Influence of bonding surface and bonding methods on the fracture resistance and survival rate of full-coverage occlusal veneers made from lithium disilicate ceramic after cyclic loading

ObjectivesThe purpose of this laboratory study was to evaluate the influence of bonding method and type of dental bonding surface on fracture resistance and survival rate of resin bonded occlusal veneers made from lithium disilicate ceramic after cyclic loading.MethodsFourty-eight extracted molars were divided into three groups (N = 16) depending on the preparation: within enamel, within dentin/enamel or within enamel/composite resin filling. Lithium disilicate occlussal veneers were fabricated with a fissure-cusp thickness of 0.3–0.6 mm. Restorations were etched (5% HF), silanated and adhesively luted using a dual-curing luting composite resin. Test groups were divided into two subgroups, one using a only a self-etching primer, the other additionally etching the enamel with phosphoric acid. After water storage (37 °C; 21 d) and thermocycling (7500 cycles; 5–55 °C), specimens were subjected to dynamic loading in a chewing simulator (600,000 cycles; 10 kg/2 Hz). Surviving specimens were loaded until fracture using a universal testing machine.ResultsAll specimens survived artificial aging, several specimens showed some damage. ANOVA revealed that enamel etching provided statistically significantly (p ≤ 0.05) higher fracture resistance than self-etching when bonding to enamel and dentin. Self-etching provided statistically significant (p ≤ 0.05) higher fracture resistance for the enamel-composite group than for the enamel group. Enamel etching provided statistically significant (p ≤ 0.05) higher fracture resistance for the enamel and dentin group than for groups enamel and enamel-composite.SignificanceEtching enamel improved the fracture resistance of occlusal veneers when bonding to dentin and enamel and increased the survival rate when bonding to enamel.     

Fracture strength of CAD/CAM composite and composite-ceramic occlusal veneers

PurposeTo determine the effect of material type and restoration thickness on the fracture strength of posterior occlusal veneers made from computer-milled composite (Paradigm MZ100) and composite-ceramic (Lava Ultimate) materials.Methods60 maxillary molars were prepared and restored with CAD/CAM occlusal veneer restorations fabricated from either Paradigm MZ100 or Lava Ultimate blocks at minimal occlusal thicknesses of 0.3, 0.6, and 1.0 mm. Restorations were adhesively bonded and subjected to vertical compressive loading. The maximum force at fracture and mode of failure were recorded. 2-Way ANOVA was used to identify any statistically significant relationships between fracture strength and material type or thickness. Spearman's rank correlation coefficient was used to analyze mode of failure with regard to fracture strength.ResultsThe average maximum loads (N) at fracture for the Paradigm MZ100 groups were 1620 ± 433, 1830 ± 501, and 2027 ± 704 for the material thicknesses of 0.3, 0.6, and 1.0 mm, respectively. The Lava Ultimate groups fractured at slightly higher loads (N) of 2078 ± 605, 2141 ± 473, and 2115 ± 462 at the respective 0.3, 0.6, and 1.0 mm thickness.Statistical analyses revealed that, while no significant difference existed among the various restoration thicknesses in terms of fracture strength (P > 0.05), the material type was found to be influential (P = 0.04). The maximum load at fracture (N) for Lava Ultimate averaged over all thicknesses (2111 ± 500) was significantly higher than that of the Paradigm MZ100 (1826 ± 564). No correlation between mode of failure and fracture strength was found.ConclusionsUnder the conditions of this study, the maximal loads at fracture for these “non-ceramic” occlusal veneer restorations were found to be higher than human masticatory forces. Occlusal veneers made from the two materials tested are likely to survive occlusal forces regardless of restoration thickness, with those fabricated from the composite-ceramic hybrid material being more likely to survive heavier loads.     

