Prediction, analysis and application of learning curve of tooth preparation for all ceramic crowns of maxillary central incisors / 北京大学学报(医学版)

OBJECTIVE@#To predict the learning curve of tooth preparation for all ceramic crowns of maxillary central incisors on phantom head simulators for graduate students participating in standardized dental resident training based on the modified Wright learning curve model, then to analyze and applicate the learning curve.@*METHODS@#Twelve graduate students participating in standardized dental resident training were selected to prepare the resin maxillary central incisors on phantom head simulators for all ceramic crowns 4 times. The results of preparation were evaluated by 3 prosthetic experts with at least 10 years' experience focusing on the reduction, contour, taper, shoulder, finish line, margin placement, adjacent tooth injury, and preparation time for tooth preparation. The learning rate of tooth preparation was calculated by scores of tooth preparation of 4 times. The learning curve of tooth preparation was predicted based on the modified Wright learning curve model. According to the criteria of standardized training skill examinations for dental residents in Beijing, 80 was taken as the qualified standard score. The minimum training times for tooth preparation to satisfy the qualified standard score (80) was calculated, to analyze the characteristics of learning curve and evaluate the effectiveness of tooth preparation.@*RESULTS@#The scores of 4 tooth preparation were 64.03±7.80, 71.40±6.13, 74.33±5.96, and 75.98±4.52, respectively. The learning rate was (106±4)%, which showed the learning curve an upward trend. There were no significant differences between the qualified standard score and the predicted scores of tooth preparation from the 5th preparation to the 13th preparation (P > 0.05). The predicted score of the 14th preparation was higher than the qualified standard score (P < 0.05).@*CONCLUSION@#The trend of the learning curve of tooth preparation for all ceramic crowns of maxillary central incisors on phantom head simulators for graduate students participating in standardized dental resident training is upward, which predicts the minimum training times higher than the qualified standard score is 14 times.

Influence of number and position of porcelain specimens in the furnace on flexural strength and translucency

The aim of this study was to investigate the influence of the quantity and positioning of feldspathic ceramic specimens inside the furnace on their flexural strength and translucency. The tested hypotheses were that the arrangement of specimens in the furnance would not influence 1) the translucency or 2) the biaxial strength of the porcelain. Methods: Ninety porcelain specimens were made (1.2 mm thickness and 13.5 mm diameter) and assigned into two main groups (n=15): G1 group - 15 firing cycles containing only one specimen each, always at the center of the refractory; and G5 group - 15 firing cycles containing five specimen each, where one specimen was at the center of the refractory and four specimens positioned equidistantly on the periphery. The translucency test was performed using a spectrophotometer, followed by the flexural strength test, according to ISO 6872:2015. T-student test was performed for both the mechanical and optical obtained data. Results: The flexural strength of the porcelain was not affected by the positioning (center x periphery) of the specimens inside the furnace (p =0.08), but the translucency was affected (periphery > center; p =0.009). Regarding to the number of feldspathic ceramic specimens, the biaxial flexural strength was affected (p =0.025), as well as the translucency (p <0.05). Conclusion: A higher quantity of feldspathic ceramic specimens for each firing cycle decreased its biaxial flexural strength and translucency. Also, specimens positioned at the center of the refractory became less translucent than those positioned at the periphery.

The Effect of Immediate Dentin Sealing on the Marginal Adaptation of LithiumDisilicate Overlay Restorations using different types of luting agents / Efeito do selamento imediato da dentina na adaptação marginal de restaurações overlay de dissilicato de lítio utilizando diferentes tipos de agentes de cimentação: estudo in vitro

Objective:This study evaluated the effect of immediate dentin sealing on the marginal adaptation of lithium disilicate overlays with three different types of resin-luting agents: preheated composite, dual-cure adhesive resin, and flowable composite. Materials and Methods: Forty-eight maxillary first premolars of similar size were prepared with a butt joint preparation design. The teeth were separated into two primary groups, each with twenty-four teeth: Group DDS: Delay dentin sealing (non-IDS) teeth were not treated. Group IDS: dentin sealing was applied immediately after teeth preparation. Each group was subsequently separated into three separate subgroups. Subgroups (DDS+Phc, IDS+Phc): cemented with preheated composite (Enamel plus HRi, Micerium, Italy), Subgroups (DDS+Dcrs, IDS+Dcrs): cemented with dual-cured resin cement (RelyX Ultimate, 3M ESPE, Germany) and Subgroups (DDS+Fc, IDS+Fc): Cemented with flowable composite (Filtek supreme flowable, 3M ESPE, USA). Using a digital microscope with a magnification of 230x, the marginal gap was measured before and after cementation at four different locations from each surface of the tooth, and the mean of measurements was calculated and analyzed statistically using the independent t-test, one-way ANOVA test, Bonferroni correction at a significance level of 0.05. Results: The samples that were immediately sealed with dentin bonding agent showed lower marginal gaps than delayed dentin sealing, both pre-and post-cementation for all subgroups, with a statistically significant difference (p˂0.01). The marginal gap was significantly lower in the IDS+Fc (48.888 ±5.5 µm) followed by the IDS+Dcrs group (53.612 ±5.8 µm) and IDS+Phc (79.19 9±6.9 µm) respectively, while the largest marginal gaps were observed in the DDS+Phc group (86.505 ±5.4 µm). Conclusion: Generally, the teeth with IDS showed better marginal adaptation than teeth without IDS. The marginal gap was smaller with flowable composite and dual-cure resin cement than with preheated composite (AU)

