Feldspathic and Lithium Disilicate Onlays with a 2-Year Follow-Up: Split-Mouth Randomized Clinical Trial

Abstract The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.

Resumo O presente estudo é um estudo clínico prospectivo, controlado, randomizado e de longo curto prazo, com o objetivo de avaliar o desempenho clínico de restauraç ões adesivas cerâmica vítrea reforçada com dissilicato de lítio e cerâmica feldspática por um período de até 2 anos. Um total de 11 pacientes (7 mulheres, 4 homens; faixa etária: 18-60 anos, idade média: 39 anos) foram inseridas para este estudo. Cada paciente recebeu duas restaurações por grupo em um delineamento de boca dividida. LD: Onze onlays, realizados com cerâmica à base de dissilicato de lítio (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein); e FP: Onze onlays, realizados com cerâmica feldspática (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Os retornos foram realizados em 2 semanas (linha de base = R1), 1 ano (R2) e 2 anos (R3) após a cimentação, por três investigadores independentes, cegos e calibrados, usando espelhos, óculos de aumento, sondas e radiografias interproximais. Foram avaliadas a sensibilidade pós-operatória, cárie secundária, integridade marginal, descoloração marginal, correspondência de cores, rugosidade da superfície, integridade dentária e integridade da restauração. O teste de Friedman (95%) foi utilizado para determinar se havia uma diferença estatisticamente significante na comparação periódica dos parâmetros nas restaurações cerâmicas. Um total de 95,4% das restaurações estava clinicamente aceitável no retorno de 2 anos, sem diferença para qualquer parâmetro de avaliação para ambos os materiais cerâmicos. Com base nos dados de 2 anos, as restaurações CAD-CAM fabricados com cerâmica feldspática e à base de dissilicato de lítio apresentaram desempenho clínico semelhante.

Effect of glazing application side and mechanical cycling on the biaxial flexural strength and Weibull characteristics of a Y-TZP ceramic

Abstract Glaze application on monolithic zirconia (Y-TZP) can be a practical approach to improve the mechanical properties of this material. Objective Our study evaluated the effect of glazing side and mechanical cycling on the biaxial flexure strength (BFS) of a Y-TZP. Methodology Eighty sintered Y-TZP discs (Ø:12 mm; thickness: 1.2 mm - ISO 6872) were produced and randomly assigned into eight groups (n=10), according to the factors "glazing side" (control - no glazing; GT - glaze on tensile side; GC - glaze on compression side; GTC - glaze on both sides) and "mechanical aging" (non-aged and aged, A - mechanical cycling: 1.2×106, 84 N, 3 Hz, under water at 37°C). Specimens were subjected to BFS test (1 mm/min; 1,000 Kgf load cell) and fractured surfaces were analyzed by stereomicroscopy and SEM. Hsueh's rigorous solutions were used to estimate the stress at failure of glazed specimens. Two-way ANOVA, Tukey's test (5%), and Weibull analysis were performed. Results The "glazing side", "mechanical aging" and the interaction of the factors were significant (p<0.05). Groups GC (1157.9±146.9 MPa), GT (1156.1±195.3 MPa), GTC (986.0±187.4 MPa) and GTC-A (1131.9±128.9 MPa) presented higher BFS than control groups (Tukey, 5%). Hsueh's rigorous solutions showed that the maximum tensile stress was presented in the bottom of zirconia layer, at the zirconia/glaze interface. Weibull characteristic strength (σo) of the GC was higher than all groups (p<0.05), except to GT, GTC-A and GTC, which were similar among them. The fractography showed initiation of failures from zirconia the tensile side regardless of the side of glaze application and fatigue. Conclusion Glazing zirconia applied on both tensile and compression sides improves the flexural strength of Y-TZP, regardless the mechanical aging.

Reinforced glass-ceramics: parametric inspection of three-dimensional wear and volumetric loss after chewing simulation

Abstract The aim of this study was to investigate the three-dimensional wear, volumetric loss and surface roughness after chewing simulation of two glass ceramics. Lithium disilicate (LD, Emax CAD, Ivoclar) and Zirconia reinforced lithium silicate (ZLS, Vita Suprinity, Vita Zhanfabrick) discs (n=20/g) were scanned to obtain stereolithography (STL) files for each sample. All discs were submitted to chewing simulation with sliding configuration (30 N, 300,000 cycles, 6 mm and 1.7 Hz) with steatite as antagonist. The samples were then scanned again and the volume loss and the deepest defect depth was measured using the superimposed file from the baseline using three-dimensional digital parametric inspection software (GOM Inspect, Braunschweig, Germany). Surface roughness (Ra and Rz) was analyzed with a contact profilometer. Data were analyzed by one-way ANOVA and Tukey test (α=0.5%). ANOVA showed significant differences among the groups. Considering the ceramic volume loss, wear depth defect length and Rz roughness, LD (-22.09±5.57%; 0.80±0.06 µm; 3.08±1.02 µm) showed higher mean values than ZLS (-15.67±4.51%; 0.56±0.09 µm; 1.51±0.90 µm). Ra mean values were similar for both materials (p=0.064). All discs exhibited slight surface scratches along with the sliding direction with pitted wear patterns, while large cracks were observed on wear traces. These same areas can be identified in blue, overlapping the STL files before and after chewing simulation in inspection software. The linear reduction generated by sliding contact shows a graph with a similar wear pattern shape. ZLS was more resistant to wear than LD, with less volume loss and shallower surface defects.