Microstructure,topography, surface roughness,fractal dimension,internal and marginal adaptation of pressed and milled lithium-disilicate monolithic restorations

PurposeTo characterize the effect of two processing techniques (pressing and CAD/CAM — Computer Aided Design/Computer Aided Machining) of lithium-disilicate (LD) based crowns on the microstructure, topography, roughness, fractal dimension, internal and marginal adaptation.MethodsOne-hundred identical preparations for monolithic crowns were made with dentin analogue material (G10 epoxy resin). One of the preparations was scanned and a monolithic crown in lithium-disilicate was planned in the CAD system. Fifty crowns were milled in a wax pattern and subjected to pressing (IPS e.max Press), while 50 crowns were machined at CAD/CAM (IPS e.max CAD) and posteriorly crystallized. Internal and marginal adaptation were assessed via replica technique at four manufacturing moments (Milled wax pattern; LD^PRESS; Milled LD^CAD; Crystallized LD^CAD) and considering 5 regions (margin, cervico-axial angle, axial wall, axial-occlusal angle and occlusal wall). Complementary analysis considering microstructure and topography, roughness and fractal dimension were performed in Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM).ResultsThe processing technique resulted in different ceramic microstructure, topography, roughness and fractal dimension, whereas CAD/CAM lead to smoother, more homogeneous but more complex topography features (higher fractal dimension) in comparison to the pressing technique (P < 0.05). Regarding marginal and internal fit, LD^PRESS crowns showed to be more adapted at the margin, while LD^CAD were more adapted at the occluso-axial angle; other regions were not statistically different (α = 0.05).ConclusionsCAD/CAM and the pressing techniques for manufacturing LD crowns lead to completely different ceramic surface characteristics and affect crown adaptation at the margin and at occluso-axial angle.     

Monolithic CAD/CAM laminate veneers: Reliability and failure modes

Objectivesto evaluate the probability of survival and failure modes of lithium-disilicate, feldspathic-ceramic, and resin-nanoceramic anterior veneers cemented on dentin analog substrates after sliding-contact step-stress accelerated life testing (SSALT).MethodsA virtual incisor tooth preparation was produced with a reduction of 1.5 mm at the incisal edge and of 0.7 mm buccally. A .STL file of the preparation was generated and CAD/CAM based G10 dentin-analog material was used for testing. Laminate veneers were milled in three different materials: lithium-disilicate (LDS, E.max CAD), resin-nanoceramic (RN, Lava Ultimate), and feldspathic-ceramic (FELDS, Vita Blocks). SSALT was employed where a spherical indenter contacted the veneer, slided along its interface with G10 to lift off and start a new cycle at 2 Hz in water. Qualitative fractography was performed. The probability of survival (90% confidence-bounds) was calculated for several load/cycle missions.ResultsThe probability of survival for a mission of 50,000 cycles decreased from 50 up to 150 N equally for all groups and were not different between them. At 200 N, the probability of survival was significantly lower for FELDS (10%) compared to RN veneers (41%), whereas LDS presented intermediate values (22%). The characteristic strength of RN (247 N) was significantly higher than LDS (149 N), and FELDS (151 N). In FELDS and LDS, hackles, wake hackles and twist hackles indicated the direction of crack propagation. In RN, hackles were observed.ConclusionsDifferences in probability of survival were observed only at 180 and 200 N between groups. Failure modes were similar with veneer fracture down to the tooth-analog substrate.     

Influence of the preparation design on the survival probability of occlusal veneers

ObjectivesThe fracture resistance of ultrathin computer-aided design and computer-aided manufacturing (CAD/CAM) occlusal veneers with different preparation designs was investigated under cycling mechanical loading and via finite element analysis (FEA).MethodsEighty molars were prepared with a circular enamel ring until complete exposure of the occlusal dentin occurred. Forty were prepared via additional circular chamfer preparation. The teeth were restored with 0.5 mm-thick occlusal veneers. Each group received a CAD/CAM fabricated occlusal veneer with a low modulus of elasticity (composite, CeraSmart) and a high modulus of elasticity material (ceramic, Celtra Duo). The restorations were adhesively luted and underwent 2000 thermocycling cycles. The samples were loaded at 50 N under 1,000,000 cycles in a chewing simulator and were checked for failure after various cycles. A visible crack was defined as failure, and the Kaplan-Meier survival rate was used for data analysis.One sample per group was digitized using microcomputed tomography, and FEA was performed using open-source software. The comparative stresses were analyzed for specimens with and without chamfer preparation.ResultsThe survival probabilities were 60% for occlusal ceramic veneers without preparation and 40% for veneers with chamfer preparation, with no statistically significant differences. Composite veneers achieved 95% survival probability regardless of the preparation method.The main principal stress in ceramic restoration was visualized via FEA. In composite veneers, stress was also visible in the luting composite and dentin.SignificanceThe preparation method had no influence on mechanical fatigue. Minimally invasive preparation can be recommended. The restoration material is crucial for survival.     

