Esthetic restorative materials and opposing enamel wear

This in vitro study compared the effects of a gold alloy (Degulor M), four dental ceramics (IPS Empress, IPS Empress 2, Duceram Plus, Duceram LFC) and a laboratory-processed composite (Targis) on the wear of human enamel. The amount of wear of the enamel (dental cusps) and restorative materials (disks) were tested in water at 37 degrees C under standard load (20 N), with a chewing rate of 1.3 Hz and was determined after 150,000 and 300,000 cycles. Before the test, the average surface roughness of the restorative materials was analyzed using the Ra parameter. The results of this study indicate that Targis caused enamel wear similar to Degulor M and resulted in significantly less wear than all the ceramics tested. IPS Empress provoked the greatest amount of enamel wear and Degulor M caused less vertical dimension loss. Targis could be an appropriate alternative material to ceramic, because it is esthetic and produces opposing enamel wear comparable to gold alloy.     

Fracture resistance of teeth restored with indirect-composite and ceramic inlay systems.

Fracture resistance of dentin-bonded inlays may be influenced by the restorative material used. The purpose of this study was to evaluate, in vitro, the fracture resistance of teeth restored with four tooth-colored materials: feldspathic ceramic, Duceram LFC, and three laboratory resins, Solidex, Artglass, and Targis. Sixty mandibular molar teeth were placed in resin cylinders, reproducing the periodontal ligaments. Mesial-occlusal-distal (MOD) inlay preparations were made in a standard cavity preparation appliance. Subsequently, the teeth were molded, and the restorations were prepared following the manufacturer's instructions. The inlays were cemented with resin composite cement, Rely X, and stored at 37 degrees C and 100% humidity for 24 hours. The samples were then submitted to an axial compression load at a speed of 0.5 mm/minute. Statistical analysis by one-way ANOVA and Tukey's multiple comparison test revealed that the teeth restored with Duceram LFC (205.44 +/- 39.51 kgf) showed statistically inferior fracture resistance than the three other groups restored with indirect resin composites (Solidex [293.16 +/- 45.86 kgf], Artglass [299.87 +/- 41.08 kgf], and Targis [304.23 +/- 52.52 kgf]).     

Assessment of an Indirect Metal Ceramic Repair System

Purpose: This study was designed to compare an alternative indirect treatment to repair fractured or chipped veneering metal ceramic using recently developed ultra‐low‐fusing ceramics. Materials and Methods: One conventional feldspathic ceramic, Vita Omega, and three ultra‐low‐fusing ceramics (ULFC), Finesse, Duceram LFC, and Vision‐low, were used. Forty ceramic specimens were prepared and divided into two groups. Group I (n = 20) was designed for bond strength testing. It comprised four subgroups (A, B, C, D): one Ceramic‐resin (A) and three Ceramic‐ULFC disc specimens of different diameters (B, C, D). Group II was composed of repaired ceramic discs using direct and indirect repair methods for biaxial testing. It was comprised of five subgroups: the fractured discs from subgroup A; Omega discs (n = 20) formed the repaired specimens of the four remaining subgroups: B, C, D, E. Data were presented as means and standard deviation (SD) values. One‐way analysis of variance (ANOVA) was used for comparison between means. Tukey's post hoc test was used for pairwise comparison between the means when ANOVA test was significant. The significance level was set at p≤ 0.05. Results: Within group I, Omega‐Ducera LFC showed the statistically highest mean bond strength (25.8 MPa) values, followed by Omega‐Finesse (15.8 MPa). No statistically significant difference was apparent between Omega‐Vision (9.3 MPa) and the control Omega‐Composite group (7.5 MPa). Regarding group II, the Control Omega subgroup showed statistically the highest mean biaxial strength values (168.8 MPa). No statistically significant difference was evident between the values of Omega‐Finesse (78.7 MPa), Omega‐Vision (78.4 MPa), and Omega‐Composite (82.5 MPa). Omega‐Ducera LFC subgroup, showed statistically the lowest mean values (53 MPa). Conclusions: Omega‐Ducera LFC yielded the statistically highest mean bond strength values, and the lowest biaxial strength values. All values were within the reported bond strength values for resin repair. All the tested groups showed significantly lower values compared to the initial biaxial strength mean values of the Omega ceramic; however, two of the tested ULFC (Vision, Finesse), recorded means that were statistically equal to the resin‐ceramic direct subgroup. Duceram LFC showed the lowest values, probably due to its totally glass composition, which showed low strength values of the repaired specimens. The recorded bond and biaxial values suggest that indirect repair of fractured LFC using some ULFC ceramics may offer an alternative solution to the traditional direct resin repair method; however, the choice of the used ceramic should be one containing some leucite crystals. Further studies are needed to investigate the long‐term performance of the proposed repair treatment.     