Resumo O objetivo deste estudo foi investigar o desgaste tridimensional, perda volumétrica e rugosidade após a simulação de mastigação de dois materiais vitro-cerâmicos. Discos de dissilicato de lítio (LD, Emax CAD, Ivoclar) e silicato de lítio reforçado com zircônia (ZLS, Vita Suprinity, Vita Zhanfabrick) (n=20/g) foram confeccionados e digitalizados para obtenção de arquivos de estereolitografia (STL) de cada amostra. Todos os discos foram submetidos à simulação de mastigação com configuração deslizante (30 N, 300.000 ciclos, 6 mm e 1,7 Hz) com esteatita como antagonista. As amostras foram escaneadas novamente e a perda de volume e o defeito mais profundo foram medidos usando o arquivo sobreposto da linha de base através de um software de inspeção paramétrica digital e tridimensional (GOM Inspect, Braunschweig, Alemanha). A rugosidade superficial (Ra e Rz) foi avaliada através de rugosímetro de contato. Os resultados foram analisados por ANOVA 1-fator e teste Tukey (α=0,5%). ANOVA mostrou diferenças significantes entre os grupos. Considerando a perda de volume cerâmico, comprimento do defeito e rugosidade Rz, LD (-22,09±5,57%; 0,80±0,06 µm; 3,08±1.02 µm) apresentou valores médios superiores a ZLS (-15,67±4,51%; 0,56±0,09 µm; 1.51±0.90 µm). Todos os discos exibiram pequenos arranhões na superfície conforme a direção de deslizamento com padrões de desgaste, enquanto grandes ranhuras foram observadas nos traços de desgaste. Essas mesmas áreas podem ser identificadas em azul, sobrepondo os arquivos STL antes e depois da simulação de mastigação no software de inspeção. A redução linear gerada pelo contato deslizante mostra um gráfico com uma forma de padrão de desgaste semelhante. ZLS foi mais resistente ao desgaste do que LD, com menor perda de volume e menores defeitos superficiais.

The wear performance of glazed and polished full contour zirconia

Abstract This study evaluated the influence of zirconia surface finishes on the wear of an enamel analogue. 40 zirconia discs were divided into four groups: control (without finish); glazed; polished; polished and glazed. All samples were subjected to wear against steatite antagonists. The specimens underwent roughness, topographic, scanning electron microscopy (SEM) and wettability analyses. Quantitative wear measurements were performed on both steatites and discs. To measure wear of steatites the weight before and after the test and the diameter after the test were used. Profilometer measurements were performed to determine the wear on discs. Roughness, volumetric wear and mass loss were analyzed using the Kruskal-Wallis and Dunn tests (5%), while contact angle values were analyzed with One-way ANOVA and Tukey tests (5%). The polished group had the lowest roughness means, being statistically different from the other groups (p-value=0.0001). The glazed group presented the lowest steatite volumetric wear (p-value=0.0001), but not statistically different from the polished and glazed group, whereas these groups presented the highest zirconia volumetric wear, with statistically different (p-value=0.0002) compared to the others. SEM showed irregularities on the control groups surface, grooves on the polished group, and a homogeneous surface for the glazed group with a few pores. All groups presented contact angles lower than 90 degrees, characterizing hydrophilic surfaces. It can be concluded that just glazed zirconia caused less wear on the antagonist when compared to no finish and polished zirconia.

Resumo Este estudo avaliou a influência dos acabamentos superficiais da zircônia no desgaste de um análogo de esmalte. 40 discos de zircônia foram divididos em quatro grupos: controle (sem acabamento); glazeado; polido; polido e glazeado. Todas as amostras foram submetidas ao desgaste contra antagonistas de esteatita. Os espécimes foram submetidos à análise de rugosidade, topografia, microscopia eletrônica de varredura (MEV) e análise de molhabilidade. Medidas quantitativas de desgaste foram realizadas nos antagonistas e nos discos de zircônia. Para medir o desgaste das esteatitas, foi mensurado o peso antes e depois do desgaste e o diâmetro após o teste. A análise de perfilometria mensurou o desgaste dos discos. Rugosidade, desgaste volumétrico e perda de massa foram analisados pelos testes de Kruskal-Wallis e Dunn (5%), enquanto os valores de ângulo de contato foram analisados com os testes One-way ANOVA e Tukey (5%). O grupo polido apresentou as menores médias de rugosidade, sendo estatisticamente diferente dos demais grupos (p-valor=0,0001). O grupo glazeado apresentou o menor desgaste volumétrico do antagonista (p-valor=0,0001), mas não foi estatisticamente diferente do grupo polido e glazeado, enquanto que esses grupos apresentaram o maior desgaste volumétrico da zircônia, com diferença estatisticamente diferente (p-valor=0,0002) em comparação com os outros. MEV mostrou irregularidades na superfície do grupo controle, sulcos no grupo polido e uma superfície homogênea para o grupo glazeado, com poucos poros. Todos os grupos apresentaram ângulos de contato menores que 90 graus, caracterizando superfícies hidrofílicas. Dentro das limitações deste estudo in vitro, é possível concluir que zircônia glazeada causou menos desgaste ao antagonista quando comparada a zircônia sem tratamento ou polida. Além disso, não foi encontrada diferença no desgaste do antagonista para os grupos de zirconia polida e controle.

Can heat-pressed feldspathic ceramic be submitted to multiple heat-pressing?