Load-bearing capacity of CAD/CAM 3D-printed zirconia,CAD/CAM milled zirconia,and heat-pressed lithium disilicate ultra-thin occlusal veneers on molars

ObjectivesThe load-bearing capacity of ultra-thin occlusal veneers made of 3D-printed zirconia were compared to the ones obtained by fabricating these reconstructions by CAD/CAM milling zirconia or heat-pressing lithium-disilicate.MethodsOn 60 extracted human molars, the occlusal enamel was removed and extended into dentin. Occlusal veneers of 0.5 mm thickness were digitally designed. The specimens were divided into 3 groups (n = 20 each) differing in the restorative material and the fabrication technique of the occlusal veneer. (1) 3DP: 3D-printed zirconia (Lithoz); (2): CAM: milled zirconia (Ceramill Zolid FX); (3) HPR: heat-pressed lithium disilicate (IPS e.max Press). After conditioning procedures, the restorations were adhesively bonded onto the conditioned tooth. Thereafter, all specimens were aged in a chewing simulator by exposure to cyclic fatigue and temperature variations. Subsequently the specimens were statically loaded and the load which was necessary to decrease the maximum load by 20% and initiate a crack (F_initial) and the load which was needed to fracture the specimen (F_max) were measured. Differences between the groups were compared applying the Kruskal-Wallis (KW) test and the Wilcoxon-Mann-Whitney-Test (WMW: p < 0.05).ResultsThe median F_initial values for the groups 3DP, CAM and HPR were 1’650 N, 1’250 N and 500 N. The differences between all three groups were statistically significant (KW: p < 0.0001). The median F_max values amounted to 2’026 N for the group 3DP, 1’500 N for the group CAM and 1’555 N for the group HPR. Significant differences were found between 3DP and CAM (WMW: p = 0.0238).SignificanceRegarding their load-bearing capacity, 3D-printed or milled zirconia as well as heat-pressed lithium disilicate can be recommended as restorative material for ultra-thin occlusal veneers to prosthetically compensate for occlusal tooth wear. Despite statistically significant differences between the restoration materials, all load-bearing capacities exceeded the clinically expected normal bite forces.     

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.     

Chairside CAD/CAM materials. Part 3: Cyclic fatigue parameters and lifetime predictions

Objectives

Chemical and mechanical degradation play a key role on the lifetime of dental restorative materials. Therefore, prediction of their long-term performance in the oral environment should base on fatigue, rather than inert strength data, as commonly observed in the dental material’s field. The objective of the present study was to provide mechanistic fatigue parameters of current dental CAD/CAM materials under cyclic biaxial flexure and assess their suitability in predicting clinical fracture behaviors.

不同核饰瓷厚度对CAD/CAM玻璃陶瓷材料透明性的影响

目的:探讨不同核饰瓷厚度的CAD/CAM玻璃陶瓷的对比度(contrast ratio,CR)以及与A2色测色试件的色差ΔE。方法:将IPS e.max CAD瓷块和IPS Empress CAD瓷块加工成厚度分别为0.8、1.0、1.2 mm的方型核心瓷片,然后在核心瓷上烧结厚度分别为0.7、0.5、0.3 mm的相应饰瓷,最后上釉。共制作30片12×12 mm、总厚度为1.5 mm的瓷试件(n=5)。采用CM-3600A分光测色计测量试件的色度值,用来计算试件的对比度(contrast ratio,CR)和与A2色片的色差(ΔE)。结果:IPS e.max CAD组的CR值明显大于IPS Empress CAD组。IPS e.max CAD组的ΔE值小于IPS Empress CAD组。结论:不同核瓷厚度组合的IPS e.max CAD和IPS Empress CAD都能较好的模拟目标颜色;IPS Empress CAD的透明性要高于IPS e.max CAD。     

