Mechanical behavior of different machinable ceramic crowns using vertical and horizontal preparations: an in-vitro study / Comportamento mecânico de diferentes coroas cerâmicas usináveis usando preparos verticais e horizontais: um estudo in vitro

Objective: the aim of this study was to compare the mechanical behavior of different ceramics when used in thin vertical preparations versus traditional horizontal preparation. Material and Methods: two stainless-steel dies were milled to simulate a minimally invasive vertical preparation (VP) and a traditional horizontal preparation (HP) for an all-ceramic crown of a maxillary first premolar. The stainless-steel dies were duplicated using epoxy resin. Eighty monolithic crowns were milled and divided into 2 groups according to preparation design. Each design group was subdivided into 4 sub-groups according to material (n=10): IPS e.max CAD (lithium disilicate), Bruxzir shaded zirconia (full contour zirconia), CeraSmart (resin nanoceramic) and CEREC Tessera (advanced lithium disilicate). The crowns were cemented on their relevant epoxy resin dies using self-adhesive resin cement. All specimens were subjected to 15,000 thermocycles and then loaded to fracture in a universal testing machine. Data were analyzed using two-way ANOVA and Tukey pair wise comparison test. Results: the fracture resistance mean values of the VP (1344 + 118 N) was significantly lower than the HP design (1646 + 191 N). Ceramic crowns made of full contour zirconia had higher fracture resistance mean values (2842 + 380 N) than advanced lithium disilicate (1272 + 125 N) followed by lithium disilicate crowns (983 + 52 N) and resin nanoceramic (882 + 61 N). Conclusion: both vertical and horizontal preparations, regardless the different ceramic materials, showed clinically acceptable fracture resistance values. (AU)

Objetivo: o objetivo deste estudo foi comparar o comportamento mecânico de diferentes cerâmicas quando utilizadas em preparos verticais finos ou preparos horizontais tradicionais. Material e Métodos: dois modelos de aço inoxidável foram fresados para simular um preparo vertical minimamente invasivo (PV) e um preparo horizontal tradicional (PH) para uma coroa totalmente em cerâmica de um primeiro pré-molar superior. As matrizes de aço inoxidável foram duplicadas usando resina epóxi. Oitenta coroas monolíticas foram fresadas e divididas em 2 grupos de acordo com o desenho do preparo. Cada grupo foi subdividido em 4 subgrupos de acordo com o material (n=10): IPS e.max CAD (dissilicato de lítio), zircônia Bruxzir (zircônia de contorno total), CeraSmart (resina nanocerâmica) e CEREC Tessera (dissilicato de lítio avançado). As coroas foram cimentadas em suas respectivas matrizes de resina epóxi usando cimento resinoso autoadesivo. Todos os espécimes foram submetidos a 15.000 ciclos térmicos e então carregados até a fratura em uma máquina de teste universal. Os dados foram analisados usando ANOVA com dois fatores e teste de comparação por pares de Tukey. Resultados: os valores médios de resistência à fratura do PV (1344 + 118 N) foram significativamente menores do que PH (1646 + 191 N). As coroas de cerâmica feitas de zircônia de contorno total apresentaram maiores valores médios de resistência à fratura (2842 + 380 N) do que dissilicato de lítio avançado (1272 + 125 N), seguido por coroas de dissilicato de lítio (983 + 52 N) e resina nanocerâmica (882 + 61 N). Conclusão: preparos verticais e horizontais, independentemente dos diferentes materiais cerâmicos, apresentaram valores de resistência à fratura clinicamente aceitáveis. (AU)

Three-dimensional assessment of internal adaptation measurement of three cad/cam ceramic systems

Abstract This study aimed to evaluate the internal adaptation of three different computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic crowns. The internal adaptation of a polymer-infiltrated ceramic network material (Vita Enamic [VE]) was compared to two machinable glass-ceramics; Zirconia-reinforced lithium silicate (Vita Suprinity [VS]) and a lithium disilicate glass-ceramic (IPS e.max. CAD). Thirty human premolars of average size were prepared (n=10 each group) by computer numerical control to fulfill the criteria of all-ceramic crown design. Optical impressions were taken for each tooth preparation using the CAD/CAM scanner. Thirty crowns were fabricated using CAD/CAM system and divided into three groups (IPS e.max, VE, and VS). To assess the internal fit of tested crowns, the gap between the intaglio of each crown and the corresponding tooth surface was evaluated using a 3D digital scanner using the Triple-scan Protocol. One-way ANOVA followed by Tukey Post Hoc statistical tests were used to statistically analyze results of the internal fit. There was a statistically significant difference for all groups at the four axial walls (p = 0.000002). For total internal fit between groups, comparisons showed a statistically significant difference between all tested groups (p=0.000002). When each pair of groups was statistically compared with each other, all pair comparisons showed a statistically significant difference. IPS e.max CAD had the best internal fit, followed by Vita Enamic, then Vita Suprinity. For all ceramics tested, values of internal fit of all ceramics tested were within the clinically acceptable range.

