Esthetic rehabilitation with indirect resin on anterior teeth: a clinical report / Reabilitação estética com resina indireta em dentes anteriores: um relato clínico / Rehabilitaciónestética con resina indirecta en dientes anteriores: reporte clínico

Introduction:The aesthetic rehabilitation of endodontically treated teeth depends on the destruction degree of the crown, the bone support, type of prosthesis, andchewing forces. In these cases, indirect restorations with composite resins are an excellent alternative. The indirect composite resins have improved physical and mechanical properties due toincorporatingof inorganic fillersand multifunctional monomers. These components offer a greater bonding strength to the indirect restorations, which is advantageous for further rehabilitations with ceramic crowns. Objective:To present an aesthetic rehabilitation of anterior teeth with indirect composite resin as a feasible and less expensive treatment alternative.Case Report:Upon clinical examination, extensive and deficient restorations were observed in the upper anterior teeth. The proposed treatment plan was the aesthetic rehabilitation of endodontically treated teeth with indirect restorations using ceromer.Conclusions:This treatment represented an excellent alternative for aesthetic rehabilitation of endodontically treated teeth in cases of great dental crown destruction or small dental absences (AU).

Introdução:A reabilitação estética de dentes tratados endodonticamente depende do grau de destruição da coroa, do dente em questão, do suporte ósseo, do tipo de prótese e dos tipos de forças a que esses dentes serão submetidos. As resinas compostas indiretas apresentam propriedades físicas e mecânicas aprimoradas graças à incorporação de componentes inorgânicos e monômeros multifuncionais com maior número de pontos de união, tornando-os capazes de solucionar os problemas em que seriam indicadas restaurações cerâmicas. Objetivo:Apresentar um relato de caso clínico de uma reabilitação estética de dentes anteriores com resina composta indireta como alternativa de tratamento viável e de menor custo.Relato de Caso:Ao exame clínico foram observadas restaurações amplas e deficientes nos dentes anteriores superiores. O plano de tratamento proposto reabilitação estética dos elementos dentários com cerômeros.Conclusões:Este tratamento representou uma opção viável e demenor custo que pode ser utilizado tanto em situações de grande destruição dentária como em pequenas ausências dentárias, em substituição às restaurações de cerâmica (AU).

Introducción: La rehabilitación estética de los dientes tratados endodónticamente depende del grado de destrucción de la corona, el diente en cuestión, el soporte óseo, el tipo de prótesis y los tipos de fuerzas a las que estos dientes serán sometidos. Las resinas compuestas indirectas tienen propiedades físicas y mecánicas mejoradas gracias a la incorporación de componentes inorgánicos y monómeros multifuncionales con mayor número de puntos de unión, lo que las hace capaces de resolver los problemas en los que estarían indicadas las restauraciones cerámicas. Objetivo: Presentar un caso clínico de rehabilitación estética de dientes anteriores con resina compuesta indirecta como alternativa de tratamiento viable y menos costosa. Reporte de Caso:En el examen clínico, se observaron restauraciones extensas y deficientes en los dientes anteriores superiores. El plan de tratamiento propuesto para la rehabilitación estética de elementos dentales con cerómeros. Conclusiones:Este tratamiento representó una opción viable y menos costosa que se puede utilizar tanto en situaciones de gran destrucción dentaria como en pequeñas ausencias dentales, en sustitución de las restauraciones cerámicas (AU).

Influencia del silano y adhesivos universales en la adhesión durante la reparación de un cerómero / Influence of silane and universal adhesives on adhesion during the repair of a ceromer

RESUMEN Introducción: No existe un protocolo definitivo para la reparación de cerómeros. Los adhesivos universales debido a su composición e indicaciones pueden ser una alternativa dentro de la reparación de restauraciones poliméricas, pero la asociación de los silanos con los adhesivos universales requiere más investigación. Objetivo: Evaluar y comparar la resistencia de unión de dos adhesivos universales en la interfase cerómero-resina, asociado o no a un agente silano. Material y métodos: Se realizaron seis bloques de cerómero y se trataron según las siguientes variables: (A) sin tratamiento, (B) agente silano, (C) adhesivo universal 1 + silano, (D) adhesivo universal 1, (E) adhesivo universal 2 + silano, (F) adhesivo universal 2 (n = 10). Se unió resina compuesta a dichas superficies y se realizó prueba de microtensión. El tipo de falla se evaluó con estereomicroscopio. Resultados: Los valores de resistencia de unión de los grupos fueron estadísticamente diferentes (p < 0.05), excepto entre ambos adhesivos universales evaluados. El grupo B presentó los valores más altos de resistencia adhesiva. Los grupos C y E obtuvieron valores de resistencia adhesiva menores en comparación con los grupos D y F. El tipo de falla predominante fue el adhesivo. Conclusión: El uso asociado de un silano funcional con los adhesivos universales no mejora los valores de resistencia adhesiva, por lo que debería evitarse. Como primera elección se recomienda el silano funcional, y en segundo grado, sólo usar adhesivos universales, pero no asociar los dos materiales en un mismo proceso adhesivo.

