (5−55 °C, 10,000x) and autoclaving (134 °C, 2 bar). In each case, the surface topography of the specimens was examined for modifications using a light microscope.Data were analysed with Kolmogorov-Smirnov test, univariate ANOVA followed by post-hoc Scheffé test with partial eta squared (η_p²), Kruskal–Wallis-, Mann–Whitney-U-, Friedman- and Wilcoxon-Test. A value of p < 0.05 was considered as significant.ResultsMilled specimens showed higher Martens parameters than printed ones (p < 0.001). Artificial aging had a negative effect on the measured parameters (p < 0.001). Horizontally printed specimens presented higher Martens parameters than vertically printed ones, regardless of material and aging process (p < 0.001). Essentium PEEK and breCAM.BioHPP showed the highest and VICTREX PEEK 450G as well as Ultaire AKP the lowest values of all investigated PAEK materials initially, after thermocycling and after autoclaving (p < 0.001). Microscopic examinations showed that artificial aging did not cause any major modifications of the materials.SignificanceAdditively manufactured PEEK materials showed lower Martens parameters than milled ones, whereas horizontally printed specimens presented higher values than vertically printed ones. Artificial aging had a negative effect on the Martens parameters, but not on the surface topography.     

Off-axis sliding contact reliability and failure modes of veneered alumina and zirconia

ObjectiveAll-ceramic dental crowns are popular because of their esthetics and biocompatibility. However, they often chip or fracture when subjected to repeated occlusal loading. Considerable efforts to improve the materials are being done through the study of fatigue and failure modes. The vast majority of fatigue studies have been conducted with uniaxial loading and no sliding action. We hypothesized different failure modes for porcelain veneered Y-TZP and that the reliability of porcelain veneered Y-TZP is higher than that of porcelain veneered alumina when subjected to fatigue under 30° off-axis sliding Y-TZP and alumina plates were porcelain veneered and cemented to aged composite blocks as a model for an all-ceramic crown on dentin.MethodsSpecimens (n = 21 per group) were fatigue at 30° off-axis with a hard sphere sliding contact in water, by means of a mouth-motion simulator apparatus.ResultsAlthough no difference between groups was found, the failure modes differed and there was a tendency to higher reliability for Y-TZP compared to alumina for a mission of 50,000 cycles at 150 N load.SignificanceFailure modes for alumina specimens were deep penetrating partial cone cracks and cementation internal surface radial cracks. Y-TZP specimens showed only surface damage with deep penetrating partial cone cracks extending to the veneer core interface, with no cementation surface radial cracking, which overall agrees with clinical finding. Angled sliding contact appears to better simulate oral function.     

Nanoleakage,ultramorphological characteristics,and microtensile bond strengths of a new low-shrinkage composite to dentin after artificial aging

ObjectivesTo study the microtensile bond strengths and nanoleakage of low-shrinkage composite to dentin. The null hypotheses tested were (1) aging does not affect the bonding of low-shrinkage composite; (2) there is no difference in microtensile bond strengths and nanoleakage using different bonding strategies.Methods32 extracted molars were assigned to one of four groups: LS System Adhesive (LS, 3M ESPE); dentin etched for 15 s with phosphoric acid + LS System Adhesive (LSpa); Adper Single Bond Plus (SB, 3M ESPE); SB + LS Bond (SBLS). Occlusal dentin was exposed and restored with Filtek LS (3M ESPE). The samples were tested after 24 h or after 20,000 thermocycles and 6 months of aging. Teeth were sectioned with a cross-section of 0.8 ± 0.2 mm² and fractured at a crosshead speed of 1 mm/min. The data were submitted to ANOVA/Duncan's post hoc test, at p < 0.05. Five slabs from each group were selected and immersed in 50 wt% ammoniacal silver nitrate. Then, specimens were processed for SEM, the silver penetration was measured and data analyzed with Kruskal–Wallis at p < 0.05.ResultsNo statistically significant difference was found among the experimental groups for the factor dentin treatment (p = 0.165) and aging (p = 0.091). All experimental groups exhibit some degree of nanoleakage. There was no adhesion of Filtek LS applied directly over dentin surfaces treated with SB.SignificanceThe new low-shrinkage resin composite showed compatibility only with its dedicated adhesive. Pre-etching did not improve the bond strengths to low-shrinkage resin composite. Some degree of nanoleakage was evident in all groups.     