Marginal adaptation of indirect composites and ceramic inlay systems

This study evaluated the marginal adaptation of four different inlay indirect restorative systems: feldspathic ceramic (Duceram LFC-Degussa) and three laboratory-processed resin composites (Solidex-Shofu; Targis-Ivoclar; Artglass-Heraeus Kulzer). Sixty mesial-occlusal-distal (MOD) standard cavities were prepared in mandibular molars and divided randomly. Polyvinylsiloxane impressions were made and the restorations were prepared following the manufacturer's instructions. Marginal adaptation evaluation was accomplished using an image collector computer system with a digital gauging appliance at four points on the occlusal, proximal and gingival regions with 250x magnification. Among all the materials, the marginal discrepancy recorded on the gingival margins was statistically larger than that recorded on the proximal and occlusal regions. Duceram LFC showed greater marginal discrepancy than Solidex, Artglass and Targis, which showed no statistically significant differences among them.     

Evaluation of low-fusing ceramic systems combined with titanium grades II and V by bending test and scanning electron microscopy

The bond strength by three point bending strength of two metal substrates (commercially pure titanium or grade II, and Ti-6Al-4V alloy or grade V) combined to three distinct low-fusing ceramic systems (LFC) and the nature of porcelain-metal fracture by scanning electron microscopy (SEM) were evaluated. The results were compared to a combination of palladium-silver (Pd-Ag) alloy and conventional porcelain (Duceram VMK68). Sixty metal strips measuring 25x3x0.5mm were made - 30 of titanium grade II and 30 of titanium grade V, with application of the following types of porcelain: Vita Titankeramik, Triceram or Duceratin (10 specimens for each porcelain). The porcelains were bonded to the strips with dimensions limited to 8x3x1mm. The control group consisted of ten specimens Pd-Ag alloy/Duceram VMK68 porcelain. Statistical analyses were made by one-way analysis of variance (ANOVA) and Tukey test at 5% significance level. Results showed that the bond strength in control group (48.0MPa ± 4.0) was significantly higher than the Ti grade II (26.7MPa ± 4.1) and Ti grade V (25.2MPa ± 2.2) combinations. When Duceratin porcelain was applied in both substrates, Ti grade II and Ti grade V, the results were significantly lower than in Ti grade II/Vitatitankeramik. SEM analysis indicated a predominance of adhesive fractures for the groups Ti grade II and Ti grade V, and cohesive fracture for control group Pd-Ag/Duceram. Control group showed the best bond strength compared to the groups that employed LFC. Among LFC, the worst results were obtained when Duceratin porcelain was used in both substrates. SEM confirmed the results of three point bending strength.     

The surface status of polished restoration biomaterials after the use of a sodium bicarbonate spray: scanning electron microscopy

The effects of an air-abrasive system on polished surfaces of restorative materials have been studied using scanning electron microscopy, metrology and profilography. Polished surfaces of composite resin, of amalgam and gold alloy show different alteration types in microtopography, in profile tracings and significant increased surface roughness after air-abrasive spraying; but ceramic and non-precious alloy surfaces are not affected. The composite resin surfaces should be repolished and amalgam and gold alloy surfaces made glossy after use of an air-abrasive system.     

Shock-absorbing behavior of five restorative materials used on implants.

The damping effect of five restorative materials used to veneer test crowns rigidly connected to a Br?nemark implant and subjected to an impact force was measured. These materials included a gold alloy; a noble metal ceramic alloy; porcelain; a laboratory-processed, light-activated microfilled resin; and a heat- and pressure-polymerized poly(methyl methacrylate) resin. The two resins were found to reduce the impact force by about 50% when compared to porcelain or the alloys. The clinical significance of the results is discussed.     

In vitro analysis of the radiodensity of indirect composites and ceramic inlay systems and its influence on the detection of cement overhangs

The purpose of this study was to evaluate the radiodensity of indirect restorative systems and to determine its influence on detection of resin cement overhangs. Sixty sound molars with similar dimensions were selected, and MOD inlay preparations were made in a standardized fashion with 6° taper of the walls. Restorations were made with a porcelain, Duceram LFC, and with three indirect composites, Solidex, Artglass, and Targis. Digital radiographic images were taken before and after cementation of the inlays (Digora system) and were analyzed on two regions, the cervical and the isthmus floor. Digital radiodensity measurements were performed on standardized points symmetrically distributed over each restoration and tooth structure. Cement overhangs were detected through visual analysis by three evaluators. Data were statistically analyzed utilizing ANOVA following Tukey’s test (p < 0.05), showing that Solidex presented lower radiodensity than Duceram LFC, and both Artglass and Targis presented similar higher levels of radiodensity than the other groups. Radiodensity of cervical regions was always greater than for isthmus floor regions. Detection of the resin cement overhangs is easier observed on Solidex and Duceram LFC. Radiodensity is highly influenced by restorative material type and tooth regions. The detection of radiopaque resin cement overhangs is influenced by radiodensity of restorative materials.     