ABSTRACT Introduction: There is no definitive protocol for ceromer repairs. Universal adhesives due to their composition and indications may be an alternative for polymeric restorations repair. But the association of silanes with universal adhesives requires more research. Objective: To evaluate and compare the bond strength of two universal adhesives in ceromer - resin interface, associated or not with a silane agent. Material and methods: Six ceromer blocks were made and treated according to the following variables: (A) No treatment, (B) Silane agent, (C) Universal Adhesive 1 + Silane, (D) Universal Adhesive 1, (E) Adhesive Universal 2 + Silane, (F) Universal Adhesive 2 (n = 10). Composite resin was attached to these surfaces and a microtension test was performed. The type of failure was evaluated with a stereomicroscope. Results: The bond strength values of the groups were statistically different (p <0.05), except between both universal adhesives were evaluated. Group (B) presented the highest values of adhesive resistance. Groups (C and E) had lower adhesive strength values compared to groups (D and F). The most prevalent type of failure was the adhesive. Conclusion: The associated use of functional silane to universal adhesives does not improve adhesive strength values, so it should be avoided. As a first choice, functionalsilane is recommended, and in the second degree, only use universal adhesives, but do not associate the two materials in the same adhesive process.

In vitro study of wear of Ceramage and IPS e.max Press / 口腔疾病防治

Objective @#To compare the wear of Ceramage and IPS e.max Press offering foundation for nonmetallic materials selection in clinical. @*Methods @#20 class I cavities were prepared in the approximal flattened sides of the extracted human maxillary first molars. The cavities were divided into 2 groups randomly, and then restored with Ceramage or IPS e.max Press. Inlays were prepared according to the manufactures’ instructions with indirect methods and cemented with Varolink N. The non-wear extracted maxillary third molars were used as antagonistic enamel cusps after standardized prepared. After the self-made wear-testing device concluded 200,000 cycles under a load of 20 N, the wear depth of specimens and antagonistic enamel cusps was assessed by Kavo PREP assistant.@*Results @# The wear in Ceramage group was (298.30 ± 40.02) μm, while the wear of normal enamel was (206.60 ± 49.17) μm. The wear in IPS e.max Press group was (212.90 ± 61.21) μm, while the wear of normal enamel was (217.00 ± 25.10) μm. The wear of IPS e.max Press inlays was higher than Ceramage inlays (P < 0.05). Ceramage inlays showed higher wear than normal enamel (P < 0.05), while IPS e.max Press inlays was not statistically different from the normal enamel (P > 0.05). @*Conclusions @#Ceramage has more wear than IPS e.max Press. Ceramage shows higher wear compared with normal enamel, while IPS e.max Press has lower antagonistic war compared with normal enamel.

Evaluation of biocompatibility of Targis Dentin and Artglass by using subcutaneous implantation test.

Introduction: Biocompatibility of a crown-bridge material is as important as its physical and mechanical properties. It is also one of the most important factors for the long-lasting clinical success of that restoration. It directly contacts the vital prepared tooth and that is the reason it has to be nontoxic to the local tissues, such as the pulp, gingiva, or the rest of the body. Materials with different physical properties are used in the conventional fixed prosthodontic restorations. Recently, metal-free systems that are reinforced with fibers have been improved for crown and bridge restorations. These new composite systems have the advantages of both ceramic and polymer chemistry. Materials and Methods: In this research, biocompatibility of two ceramic-polymer-based prosthetic materials (Targis Dentin® and Artglass Dentin® ) was studied using a subcutaneous implantation test on rats. Initially (15 th day) mild inflammatory reactions were observed in tissues, which directly contacted the Artglass, Targis, and control tubes. These probably originated from the surgical traumas. After the 90th day of implantation, these reactions resolved and healthy, well-organized fibrous connective capsules were seen around the implants. Results: Initially (15 th day) mild inflammatory reactions were observed in tissues, which directly contacted the Artglass, Targis, and control tubes. These probably originated from the surgical traumas. After the 90 th day of implantation, these reactions resolved and healthy, well-organized fibrous connective capsules were seen around the implants. Conclusion: At the end of the study, according to the FDI and ISO-7405 standards, Targis and Artglass indicated biocompatibility with the subcutaneous connective tissue of the rat.