Abstract The aim of this study was to determine if multiple processing (heat-pressing) of a dental ceramic influences flexural strength, hardness, and microstructure. Ninety bar-shaped specimens (15 mm × 4 mm × 2 mm) of a pressed ceramic (Vita PM9) were fabricated and randomly divided into 6 groups (n = 15) according to the factors "number of pressings" (C1, C2, and C3, fired 1, 2, and 3 times, respectively) and "mechanical cycling" (M). Half of the specimens were mechanically cycled (106 cycles, 45 N, 3.4 Hz, in water) and all specimens were tested for 3-point bending (0.5 mm/min, load 1000 kgf) and Vickers hardness (19.6 N for 20 s). X-ray diffraction was used to characterize the phases and scanning electron microscopy to characterize the microstructure. The flexural strength data was statistically analyzed with Weibull analysis, ANOVA, and Tukey test. Hardness data was evaluated by 2-way ANOVA and Fisher test. All tests were performed with a significance level of 0.05. Two-way ANOVA revealed that neither "number of pressings" (p=0.085) or "mechanical cycling" (0.055) significantly affected flexural strength. But Weibull analysis showed significant difference for Weibull moduli and characteristic strength between groups. For hardness, a statistical difference was seen for the interaction "Number of pressings * Mechanical cycling", (p = 0.016). Hardness decreased in the following order: C1 (775±17.2), CM3 (751±101), CM2 (735±45), C3 (701±82), CM1 (671±82), and C2 (663±92). Fewer defects were observed with an increased number of firings. Therefore, the possibility of recycling PM9 ceramic does not interfere in the evaluated mechanical properties and improves microstructure.

Bond strength between a polymer-infiltrated ceramic network and a composite for repair: effect of several ceramic surface treatments

Abstract: The effects of several ceramic surface treatments on bond strength of a polymer-infiltrated ceramic network and resin composite as repair material were evaluated. CAD-CAM blocks of a polymer-infiltrated ceramic network (Vita Enamic) were sliced and subjected to aging process, followed by embedding in acrylic resin. The bonding/repair area was treated as follows (n = 30): C- without treatment; UA- universal adhesive application; FM- 10% hydrofluoric acid and silane application; OM-airborne-particle abrasion with aluminum oxide and silane application; RP- tribochemical silica coating; and CA- surface grinding and application of universal adhesive. Composite resin cylinders were made on the treated surface. Specimens from each group were assigned randomly to two subgroups (n = 15) considering storage condition: Baseline (shear tests after 48 hours) or Storage (tests after 6 months under distilled water). The treated surfaces were analyzed by goniometry, roughness, and SEM. Two-way ANOVA and 1-way ANOVA were applied to analyze the bond data and roughness / contact angle data, respectively, followed by Tukey's test (α = 5%). Surface treatments and storage conditions affected bond strengths (p < 0.01). Surface grinding (CA) followed by universal adhesive promoted the highest value of bond strength (14.5 ± 4.8 MPa for baseline, 8.5 ± 3.4 MPa for storage) and the roughest ceramic surface. Grinding with silicon carbide paper (simulating diamond bur) followed by the application of a universal adhesive system is the best option for repairing fractures of the polymer-infiltrated ceramic network.

Effect of several repair techniques on the bond strength between composite resin and degraded Y-TZP ceramic / Efeito de várias técnicas de reparo na resistência de união entre resina composta e zircônia degradada

Objective: To evaluate the bond strength of different repair treatments for composite resin to aged Y-TZP ceramics. Material and Methods: Zirconia blocks were cut into smaller specimens, sintered according to manufacturer's recommendations (final dimensions of 4×4×3 mm), and randomly allocated into nine groups (n=15) according to the surface treatment and presence/ absence of aging of the substrate (subjected to lowtemperature degradation - LTD), as follows: without LTD (Control: without treatment; TBS: tribochemical silica coating + silane + adhesive); with LTD (Control-LTD: without treatment; TBS-LTD: TBS with hydrothermal degradation; MoS-LTD: Monobond S + adhesive; MoPLTD: Monobond Plus + adhesive; MZP-LTD: Metal/ Zirconia Primer + adhesive; USB-LTD: Single Bond Universal; AP-LTD: Alloy primer + adhesive). LTD was simulated in an autoclave (134 °C, 2 bar, 5 h). The ceramic blocks were embedded in PVC cylinders with a self-curing acrylic resin; each surface treatment protocol was performed; a composite resin cylinder ( : 3.25 mm and height: 3 mm) was then build-up using split metallic matrices. All the specimens were aged (thermocycling + storage in water for 90 days) and subjected to the shear bond strength test using a universal testing machine (1 mm/min). The failure mode was classified into four types: adhesive, composite resin cohesive fracture, ceramic cohesive fracture, and mixed. The bond strength values were subjected to Mann­Whitney test. Results: Only air-abraded samples (TBS and TBS­LTD) survived thermocycling. More than 80% of the samples of the other groups presented pre-test failures. TBS groups presented higher values of bond strength (3.94) compared to TBSLTD (0.96). The predominant type of failure for the surviving samples were adhesive. Conclusion: Air particle abrasion is mandatory to improve the bond strength of the Y-TZP substrate; an aged substrate presents an even more unfavorable scenario for adhesion. (AU)

Objetivo: Avaliar a resistência de união ao cisalhamento gerada por diferentes técnicas de reparo em resina composta aderida em zircônia envelhecida (sujeita a degradação a baixa temperatura - LTD). Material e Métodos: blocos de zircônia foram seccionados em espécimes, sinterizados de acordo com o fabricante (dimensões finais de 4x4x3 mm), e aleatorizados em nove grupos (n=15) de acordo com o tratamento de superfície e presença/ausência de envelhecimento do substrato (LTD), conforme: sem LTD (Control: sem tratamento; TBS: tribosilicatização + silano + adesivo); com LTD (Control-LTD: Monobond S + adesivo; MoP-LTD: Monobond plus + adesivo; MZPLTD: Meta/Zirconia primer + adesivo). LTD foi simulada em autoclave (134 °C, 2 bar, 5 h). Os blocos de cerâmica foram embutidos em cilindros de PVC com resina acrílica autopolimerizável; cada tratamento de superfície foi realizado; um cilindro de resina composta ( : 3,25 mm 3 mm de altura) foi confeccionado usando matrizes metálicas bipartidas. Todos os espécimes foram envelhecidos (termociclagem + armazenagem em água por 90 dias) e sujeitos ao teste de cisalhamento usando um equipamento de teste universal (1 mm/ min). O modo de falha foi classificado em quatro grupos: adesivo, fratura coesiva em resina composta, fratura coesiva da cerâmica, e mista. Os valores de adesão foram sujeitos ao teste de Mann-Whitney. Resultados: somente as amostras jateadas (TBS e TBSLTD) sobreviveram a termociclagem. Mais que 80% dos espécimes dos outros grupos apresentaram falhas préteste. Os grupos TBS apresentaram os maiores valores de resistência ao cisalhamento (3,94) comparado com TBS-LTD (0,96). Os tipos predominantes de falha para os espécimes sobreviventes foi adesiva. Conclusão: o jateamento é recomendável para aumentar a resistência adesiva à zircônia; um substrato envelhecido apresenta um cenário mais desfavorável de adesão. (AU)