Estimation of stress distribution and risk of failure for maxillary premolar restored by occlusal veneer with different CAD/CAM materials and preparation designs

Objectives

To compare stress distribution and failure probability in maxillary premolars restored by simple occlusal veneer (SOV) and buccal-occlusal veneer (BOV) with 3 different CAD/CAM materials.

Materials and methods

A maxillary premolar was digitized by a micro-CT scanner. Three-dimensional dynamic scan data were transformed, and finite element models of 2 different models (SOV and BOV restored teeth) were designed. Three different CAD/CAM materials, including lithium disilicate glass ceramic (LD) IPS e.max CAD, polymer-infiltrated ceramic-network (PICN) Vita Enamic, and resin nano-ceramic (RNC) Lava Ultimate, were designated to both veneers. Maximum principle stresses were determined by applying a 300-N axial load to the occlusal surface. Weibull analyses were performed to calculate the failure probability of the models.

Results

LD-restored teeth showed the highest stress in the veneer, lowest stress in substrate teeth, and lowest failure probability for the overall system; RNC-restored teeth showed the lowest stress in the veneer, highest stress in substrate teeth, and highest failure probability. No significant differences were found in the cement layer among the different models. No significant differences of stress and failure probability existed between SOV and BOV preparations.

Conclusions

CAD/CAM composite resin occlusal veneers bear lower maximum stress than ceramic veneers. Teeth restored by composite veneers are more prone to failure than those restored by ceramic veneers. Additional reduction of the buccal surface did not increase the stress on the occlusal veneer under axial load.

Clinical relevance

Both occlusal veneers could be used under physiological masticatory force. CAD/CAM glass ceramic was safer than composite resins.

     

Sliding contact wear and subsurface damage of CAD/CAM materials against zirconia

ObjectiveMost previous work conducted on the wear behavior of dental materials has focused on wear rates and surface damage. There is, however, scarce information regarding the subsurface damage arising from sliding contact fatigue. The aim of this study was to elucidate the wear mechanisms and the subsurface damage generated during sliding contact fatigue in 5 contemporary CAD/CAM materials against a zirconia indenter.MethodsForty discs (Ø12 mm, 1.55 mm thick) were cut out of IPS e.max CAD (e.CAD), Suprinity PC (SUP), Enamic (ENA), Vitablocs Mark II (VMII) and Lava Ultimate (LU) blocks and mirror polished. After cementation onto a dentin-like composite, off-axis mouth-motion cycling was conducted with a spherical zirconia indenter (r = 3.18 mm) in water (200 N load, 2 Hz frequency) for 5 different cycling periods (10², 10³, 10⁴, 10⁵, 10⁶ cycles, n = 8). Analysis of the wear scars was conducted using light-microscopy, scanning-electron-microscopy and optical profilometry. Subsurface damage was assessed using sagittal and transverse sections of the samples.ResultsFatigue wear mechanisms predominated in glassy materials (e.CAD, SUP, VMII), accompanied by extensive subsurface damage, whereas abrasive wear mechanisms were responsible for the large wear craters in the resin composite (LU) with an absolute absence of subsurface fracture. A combination of both mechanisms was observed in the polymer-infiltrated reinforced-glass (ENA), displaying large wear craters and severe subsurface damage.SignificanceWell-controlled laboratory simulation can identify wear and subsurface damage susceptibility of various classes of restorative materials. Both wear and subsurface fracture are determining factors for the long-term success of restorations.     