Objetivo:Esse estudo avaliou o efeito do selamento imediato da dentina na adaptação marginal de overlays em dissilicato de lítio com três tipos diferentes de agentes de cimentação resinosos: resina composta pré-aquecida, adesivo resinoso dual e resina fluida. Materiais e métodos: Quarenta e oito primeiros pré-molares maxilares com tamanho similar foram preparados com término em ombro. O dente foi separado em dois grupos primários, cada um com vinte e quatro dentes: Grupo DDS: retardado selamento da dentina (non-IDS) dente não foi tratado. Grupo IDS: selamento dentinário foi aplicado imediatamente após a preparação do dente. Cada grupo foi separado de modo subsequente em três subgrupos. Subgrupo (DDS+Phc, IDS+Phc): cimentado com resina pré-aquecida (Enamel plus HRi, Micerium, Italy), Subgrupo (DDS+Dcrs, IDS+Dcrs): cimentado com cimento resinoso dual (RelyX Ultimate, 3M ESPE, Germany) e Subgrupo (DDS+Fc, IDS+Fc): cimentado com resina fluida (Filtek supreme flowable, 3M ESPE, USA). Usando um microscópio digital com magnificação de 230x, o gap marginal foi medido antes e após a cimentação em quatro diferentes localizações de cada superfície do dente e a média das medidas foi calculada e estatisticamente analisada através do uso do teste ANOVA um-fator e teste independente de Tukey e correção Bonferroni com nível de significância de 0,05. Resultado: As amostras que foram imediatamente seladas com agente adesivo dentinário apresentaram menores gaps marginais do que o selamento dentinário retardado, ambos pré e pós cimentação para todos os subgrupos apresentaram diferença estatística significante (p˂0.01). O gap marginal foi significativamente menor para IDS+Fc (48.888 ±5.5 µm) acompanhado do IDS+Dcrs group (53.612 ±5.8 µm) e IDS+Phc (79.19 9 ±6.9 µm) respectividamente, enquanto o maior gap marginal foi observado no grupo DDS+Phc (86.505 ±5.4 µm). Conclusão:Geralmente, o dente com IDS apresentou melhor adaptação marginal do que o dente sem IDS. O gap marginal foi menor com resina fluida e cimento resinoso dual do que com a resina composta pré-aquecida (AU)

Determination of Shear Bond Strength of Nanocomposite to Porcelain and Metal Alloy

Abstract Objective: To compare porcelain and metal repair done with both nanocomposite and conventional composite. Material and Methods: A total of 30 cylinders were fabricated from Porcelain (I), Porcelain fused to metal (II), and metal (III) substrate each. Control group (A) was bonded with conventional micro-hybrid composite and experimental group (B) was bonded with nanocomposite in a 2 mm thickness. All specimens were thermocycled and stored in distilled water at 37 °C for 7 days. A universal testing machine was used to measure the Shear bond strength (SBS). The difference between bond strengths of the groups was compared using an independent t-test. Results: In all three groups, the SBS was higher in the experimental group as compared to the control group. The use of nanocomposite of metal alloy presented maximum shear bond strength, followed by samples of porcelain fused to metal and finally porcelain, showing the lowest values of SBS. Conclusion: Porcelain and alloys bonded with nanocomposite exhibit enhanced adhesiveness as well as aesthetic and mechanical properties. This subsequently would translate into providing higher clinical serviceability and durability and hence a cost-effective and accessible repair option for human welfare (AU).

The Effect of Coloring Beverages on Color Stability of Hybrid Ceramics with Different Surface Treatments

ABSTRACT Objective To assess the effects of coloring beverages on the color stability of two types of hybrid ceramics with different surface treatments. Material and Methods 180 specimens of two hybrid ceramics (Vita Enamic and Mazic Duro) and a feldspathic ceramic (Vita Mark II) were prepared (n=60 in each group). Half of the discs in each group were glazed while the other was polished. The specimens were then divided into three subgroups and immersed in distilled water, carrot juice, and coffee. The overall color difference (∆E) was calculated based on CIE L*a*b* color space. Data were analyzed using three-way and one-way ANOVA; Tukey's honest significant difference was also done for pairwise comparisons (α=0.05). Results Vita Mark II specimens revealed less overall color changes compared to other groups. The ∆E of the glazed Vita Enamic specimens was greater than polished specimens following immersion in distilled water (p=0.03) and coffee (p=0.001), but it was not significant for carrot juice. The same results were obtained for polished Mazic Duro specimens. Relatively similar amounts of ∆E were recorded in polished and glazed subgroups of Vita Mark II. Conclusion The ∆E of hybrid ceramics was higher than Vita Mark II. Polishing could be recommended for surface treatment of hybrid ceramics instead of glazing, saving time and facilitating the process.

In Vitro Microscopic Evaluation of Metal- And Zirconium-Oxide-Based Crowns' Marginal Fit

ABSTRACT Objective To evaluate the marginal adaptation of computer-aided designing and computer-aided machining (CAD/CAM) fabricated cobalt-chromium and zirconium-oxide-based ceramic crowns compared to those produced by a conventional method. Material and Methods The study consists of three groups; 45 crowns fabricated from cobalt-chromium (CAD-CoCr) and 45 crowns manufactured from zirconium CAD/CAM technology (CAD-Z), and 45 control (C) which consists of conventional metal-ceramic crowns. The marginal discrepancies in vertical dimensions were assessed utilizing a microscope in four surfaces (mesial, distal, vestibular, and oral) for each crown. On completion of the microscopic evaluation, multivariate analysis of variance (MANOVA) was used to study the difference in the four surfaces, considered altogether. Two-way ANOVA revealed the effect of three systems used for gap measurements of each landmark. The differences observed were considered significant at p<0.05. Results There were no differences in the four surfaces revealed by АNOVА in the three groups when considered altogether. Two-way ANOVA of each surface discovered no differences among all groups as well. Conclusion The CAD/CAM crowns revealed a comparable and satisfactory marginal adaptation compared to conventional metal-ceramic crowns.