Antimicrobial and mechanical acrylic resin properties with silver particles obtained from Fusarium oxysporum / Propriedades antimicrobiana e mecânica de resina acrílica com partículas de prata obtidas a partir de Fusarium oxysporum

Objective: This study evaluated the effects of the incorporation of silver nanoparticles (AgNPs) obtained from Fusarium oxysporum on heat-activated acrylic resin (HAAR) and their influence on resin's surface roughness, hardness, color alteration and antimicrobial capacity against Candida albicans. Material and Methods: For this, 50 discs of HAAR (2x5 mm) were produced and divided into three groups, Control: HAAR; Ag1: HAAR plus 0.539 mg of AgNPs; and Ag2: HAAR plus 1.1 mg of AgNPs. Knopp hardness (HK), surface roughness (Ra and Rz) and color alteration according to the CIE Lab were measured. Specimens were then evaluated in vitro with regard to C. albicans biofilm formation through formed colony count (CFU/mL). Scanning Electron Microscopy (SEM) and Atomic force microscopy (AFM) analyses were performed. Results: The addition of AgNPs of both concentrations changed Ra, Rz and HK significantly. There was statistically significant difference for L (p=0.00); a*(p=0.00) and b*(p=0.00) parameters. There were no differences between Ag1 and Ag2 biofilm formation, but the comparison of both with the control group presented a significant reduction (p=0.0091) on biofilm formation. SEM and AFM images showed no signs of NPs clustering. Conclusion: It can be concluded tha AgNPs incorporation in HAAR was effective in reducing C. albicans activity, with a slight change in color and hardness of the material, being effective therefore, in regions such as the dental prostheses palate, which have lesser aesthetic appeal. (AU)

Objetivo: Este estudo avaliou os efeitos da incorporação de nanopartículas de prata (AgNPs) obtidas a partir de Fusarium oxysporum em resina acrílica ativada termicamente (RAAT) e sua influência na rugosidade, dureza, cor e capacidade antimicrobiana contra Candida albicans. Material e Métodos: Para isso, 50 discos de RAAT (2x5 mm) foram produzidos e divididos em três grupos, Controle: RAAT; Ag1: RAAT com 0,539 mg de AgNPs; e Ag2: RAAT com 1,1 mg de AgNPs. Foram medidas a dureza Knopp (DK), a rugosidade superficial (Ra e Rz) e a alteração da cor de acordo com o sistema CIE Lab. As amostras foram então avaliadas in vitro em relação à formação de biofilme de C. albicans através da contagem de unidades formadoras de colônia (UFC / mL). Foram realizadas análises de Microscopia Eletrônica de Varredura (MEV) e Microscopia de Força Atômica (AFM). Resultados: A adição de AgNPs de ambas as concentrações alterou significativamente Ra. Rz e DK. Houve diferença estatisticamente significativa para os parâmetros L (p = 0,00); a * (p = 0,00) e b * (p = 0,00). Não houve diferenças entre a formação de biofilme Ag1 e Ag2, mas a comparação entre ambos com o grupo controle apresentou redução significativa (p = 0,0091) na formação de biofilmes. As imagens de MEV e AFM não mostraram sinais de agrupamento de NPs. Conclusão: Pode-se concluir que a incorporação de AgNP no RAAT foi eficaz na redução da atividade de C. albicans, com uma discreta alteração na cor e dureza do material, sendo efetiva, portanto, em regiões linguais de próteses dentárias, que possuem menor apelo estético. (AU)

Effects of porcelain thickness on the flexural strength and crack propagation in a bilayered zirconia system

Abstract Objective: This study evaluated the influence of porcelain (VM9, VITA Zahnfabrik, Germany) thickness on the flexural strength and crack propagation in bilayered zirconia systems (YZ, VITA Zahnfabrik, Germany). Material and Methods: Thirty zirconia bars (20.0x4.0x1.0 mm) and six zirconia blocks (12.0x7.5x1.2 mm) were prepared and veneered with porcelain with different thickness: 1 mm, 2 mm, or 3 mm. The bars of each experimental group (n=10) were subjected to four-point flexural strength testing. In each ceramic block, a Vickers indentation was created under a load of 10 kgf for 10 seconds, for the propagation of cracks. Results: The results of flexural strength were evaluated by One-way ANOVA and Tukey's test, with a significance level of 5%. The factor "thickness of the porcelain" was statistically significant (p=0.001) and the l-mm group presented the highest values of flexural strength. The cracks were predominant among the bending specimens with 1 and 2 mm of porcelain, and catastrophic failures were found in 50% of 3-mm-thick porcelain. After the indentation of blocks, the most severe defects were observed in blocks with 3-mm-thick porcelain. Conclusion: The smallest (1 mm) thickness of porcelain on the zirconia infrastructure presented higher values of flexural strength. Better resistance to defect propagation was observed near the porcelain/ zirconia interface for all groups. Higher flexural strength was found for a thinner porcelain layer in a bilayered zirconia system. The damage caused by a Vickers indentation near and far the interface with the zirconia shows that the stress profiles are different.

