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OBJECTIVE@#To evaluate the effects of different edge compensation angles on the fracture strength of multilayer zirconia all-ceramic crowns and traditional uniform zirconia all-ceramic crowns.@*METHODS@#The resin tooth preparation specimen of the mandibular first molar with a knife-edge was fabricated. A 3D digital model of the specimen was obtained by scanning it with a 3D dental model scanner. The 3D digital model was imported into computer aided design (CAD) software, and three 3D digital models of the full crown with the same surface shape are designed with the edge compensation angles of 30°, 45° and 60°, respectively. Then, the designed 3D digital model is imported into computer aided manufacturing (CAM) software. Three kinds of multilayer and homogeneous zirconia all-porcelain crowns with different edge compensation angles were fabricated, 10 each for a total of 60. The fracture load of each crown was measured under the electronic universal testing machine.@*RESULTS@#Fracture load of multilayer and uniform zirconia all-ceramic crowns, (4 322.86±610.07) N and (5 914.12±596.80) N in the 30° group, (5 264.82±883.76) N and (5 220.83±563.38) N in the 45° group and (4 900.42±345.41) N and (5 050.22±560.24) N in the 60° group, respectively. The fracture load of multi-layer zirconia all-ceramic crowns in the 30° group was significantly lower than that of homogeneous zirconia all-ceramic crowns(P < 0.05); there was no statistical significance in 45° group and 60° group(P>0.05). In the multi-layer zirconia all-ceramic crowns: the fracture load of the 30° group was significantly lower than that of the 45° group (P < 0.05); there was no significant difference between the 30° group and the 60° group, the 45° group and the 60° group (P>0.05).In uniform zirconia full crown group: the 30° group was higher than the 45° group, the 30° group was higher than the 60° group (P < 0.05), and there was no significant difference between the 45° group and the 60° group (P>0.05).@*CONCLUSION@#The fracture loads of three kinds of uniform and multilayer zirconia all ceramic crowns with different edge compensation angles can meet the clinical requirements. A smaller edge compensation angle is recommended when using traditional zirconia all-ceramic crowns, while 45° is recommended when using multi-layer zirconia all-ceramic crowns.
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Ceramics , Computer-Aided Design , Crowns , Dental Porcelain , Dental Prosthesis Design , Dental Restoration Failure , Dental Stress Analysis , Flexural Strength , Materials Testing , ZirconiumABSTRACT
Objective@#To evaluate the clinical efficacy of CAD/CAM glass-ceramic onlays in molars with complicated oblique crown fracture within 3.0 mm subgingival. @*Methods@#Fifty-six molars from 56 patients with complicated oblique crown fracture within 3.0 mm subgingival were recruited after endodontic treatment and divided into 2 groups according to the restorative methods used. The glass-ceramic onlays group was restored with CAD/CAM glass-ceramic onlays, while the all-ceramic crown group received CAD/CAM all-ceramic crowns. The success rates of the restorations were analyzed, and the sulcus bleeding index (SBI), plaque index (PLI), and gingival index (GI) were recorded at the prerestoration and postrestoration stages. @*Results @#After one year of follow-up, the success rate of the glass-ceramic onlay group was 96.4%, and the success rate of the all-ceramic crown group was 92.9%. The difference was not statistically significant (P > 0.05). No differences in SBI, PLI, or GI were found between the glass-ceramic onlay group and the all-ceramic crown group (P > 0.05).@*Conclusion@#Conclusion
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Objective@#To investigate the reliability of using virtual articulator in the fabrication of zirconia crowns for tetracycline discolored teeth.@*Methods@#To treat the patient with serious tetracycline stained teeth, we use zirconia crowns to shield the stained abutment teeth. To retain the characteristics of patient′s original occlusal contacts, meanwhile, to establish a stable and evenly distributed occlusal contacts, we recorded the functional movements of the patient′s jaw before preparing the teeth and transferred this relations to a physical articulator. Afterwards, relationship of the upper and lower arches was scanned through a specified fixature. Then we can customized the fabrication of the occlusal contacts of the restorations conveniently and efficiently with virtual articulator in CAD/CAM system.@*Results@#When the final restorations were inserted , a charming smile was achieved on patient′s face with satisfactory esthetics. With the application of virtual articulator in designing process, we made evenly distributed and stable bilateral occlusal contacting spots, smooth protrusive and lateral guidance on the lingual aspects of the upper anteriors. One year follow-up, this patient was observed in good oral hygiene, and was satisfied with her esthetic and functional outcome. The soft tissue around the restorations was assessed to be healthy and no signs of inflammation.@*Conclusion@# Applying the virtual articulator kits in CAD/CAM system in designing and fabricating the function-driven restorations could be an efficient way to obtain an satisfactory long-term outcome.