Influência da espessura e diferentes graus de opacidade do dissilicato de lítio no grau de conversão e resistência de união de cimentos resinosos / Influence of thickness and different degrees of opacity of lithium disilicate on the degree of conversion and bond strength of resin cements

O objetivo desse trabalho foi avaliar a influência de diferentes graus de opacidade e espessuras do dissilicato de lítio no grau de conversão de dois cimentos resinosos e na resistência de união dos mesmos à cerâmica. Duzentos e quarenta amostras cerâmicas de dissilicato de lítio (6x6 mm) foram obtidos a partir de blocos de IPS E-max CAD (Ivoclar Vivadent, Schaan, Liechtensten), nas opacidades HT (alta translucidez), LT (baixa translucidez) e MO (média opacidade), nas espessuras de 0,3 mm, 0,7 mm, 1,2mm, 1,7 mm, 2,0 mm. Para as análises do grau de conversão (n=9) e resistência de união (n=8) foram utilizados um cimento de ativação física (Variolink Esthetic LC) e um cimento dual (Multilink N). Para análise do grau de conversão, as amostras de cimento foram fotoativadas sob as amostras de cerâmica e levadas a um espectrômetro Raman confocal. Para o teste de resistência de união foram confeccionados cilindros de cimento resinoso sobre as amostras cerâmicas e submetidos ao ensaio de microcisalhamento. Os resultados mostraram que o aumento das espessuras causou diminuição no grau de conversão dos dois cimentos em todas as condições estudadas, porém só influenciou negativamente a resistência de união do cimento Variolink Esthetic LC quando unido à cerâmica na opacidade MO. Na comparação entre as opacidades, de maneira geral, a cerâmica de maior translucidez HT apresentou maiores valores de grau de conversão em comparação às outras opacidades. Já para resistência de união, em algumas espessuras as cerâmicas LT e MO apresentaram os maiores valores. O cimento dual Multilink N apresentou os maiores valores nas duas análises comparado ao cimento fotoativado Variolink Esthetic LC. Portanto, o aumento da espessura e da opacidade do material cerâmico podem promover uma diminuição no grau de conversão do cimento. A resistência de união também sofre uma diminuição com o aumento da espessura de cerâmicas mais opacas. No entanto, a maior translucidez do material não garante valores mais altos dessa mesma propriedade(AU)

This research aims to evaluate the influence of different degrees of opacity and thicknesses of lithium disilicate on the degree of conversion of two resin cements and on their bond strength to the ceramic. Two hundred and forty lithium disilicate ceramic samples (6x6 mm) were obtained from IPS E-max CAD (Ivoclar Vivadent, Schaan, Liechtensten), in HT, LT and MO opacities, with thicknesses of 0.3 mm, 0.7 mm, 1.2 mm, 1.7 mm, 2.0 mm. For degree of conversion (n=9) and bond strength analysis (n=8) a light cured (Variolink Esthetic LC) and a dual cured resin cement (Multilink N) were used. To analyze the degree of conversion, the cement samples were light cured under the ceramic samples and taken to a confocal Raman spectrometer. For the bond strength test, resin cement cylinders were made on the ceramic samples that were later subjected to a microshear. The results showed that the increase in thickness caused a decrease on degree of conversion of both cements in all the conditions studied, but it only had an influence on bond strength of Variolink LC cement for MO ceramic. Comparing the opacities, for the degree of conversion, the most translucent ceramics had higher conversion values compared to the less translucent ones in some thicknesses. As for bond strength, in some thicknesses the LT and MO ceramics showed the highest values. The dual cement Multilink showed the highest values of conversion degree and bond strength compared to Variolink Esthetic LC light-cured cement. The Multilink dual cement showed the highest values in both analyzes compared to the Variolink LC light-cured cement. Therefore, increasing the thickness and opacity of the ceramic material can promote a decrease in the degree of cement conversion. The bond strength also suffers a decrease with increasing thickness of more opaque ceramics and the greater translucency of the material does not guarantee higher values of this same property(AU)

Influência do material cerâmico, cimento e tipo de substrato na qualidade estética de restaurações indiretas / Influence of ceramic material, resin cement and type of substrate in the aesthetic quality of indirect restorations

O objetivo deste estudo foi avaliar a influência do material cerâmico, cimento e tipo de substrato na qualidade estética de restaurações indiretas. A pesquisa científica foi dividida em duas partes. Na primeira análise, a alteração de cor e luminosidade de restaurações cerâmicas à base de dissilicato de lítio (e.max CAD), monossilicato de lítio (Celtra Duo) e cerâmica híbrida (Vita-Enamic CAD) foram analisadas quando sobrepostas em diferentes substratos (esmalte bovino, metal e zircônia), após a aplicação de pastas de prova "try-in" e após a cimentação com diferentes tipos de cimentos resinosos (RelyX Veneer, Variolink Esthetic LC e RelyX Ultimate). As análises foram realizadas em espectrofotômetro de reflexão UVVisivel (n=6). Os resultados mostraram que o tipo de substrato influenciou de maneira mais significante a estabilidade de cor e luminosidade das cerâmicas, independente da cor e tipo de material de cimentação. No segundo projeto, o objetivo foi avaliar a alteração cromática e a transmitância de diferentes restauraçoes cerâmicas: dissilicato de lítio (e.max CAD), monossilicato de lítio (Celtra Duo) e cerâmica híbrida (Vita-Enamic CAD) em oito diferentes espessuras (0,3mm à 2,0mm), com variação da potência do fotopolimerizador (1000mW/cm2 e 3200mW/cm2 ) e submetidos ao envelhecimento UV. As análises da alteração cromática foram realizadas em espectrofotômetro de reflexão UV-Visivel (n=8), enquanto que a análise da transmitância das cerâmicas foi realizada medindo-se a radiação de luz transmitida pelos diferentes materiais com um medidor de potência. Os resultados obtidos mostraram que os materiais cerâmicos estudados apresentam comportamentos diferentes quanto a estabilidade de cor das peças cimentadas. As diferentes espessuras influenciaram na cor do conjunto após o envelhecimento UV em todos os materiais estudados, sendo que a cerâmica de dissilicato de lítio e a cerâmica híbrida apresentaram influência nas espessuras mais delgadas. A transmitância dos materiais foi influenciada pela sua espessura e composição. A variação da potência do fotopolimerizador não influenciou na estabilidade de cor de todos os materiais analisados nas diferentes espessuras(AU)