Dimensional Changes of Ceromer Crown by Water Absorption / 대한치과보철학회지

STATEMENT OF PROBLEM: The increasing demand for esthetic restorations has been required developing new materials for tooth colored restoration. Ceromer (Ceramic Optimized Polymer) has some advantages over porcelain, and has gained increasing popularity in restorative dentistry. However, there is little information on the dimensional changes in a clinical restoration in moist conditions. PURPOSE: This study examined the dimensional changes in Ceromer restorations with a clinical crown shape that were fabricated in a clinical manner. MATERIAL AND METHODS: The crowns for the maxillary central incisor were fabricated with two Ceromers (BelleGlass(R) and Targis(R)) using a similar clinical restoration manufacturing technique. A total of twenty specimens were prepared and immersed in distilled water at room temperature to allow for water absorption. The weight, height and width were measured at 24, 72 and 168 hours. The accumulated ratios of the changes were calculated and evaluated using a paired t-test and an independent independent t-test. RESULTS: The dimensions and weight increased with increasing soaking time. Targis(R) showed significant differences in height and weight between 24 hours and the other times (P < .05). BelleGlass(R) showed significant differences in width and weight between 24 hours and the other times. The two materials showed different changing patterns of the dimensions but there were no statistically significant differences between them. CONCLUSION: The dimensions and weight of the Ceromer restorations were changed by water absorption. The clinical crown shaped specimen showed more complicated dimensional changes than the simplified specimens.

Fracture strengths of ceromer crowns supported on the various abutment core materials / 대한치과보철학회지

STATEMENT OF PROBLEM: The effects of various core buildup materials which differs in the mechanical properties on the fracture strength of metal-free crowns is unknown. PURPOSE: This study was carried out to evaluate the fracture strengths of Artglass ceromer crowns supported by 3 different core materials in clinically simulated anterior tooth preparation. Material and methods. Ten crowns from each group were constructed to comparable dimensions on the various dies made by gold alloy, Ni-Cr alloy, and composite resin. The ten crowns were then cemented onto the dies and loaded until catastrophic failure took place. Fracture resistance to forces applied to the incisal edges of the anterior crowns supported by three types of dies was tested. RESULTS: The ceromer crowns on the composite resin dies fractured at significantly lower values(287.7 N) than the ceromer crowns on the metal dies(approximately 518.4 N). No significant difference was found between the fracture values of the ceromer crowns on the dies of gold alloy and Ni-Cr alloy. CONCLUSION: The failure loads of the ceromer crowns on the metal dies were almost the same and not affected by the differences of casting alloys. However, the fracture values of the ceromer crowns on the resin dies were significantly reduced by the relative weak properties of composite resin core material.

Macro-shear bond strength and micro-shear bond strength of ceromer bonded to metal alloy and fiber reinforced composite / 대한치과보철학회지

STATEMENT OF PROBLEM: According to the fracture pattern in several reports, fractures most frequently occur in the interface between the ceromer and the substructure. PURPOSE: The aim of this in vitro study was to compare the macro shear bond strength and microshear bond strength of a ceromer bonded to a fiber reinforced composite (FRC) as well as metal alloys. MATERIAL AND METHODS: Ten of the following substructures, type II gold alloy, Co-Cr alloy, Ni-Cr alloy, and FRC (Vectris) substructures with a 12 mm in diameter, were imbedded in acrylic resin and ground with 400, and 1, 000-grit sandpaper. The metal primer and wetting agent were applied to the sandblasted bonding area of the metal specimens and the FRC specimens, respectively. The ceromer was placed onto a 6 mm diameter and 3 mm height mold in the macro-shear test and 1 mm diameter and 2 mm height mold in the micro-shear test, and then polymerized. The macro- and micro-shear bond strength were measured using a universal testing machine and a micro-shear tester, respectively. The macro- and micro-shear strength were analyzed with ANOVA and a post-hoc Scheffe adjustment (alpha= .05). The fracture surfaces of the crowns were then examined by scanning electron microscopy to determine the mode of failure. Chi-square test was used to identify the differences in the failure mode. RESULTS: The macro-shear strength and the micro-shear strength differed significantly with the types of substructure (P< .001). Although the ceromer/FRC group showed the highest macro and micro-shear strength, the micro-shear strength was not significantly different from that of the base metal alloy groups. The base metal alloy substructure groups showed the lowest mean macro-shear strength. However, the gold alloy substructure group exhibited the least micro-shear strength. The micro-shear strength was higher than the macro-shear strength excluding the gold alloy substructure group. Adhesive failure was most frequent type of fracture in the ceromer specimens bonded to the gold alloys. Cohesive failure at the ceromer layer was more common in the base metals and FRC substructures. CONCLUSION: The Vectris substructure had higher shear strength than the other substructures. Although the shear strength of the ceromer bonded to the base metals was lower than that of the gold alloy, the micro-shear strength of the base metals were superior to that of the gold alloy.