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PURPOSE: This in vitro study aimed to analyze and compare the reproducibility of zirconia and lithium disilicate crowns manufactured by digital workflow. MATERIALS AND METHODS: A typodont model with a prepped upper first molar was set in a phantom head, and a digital impression was obtained with a video intraoral scanner (CEREC Omnicam; Sirona GmbH), from which a single crown was designed and manufactured with CAD/CAM into a zirconia crown and lithium disilicate crown (n=12). Reproducibility of each crown was quantitatively retrieved by superimposing the digitized data of the crown in 3D inspection software, and differences were graphically mapped in color. Areas with large differences were analyzed with digital microscopy. Mean quadratic deviations (RMS) quantitatively obtained from each ceramic group were statistically analyzed with Student's t-test (α=.05). RESULTS: The RMS value of lithium disilicate crown was 29.2 (4.1) µm and 17.6 (5.5) µm on the outer and inner surfaces, respectively, whereas these values were 18.6 (2.0) µm and 20.6 (5.1) µm for the zirconia crown. Reproducibility of zirconia and lithium disilicate crowns had a statistically significant difference only on the outer surface (P<.001). The outer surface of lithium disilicate crown showed over-contouring on the buccal surface and under-contouring on the inner occlusal surface. The outer surface of zirconia crown showed both over- and under-contouring on the buccal surface, and the inner surface showed under-contouring in the marginal areas. CONCLUSION: Restoration manufacturing by digital workflow will enhance the reproducibility of zirconia single crowns more than that of lithium disilicate single crowns.
Subject(s)
Ceramics , Crowns , Head , In Vitro Techniques , Lithium , Microscopy , MolarABSTRACT
Objective @#To compare the clinical effects of polymer ceramic onlay and all ceramic crown in short crown molars@*Methods @# 45 cases of polymer ceramic onlay and 45 cases of Zirconium dioxide all ceramic crowns which repaired the short crowm molars after root canal therapy were compared clinically from the aspects of beauty of restoration, fracture and dislodgement, marginal adaptation and the preservation of abutment teeth. @*Results @# One polymer ceramic onlay had fall out form the teeth after half year, while the all ceramic crowns have been 8 cases after 6~12 months. There were significant differences in fracture and dislodgement between the two groups (χ2=4.44, P < 0.05). @*Conclusion @# Polymer ceramic onlay has good clinical effects in the restoration of short crown molars.
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Objective To study the influence of the convergence angle and cement space on the fit of CAD/CAM all-ceramic crowns.Methods The PMMA resin was produced in two groups,group A (2 degrees) and group B (4 degrees),30 in each group,and each group was divided into 3 sub-groups A 1,A2,A3;or B 1,B2,B3.Each subgroup included 10 patients with a CAD/CAM all-ceramic crown with PMMA resin generation type,but the cement space was 40 μm,60 μm,or 80 μm.The internal clearance edge of the double color silicone rubber impression reproduction technology of the all-ceramic crown was observed under the microscope.Analysis Micro-image software was used to measure the edge gap,and the resulting data were analyzed using SPSS 20.0 software.Results When the cement space is the same,the difference between 2 degrees and 4 degrees was statistically significant.Conclusion The fit is the best when the cement space is 60 μm and the convergence angle space is 4 degrees.
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56 teeth in 48 patients were divided into thick gingiva group (28 teeth)and thin gingiva group (28 teeth) and repaired with zirconia ceramic crown.Before 1 and 2 years after repair,gingival index,gingival margin recession and edge color satisfaction were evaluated.1 and 2 years after,repair gingival index was increase in thick group (P ＜ 0.05),but other indices were not (P ＞ 0.05);in thin gingiva group 2 years after repair the gingival margin recession index was increased(P ＜0.05),the other indices were not(P ＞ 0.05).