The aim of this study was to evaluate the influence of ceramic material, resin cement and type of substrate in the aesthetic quality of indirect restorations. The research was divided into two chapters. In the first analysis, the color difference and luminosity of lithium disilicate (e.max CAD), zirconia-reinforced lithium silicate (Celtra Duo) and polymer infiltrated ceramic network (Vita Enamic CAD) were analyzed on different substrates (bovine enamel, metal and zirconia), after try-in pastes placed between the ceramics and substrates and after luting with different resin cements (RelyX Veneer, Variolink Esthetic LC e RelyX Ultimate) (n=6). The results showed that the type of substrate had more influence on the color stability and luminosity of ceramics, independent of the color and resin cement used. In the second study, the aim was to evaluate the color difference and transmittance of different ceramic restorations: lithium disilicate (e.max CAD), zirconia-reinforced lithium silicate (Celtra Duo) and polymer infiltrated ceramic network (Vita Enamic CAD) in eight thickness (0.3mm to 2.0mm), using light-emitting diode Valo Cordless (Standard and Xtra power modes) submitted to UV aging (n=8). The transmittance was done measuring the light transmitted through the materials with a power meter. The results showed that the ceramic materials showed different behavior in the color stability, especially for the thinner lithium disilicate and polymer infiltrated ceramic network materials. The transmittance was influenced by the thickness and composition of the materials. The variation in the power intensity of the lightemitting diode did not influence the color stability of the materials, independent of its thickness(AU)

Ciencia y evolución del dióxido de zirconio, de la prioridad mecánica a la necesidad estética / Science and evolution of zirconium dioxide, from mechanical priority to aesthetic need

RESUMEN En la actualidad, los procedimientos de alta tecnología enfocados a las restauraciones en base a cerámicas dentales han permitido la evolución y perfeccionamiento de distintas formas de manufactura de restauraciones, iniciándose así, la utilización de cerámicas como el dióxido de zirconio. Objetivo : Identificar las publicaciones recientes de los materiales de restauración a base de dióxido de zirconio que incluyan estudios clínicos, propiedades mecánicas, físicas y estéticas, así como su evolución, manufactura y diversas aplicaciones en la práctica clínica diaria. Material y métodos : La búsqueda sistemática de la literatura se realizará en las bases de datos de PubMed y Ebsco, se considerarán publicaciones del 2010- 2019 y que fueran investigaciones clínicas, laboratoriales y todas aquellas que mostraban la evolución en el tiempo del dióxido de zirconio, así como su aplicabilidad y diversificación. Resultados: Se revisaron 48 artículos que cumplieron con los criterios de selección para la revisión bibliográfica. Se encontró que todas las restauraciones protésicas a base de dióxido de zirconio, indistintamente a su forma de utilización, mostraron un desempeño clínico muy similar a los tres años, después de ese tiempo, dependerá del tipo de utilización, composición y elección del caso. Conclusiones: El éxito clínico de las restauraciones en base a dióxido de zirconio, es debido a las múltiples ventajas mecánicas y, con las recientes modificaciones estructurales, sumadas al agregado de aditivos para su estabilización, se perfila como un material idóneo para el trabajo tanto en zonas estéticas como en áreas de necesidad de soporte mecánico con carga funcional elevada.

SUMMARY At present, high-tech procedures focused on restorations based on dental ceramics have allowed the evolution and improvement of different forms of manufacturing restorations, thus initiating the use of ceramics such as zirconium dioxide. Objective: To identify recent publications of zirconium dioxide based restoration materials that include clinical studies, mechanical, physical and aesthetic properties, as well as their evolution, manufacturing and various applications in daily clinical practice. Materials and methods: The systematic search of the literature will be carried out in the databases of PubMed and Ebsco, publications from 2010-2019 will be considered and that they were clinical, laboratory research and all those that showed the evolution in time of zirconium dioxide , as well as its applicability and diversification. Results: 48 articles were reviewed that met the selection criteria for the literature review. It was found that all prosthetic restorations based on zirconium dioxide, regardless of their use, showed a clinical performance very similar to three years, after that time, will depend on the type of use, composition and choice of case. Conclusions: The clinical success of restorations based on zirconium dioxide is due to the multiple mechanical advantages and, with the recent structural modifications, added to the addition of additives for stabilization, is emerging as an ideal material for work both aesthetic areas as in areas of need for mechanical support with high functional load.

Effects of methacryloyloxydecyl dihydrogen phosphate on bond durability of zirconia / 中华口腔医学杂志

Objective@#To evaluate the bond performance of primers, universal adhesives and self-adhesive resin cements containing methacryloyloxydecyl dihydrogen phosphate (MDP) to zirconia.@*Methods@#Two hundred and ten yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) plates were prepared and divided into seven groups according to each of six MDP-containing products and one MDP-free resin cement. Two primers, two universal adhesives and two self-adhesive resin cements were applied on the specimens after these specimens recived alumina air abrasion. The group of MDP-free resin cement was set as control. Each group contained 30 specimens. Y-TZP plates were bonded to resin composite to build resin bonding specimens, and half of these plates were stored in distilled water at 37 ℃ for 24 hours, the other half were stored for 12 months. Shear bond strength (SBS) test and fracture modes analysis were performed.@*Results@#The SBS values of all the experimental groups were above 9.51 MPa, which increased 24-hour values compared to the (5.04±0.50) MPa of the control group. Group using one of the self-adhesive resin cement yielded the highest SBS, (11.06±0.84) MPa. SBS of all groups decreased significantly compared to 24-hour SBS after aging (P<0.05), however, the SBS values of MDP-containing products groups can still be maintained above 7.44 MPa. Two self-adhesive cement groups and one of the universal adhesive group maintained higher SBS values, and the values were statistical different from those from the two primer groups (P<0.05) .@*Conclusions@#Different MDP-containing products have different effects on the bond durability of zirconia.