Evaluation of interface characterization and adhesion of glass ceramics to commercially pure titanium and gold alloy after thermal- and mechanical-loading

ObjectivesThis study evaluated the effect of thermal- and mechanical-cycling on the shear bond strength of three low-fusing glassy matrix dental ceramics to commercial pure titanium (cpTi) when compared to conventional feldspathic ceramic fused to gold alloy.MethodsMetallic frameworks (diameter: 5 mm, thickness: 4 mm) (N = 96, n = 12 per group) were cast in cpTi and gold alloy, airborne particle abraded with 150 μm aluminum oxide. Low-fusing glassy matrix ceramics and a conventional feldspathic ceramic were fired onto the alloys (thickness: 4 mm). Four experimental groups were formed; Gr1 (control group): Vita Omega 900–Au–Pd alloy; Gr2: Triceram–cpTi; Gr3: Super Porcelain Ti-22–cpTi and G4: Vita Titankeramik–cpTi. While half of the specimens from each ceramic–metal combination were randomly tested without aging (water storage at 37 °C for 24 h only), the other half were first thermocycled (6000 cycles, between 5 and 55 °C, dwell time: 13 s) and then mechanically loaded (20,000 cycles under 50 N load, immersion in distilled water at 37 °C). The ceramic–alloy interfaces were loaded under shear in a universal test machine (crosshead speed: 0.5 mm/min) until failure occurred. Failure types were noted and the interfaces of the representative fractured specimens from each group were examined with stereomicroscope and scanning electron microscope (SEM). In an additional study (N = 16, n = 2 per group), energy dispersive X-ray spectroscopy (EDS) analysis was performed from ceramic–alloy interfaces. Data were analyzed using ANOVA and Tukey's test.ResultsBoth ceramic–metal combinations (p < 0.001) and aging conditions (p < 0.001) significantly affected the mean bond strength values. Thermal- and mechanical-cycling decreased the bond strength (MPa) results significantly for Gr3 (33.4 ± 4.2) and Gr4 (32.1 ± 4.8) when compared to the non-aged groups (42.9 ± 8.9, 42.4 ± 5.2, respectively). Gr1 was not affected significantly from aging conditions (61.3 ± 8.4 for control, 60.7 ± 13.7 after aging) (p > 0.05). Stereomicroscope images showed exclusively adhesive failure types at the opaque ceramic–cpTi interfacial zone with no presence of ceramic on the substrate surface but with a visible dark titanium oxide layer in Groups 2–4 except Gr1 where remnants of bonder ceramic was visible. EDS analysis from the interfacial zone for cpTi–ceramic groups showed predominantly 34.5–85.1% O₂ followed by 1.1–36.7% Al and 0–36.3% Si except for Super Porcelain Ti-22 where a small quantity of Ba (1.4–8.3%), S (0.7%) and Sn (35.3%) was found. In the Au–Pd alloy–ceramic interface, 56.4–69.9% O₂ followed by 15.6–26.2% Si, 3.9–10.9% K, 2.8–6% Na, 4.4–9.6% Al and 0–0.04% Mg was observed.SignificanceAfter thermal-cycling for 6000 times and mechanical-cycling for 20,000 times, Triceram–cpTi combination presented the least decrease among other ceramic–alloy combinations when compared to the mean bond strength results with Au–Pd alloy–Vita Omega 900 combination.     

Influence of mandibular residual ridge resorption on objective masticatory measures of lingualized and fully bilateral balanced denture articulation

PurposeTo assess the influence of mandibular residual ridge resorption (RRR) on objective masticatory measures of two occlusal schemes: lingualized occlusion (LO) and fully bilateral balanced articulation (FBBA).MethodsThe enrolled patients (n = 22) were randomly allocated one set of complete dentures with either LO or FBBA. Maximum occlusal force, masticatory performance (by the MPI), and mandibular movements were measured at 3- and 6-month follow-ups. Mandibular RRR was assessed as the sum of the mandibular bone height at the midline, first premolar region, and least vertical height region, and from the mental foramen to the alveolar crest, measured on panoramic radiographs; the treatment groups were subclassified into severe or moderate RRR subgroups by the value of the sum of individual measurements.ResultsSignificant differences were observed in the between-subgroup comparisons (Kruskal–Wallis test) of the MPI (3 months, p = 0.01; 6 months, p = 0.04) and linear deviation from intercuspal position (anterior–posterior: 6 months, p = 0.01; inferior–superior: 3 months, p = 0.008; 6 months, p = 0.02). The patients with severe RRR in the FBBA group showed a significant decrease in the MPI and increase in linear inferior deviation from intercuspal position at 3 months (post hoc comparison) as well as a significant increase in the linear posterior and inferior deviation from intercuspal position at 6 months.ConclusionsLO is the preferable occlusal scheme for patients with severe RRR. (This trial has been registered at http://clinicaltrials.gov/ct2/show/NCT00959530.)     