Effect of ceramic thickness, grinding, and aging on the mechanical behavior of a polycrystalline zirconia

Abstract Monolithic restorations of Y-TZP have been recommended as a restorative alternative on prosthetic dentistry as it allows a substantial reduction of ceramic thickness, which means a greater preservation of tooth structure. However, the influence of grinding and aging when using a thinner layer of the material is unclear. This investigation aimed to evaluate and compare the effects of ceramic thickness (0.5 mm and 1.0 mm), grinding and aging (low-temperature degradation) on the mechanical behavior and surface characteristics of a full-contour Y-TZP ceramic. Y-TZP disc-shaped specimens (15 mm diameter) were manufactured with both thicknesses and randomly assigned into 4 groups considering the factors 'grinding with diamond bur' and 'aging in autoclave'. Surface topography (roughness, 3D profilometry and SEM), phase transformation, flexural strength and structural reliability (Weibull) analyses were executed. Grinding affected the surface topography, while aging did not promote any effect. An increase in m-phase content was observed after grinding and aging, although different susceptibilities were observed. Regardless of zirconia's thickness, no deleterious effect of grinding or aging on the mechanical properties was observed. Thus, in our testing assembly, reducing the thickness of the Y-TZP ceramic did not alter its response to grinding and low temperature degradation and did not impair its mechanical performance.

Bonding of the Polymer Polyetheretherketone (PEEK) to Human Dentin: Effect of Surface Treatments

Abstract Polyetheretherketone (PEEK) is a material suitable for frameworks of fixed dental prostheses. The effect of different surface treatments on the bond strength of PEEK bonded to human dentin was evaluated. One hundred PEEK cylinders (3 mm×3 mm) were divided into five groups according to surface treatment: silica coating, sandblasting with 45 μm Al2O3 particles, etching with 98% sulfuric acid for 5, 30 and for 60 s. These cylinders were luted with resin cement onto 50 human molars. First, each tooth was embedded in epoxy resin and the buccal dentin surface was exposed. Then, two delimited dentin areas (Æ:3 mm) per tooth were etched with 35% phosphoric acid and bonded with a two-step self-priming adhesive system. After the luting procedure the specimens were stored in water (24 h/37 °C). Shear bond strength (SBS) was tested using a universal testing machine (crosshead speed 0.5 mm/min; load cell 50 kgf) and failure types were assessed. Stress data (MPa) were analyzed using the Kruskal-Wallis test. Comparison of the proportions of different failure types was performed using the Bonferroni method (p<0.05). Kruskal-Wallis demonstrated that differences among groups were not significant (p=0.187). Mean SBS were as follows: silica coating, 2.12±1.12 MPa; sandblasting, 2.37±0.86 MPa; sulfuric acid 5 s, 2.28±1.75 MPa; sulfuric acid 30 s, 1.80±0.85 MPa; sulfuric acid 60 s, 1.67±0.94 MPa. Adhesive and mixed failures were predominant in all groups. Both physical and chemical surface treatments produced adhesion between PEEK, resin cement and dentin.

Resumo O poli-éter-éter-cetona (PEEK) é um material indicado para as estruturas de próteses parciais fixas. O efeito de diferentes tratamentos de superfície na resistência de união entre PEEK e dentina humana foi avaliado. Cem cilindros de PEEK (3 mm×3 mm) foram divididos em cinco grupos de acordo com tratamento de superfície: silicatização, jateamento com partículas de Al2O3 45 µm, condicionamento com ácido sulfúrico 98% por 5, 30 e 60 s. Esses cilindros foram cimentados com cimento resinoso em cinquenta molares humanos. Primeiro, cada dente foi incluído em resina epóxica e a superfície dentinária vestibular foi exposta. Depois, duas áreas (Æ:3 mm) em dentina/por dente foram delimitadas, condicionadas com ácido fosfórico a 35% e receberam aplicação de um sistema adesivo de dois passos. Após o procedimento de cimentação, as amostras foram armazenadas em água (24 h/37 °C). A resistência da união ao cisalhamento (SBS) foi testada em uma máquina universal de ensaios (velocidade 0,5 mm/min; célula de carga 50 kgf), e foram avaliados os tipos de falha. Os dados de tensão (MPa) foram analisados pelo teste de Kruskal-Wallis. A comparação das percentagens de diferentes tipos de falha foi realizada utilizando o método de Bonferroni (p<0,05). O teste de Kruskal-Wallis demonstrou que as diferenças entre os grupos não foram significantes (p=0,187). As médias de SBS foram: silicatização, 2,12±1,12 MPa; jateamento, 2,37±0,86 MPa; ácido sulfúrico por 5 s, de 2,28±1,75 MPa; ácido sulfúrico por 30 s, 1,80±0,85 MPa, ácido sulfúrico por 60 s, 1,67±0,94 MPa. Falhas adesivas e mistas foram predominantes em todos os grupos. Ambos tratamentos de superfície, físicos e químicos, promoveram adesão entre PEEK, cimento resinoso e dentina.