Effect of glaze technology on adhesive and mechanical properties of Yttria-stabilized tetragonal zirconia polycrystal ceramic / 中国组织工程研究

BACKGROUND: Any surface treatments should Improve the bond strength of yttria-stabilized tetragonal zlrconia polycrystal ceramics without damaging the original strength. Currently, there is no Information about the influence of glaze technology on the bond strength of yttria-stabilized tetragonal zlrconia polycrystal ceramics, and its Influence on the material strength Is unclear. OBJECTIVE: To evaluate the effect of glaze technology on the mechanical behavior of yttria-stabilized tetragonal zlrconia polycrystal ceramics and on the bond strength with resin cements. METHODS: Yttria-stabilized tetragonal zlrconia polycrystal ceramics specimens were prepared and randomly divided into four groups: group A: the surface was not treated; group B: sandblasting with 110 urn Al203 particles; group C: glaze + hydrofluoric acid etching; group D: glaze + hydrofluoric acid etching + sllanlzation. The surface morphology, surface roughness, phase transformation, elemental composition, shear bond strength and flexural strength of zlrconia specimens after surface treatments were tested. RESULTS AND CONCLUSION: (1) The surface roughness of treatment groups increased obviously, whose descending order was group C (0.62±0.01) um > group D (0.55±0.02) um > group B (0.11±0.02) um > group A (0.05±0.01) urn (p 0.05). (6) The effect of glaze technology on improving the flexural strength of yttria-stabilized tetragonal zirconia polycrystal ceramics is not as obvious as that of sandblasting, but the bond strength between tetragonal zirconia polycrystal ceramics and resin cements can be significantly Improved with hydrofluoric acid etching and silanization after glaze.

Harmonização do sorriso com laminados cerâmicos: relato de caso / Harmonization of smile with ceramic veneers: case report / Armonización de la sonrisa con laminados cerámicos: informe de caso

Introdução: Os padrões de beleza atuais aumentaram o nível de exigência estética e a busca por sorrisos cada vez mais harmônicos. As facetas cerâmicas destacam-se dentre as opções de tratamentos por associarem estética, longevidade e previsibilidade. Objetivo: Este trabalho objetivou apresentar um caso clínico de substituição de facetas diretas de resina composta por facetas indiretas de porcelana. Descrição do caso: A pacienteC.L.M, 25 anos, sexo feminino relatou insatisfação com a estética do seu sorriso, destacando o formato, o tamanho e a cor 1M2dos elementos dentários 11 e 21. Diante da queixa e da situação clínica observada, propôs-se a confecção de laminados cerâmicos de dissilicato de lítio, mediante a realização prévia de gengivoplastia e de clareamento dentário. Conclusões: Conclui-se que o planejamento cuidadoso, o conhecimento da técnica operatória e a execução adequada do protocolo reabilitador permitem que os laminados cerâmicos reestabeleçam o sorriso de forma estética e funcional (AU).

Introduction:The current beauty standards have increased the level of aesthetic demand and the search for more and more harmonious smiles. The ceramicveneers stand out among the treatment options for combining aesthetics, longevity and predictability. Objective:This study aimed to present a clinical case of substitution of direct resin veneers composed of indirect porcelain veneers. Case description:Patient C.L.M, 25 years old, female, reported dissatisfaction with the aesthetics of her smile, highlighting the shape, size and 1M2 colorof dental elements 11 and 21. In view of the complaint and the clinical situation observed, it was proposed to make lithium disilicate ceramic veneers, through previous gingivoplasty and tooth bleaching. Conclusions:It is concluded that the careful planning, the knowledge of the operative technique and the proper execution of the rehabilitation protocol allow the ceramic veneers to reestablish the smile in an aesthetic and functional way (AU).

Introducción: los estándares de belleza actuales han aumentado el nivel de demanda estética y la búsqueda de sonrisas cada vez más armoniosas. Las facetas cerámicas se destacan entre las opciones de tratamiento para combinar estética, longevidad y previsibilidad. Objetivo: Este estudio tuvo como objetivo presentar un caso clínico de sustitución de carillas de resina directas compuestas de carillas de porcelana indirectas.Descripción del caso: La paciente C.L.M, 25 años, mujer, refirió insatisfacción con la estética de su sonrisa, destacando la forma, tamaño y color 1M2de los elementosdentales 11 y 21. En vista de la queja y la situación clínica observada, se propuso hacer laminados de cerámica disilicato de litio, mediante reparación gingival previa y blanqueamiento dental. Conclusiones: se concluye que la planificación cuidadosa, el conocimiento de la técnica operativa y la ejecución adecuada del protocolo de rehabilitación permiten a los laminados cerámicos restablecer la sonrisa de una manera estética y funcional (AU).