Determining the force absorption quotient for restorative materials used in implant occlusal surfaces.

It has been hypothesized that the type of material used to form the occlusal surface of restorations retained by dental implants may impart a "dampening effect" to the bone-implant interface. This study compared the force transmitted to human bone by gold, porcelain, and resin occlusal surfaces in a simulated implant occlusal rehabilitation. A Branemark self-tapping implant was placed in a human cadaver mandible with a stacked three element strain gauge cemented to the lingual cortical plate. An Instron testing machine was used to apply an axial force, through a peanut sample, to a restoration that contained interchangeable occlusal surfaces. Applied force was divided by recorded microstrain at the bone-strain gauge junction to derive a calculated ratio, or force absorption quotient. No statistically significant difference of the force absorption quotient between the occlusal surfaces of gold, porcelain, and resin was observed.     

Shear bond strength of dental porcelains to nickel-chromium alloys

The continuous technological advance and increasing availability of new base metal alloys and ceramic systems in the market, coupled to the demands of daily clinical practice, have made the constant evaluation of the bond strength of metal/porcelain combinations necessary. This study evaluated the metal/porcelain shear bond strength of three ceramic systems (Duceram, Williams and Noritake) in combination with three nickel-chromium (Ni-Cr) alloys (Durabond, Verabond and Viron). Thirty cast cylinder specimens (15 mm high; 6 mm in diameter) were obtained for each alloy, in a way that 10 specimens of each alloy were tested with each porcelain. Bond strength was measured with an Emic screw-driven mechanical testing machine by applying parallel shear forces to the specimens until fracture. Shear strength was calculated using the ratio of the force applied to a demarcated area of the opaque layer. Mann-Whitney U test was used for statistical analysis of the alloy/ceramic combinations (p<0.05). Viron/Noritake had the highest shear bond sregnth means (32.93 MPa), while Verabond/Duceram (16.31 MPa) presented the lowest means. Viron/Noritake differed statistically from other combinations (p<0.05). Viron/Duceram had statistically significant higher bond strengths than Verabond/Duceram, Verabond/Williams and Durabond/Noritake (p<0.05). It was also found significant difference (p<0.05) between Verabond/Noritake, Verabond/Duceram and Durabond/Noritake. No statistically significant difference (p>0.05) were observed among the other combinations. In conclusion, the Noritake ceramic system used together with Viron alloy presented the highest resistance to shear forces, while Duceram bonded to Verabond presented the lowest bond strength. Viron/Duceram and Verabond/Noritake provided intermediate results. The combinations between the Williams ceramic system and Ni-Cr alloys had similar shear strengths among each other.     

Shear bond strength of resin composite veneering material to gold alloy with varying metal surface preparations

STATEMENT OF PROBLEM: Although adequate surface preparation is indispensable to achieve a consistent and durable bond between resin composite materials and the metal substructures of veneered restorations, information on the bonding performance of current metal adhesive systems is limited. PURPOSE: The purpose of this study was to evaluate the surface preparation effects of 4 metal conditioners and 1 adhesive system on bonding between a prosthetic resin composite veneering material and a gold casting alloy. MATERIAL AND METHODS: Four primers containing sulfur derivative monomer and designed for conditioning noble metal alloys (Alloy Primer, Infis Opaque Primer, Metal Primer II, and Metaltite) and a surface modification technique (Siloc) were assessed. Cast disk specimens made of gold alloy (Pontor LFC) were either primed with 1 of the 4 primers or treated with the Siloc system and bonded with a light-activated prosthetic resin composite material (New Metacolor Infis). Control specimens were also prepared without the use of a bonding agent. Shear bond strengths were determined before and after thermocycling (20,000 cycles) for evaluation of bond durability. RESULTS: All of the primed and Siloc-treated groups showed improved 24-hour shear bond strengths compared with the control group. After thermocycling, the groups either primed with the Metaltite conditioner or treated with the Siloc system exhibited the highest mean shear bond strengths. CONCLUSION: The Metaltite conditioner and Siloc system each represent a useful method for improving the bond between the gold alloy and resin composite material tested.     