Low-Fusing Porcelain Glaze Application on 3Y-TZP Surfaces can Enhance Zirconia-Porcelain Adhesion

Abstract The aim of this study was to assess whether surface treatment improves zirconia-porcelain adhesion. The 3Y-TZP blocks were cut into squares, then polished and sintered. The zirconia surface treatments were performed as follows: no treatment (C); tribochemical silica coating (TBS); glaze application + hydrofluoric acid etching (GA); glaze application + hydrofluoric acid etching + silanization (GAS); deposition of silica nanofilm (NF). After treatments, veneering porcelain cylinders (3.3 x 3.3 mm) were built up on all specimens and fired. Then the specimens were subjected to thermal cycling (6000 cycles), and subjected to shear test. Fractures were analyzed by stereomicroscopy and SEM. Data were statistically analyzed by 1-way ANOVA and Tukey's test (5%). Zirconia-porcelain bond strength was affected by the ceramic surface treatments (p=0.0001). GA (19.5±3 MPa) and GAS (16.2±4 MPa) recorded the highest bond strength values, while control group had the lowest bond value (10.1±4 MPa). Adhesive failure of the samples predominated. Therefore, glaze application as 3Y-TZP treatment before veneering porcelain stratification may enhance zirconia-porcelain adhesion.

Resumo O objetivo do estudo foi avaliar o efeito de tratamentos de superfície para melhora a união entre zircônia-porcelana. Os materiais testados foram 3Y-TZP e VM9. Os blocos de 3Y-TZP foram cortados em quadrados, polidos e sinterizados. Os tratamentos de superfície foram: Rocatec soft e aplicação de silano (TBS), vitrificação e ácido fluorídrico (GA), vitrificação, ácido fluorídrico e aplicação de silano (GAS), deposição de nanofilme de sílica (NF) e ausência de tratamento (C). Após os tratamentos, cilindros de porcelana foram construídos sobre as amostras e sinterizados. Após a sinterização da porcelana, todas as amostras foram submetidas a ciclos térmicos (6000 ciclos). Em seguida, os espécimes foram acoplados em uma máquina de ensaio universal e foi realizado o teste de micro cisalhamento a uma velocidade de 1,0 mm/min. As fraturas foram analisadas por estereomicroscópio e MEV. Os dados foram submetidos à ANOVA 1fator e teste de Tukey (5%). A resistência de união zircônia-porcelana foi afetado pelos tratamentos de superfície de cerâmica (p=0,0001). GA e GAS registraram os maiores valores de resistência de união, os valores mais baixos de resistência de união foram observados no grupo C (ausência de tratamento) (19,5 ± 3a, 16,2 ± 4ab e 10,1 ± 4c respectivamente). Houve predominância de falhas adesivas. Portanto, a vitrificação pode ser considerada uma opção para aumentar a resistência de união entre zircônia-porcelana.

Effect of composite surface treatment and aging on the bond strength between a core build-up composite and a luting agent

Objective The purpose of this study was to assess the influence of conditioning methods and thermocycling on the bond strength between composite core and resin cement. Material and Methods Eighty blocks (8×8×4 mm) were prepared with core build-up composite. The cementation surface was roughened with 120-grit carbide paper and the blocks were thermocycled (5,000 cycles, between 5°C and 55°C, with a 30 s dwell time in each bath). A layer of temporary luting agent was applied. After 24 h, the layer was removed, and the blocks were divided into five groups, according to surface treatment: (NT) No treatment (control); (SP) Grinding with 120-grit carbide paper; (AC) Etching with 37% phosphoric acid; (SC) Sandblasting with 30 mm SiO2 particles, silane application; (AO) Sandblasting with 50 mm Al2O3 particles, silane application. Two composite blocks were cemented to each other (n=8) and sectioned into sticks. Half of the specimens from each block were immediately tested for microtensile bond strength (µTBS), while the other half was subjected to storage for 6 months, thermocycling (12,000 cycles, between 5°C and 55°C, with a dwell time of 30 s in each bath) and µTBS test in a mechanical testing machine. Bond strength data were analyzed by repeated measures two-way ANOVA and Tukey test (α=0.05). Results The µTBS was significantly affected by surface treatment (p=0.007) and thermocycling (p=0.000). Before aging, the SP group presented higher bond strength when compared to NT and AC groups, whereas all the other groups were statistically similar. After aging, all the groups were statistically similar. SP submitted to thermocycling showed lower bond strength than SP without thermocycling. Conclusion Core composites should be roughened with a diamond bur before the luting process. Thermocycling tends to reduce the bond strength between composite and resin cement. .

Surface agents' influence on the flexural strength of bilaminated ceramics

The objective of this study was to evaluate the influence of different surface agents on the flexural strength of a ceramic system. Eighty bar-shaped specimens of zirconia were divided into four groups according to the agent to be used: group Control - to be cleaned with alcohol; group VM9 - application of a fluid layer of porcelain; group Effect Bonder - application of a bonding agent; and group Coloring Liquid - application of coloring liquid. All specimens received the porcelain application by the layering technique and were then subjected to thermocycling. The four-point bending test was performed to calculate the strength values (σ, MPa) and the failure modes were classified. ANOVA did not detect significant differences among the groups. The Weibull modulus were 5 (Control, VM9 and Effect Bonder) and 6 (Coloring Liquid). The cracking of the porcelain ceramic toward the interface was the predominant failure mode. It was concluded that the surface agents tested had no effect on the flexural strength of the bilaminated ceramic specimens.

Efeitos do suco de laranja e da molhabilidade da cerâmica sobre a formação do in situ / The effects of orange juice and ceramic wettability on in situ biofi lm formation

Este estudo procurou determinar os parâmetros do biofilme formado in situ, em cerâmica de revestimento, de acordo com a disponibilidade de carboidrato (suco de laranja) e a molhabilidade da superfície cerâmica. Discos de duas cerâmicas foram feitos (Vita VM7 e VM13, Vita Zahnfabrik, Bad Sackingen, Alemanha). Quatro discos foram aderidos a dispositivos palatais usados por oito voluntários. Colocou-se três gotas da água destilada (pH=6) ou suco de laranja (pH=3,5) sobre os discos oito vezes/dia. Após 48 horas in situ, os dois discos mais palatais foram removidos do dispositivo e analisados com microscopia confocal de varredura a laser (MCVL) para caracterização do biofilme (espessura média, μm e biovolume, μm3/μm2). O ângulo de contato (°) foi medido nas superfícies polidas de espécimes controle, e após 15 dias de uso nos espécimes da região frontal do dispositivo palatal. Os dados foram submetidos à estatística descritiva e inferencial (Mann-Whitney e teste t, p < 0,05). A molhabilidade de ambas as cerâmicas não diferiu estatisticamente. A formação do biofilme sobre as cerâmicas de revestimento não foi influenciada pelo suco de laranja ou pela molhabilidade da cerâmica...