Color stability of ceromers in three food colorants / 대한치과보철학회지

STATEMENT OF PROBLEM: Ceramic and composite resin have been used to fulfill the demand for esthetic prosthesis. However, ceramic is easy to break and wears off the opposite natural teeth. Conventional composite resin also has low abrasive resistance and color stability. Ceramic Optimized Polymer (ceromer) was developed in mid-1990s to overcome the shortfalls of ceramic and composite resin. Ceromer has similar abrasiveness with the natural tooth and has relatively high strength. Color stability affects esthetics and long-term prognosis of the prosthesis. PURPOSE: The purpose of this study was to compare color stability of ceromers(2 types : Artglass., Targis.) with ceramics(Vintage.-polishing, Vintage.-glazing). MATERIAL AND METHOD: The color difference(E*) was measured by spectrophotometer with different immersion time. Twenty disks, 3mm in thickness and 10mm in diameter, were fabricated for each specimen in shade A2(Vita Lumin shade guide). Specimens(5 samples in each group) were immersed in the food colorants(Red no.3, Yellow no.4, Blue no.1, Distilled water) for 24 hours, 48 hours and 72 hours respectively. L*, a* and b* value were measured with spectrophotometer (CM 503i : Minolta Co., Japan) and mean E* value was calculated for statistical analysis. RESULTS: The results of this study were obtained as follows. 1. The E* values of all test samples increased with the time of immersion. 2. The E* values of all materials increased in order of Distilled Water, Yellow no.4, Blue no.1 and Red no.3. There was significant difference between Red no.3 and the other food colorants(p<0.05). 3. The E* values increased in order of Vintage-glazing, Vintage-polishing, Artglass and Targis. There was significant difference between Vintage.-glazing and the other materials (p<0.05). CONCLUSION: By means of the above results, immersion time was found to be a critical factor for color stability of ceromer. For the long-term color stability of prosthesis it is recommended patients having ceromer prosthesis(Artglass., Targis.) to reduce the habitual intake of Red no.3 colorants con taining foods.

Avaliação in vitro da resistência de união do cerômero ao sistema de cimentação adesiva, através do teste de micro-tração: efeito de diferentes tratamentos de superfície / In vitro avaliation of bond strength of ceromer at resin cement, by the micro-tensile test: effect of different surface treatments

A proposta deste estudo foi avaliar "in vitro" a resistência de união do Cerômero Artglass (Heraeus/Kulzer) ao cimento resiniso RelyX (3M), através do teste de Micro-Tração. Os seguintes tratamentos de superfície foram investigados: microjateamento com óxido de alumínio (AO), Artglass Liquid (AL), Silano (S), ácido fluorídrico (HF) e ácido fosfórico (AF). Cinco espécimes cada qual consistindo de um par de cilindro (10x10mm) foram confeccionados. As superfícies de união foram regularizadas através de desgaste com lixas abrasivas de granulação seqüencial sob refrigeração. Os espécimes foram nomeados ao acaso e submetidos aos seguintes tratamentos antes da cimentação: grupo 1 (AO/AGL), grupo 2 (AO/AF), grupo 3, (AO/AF/S), grupo 4 (AO/HF), e grupo 5 (AO/HF/S). Os espécimes aos pares foram cimentados com um sistema adesivo dual e cimento resinoso dual, de acordo com as recomendações do fabricante. Espécimes foram fotopolimerizados, armazenados por 48 horas a 37°C e, posteriormente, termociclados. Com auxílio de um disco de diamante perpendicular a superfície de união, "palitos" com 1 mm² de área de seção foram obtidos. Os valores de resistência de união (MPa) foram obtidos com auxílio de uma máquina de teste universal (MTS 800). Resultados foram: grupo 1 (29,39 ± 5,13), grupo 2 (27,49 ± 5,32), grupo 3 (29,49 ± 4,94), grupo 4 (24,41 ± 2,67), e grupo 5 (22,19 ± 2,33). ANOVA e o Teste de Tukey foram aplicados com p<0,05. Não houve diferenças estatisticamente significante entre os grupos 1,2 e 3; 4 e 5; e 2 e 4. As forças de união foram siginificantemente maiores nos grupos 1 e 3 do que nos grupos 4 e 5; e no grupo 2 do que o grupo 5. Conclusões: Microjateamento com óxido de alumínio e Artglass Liquid foi um prétratamento de superfície efetivo; a silanização pode melhorar a força de união promovida pelo microjateamento e condicionamento com ácido fosfórico; e o condicionamento com ácido fluorídrico não é recomendado, pois diminui a resistência de união