Influence of abutment substrates on the colour of metal-free polymer crowns

New-generation composite materials have excellent strength and wear resistance, and thus can be used to make metal-free crowns. However, composite materials are translucent, and so when using them to make metal-free crowns, it is necessary to take the effect of the abutments into consideration. In this study, five types of materials including three types of new-generation composite materials, a conventional composite material, and a ceramic material were used to examine the translucency (contrast ratio) of the materials and the effects of the colour of the abutments on the final appearance of metal-free crowns. It was found that the materials varied slightly from one-another in translucency and that it was possible to reproduce the desired colour when gold alloy was used for the background. However, it was difficult to produce an adequate colour match when silver-palladium alloy was used for the background. When a tooth colour material that was darker than the target colour was used for the abutment teeth, some materials could not reproduce the target colour satisfactorily.     

Fracture toughness comparison of three test methods with four dental porcelains.

OBJECTIVE: The aim of this study was to compare three fracture toughness test methods, using four commercial dental porcelains. MATERIALS AND METHODS: The fracture toughness test techniques involved were: the single-edge-notched beam (SENB), the indentation strength method (IS), and a rather convenient ASTM standard for advanced ceramics, which is still rarely used in dental ceramic research, the Chevron-notched beam method (CN). Duceram, Duceram LFC, Sintagon Zx and Carrara Vincent were chosen for study. Data was analyzed by two-way and paired ANOVA. RESULT: No statistical difference was found between the CN and SENB methods with four dental porcelains, but IS was not always in statistical agreement with SENB or CN. Statistical agreement among all three methods occurred only with Duceram LFC. CONCLUSION: The different test methods did not always lead to the same ranking or values of fracture toughness. Yet the toughness results of the SENB method were comparable to those of the CN method for all the four dental porcelains tested in this study.     

Study of wear of restorative materials and teeth-antagonists in vitro

Since clinical evaluation of wear turns out to be particularly time consuming, a standardized method was developed to model oral mastication. So-called artificial mouth was used to assess the extent of wear caused from different restorative materials in contact with bovine enamel. Ball heads manufactured from modern veneering ceramics, gold alloy, amalgam and resin composite materials were loaded with a contact load of 50 N for 200,000 chewing cycles. Additional thermo-cycling (5 degrees /55 degrees C) for 2,500 cycles was conducted in the artificial mouth. The worn surfaces, both on the material specimens and on the antagonist bovine enamel surfaces were volumetrically scanned under a laser microscope. Negligible wear rates were observed for the veneering ceramics and for the gold alloy. Most veneering ceramics as well as the resin composite materials caused low wear on the antagonist enamel surfaces. In contrast, the antagonist enamel was significantly damaged in contact with amalgam or some of the ceramic materials. However, modern veneering ceramics as well as gold alloys might be recommended in occlusally loaded contact with the antagonist enamel, whereas resin composite materials might be indicated for non load-bearing areas. Ceramics are contraindicated in case of bruxism.     

Dentin bonding of cements. The bonding of cements with dentin in combination with various indirect restorative materials

The number of both luting agents and restorative materials available on the market has rapidly increased. This study compared various types of luting agents when used to bond different indirect, laboratory restorative materials to dentin. Cylinders were produced of six restorative materials (gold alloy, titanium, feldspathic porcelain, leucite-glass ceramic, zirconia, and an indirect resin composite). Following relevant pretreatment, the end surface of the cylinders were luted to ground, human dentin with eight different luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37 °C for one week, the shear bond strength of the specimens was measured and the fracture mode was examined stereo-microscopically. Restorative material and luting agent both had a significant effect on bond strength and there was a significant interaction between the two variables. The zinc phosphate cement and the glass ionomer cements resulted in the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements.     

Retention of prefabricated and individually cast root canal posts in vitro

OBJECTIVES: The aim of the study was to evaluate the retention of prefabricated root canal posts made of a variety of materials that have recently been introduced into dentistry. MATERIALS AND METHODS: The posts studied were CosmoPost, Composipost carbon fibres, Composipost Aestheti-Plus, Composipost Light-Post and Para Post Fiber White. The posts were luted in extracted human premolars and the cores were built up with the resin composites recommended by the manufacturers. The retention of individually cast gold alloy posts luted with zinc-phosphate cement were used as reference. A universal testing machine was used to determine the retention of each cemented post Data were compared using ANOVA supplemented with Fisher's PLSD at a significance level of p < 0.05. RESULTS: Only the CosmoPost system exhibited retention values that were significantly lower than for the conventionally cast gold alloy posts luted with zinc-phosphate cement The force necessary to loosen the CosmoPost specimens was significantly less than that needed to loosen the Composipost. Estheti-Plus (p < 0.05) and the Composipost Ught-Post systems (p < 0.001]. The force necessary to loosen the ParaPost Fiber White specimens was significantly less than for the Composipost Light-Post system (p < 0.01). Other combinations did not differ significantly (p > 0.05). CONCLUSIONS: When zirconium oxide ceramic posts are luted with resin composites the bonding between the ceramic and resin composite seems to be weak. Further studies are thus necessary to achieve improved retention of all-ceramic root canal posts.     