This study aimed to determine the in situ biofilm parameters on veneering ceramics, according to the carbohydrate (orange juice) availability and the ceramic surface wettability. Disks were made out of two veneering ceramics (Vita VM7 and VM13, Vita Zahnfabrik, Bad Sackingen, Alemanha). Four disks were bonded to palatal devices worn by eight volunteers. The subjects dripped three drops of distilled water (pH=6) or orange juice (pH=3.5) on the disks 8x/day. After 48 h in situ, the two palatal disks were removed from the device and analyzed by Confocal Laser Scanning Microscopy (CLSM) for biofilm characterization (mean thickness, μm and biovolume, μm3/ μm2). The contact angle (°) was measured on the polished surfaces of as sintered specimens and after 15 day of in situ usage, on the frontal disks of the palatal device. The data were subjected to descriptive and inferential (Mann-Whitney and paired-t test, at p < 0.05) statistics. The biofi lm parameters of VM13 were not measurable, whereas the VM7 biofilm parameters were not signifi cantly affected by the type of liquid. The wettability of both ceramics also did not differ statistically. The biofi lm formation on the veneering ceramics was neither influenced by the orange juice dripping nor the ceramics’ wettability...

Caracterização in vitro de um novo sistema de resina composta de laboratório / In vitro characterization of a new laboratory composite resin

Objetivo: este estudo caracterizou algumas propriedades de uma resina composta de processamento laboratorial (Resilab, Wilcos do Brasil), indicada para confecção de coroas com e sem metal, pontes anteriores e posteriores, inlays, onlays e facetas laminadas. Metodologia: as propriedades avaliadas foram rugosidade superficial, dureza, resistência à flexão, resistência adesiva a três ligas metálicas (Au, NiCr e CoCr) e microinfiltração da interface resina/metal. Todos os espécimes foram submetidos a dois ciclos de polimerização, conforme instruções do fabricante. Dez espécimes circulares (4x3 mm) foram preparados para os testes de dureza (VHN) e rugosidade superficial (Ra). A resistência flexural em três pontos (MPa) foi medida a partir de espécimes retangulares (10x5x2 mm), sob velocidade de 1 mm/min. Os ensaios que envolveram ligas metálicas (resistência adesiva e microinfiltração) foram submetidos à análise estatística (p<0,05) (Anova, Tukey, Kruskal-Wallis). Resultados: não houve diferenças entre as médias de resistência de união. Quanto à infiltração marginal, o grupo CoCr diferiu dos grupos Au e NiCr em espécimes sem retenção mecânica e submetidos a ciclagem térmica. Conclusão: considerando os resultados deste estudo in vitro e a literatura pesquisada, o sistema Resilab mostrou comportamento satisfatório quanto às propriedades estudadas. A resistência de união não dependeu da liga metálica utilizada.

Aim: this study aimed to determine some of the properties of a laboratory composite indicated for metallic and non-metallic crowns, anterior and posterior bridges, inlays, onlays and laminate veneers. Methology: the properties evaluated were surface roughness, flexural strength, shear bond strength to three metal alloys and the microleakage at the composite/ metal interface. All specimens were subjected to cycles of polymerization, according the manufacturer instructions. Ten round specimens (4x3 mm) were prepared for hardness (VHN) and surface roughness tests (Ra). The three-point flexural strength was measured on rectangular shaped specimens (10x5x2 mm), at 1 mm/min speed. The experiments involving dental alloys (bond strength and microleakage) were submitted to statistical analysis (p<0, 05) (Anova, Tukey, Kruskal-Wallis). Results: there were no statistically significant diferences between the bond strength means. As for the marginal leakage, the CoCr group differed of the Au and NiCr groups in specimens without mechanical retention and subjected to thermocycling. Conclusion: according to our results and the literature search, the Resilab system showed satisfactory performance regarding the properties evaluated. The bond strength was not dependable on the metal alloy used.

The adhesive system and root canal region do not influence the degree of conversion of dual resin cement

OBJECTIVES: The aim of this study was to evaluate the influence of two adhesive systems and the post space region on the degree of conversion of dual resin cement and its bond strength to root dentin. MATERIAL AND METHODS: One three-step etch-and-rinse (All-bond 2, Bisco) and another one-step self-etch (Xeno III, Dentsply) adhesive systems were applied on 20 (n=10) crownless bovine incisors, at 12-mm-deep post space preparation, and a fiber post (DT Light Post, Bisco) was cemented using a dual cure resin cement (Duo-Link, Bisco). Three transverse sections (3 mm) were obtained, being one from each study region (cervical, middle and apical). The degree of conversion of the dual cure resin cement was determined by a micro-Raman spectrometer. The data ( percent) were submitted to repeated-measures analysis of variance and Tukey's test (p<0.05). RESULTS: For both groups, the degree of conversion means ( percent) (All bond 2cervical = 69.3; All bond 2middle = 55.1; All bond 2apical= 56; Xeno III cervical = 68.7; Xeno IIImiddle = 68.8; Xeno III apical = 54.3) were not significantly different along the post space regions (p<0.05). CONCLUSION: Neither the adhesive nor the post space region influenced the degree of conversion of the cement layer.