Surface characterisation and bonding of Y-TZP following non-thermal plasma treatment

Objectives(1) To chemically characterise Y-TZP surface via X-ray photoelectron spectroscopy (XPS) and evaluate the surface energy levels (SE) after non-thermal plasma (NTP). (2) To test the microtensile bond strength (MTBS) of Y-TZP bonded to cured composite disks, after a combination of different surface conditioning methods.MethodsTwenty-four Y-TZP discs (13.5 mm × 4 mm) were obtained from the manufacturer and composite resin (Z-100) discs with similar dimensions were prepared. All discs were polished to 600 grit and divided into 8 groups (n = 3 disks each), four control (non-NTP treated) and four experimental (NTP treated for 10 s) groups. All groups received one of the four following treatments prior to cementation with Rely × Unicem cement: sand-blasting (SB), a Clearfil ceramic primer (MDP), sand-blasting + MDP (SBMDP), or baseline (B), no treatment. SE readings and surface roughness parameters were statistically analysed (ANOVA, Tukey's, p < 0.05). Mixed model and paired samples t-tests were used to compare groups on MTBS.ResultsXPS showed increase in O and decrease in C elements after NTP. The polar component increased for BP (42.20 mN/m) and SBP (43.77 mN/m). MTBS values for groups BP (21.3 MPa), SBP (31 MPa), MDPP (30.1 MPa) and SBMDPP (32.3 MPa) were significantly higher in specimens treated with NTP than their untreated counterparts B (9.1 MPa), SB (14.4 MPa), MDP (17.8 MPa) and SBMDP (24.1 MPa).Conclusions(1) Increase of O and decrease of C led to higher surface energy levels dictated by the polar component after NTP; (2) NTP application increased MTBS values of Y-TZP surfaces.     

Impact of thermal misfit on shear strength of veneering ceramic/zirconia composites

ObjectivesThermal misfit is discussed as one reason for chipping of veneered zirconia restorations. The aim of the investigation was to assess the effect of thermal misfit on the shear strength of zirconia/veneering ceramic composites.MethodsShear strengths of 12 different veneering ceramic/zirconia composites were measured (n = 10). The veneering ceramics were fired onto polished Y-TZP. In order to create a strong thermal mismatch, one of the veneering ceramics was intended for use on alumina and one for the metal–ceramic technique. The glass transition temperatures of the veneering ceramics and the coefficients of thermal expansion of all ceramics were measured (n = 6). Statistical analysis was performed with one-way ANOVA and a post hoc Bonferroni test (p < 0.05).ResultsShear strength ranged from 21.9 ± 6.2 to 31.0 ± 7.1 MPa. The ceramic for the metal–ceramic technique showed spontaneous debonding. The differences in the coefficients of thermal expansion of core and veneer (Δα) were calculated. In addition the differences between glass transition temperatures of the veneering ceramics and room temperature (ΔT) as the effective temperature range for stress formation were calculated. Highest shear strength was observed when ΔαΔT ≈ 1000 × 10^?6.ConclusionsThermal expansion and glass transition temperature of the veneering ceramic have an impact on the shear strength of veneer/zirconia composites.     

Digitization of simulated clinical dental impressions: Virtual three-dimensional analysis of exactness

ObjectivesTo compare the exactness of simulated clinical impressions and stone replicas of crown preparations, using digitization and virtual three-dimensional analysis.MethodsThree master dies (mandibular incisor, canine and molar) were prepared for full crowns, mounted in full dental arches in a plane line articulator. Eight impressions were taken using an experimental monophase vinyl polysiloxane-based material. Stone replicas were poured in type IV stone (Vel-Mix Stone; Kerr). The master dies and the stone replicas were digitized in a touch-probe scanner (Procera^® Forte; Nobel Biocare AB) and the impressions in a laser scanner (D250, 3Shape A/S), to create virtual models. The resulting point-clouds from the digitization of the master dies were used as CAD-Reference-Models (CRM). Discrepancies between the points in the pointclouds and the corresponding CRM were measured by a matching-software (CopyCAD 6.504 SP2; Delcam Plc). The distribution of the discrepancies was analyzed and depicted on color-difference maps.ResultsThe discrepancies of the digitized impressions and the stone replicas compared to the CRM were of similar size with a mean ± SD within 40 μm, with the exception of two of the digitized molar impressions. The precision of the digitized impressions and stone replicas did not differ significantly (F = 4.2; p = 0.053). However, the shape affected the digitization (F = 5.4; p = 0.013) and the interaction effect of shape and digitization source (impression or stone replica) was pronounced (F = 28; p < 0.0001). The reliability was high for both digitization methods, evaluated by repeated digitizations.SignificanceThe exactness of the digitized impressions varied with shape. Both impressions and stone replicas can be digitized repeatedly with a high reliability.