Dental bleaching gels do not alter the surface roughness and microhardness of feldspathic porcelain / A rugosidade e a microdureza da superfície de porcelana feldspática não são alteradas pelo clareamento dental

ABSTRACT Objective: To evaluate whether two different bleaching gels affect the microhardness and surface roughness of feldspathic ceramic specimens, in vitro. Methods: A total of 48 feldspathic porcelain IPS In Line (Ivoclar-Vivadent) discs (16/treatment group) were immersed in distilled water (Group I, Untreated control, UN), or treated with the bleaching gels: Opalescence (15% carbamide peroxide; OPA) and Opalescence Xtra Boost (38%hydrogen peroxide; OPAXB), for 1h or 6h daily for 14 days. Surface roughness (Ra) and microhardness (Knoop, or KNP) measurements were made before and after treatment, and data were subjected to statistical analysis by paired Student's t-test (p < 0.05). Results: Treatments using Opalescence and Opalescence Xtra Boost did not altered surface roughness (p=0.6199861) or microhardness (p=0.14286744) of the feldspathic porcelain tested in this study. Conclusion: Bleaching treatments using Opalescence and Opalescence Xtra Boost may be suitable for treatment in patients having ceramic prosthodontic treatment. Conclusion: Bleaching treatments using Opalescence and Opalescence Xtra Boost may be suitable for treatment in patients having ceramic prosthodontic treatment.

RESUMO Objetivo Avaliar se dois géis clareadores diferentes afetam a microdureza e a rugosidade superficial de corpos de prova de cerâmicafeldspática, in vitro. Métodos um total de 48 discos de porcelana feldspática IPS In Line (Ivoclar-Vivadent) (16 / grupo de tratamento) foram imersos em água destilada (Grupo I, Controle não tratado, ONU), ou tratados com os géis clareadores: Opalescence (15 % peróxido de carbamida; OPA) e Opalescence Xtra Boost (38% peróxido de hidrogênio; OPAXB), por 1h ou 6h diariamente por 14 dias. Medidas de rugosidade superficial (Ra) e microdureza (Knoop, ou KNP) foram regristradas antes e depois do tratamento, e os dados foram submetidos à análise estatística por teste t de Student pareado (P <0,05). Resultados Os tratamentos com Opalescence e Opalescence Xtra Boost não alteraram a rugosidade superficial (p = 0,6199861) ou a microdureza (p = 0,14286744) da porcelana feldspática testada neste estudo. Conclusão Os tratamentos clareadores com Opalescence e Opalescence Xtra Boost podem ser adequados para o tratamento de pacientes submetidos ao tratamento com prótese cerâmica.

Efeito da aplicação de plasma não-térmico atmosférico no reparo de cerâmicas CAD/CAM de matriz resinosa com resina composta / Effect of non-thermal atmospheric plasma application on the resin composite repair of resin matrix CAD/CAM ceramics

O objetivo deste trabalho foi avaliar o efeito do plasma atmosférico não-térmico (PANT), sozinho ou associado ao jateamento ou adesivo, e do tempo de armazenamento em água na resistência de união por cisalhamento (RUC) do reparo de cerâmicas CAD/CAM de matriz resinosa (CMR) com resina composta. Amostras de 14x7x1mm de três CMRs, Enamic (VITA Zahnfabrik), Cerasmart (GC Corp.) e Lava Ultimate (3M Oral Care), foram obtidas e submetidas ao envelhecimento artificial (EQ-UV, Equilam) por 300 horas. Os seguintes tratamentos de superfície foram realizados: (1- Controle) jateamento + silano + adesivo; (2) PANT; (3) PANT + adesivo; (4) jateamento + PANT. Cilindros de resina composta (Spectra Smart, Dentsply Sirona, 1,5 mm diâmetro e altura) foram aderidos às superfícies tratadas e a RUC foi avaliada em uma máquina de ensaio universal (EZ Test, Shimadzu) após 24 horas ou 1 ano de imersão em água, a 37oC (n=10). No geral, o tratamento controle obteve os melhores resultados de RUC, comparado aos grupos tratados com PANT. Houve redução da RUC após 1 ano de imersão em água para a maioria dos grupos, entre eles para o controle do Enamic e Lava Ultimate, enquanto Cerasmart não mostrou redução. O tratamento com PANT, sozinho ou associado a outro tratamento, não foi capaz de aumentar a RUC do reparo das CMRs com resina composta. O tratamento controle parece ser o melhor método de reparo das CMRs, principalmente considerando-se a longevidade do tratamento.

The objective of this study was to evaluate the effect of nonthermal atmospheric plasma (NTAP), alone or combined with sandblasting or adhesive, and water-storage time on the shear bond strength (SBS) of resin composite repair of resin matrix ceramics (RMC). Samples (14x7x1mm) of three RMCs, Enamic (VITA Zahnfabrik), Cerasmart (GC Corp.), and Lava Ultimate (3M Oral Care), were prepared and submitted to artificial aging (EQ-UV, Equilam) for 300 h. The following surface treatments were performed: (1- Control) sandblasting + silane + adhesive; (2) NTAP; (3) NTAP + adhesive; (4) sandblasting + NTAP. Resin composite cylinders (Spectra Smart, Dentsply Sirona, 1,5 mm diameter and height) were bonded to the treated surfaces and the SBS was evaluated in a universal testing machine (EZ Test, Shimadzu) after 24 h or 1 year of water storage, at 37oC (n=10). In general, the control treatment obtained the best SBS results, compared to groups treated with NTAP. There was a decrease in SBS after 1 year of water immersion for most groups, including the control treatment for Enamic and Lava Ultimate, while Cerasmart presented no reduction. The treatment with NTAP alone or combined with another treatment, was not capable of increasing the SBS of resin composite repair to RMCs. Control treatment seems to be the best method for repairing CMRs, mainly considering the treatment longevity.

Expert consensus on clinical application of all-ceramic esthetic restorative materials / 中华口腔医学杂志

All-ceramic materials have become the most commonly used dental esthetic restorative material in clinic due to their excellent esthetic and mechanical properties and biocompatibility. However, there are still many confusions about the clinical application of all-ceramic materials. Society of Esthetic Dentistry in conjunction with Society of Dental Material Science, Chinese Stomatological Association organized multidisciplinary experts in prosthodontics, dental materials, implantology and dental esthetics to develop a consensus on the clinical application of all-ceramic esthetic restorative materials. The expert consensus covers such aspects of all-ceramic materials as the classification, major properties, selection of clinical indications and treatment of bonding interfaces. It is hoped that the consensus may help the clinicians to make correct decisions in selecting adequate materials in all-ceramic restoration according to various specific cases in the clinic.