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Objective:To evaluate the clinical performance of CAD/CAM zirconia all-ceramic restorations.Methods:287 all-ce-ramic Zirconia restorations in 206 patients were included in a 3-year prospectively survey with California Dental Association Standard (CDA)as a reference.The effects and the related factors such as restoration type,tooth region,fiber reinforced composite application on survival rate were analyzed.Kaplan-Meier survival analysis and Log-Rank test were used for data analysis.Results:Chipping frac-tures in 5 restorations,intense gingivitis at 4 restorations and periapical inflammation for 3 restorations were observed during the obser-vation period.The 3-year cumulative survival rate (CSR)of CAD/CAMzirconia restorations was 95.7%,The differences among the CSR of single crowns(96.3%),linked crowns (93.6%)and fixed partial dentures(95.7%)were not statistically significant(P >0.05).The difference was not statistically significant(P >0.05)between the CSR of the anterior region group(94.5%)and posterior region group(96.3%)as well as difference(P >0.05)between the CSR of fiber reinforced composite group (95.0%)and without fiber reinforced composite group(96.1%).Conclusion:The cumulative survival rate of CAD/CAM zirconia all-ceramic restorations is high.Chipping fracture is the main reason of failure.Restoration type,tooth region and fiber reinforced composite have no significant effect on the survival of zirconia restorations.
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The left lateral incisor with occlusal soreness of a 30-year old female was examined and treated.Radiographic examination re-vealed periradicular radiolucency around the apical and 3 canals.The 3 root canals were treated by root canal therapy,the tooth was restored by all-ceramic crown for the prevention of fracture.12 month follow-up showed that the treatment was effective.
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Objective:To explore the influence of the veneering porcelain thickness on the compressive strength of zirconia all-ceramic crown.Methods:25 zirconia basement crowns with the thickness of 0.5 mm were made by CAD-CAMsystem,and then were divided into 5 groups randomly with the veneering porcelain thickness of 0.5(A),1.0(B),1.5(C),2.0(D)and 2.5 mm(E)respectively. The compressive strength of the samples was measured by a testing machine.Statistical analysis was conducted by SPSS13.0 software. The microstructure of the fractured bonding interface of the specimens was observed by scanning electron microscope(SEM).Results:The compressive strength in group A,B,C,D and E were:(1 279.96 ±42.85)N,(2 235.44 ±50.14)N,(2 216.38 ±48.97)N, (2 169.22 ±60.40)N and (2 028.70 ±47.37)N respectively(A or E vs B,C or D,P 0.05;C vs D,P >0.05).SEMobservation found that in group A and E the bonding interface was uneven and loose,the cracks and spores in veneering porcelain appeared more and larger,and had a more intensive distribution.Conclusion:When the veneering porce-lain is too thick or too thin,the compressive strength of zirconia all-ceramic crown decreases,the thickness of the veneering porcelain should be controled in an appropriate range.
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PURPOSE: To investigate the influence of crown margin design on the stress distribution and to localize critical sites in maxillary canine under functional loading by using three dimensional finite element analysis. MATERIALS AND METHODS: The bite force of 100 N, 150 N, and 200 N was applied with an angulation of 45degrees to the longitudinal axis of tooth. Six models were restored with IPS e.max (Ivoclar Vivadent, Schaan, Liechtenstein) with a different margin design. With lingual ledge and various thicknesses, three different core ceramics were designed in each model. RESULT: In the core ceramic, the maximum tensile stresses were found at the labiocervical region. In the veneering ceramic the maximum tensile stresses were found at the area where the force was applied in all models. CONCLUSION: Shoulder and chamfer margin types are acceptable for all-ceramic rehabilitations. A ledge on the core ceramic at cervical region may affect the strength of all-ceramic crowns.
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Axis, Cervical Vertebra , Bite Force , Ceramics , Crowns , Finite Element Analysis , Shoulder , ToothABSTRACT
Dilaceration refer to an angulation or sharp bend or curve in the root or crown of formed tooth. It is usually occur due to trauma that lead to white or yellow brown discoloration, crown dilaceration, root dilacerations, crown duplication, root duplication, odontoma like malformation etc. This paper elaborated a useful clinical considerations for diagnosis and treatment planning of a severely dilacerated root of malformed tooth having turner’s hypoplasia.