The effect of veneering materials on stress distribution in implant-supported fixed prosthetic restorations

In this study, the effect of various materials used in fabricating superstructures for implant-retained fixed partial dentures on stress distribution around implant tissues was investigated. Five different mathematical models consisting of 11,361 nodes and 54,598 elements were constructed to study porcelain, gold alloy, composite resin, reinforced composite resin, and acrylic resin veneering materials using the 3-dimensional finite element analysis method. MARC K7.2/Mentat 3.2 software was used for the analysis. Reference points were determined on the cortical bone, where perpendicular, oblique, and horizontal forces were applied. Stress values created by oblique and horizontal forces appeared to be higher than those created by vertical forces. Stress seemed to be concentrated at the cortical bone around the cervical region of the implant. Gold alloy and porcelain produced the highest stress values in this region. Stresses created by acrylic resin and reinforced composite resin were 25% and 15% less, respectively, than porcelain or gold alloy. Porcelain and gold alloy produced stress values at the lingual implant sites that reached the ultimate strength values of the cortical bone.     

Wear evaluation of porcelain opposing gold, composite resin, and enamel

STATEMENT OF PROBLEM: When porcelain surfaces oppose gold and composite resin restorations as well as enamel, wear resistance and abrasiveness of the porcelain are clinical concerns to maintain the occlusal relationship. However, there is limited information on comparison of mutual wear rates when these materials oppose in 2-body and 3-body conditions. PURPOSE: The purpose of this study was to evaluate mutual wear rates of dental porcelain and opposing materials, including a gold alloy, a composite resin, and human enamel, using an in vitro wear test. MATERIAL AND METHODS: Mutual wear between high-fusing dental porcelain (Ceramco II) disks (9 x 5-mm thick) with a rough or smooth surface and opposing styli made of gold alloy, composite resin, or human enamel was evaluated in 2-body and 3-body conditions using a wear simulator (n=8). Wear depths (microm) of porcelain disks were determined using a profilometer. Wear depths (microm) of the opposing materials were obtained by converting the worn surface areas into wear depths using image-analysis software. All data were statistically analyzed by 3-way analysis of variance and Bonferroni-Dunn test (alpha=.05). The worn surfaces were observed by scanning electron microscope (SEM). RESULTS: The wear values for porcelain opposing composite resin or enamel in the 2-body condition were significantly greater than those in the 3-body condition, regardless of the surface condition of the porcelain (P<.001). For stylus specimens, all values in the 2-body condition were significantly greater than those in the 3-body condition, regardless of the surface condition of the opposing porcelain (P<.001). These results are supported by SEM observations of worn surfaces. CONCLUSION: The results of this study suggest that mutual wear rates, when porcelain opposes gold, composite resin, and enamel, are influenced by 2-body and 3-body wear conditions.     

Bonding of restorative materials to dentin with various luting agents

The aim was to compare eight types of luting agents when used to bond six indirect, laboratory restorative materials to dentin. Cylinders of the six restorative materials (Esteticor Avenir [gold alloy], Tritan [titanium], NobelRondo [feldspathic porcelain], Finesse All-Ceramic [leucite-glass ceramic], Lava [zirconia], and Sinfony [resin composite]) were ground and air-abraded. Cylinders of feldspathic porcelain and glass ceramic were additionally etched with hydrofluoric acid and were silane-treated. The cylinders were luted to ground human dentin with eight luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], and RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37°C for one week, the shear bond strength of the specimens (n=8/group) was measured, and the fracture mode was stereomicroscopically examined. Bond strength data were analyzed with two-factorial analysis of variance (ANOVA) followed by Newman-Keuls' Multiple Range Test (α=0.05). Both the restorative material and the luting agent had a significant effect on bond strength, and significant interaction was noted between the two variables. Zinc phosphate cement and glass ionomer cements produced the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements. Generally, the fracture mode varied markedly with the restorative material. The luting agents had a bigger influence on bond strength between restorative materials and dentin than was seen with the restorative material.