Impact of tooth structure and fatigue cycles on the fracture strength of glass-ceramic onlays in the elderly / 中华老年医学杂志

Objective To investigate the impact of tooth structure and fatigue cycles on the fracture strength of glass-ceramic onlays for molar restoration in the elderly.Methods A total of 72 extracted molars due to periodontitis from people aged 60 years or over were selected and flattened to different levels of the occlusal surface.The percentage of enamel was calculated.Two groups with different percentages of enamel were selected from 72 molars,one group with(80±10)％ enamel or the E group and the other group with (20±10)％ enamel or the D group,with 12 samples in each group.IPS e.max CAD discs(diameter=9 mm,thickness=1.3 mm)were cemented to the prepared sample surface by using Variolink N resin cement system.Furthermore,three subgroups were formed randomly from each group(n=4,in each group).Subgroups were treated with 5,100 000 and 1000 000 fatigue cycles,respectively,with the same load(180 N,1.5 Hz)in water,following thermal cycling(5～55 ℃ for 1 500 cycles),and then fracture strength was tested.Results The fracture strength was(2 761.8±477.2)N in the E group and(1 100.1±216.9)N in the D group.The two-factor analysis of variance indicated that tooth structure had a significant influence on fracture strength(F =98.51,P＜0.05),while the influence of fatigue cycles on fracture strength was not significant (F =0.22,P ＞0.05).Enamel percentage had a positive linear correlation with fracture strength(r=0.915,=10.66,P ＜0.05).Conclusions Enamel percentage has a positive correlation with fracture strength of glass-ceramic onlays.For elderly people who have severe tooth wear,preserving more enamel within the adhesive area can increase the fracture strength of ceramic onlays for an extended period of time.

Simulated occlusal adjustments and their effects on zirconia and antagonist artificial enamel

PURPOSE: The aim of this study was to evaluate the effect of occlusal adjustments on the surface roughness of yttria-tetragonal zirconia polycrystal (Y-TZP) and wear of opposing artificial enamel.

Effect of zirconia substructure thickness on the mechanical properties and adhesion of veneering porcelain

Aim: This study investigated the influence of yttrium-stabilized tetragonal zirconia polycrystals (Y-TZP) thickness on fracture load of porcelain-veneered crowns (FL), fracture toughness of porcelain (FT), and the shear bond strength zirconia/porcelain (SBS). Methods: Artificial first molar was prepared for full crown (N=45) with different occlusal reduction. Y-TZP cores were made with different thickness at the occlusal face (1mm, 2mm and 3mm) (n=15). The cores were veneered with VM9 ­ Vita porcelain with 1.0 mm layer. For FL testing, axial load was applied to the mesiolingual cusp of the crowns. For FT testing, flat Y-TZP plates (5X5 mm) with 1, 2 or 3 mm thickness were veneered with 1.0 mm porcelain layer (n=10). FT by indentation fracture technique was measured close to the interface and at the top surface. For SBS by knife-edge shearing rod, cylindrical porcelain with 5 mm in diameter and 3 mm was applied on flat Y-TZP plates (1, 2 and 3 mm thickness) (n = 10). Results: Data analyzed by 1-Way ANOVA for FL of crowns and SBS between Y-TZP and porcelain were not significant. Two-way ANOVA for FT was significant for zirconia thickness and measurement area. The post-hoc test showed higher values for the groups with 2 and 3mm, and higher values at the interface, irrespectively of Y-TZP thickness. Conclusion: The zirconia thickness did not affect the FL of veneered crowns and the SBS between the ceramics, but FT of porcelain was lower in thinner zirconia substructure and close to the interface Y-TZP/Porcelain

Restabelecimento da estética do sorriso com laminados cerâmicos: relato de caso / Restoration of smile esthetics with ceramic laminates: case report / Restauración de la estética de la sonrisa con laminado cerámico: caso clínico

Introdução:A estética é uma preocupação do ser humano, tendo o sorriso nesse contexto um papel fundamental. Dessa forma, os laminados cerâmicos, caracterizados pelo recobrimento da face vestibular do elemento dental e restabelecimento estético do sorriso, com desgaste minimamente invasivo, vem sendo bastante indicado.Objetivo:relatar o restabelecimento do sorriso por meio da reanatomização de dentes anteriores com laminados cerâmicos a fim de realizar o fechamento de diastemas e melhorar a qualidade de vida do paciente que possuía prejuízo estético e funcional. O trabalho salienta desde a estética até a manutenção da saúde bucal, passando pelas fases de clareamento até a cimentação dos laminados, proporcionado por um tratamento integrado.Descrição do Caso:Paciente de 25 anos, sexo masculino, não apresentava exposição dos elementos dentários superiores, caracterizando um envelhecimento facial, além de dentes curtos, com diastemas e coloração amareladaConclusão:Conseguiu-se alcançar forma e estética com mínimo desgaste dentário e devolução da jovialidade do paciente (AU).

Introduction:esthetics is a concern of the human being, with the smile being in this context a fundamental role. In this way, the ceramic laminates veneers, characterized by the covering of the vestibular face of the dental element and esthetic restoration of the smile, with minimally invasive approach, has been quite indicated.Objective:to report the reestablishment of the smile by means of the reanatomization of anterior teeth with ceramic laminates veneers in order to close the diastema and improve the quality of life of the patient who had esthetic and functional impairment. This study goes from esthetics to the maintenance of oral health, through the stages of dental bleaching to the cementation of laminates, provided by an integrated treatment.Case Description:A 25-year-old male patient, had no upper dental exposure, characterizing a facial aging, as well as short teeth with diastema and yellowish coloration.Conclusion:It was possible to achieve form and esthetics with a minimally invasive approach and return of the patient's joviality (AU).