The purpose of this study was to investigate the effect of surface treatments on microtensile interfacial bond strength of a composite Artglass (Kulzer) to resin cement RelyX (3M). Methods of surfaces roughening or preparation included microetching with aluminum oxide (AO), Artglass Liquid (AGL), Silane (S), hydrofluoric acid (HF), and fosforic acid (AF). Five specimens, each consisting of a pair of cylinders (10x10 mm) were fabricated. The bonding surfaces were finished with 600-grit silicon carbide paper. Specimen pairs were randomly assigned to one of five surface treatment groups: group 1 (AO/AGL), group 2 (AO/AF), group 3 (AO/AF/S), group 4 (AO/HF), and group 5 (AO/HF/S). Specimen pairs were cemented with a dual resin bonding and a dual cure resin cement, in accordance with the manufacturer's instructions. Specimens were light-cured, then thermocycled 500 times at between 5°C and 55°C. Using a diamond disk perpendicular to the bonding interface, 'sticks' with 1.0 mm² cross-sectional area were obtained. Microtensile bond strengths were determined using a MTS 800 Materials Testing Machine at a crosshead speed of 0.5 mm/min. Results: Means (n=20) and standard deviations of bond strengths (MPa) were: group 1 (29.39 ± 5.13), group 2 (27.49 ± 5.32), group 3 (29.49 ± 4.94), group 4 (24.41± 2.67), and group 5 (22.19 ± 2.33). Data were analyzed with ANOVA and Tukey Test at p<0.05. There were no significant statistical differences among the groups 1, 2, and group 3; groups 4 and 5; and groups 2 and 4. Microtensile bond strengths were significantly higher in groups 1 and 3 than in groups 4 and 5; and in group 2 than in group 5. Conclusions: AO and AGL was an effective surface pretreatment; silanation may improve the bond provided by AO and etching with AF; and etching with HF is not recommended, as it decreases bond strength

MARGINAL FITNESS AND MARGINAL LEAKAGE OF FIBER-REINFORCED COMPOSITE CROWNS DEPENDING UPON LUTING CEMENTS / 대한치과보철학회지

As Fiber-reinforced composite restorations cannot be made without leaving a marginal gap, luting cements play a pivotal role in sealing the margins as a prevention against margnal leakage. A recently introduced adhesive resin cement system is claimed to adhere chemically, as well as mechanically, to tooth substances, dental alloys and porcelain. But when considering the clinical variation, conventional cementation using Zinc Phosphate and Glass-Ionomer can be requested. A vitro study was undertaken to compare microleakage and marginal fitness of Fiberreinforced composite crowns(Targis/Vectris) depending upon luting cements. Fifty non-carious human premolar teeth were randomly divided into five experimental groups of 10 teeth each and luted with five luting cements.(Bistite II., Super-bond., Variolink II.), Zinc phosphate and Glass- Ionomer cement) After 24 hours of being luted, all specimens were thermocycled 300 times through water bath of 5degrees C and 55degrees C in each bath, then the quality of the marginal fitness was measured by the Digital Microscope and marginal leakage was characterized using Dye Penetration technique and the Digital Microscope The results were as follows : 1. The mean values of marginal fit were Bistite II(46.78micrometer), Variolink II(56.25micrometer), Super-Bond(56.78 micrometer), Glass-Ionomer(99.21micrometer), Zinc Phosphate(109.49micrometer) indicated a statistically significant difference at p<0.001. 2. The mean microleakage values of tooth-cement interface, restoration-cement interface were increased in the order of Variolink II, Bistite II, Super-Bond, Glass-Ionomer, Zinc Phosphate. 3. Crowns luted with resin cement (Bistite II, Super-Bond, Variolink II, etc) exhibited less marginal gap and marginal leakage than those luted with conventional Glass-Ionomer and Zinc Phosphate cement. 4. The results indicated that all five luting systems yielded comparable and acceptable marginal fit.