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Objective To analyze the contact failure of monolithic lithium disilicate CAD/CAM crowns by experiment and numerical simulation, and explore the influences of adhesives aging in water on load-bearing capacity of the crowns. Methods The specimens of sectioned monolithic lithium disilicate crowns were designed and manufactured, and evenly divided into two groups and stored in the air and in the distilled water for 30 days, respectively. The specimens were then subjected to monotonic contact loads to compare and analyze their load-bearing capacity. The fractured surfaces and adhesive interfaces of the specimens were observed by scanning electronic microscope. Meanwhile, the stress distribution on the crowns was calculated by numerical simulation to analyze the adhesives aging influence on load-bearing capacity of the crowns. Results The fracture loads on crowns stored in the air and in the water were (561.51 ± 65.66) N and (398.09 ± 90.20) N, respectively, indicating a significant difference. The tensile stress increased considerably at lower surface of the ceramic crown due to the reduction of adhesive strength at the interface of ceramic crown and substrate, which could increase the propensity of contact failure. Conclusions The adhesives aging in water reduces the bonding strength, and accordingly changes the tensile stress distributions, which can lower the load bearing capacity of the lithium disilicate crowns. The research finding provides references for the design and manufacturing of all-ceramic CAD/CAM restored crowns in clinic.
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PURPOSE: This in vitro study aimed to compare the failure load and failure characteristics of two different zirconia framework designs of premolar crowns when subjected to static loading. MATERIALS AND METHODS: Two types of zirconia frameworks, conventional 0.5 mm even thickness framework design (EV) and 0.8 mm cutback of full contour crown anatomy design (CB), were made for 10 samples each. The veneer porcelain was added on under polycarbonate shell crown made by vacuum of full contour crown to obtain the same total thickness of the experiment crowns. The crowns were cemented onto the Cobalt-Chromium die. The dies were tilted 45 degrees from the vertical plane to obtain the shear force to the cusp when loading. All crowns were loaded at the lingual incline of the buccal cusp until fracture using a universal testing machine with cross-head speed 0.5 mm/min. The load to fracture values (N) was recorded and statistically analyzed by independent sample t-test. RESULTS: The mean and standard deviations of the failure load were 1,170.1 +/- 90.9 N for EV design and 1,450.4 +/- 175.7 N for CB design. A significant difference in the compressive failure load was found (P<.05). For the failure characteristic, the EV design was found only cohesive failures within veneering porcelain, while the CB design found more failures through the zirconia framework (8 from 10 samples). CONCLUSION: There was a significant difference in the failure load between two designs, and the design of the framework influences failure characteristic of zirconia crown.
Subject(s)
Bicuspid , Crowns , Dental Porcelain , VacuumABSTRACT
PURPOSE: This in vitro study aimed to compare the failure load and failure characteristics of two different zirconia framework designs of premolar crowns when subjected to static loading. MATERIALS AND METHODS: Two types of zirconia frameworks, conventional 0.5 mm even thickness framework design (EV) and 0.8 mm cutback of full contour crown anatomy design (CB), were made for 10 samples each. The veneer porcelain was added on under polycarbonate shell crown made by vacuum of full contour crown to obtain the same total thickness of the experiment crowns. The crowns were cemented onto the Cobalt-Chromium die. The dies were tilted 45 degrees from the vertical plane to obtain the shear force to the cusp when loading. All crowns were loaded at the lingual incline of the buccal cusp until fracture using a universal testing machine with cross-head speed 0.5 mm/min. The load to fracture values (N) was recorded and statistically analyzed by independent sample t-test. RESULTS: The mean and standard deviations of the failure load were 1,170.1 +/- 90.9 N for EV design and 1,450.4 +/- 175.7 N for CB design. A significant difference in the compressive failure load was found (P<.05). For the failure characteristic, the EV design was found only cohesive failures within veneering porcelain, while the CB design found more failures through the zirconia framework (8 from 10 samples). CONCLUSION: There was a significant difference in the failure load between two designs, and the design of the framework influences failure characteristic of zirconia crown.
Subject(s)
Bicuspid , Crowns , Dental Porcelain , VacuumABSTRACT
PURPOSE: This study was to evaluate the marginal fit of two CAD-CAM anatomic contour zirconia crown systems compared to lithium disilicate glass-ceramic crowns. MATERIALS AND METHODS: Shoulder and deep chamfer margin were formed on each acrylic resin tooth model of a maxillary first premolar. Two CAD-CAM systems (Prettau(R)Zirconia and ZENOSTAR(R)ZR translucent) and lithium disilicate glass ceramic (IPS e.max(R)press) crowns were made (n=16). Each crown was bonded to stone dies with resin cement (Rely X Unicem). Marginal gap and absolute marginal discrepancy of crowns were measured using a light microscope equipped with a digital camera (Leica DFC295) magnified by a factor of 100. Two-way analysis of variance (ANOVA) and post-hoc Tukey's HSD test were conducted to analyze the significance of crown marginal fit regarding the finish line configuration and the fabrication system. RESULTS: The mean marginal gap of lithium disilicate glass ceramic crowns (IPS e.max(R)press) was significantly lower than that of the CAD-CAM anatomic contour zirconia crown system (Prettau(R)Zirconia) (P<.05). Both fabrication systems and finish line configurations significantly influenced the absolute marginal discrepancy (P<.05). CONCLUSION: The lithium disilicate glass ceramic crown (IPS e.max(R)press) had significantly smaller marginal gap than the CAD-CAM anatomic contour zirconia crown system (Prettau(R)Zirconia). In terms of absolute marginal discrepancy, the CAD-CAM anatomic contour zirconia crown system (ZENOSTAR(R)ZR translucent) had under-extended margin, whereas the CAD-CAM anatomic contour zirconia crown system (Prettau(R)Zirconia) and lithium disilicate glass ceramic crowns (IPS e.max(R)press) had overextended margins.