Bond strength durability of self-etching adhesives and resin cements to dentin

OBJECTIVES: To evaluate the microtensile bond strength (µTBS) of one- (Xeno III, Dentsply) and two-step (Tyrian-One Step Plus, Bisco) self-etching adhesive systems bonded to dentin and cemented to chemically cured (C&B Metabond) or light-cured paste of a dual-cure resin cement (Variolink II, Ivoclar) within a short (24 h) and long period of evaluation (90 days). MATERIAL AND METHODS: Forty recently extracted human molars had their roots removed and their occlusal dentin exposed and ground wet with 600-grit SiC paper. After application of one of the adhesives, the resin cement was applied to the bonded surface and a composite resin block was incrementally built up to a height of 5 mm (n=10). The restored teeth were stored in distilled water at 37ºC for 7 days. The teeth were then cut along two axes (x and y), producing beam-shaped specimens with 0.8 mm² cross-sectional area, which were subjected to µTBS testing at a crosshead speed of 0.05 mm/min and stressed to failure after 24 h or 90 days of storage in water. The µTBS data in MPa were subjected to three-way analysis of variance and Tukey's test (α= 0.05). RESULTS: The interaction effect for all three factors was statistically significant (three-way ANOVA, p<0.001). All eight experimental means (MPa) were compared by the Tukey's test (p<0.05) and the following results were obtained: Tyrian-One Step Plus /C&B/24 h (22.4±7.3); Tyrian-One Step Plus /Variolink II/24 h (39.4±11.6); Xeno III/C&B/24 h (40.3±12.9); Xeno III/Variolink II/24 h (25.8±10.5); Tyrian-One Step Plus /C&B/90 d (22.1±12.8) Tyrian-One Step Plus/VariolinkII/90 d (24.2±14.2); Xeno III/C&B/90 d (27.0±13.5); Xeno III/Variolink II/90 d (33.0±8.9). CONCLUSIONS: Xeno III/Variolink II was the luting agent/adhesive combination that provided the most promising bond strength after 90 days of storage in water.

Influência de sistemas adesivos e da região do dente na durabilidade da união entre dentina e pino de fibra / Effects of bonding agents and tooth region on the bonding durability between dentin and fiber post

Esse estudo avaliou a performance de dois adesivos com condicionamento acido prévio (All-Bond 2 e One-step Plus - Bisco) e dois sistemas adesivos autocondicionantes (Clearfil SEBond- Kuraray e Xeno III- Dentsply) quanto a resistência de união a dentina coronária e do canal radicular, penetração do adesivo na dentina desmineralizada e influencia sobre o grau de conversão do cimento resinoso. Também foi determinada, com mecânica da fratura, a tenacidade da interface pino/cimento/dentina formada com o adesivo All-Bond 2. O canal radicular de 80 dentes humanos anteriores superiores foi instrumentado e, em seguida, preparado com brocas do sistema de pinos FRC Postec (Ivoclar). A dentina foi tratada com um dos sistemas adesivos e o pino foi cimentado com cimento Duo-link (Bisco). Oito grupos foram formados de acordo com o sistema adesivo e o tempo de armazenagem em saliva artificial (7 d ou 4 m). Seis secções transversais (~1,0 mm) foram obtidas das regiões compreendidas entre 4 mm acima da JEC ate 4mm do ápice radicular, isto e, dentina coronária e do canal radicular. Tres destas seis secções foram submetidas ao teste de pushout em máquina de ensaio universal Instron (1 mm/min, 50 Kgf). Nas secções restantes foram avaliados o grau de conversão do cimento e a penetração do adesivo na dentina com μ-Espectroscopia Raman. As amostras de tenacidade consistiram de dois hemi-discos de resina reforçada por fibra (pino) cimentados a duas fatias de dentina da câmara pulpar, formando um sanduíche (espécime Brazil nut). Os resultados do teste Anova 3-fatores de medida repetida (p<0.05) indicam que, apenas, a “região” exerceu efeito significante sobre a resistência de união (MPa). Na porção coronária (4,20 MPa) a resistência foi maior que nas regiões média (3,45 MPa) e apical (3,26 MPa) (Tukey, 5%). A tenacidade de fratura da interface cimento-dentina foi maior que a da interface cimento-pino....

Adhesive cementation of zirconia posts to root dentin: evaluation of the mechanical cycling effect

This study evaluated the effect of mechanical cycling on the bond strength of zirconia posts to root dentin. Thirty single-rooted human teeth were transversally sectioned to a length of 16 mm. The canal preparation was performed with zirconia post system drills (CosmoPost, Ivoclar) to a depth of 12 mm. For post cementation, the canals were treated with total-etch, 3-steps All-Bond 2 (Bisco), and the posts were cemented with Duolink dual resin cement (Bisco). Three groups were formed (n = 10): G1 - control, no mechanical cycling; G2 - 20,000 mechanical cycles; G3 - 2,000,000 mechanical cycles. A 1.6-mm-thick punch induced loads of 50 N, at a 45° angle to the long axis of the specimens and at a frequency of 8 Hz directly on the posts. To evaluate the bond strengths, the specimens were sectioned perpendicular to the long axis of the teeth, generating 2-mm-thick slices, approximately (5 sections per teeth), which were subjected to the push-out test in a universal testing machine at a 1 mm/min crosshead speed. The push-out bond strength was affected by the mechanical cycling (1-way ANOVA, p = .0001). The results of the control group (7.7 ± 1.3 MPa) were statistically higher than those of G2 (3.9 ± 2.2 MPa) and G3 (3.3 ± 2.3 MPa). It was concluded that the mechanical cycling damaged the bond strength of zirconia posts to root dentin.