Mathematical model for assessing true irradiance received by luting materials while curing through modern CAD/CAM resin composites

Statement of problemMeasurement of irradiance passing through a dental restoration for properly curing a dual- or light-polymerized luting composite is imprecise due to surface reflection.ObjectiveTo provide a mathematical correction of measured transmitted irradiance for predicting true transmitted light intensity through CAD/CAM restorations.MethodsA total of 432 specimens were fabricated. Seven modern CAD/CAM resin-based composites (RBCs) and one CAD/CAM glass-ceramic (control group) were sectioned and polished into specimens of 0.5–5 mm thickness (in 0.5 mm steps, n = 6). Irradiance of a violet-blue LED light curing unit (LCU) (power modes: Standard, High and Plasma) was measured after passing through each specimen with a spectrometer. Data was compared based on 95% confidence intervals and using univariate ANOVA followed by Tukey HSD (α = 0.05).ResultsThe measured transmitted irradiance passing through the specimens decreased exponentially. Significantly highest values of transmitted irradiance were measured for 0.5 mm thick specimens for all materials (p < 0.05). The decadic absorption coefficient for CAD/CAM-RBCs ranged from 0.292 mm⁻¹ to 0.387 mm⁻¹ while the control group (glass-ceramic) reached a significantly lower value of 0.283 mm⁻¹. The reflection ratio for all materials ranged from 12.6% to 18.5%.SignificanceA correction can be implemented to predict the true transmitted irradiance after passing through a dental restoration as function of initial irradiance, specimen thickness and material specific parameters. For a practitioner, this model may be applied depending on the specific treatment conditions, the individual LCU's radiant emittance and restoration thickness for the tested materials.     

Effects of layering techniques on the micro-tensile bond strength to dentin in resin composite restorations

ObjectivesThe purpose of this work was to investigate the effects of layering techniques in resin composite restorations on the micro-tensile bond strength to the dentin of the occlusal cavity.MethodsHuman premolars were extracted and randomly divided into four groups. The occlusal enamel was then removed to expose a flat superficial dentin surface. Cavities 3.5 mm long and 3.5 mm wide were prepared to a depth 3 mm below the dentin surface. The adhesive Single Bond was applied according to the manufacturer's instructions. The teeth were then restored with Z100 resin composite as follows: Group 1 was restored in horizontal increments (three layers). Groups 2 and 3 were restored in different oblique increments (three layers). Group 4 was restored in oblique increments (four layers). After 24 h storage at 37 °C in water, all the teeth were sectioned to obtain bar-shaped specimens with a bonded surface area of approximately 0.9 mm × 0.9 mm. Dentin micro-tensile bond strength was measured at a crosshead speed of 0.5 mm/min. The results obtained were statistically analyzed using one-way ANOVA and SNK test at a significance level of P = 0.05. All fractures were then observed under a scanning electron microscope (SEM).ResultsThe results showed that there is a significant difference between the strength of the micro-tensile bonds to the dentin of occlusal cavities depending on which of the four layering restorative techniques was used (P < 0.01). SEM observation showed that failure patterns were most evidently interfacial cohesive failure.SignificanceLayering techniques in resin composite restorations affected the micro-tensile bond strength between the resin composite and the dentin. But the outcomes related to only Single Bond, as the same using other adhesives might have different outcomes.     

Adhesive class I restorations in sound molar teeth incorporating combined resin-composite and glass ionomer materials: CAD-FE modeling and analysis

ObjectivesTo investigate the influence of different resin composite and glass ionomer cement material combinations in a “bi-layer” versus a “single-layer” adhesive technique for class I cavity restorations in molars using numerical finite element analysis (FEA).Materials and MethodsThree virtual restored lower molar models with class I cavities 4 mm deep were created from a sound molar CAD model. A combination of an adhesive and flowable composite with bulk fill composite (model A), of a glass ionomer cement with bulk fill composite (model B) and of an adhesive with bulk fill composite (model C), were considered. Starting from CAD models, 3D-finite element (FE) models were created and analyzed. Solid food was modeled on the occlusal surface and slide-type contact elements were used between tooth surface and food. Polymerization shrinkage was simulated for the composite materials. Physiological masticatory loads were applied to these systems combined with shrinkage. Static linear analyses were carried out. The maximum normal stress criterion was adopted as a measure of potential damage.ResultsAll models exhibited high stresses principally located along the tooth tissues–restoration interfaces. All models showed a similar stress trend along enamel–restoration interface, where stresses up to 22 MPa and 19 MPa was recorded in the enamel and restoration, respectively. A and C models showed a similar stress trend along the dentin-restoration interface with a lower stress level in model A, where stresses up to 11.5 MPa and 7.5 MPa were recorded in the dentin and restoration, respectively, whereas stresses of 17 MPa and 9 MPa were detected for model C. In contrast to A and C models, the model B showed a reduced stress level in dentin, in the lower restoration layer and no stress on the cavity floor.SignificanceFE analysis supported the positive effect of a “bi-layer” restorative technique in a 4 mm deep class I cavities in lower molars versus “single-layer” bulk fill composite technique.     