Subject(s)
Bicuspid , Ceramics , Computer-Aided Design , Crowns , Glass , Lithium , Resin Cements , Shoulder , ToothABSTRACT
PURPOSE: When the full veneer crown was treated in the tooth with abfraction lesion due to various causes, the prognosis of it may be compromised according to the location of the finish line, but there is few study about the location of its buccal finish line. The purpose of this study was to investigate the effect of location of the finish line of the full veneer crown on stress distribution of the tooth with abfraction lesion. MATERIALS AND METHODS: The two dimensional finite element model was developed to express tooth, surrounding tissue and full veneer crown. The stress distribution under eccentric 144 N occlusal load was analyzed using finite element analysis. The location of finish line was set just at the lower border of the lesion (Group 0), 1 mm (Group 1) and 2 mm (Group 2) below the lower border of the lesion. RESULTS: In the Group 0, von Mises stress was concentrated at the finish line and the apex of the lesion. Also, the stress at the bucal finish line propagated to the lingual side. In the Group 1 and Group 2, stress distribution was similar each other. Stress was concentrated at the apex of lesion, but the stress at the buccal finish line did not propagate to the lingual side. That implied decrease of the possibility of horizontal crown fracture. CONCLUSION: Full veneer crown alleviated the stress concentrated at the apex of the abfraction lesion, when the finish line of full veneer crown was set below the lower border of abfraction lesion.
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Crowns , Finite Element Analysis , Prognosis , ToothABSTRACT
Fabricating a crown to retrofit an existing abutment tooth for a partial removable dental prosthesis (PRDP) is one of the most time-consuming and labor-intensive clinical procedures. In particular, when the patient is concerned with esthetic aspects of restoration, the task of fabricating becomes more daunting. Many techniques for the fabrication of all-metallic or metal-ceramic crowns have been discussed in the literature. This article was aimed to describe a simple fabrication method in which a retrofitting crown was fabricated for a precise fit using a ceramic-pressed-to-metal system.
Subject(s)
Humans , Ceramics , Crowns , Dental Prosthesis , ToothABSTRACT
PURPOSE: All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. MATERIALS AND METHODS: Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. RESULTS: The mean fracture strengths were as follows: 54.9 +/- 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 +/- 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. CONCLUSION: The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain.
Subject(s)
Ceramics , Collodion , Crowns , Dental Porcelain , Tooth , ZirconiumABSTRACT
Occlusal plane is a sagittal expression of dental arch form, and it composes the shape of occlusion, which is one of the most important elements of Maxillo-oral system. In this case, vertical, horizontal coordinates of bionic-median-sagittal plane was produced in articulator, and to achieve relation of left and right position of upper, lower teeth and deficits in alveola, Shilla system was used to reconstruct occlusal plane. In this case, a 41 year-old male patient visited for fracture of 10 unit metal-ceramic fixed partial denture of upper anterior teeth and for overall treatment. Clinical, radiographical, model examination was held, full mouth rehabilitation was achieved by placing dental implant. Maxillo-oral relation was recorded using Gothic arch Tracer complex and were mounted. And for the next step, we estimated original occlusal plane using Shilla system. After analysis we produced diagnosis wax pattern. On the basis of this, radiography stent was manufactured and dental implant was placed, and temporary prosthesis was made by using diagnosis wax pattern. Cross mounting and anterior guiding table were performed in order to reproduce temporary restoration morphology and bite pattern, followed by final restoration made of all ceramic crown with zirconia coping. As stated above, appropriately esthetic and functional results can be seen in using Shilla system in diagnosis and treatment procedure of full mouth rehabilitation patient.