Introducción: la estética es una preocupación del ser humano, teniendo la sonrisa en este contexto un papel fundamental. Por lo tanto, los laminados cerámicos, caracterizados por cubrir la cara vestibular del elemento dental y restablecer la sonrisa con un desgaste mínimamente invasivo, han sido ampliamente indicados.Objetivo: informar sobre la restauración de la sonrisa a través de la reanatomización de los dientes anteriores con laminados cerámicos para cerrar el diastema y mejorar la calidad de vida de los pacientes con discapacidad estética y funcional. El trabajo enfatiza desde la estética hasta el mantenimiento de la salud bucal, pasando por las fases de blanqueamiento hasta la cementación de los laminados, proporcionados por un tratamiento integrado. Descripción del Caso: Un paciente masculino de 25 años no tuvo exposición de los elementos dentales superiores, caracterizando el envejecimiento facial, así como dientes cortos, diastema y amarillentos.Conclusión: Se logró la forma y la estética con un desgaste dental mínimo y el retorno de la juventud del paciente (AU).

Cerámicas: una actualización / Ceramics: an update / Cerâmica: uma atualização

Las cerámicas dentales utilizadas para restaurar y reemplazar tejido dental perdido de los dientes o las piezas dentales mismas, han sufrido una enorme transformación desde que aparecieron las primeras porcelanas hace ya varias décadas. Con las feldespáticas se podían hacer dientes, coronas y puentes pero, necesitaban un soporte de metal para que no sufran fracturas con los esfuerzos masticatorios, y por ello no tenían una apa-riencia vital. Hoy en día, han aparecido muchas otras cerámicas con diferentes y mejoradas características mecánicas y ópticas, lo que ha permitido que los odontólogos puedan por primera vez ofrecer a sus pacientes dientes artificiales con sorprendente naturalidad. Objetivo: Describir la clasificación actual, las características mecánicas y ópticas, así como la microestructura y los usos clínicos de las diferentes cerámicas dentales utilizadas hoy en día. Materiales y métodos: Revisión de la literatura acerca del tema, en tres de los más importantes buscadores de internet (Pubmed,Cochrane,Web of Science). Limitando su busca a artículos en inglés y publicados en los journals de investigación de materiales dentales con calificación Q1 y Q2. Resul-tados: Se revisaron 69 artículos publicados entre 1975 y 2019 los cuales aportaron una fuente interesante de información que permitió desarrollar el conocimiento acerca de la clasificación, microestructura, propiedades mecánicas y ópticas, usos clínicos y forma de procesamiento de las cerámicas. Conclusiones: Actualmente los odontólogos tienen a disposición una amplia variedad de materiales cerámicos con diferentes composicio-nes y características únicas que son necesarias conocer al momento de escoger la cerámica específica para cada necesidad de los pacientes.

The dental ceramics used to restore and replace lost tooth tissue or the teeth have undergone a huge trans-formation since the first porcelains appeared several decades ago. With the feldspathic teeth, crowns and bridges could be made but, they needed a metal support so that they did not suffer fractures with the mastica-tory efforts, and therefore they did not have a vital appearance. Today, many other ceramics with different and improved mechanical and optical characteristics have appeared, which has allowed dentists to offer artificial teeth to their patients for the first time with surprising naturalness. Objective: Describe the current classifica-tion, mechanical and optical characteristics, as well as the microstructure and clinical uses of the different dental ceramics used today. Materials and methods: Review about the literature on the subject, in three of the most important internet search engines (Pubmed, Cochrane, Web of Science). Limiting your search to articles in English and published in the journals of research of dental materials with qualification Q1 and Q2. Results:69 articles published between 1975 and 2019 were reviewed, which provided an interesting source of informa-tion that allowed the development of knowledge about classification, microstructure, mechanical and optical properties, clinical uses and method of processing ceramics. Conclusions: Currently, dentists have available a wide variety of ceramic materials with different compositions and unique characteristics that are necessary to know when choosing the specific ceramic for each patient need.

A cerâmica dentária usada para restaurar e substituir o tecido dentário perdido ou as próprias peças dentárias sofreram uma enorme transformação desde que as primeiras porcelanas surgiram várias décadas atrás. Com os materiais feldespáticos, podiam ser feitas coroas e pontes, mas eles precisavam de um suporte de metal para não sofrer fraturas com os esforços mastigatórios e, portanto, não tinham uma aparência de vitalidade. Hoje, outras cerâmicas com características mecânicas e ópticas diferentes e aprimoradas surgiram, o que permitiu aos dentistas oferecer dentes artificiais a seus pacientes pela primeira vez com uma naturalidade surpreendente. Objetivo: Descrever a classificação atual, características mecânicas e ópticas, bem como a microestrutura e os usos clínicos das diferentes cerâmicas odontológicas utilizadas atualmente. Materiais e métodos: Revisão da literatura sobre o assunto, em três dos mais importantes mecanismos de busca na In-ternet (Pubmed, Cochrane, Web of Science). Limitando a sua pesquisa a artigos em inglês e publicados nas revistas científicas de materiais dentários com qualificação Q1 e Q2. Resultados: Foram revisados 69 artigos publicados entre 1975 e 2019, que forneceram uma fonte interessante de informações que permitiram desen-volver conhecimento sobre a classificação, microestrutura, propriedades mecânicas e ópticas, usos clínicos e forma de processamento da cerâmica. Conclusões: Atualmente, os dentistas têm disponível uma ampla variedade de materiais cerâmicos com composição diferente e características únicas que são necessárias conhecer ao escolher a cerâmica específica para cada necessidade do paciente.