Effect of staining and whitening systems on color stability of computer aided design/computer aided manufacturing lithium disilicate glass ceramic

PurposeTo investigate the effect of coffee stain and whitening systems on the color stability of CAD/CAM glazed lithium disilicate glass-ceramics (LDGCs).Methods 68 glazed LDGC discs (12 × 10 × 2 mm) were fabricated using blocks of CAD/CAM systems (IPS e.max CAD ceramic). Baseline color was measured (CIE/L*a*b*), and specimens were randomized into four groups (n = 17). All specimens were stained (coffee solution; 24 h/d × 12) and then subjected to two whitening protocols. G1- (kept moist × 7 days); G2-positive control (brushed with distilled water, 200gm/load, 2 min twice daily × 7 days); G3- whitening toothpaste (Colgate optic white; relative dentin abrasivity = 100, 200gm/load, 2 min twice daily × 7 days) and G4-simulated at-home bleaching protocol (Opalescence,15% carbamide peroxide (CP), 6 h/day × 7 days). The study outcome was color change (ΔE) measured at baseline, after staining, and after whitening treatments. Data were analyzed using paired T-test and one-way ANOVA (α = 0.05).ResultsAll groups stained equally (p > 0.05) but were not clinically significant (ΔE ≤ 1.05). Stains were significantly (p ≤ 0.01) improved in G2 and G3 (ΔE = 0.69 and 0.63), yet were not eliminated compared to bleaching, which had the highest color improvement and completely removed the stains (ΔE = 0.72).ConclusionsGlazed LDGC was color stable after simulating one year of coffee staining. Bleaching, using 15% CP for a week, completely removed the stains and returned the LDGCs to their original shade. However, simulating eight months of brushing, regardless of the toothpaste content, improved the color outcome but didn’t remove it completely.     

Precision of orthognathic digital plan transfer using patient-specific cutting guides and osteosynthesis versus mixed analogue–digitally planned surgery: a randomized controlled clinical trial

Over the last decade, the accuracy of three-dimensional computer-assisted orthognathic surgery has been investigated extensively. The absence of high-quality controlled trials, limited number of studies overall, and methodological flaws have hindered its use in general clinical practice. The aim of this study was to assess the accuracy of computer-assisted orthognathic surgery compared to the classic occlusal wafers. Eighteen patients were randomly allocated to two groups: CAD/CAM splints and patient-specific osteosynthesis were used for maxillary positioning in group 1; occlusal wafers fabricated on a semi-adjustable articulator were used in group 2. Patients were assessed for linear and angular deviations of maxillary position from the virtual plan using cone beam computed tomography scans. The CAD/CAM group showed mean deviations of 0.26 mm vertically, 0.17 mm anteroposteriorly, and 0.07 mm mediolaterally, while the classic wafer group showed mean deviations of 1.45 mm vertically, 1.31 mm anteroposteriorly, and 0.71 mm mediolaterally. Statistical analysis showed that the proposed workflow provided a significantly more accurate plan transfer compared to classic occlusal wafers. Despite the statistical significance, the clinical significance was less appreciated. However, this new technology facilitated cases with skeletal asymmetry, reduced operating times, and allowed a trainee surgeon to perform the procedure with great accuracy and minimal time. The main limitation was the high cost.     

Wear resistance of crowns made from different CAM/CAD materials

ObjectivesThe aim of this laboratory study was to evaluate the wear resistance of crowns made from current computer-aided design and computer-aided manufacture (CAD/CAM) materials. In addition, the abrasion of the steatite antagonist against these materials was compared.MethodsIdentically shaped crowns of lithium disilicate, zirconia-reinforced lithium disilicate and a polymer-infiltrated ceramic network (PICN) were fabricated with an occlusal thickness of 1.5 mm and a lateral wall thickness of 1.2 mm (n = 8). The crowns were cemented with a dual-polymerizing luting resin on composite resin dies. Using spherical steatite antagonists, all specimens were loaded with 49 N for 1,200,000 cycles in a mastication simulator with additional thermocycling. After 120,000, 240,000, 480,000, 960,000, and 1,200,000 cycles, precision impressions were made and investigated with a laser scanning microscope. The vertical and volume substance loss was measured. Additionally, the substance loss of the antagonists was evaluated after 1,200,000 loading cycles.ResultsNo significant difference (p > 0.05) was found in the median volume loss of the test materials after 1,200,000 cycles (lithium disilicate: 0.405 mm³, PICN: 0.362 mm³, zirconia-reinforced lithium disilicate: 0.340 mm³). The vertical substance loss of PICN (157 μm) was significantly lower (p ≤ 0.05) than that of lithium disilicate (201 μm) and zirconia reinforced lithium disilicate (191 μm). However, the substance loss of steatite against zirconia-reinforced lithium disilicate (0.191 mm³) was significantly lower (p ≤ 0.05) than against lithium disilicate (0.296 mm³) and PICN (0.531 mm³).SignificanceAll three CAD/CAM materials showed wear resistance that seems appropriate for clinical application. Also, the abrasion of the antagonist looks promising.     

2种椅旁CAD/CAM修复材料冠抗折强度的体外研究

目的:比较2 种椅旁CAD/CAM 即刻修复材料(IPS e.max CAD 和Vita Enamic)体外不同面厚度下冠抗折强度的差异,为临床CAD/CAM 修复体的制作提供参考.方法 :定制树脂全冠预备体代型42 个,以面预备量1.5、2.0、2.5 mm 随机分为3 组,CEREC 扫描代型,储存数据,分别利...     

Effect of immediate dentin sealing on load-bearing capacity under accelerated fatigue of thin occlusal veneers made of CAD-CAM glass-ceramic and resin composite material

ObjectiveThe objective of this study was to assess the influence of immediate dentin sealing (IDS) on the fatigue behavior of laminate occlusal veneers fabricated with CAD/CAM lithium disilicate ceramic and resin composite.MethodsForty sound human molars were prepared and randomly divided into 4 groups (n = 10): RC–IDS+ (IDS and resin composite occlusal laminate veneer); RC–IDS- (resin composite occlusal laminate veneer without IDS); LD–IDS+ (IDS and lithium disilicate laminate veneer); LD–IDS- (lithium disilicate occlusal laminate veneer without IDS). The restorations were obtained using a digital workflow. After surface conditioning and bonding, thermocycling and accelerated fatigue tests (20 Hz, 5000 cycles with an initial load of 300 N, step-size of 100 N for 10,000 cycles, up to 1000 N, and then a step-size of 50 N until failure) were conducted. Fatigue data were recorded for both outcomes (crack or fracture) and statistically analyzed. Fractographic and adhesive interface analysis were conducted.ResultsThe indirect resin composite groups showed better fatigue behavior compared to lithium disilicate. IDS only had a positive effect for the survival of resin composite restorations for the ‘fracture’ outcome. Evident presence of micro-gaps at the adhesive interface in the LD–IDS- group could be noted.SignificanceImmediate dentin sealing improved fatigue resistance behavior of resin composite occlusal veneers. However, this effect was not observed in lithium disilicate veneers.     

Five year clinical outcomes and survival of chairside CAD/CAM ceramic laminate veneers — a retrospective study

Purpose

The aim of this clinical study was to compare the survival, modified California Dental Association (CDA) criteria, and periodontal parameters of laminate veneers made with Empress CAD and emax CAD over 60 months.