Resumo Este estudo teve como objetivo avaliar a adaptação interna de três diferentes coroas cerâmicas CAD/CAM (Computer-aided design/computer-aided manufacturing). A adaptação interna de um material cerâmico de rede com infiltração de polímero (Vita Enamic [VE]) foi comparada com duas cerâmicas de vidro maquináveis; silicato de lítio reforçado com zircónio (Vita Suprinity [VS]) e uma cerâmica-vidro de dissilicato de lítio (IPS e.max. CAD). Trinta dentes pré-molares humanos de tamanho médio foram preparados (n=10 cada grupo) por controle numérico computadorizado para preencher os critérios de desenho de coroa em cerâmica pura. Foram tiradas impressões ópticas para cada preparação dentária utilizando o scanner CAD/CAM. Trinta coroas foram fabricadas usando o sistema CAD/CAM e divididas em três grupos (IPS e.max, VE, e VS). Para avaliar o ajuste interno das coroas testadas, o espaço entre o entalhe de cada coroa e a superfície dentária correspondente foi avaliado usando um scanner digital 3D usando o Protocolo Triple-scan. Para analisar estatisticamente os resultados do ajuste interno, utilizou-se a ANOVA unidirecional seguida dos testes estatísticos Tukey Post Hoc. Houve uma diferença estatisticamente significativa para todos os grupos nas quatro paredes axiais (p = 0,000002). Para o ajuste interno total entre grupos, as comparações mostraram uma diferença estatisticamente significativa entre todos os grupos testados (p=0,000002). Quando cada par de grupos foi comparado estatisticamente uns com os outros, todas as comparações de pares mostraram uma diferença estatisticamente significativa. IPS e.max CAD teve o melhor ajuste interno, seguido por Vita Enamic, depois Vita Suprinity. Para todas as cerâmicas testadas, os valores de ajuste interno de todas as cerâmicas testadas encontravam-se dentro da gama clinicamente aceitável.

Survival of Hybrid Laminate Veneers using two different tooth preparation techniques: Randomized Clinical Trial

Abstract The aim of this study was to evaluate the survival of laminate veneers constructed using a recent polymer-infiltrated ceramic network material following the aesthetic pre-evaluative temporary (APT) technique of tooth preparation in comparison to traditional technique. Six patients received 54 laminate veneers. They were divided into two equal groups (n=27) according to the technique of tooth preparation: group T: traditional technique and group A: aesthetic pre-evaluative temporary technique. VITA ENAMIC material was used for CAD/CAM construction of laminate veneers. Cementation was performed using a light cured resin cement. The laminate veneers were evaluated at baseline, after 3, 6 and 12 months according to the modified United States Public Health Service (USPHS) criteriea. The data was collected, tabulated and statistically analyzed. Secondary caries, endodontic complications, cracks and loss of retention were not noted in any laminate veneer. Extensive fractures were not detected in both study groups through the study period. There was a statistically significant decrease of color match criteria between the two groups at the 6 and 12 months recalls. Based on this study, both preparation techniques resulted in successful clinical performance. After 12 months, all the veneers in both groups showed no post-operative sensitivity and all patients were highly satisfied regarding their veneers. However, there was a deterioration in color match criteria through the study period in both study groups.

Resumo O objetivo deste estudo foi avaliar a sobrevivência de facetas laminadas construídas utilizando um material recente de rede de cerâmica impregnada de polímero, seguindo a técnica estética pré-avaliadora temporária (APT) de preparação de dentes em comparação com a técnica tradicional. Seis pacientes receberam 54 facetas de laminados. Foram divididos em dois grupos iguais (n=27) de acordo com a técnica de preparação do dente: grupo T: técnica tradicional e grupo A: técnica temporária pré-avaliativa estética. O material VITA ENAMIC foi utilizado para a construção de facetas de CAD/CAM de laminados. A cimentação foi realizada utilizando um cimento de resina fotopolimerizável. Os laminados foram avaliados na linha de base, após 3, 6 e 12 meses de acordo com os critérios modificados do Serviço de Saúde Pública dos Estados Unidos (USPHS). Os dados foram recolhidos, tabulados e analisados estatisticamente. Cáries secundárias, complicações endodônticas, fissuras e perda de retenção não foram observadas em nenhuma faceta laminada. Não foram detectadas fraturas extensas em ambos os grupos de estudo durante o período do estudo. Verificou-se uma diminuição estatisticamente significativa dos critérios de correspondência de cor entre os dois grupos nos 6 e 12 meses. Com base neste estudo, ambas as técnicas de preparação resultaram num desempenho clínico bem sucedido. Após 12 meses, todos os laminados de ambos os grupos não mostraram qualquer sensibilidade pós-operatória e todos os pacientes ficaram altamente satisfeitos com os seus laminados. No entanto, houve uma deterioração dos critérios de correspondência de cor durante o período de estudo em ambos os grupos de estudo.

Physical characteristics of ceramic/glass-polymer based CAD/CAM materials: Effect of finishing and polishing techniques

PURPOSE: The aim of this study was to compare the effect of different finishing and polishing techniques on water absorption, water solubility, and microhardness of ceramic or glass-polymer based computer-aided design and computer-aided manufacturing (CAD/CAM) materials following thermocycling. MATERIALS AND METHODS: 150 disc-shaped specimens were prepared from three different hybrid materials and divided into five subgroups according to the applied surface polishing techniques. All specimens were subjected up to #4000 grit SiC paper grinding. No additional polishing has been done to the control group (Group I). Other polishing procedures were as follows: Group II: two-stage diamond impregnated polishing discs; Group III: yellow colored rubber based silicone discs; Group IV: diamond polishing paste; and Group V: Aluminum oxide polishing discs. Subsequently, 5000-cycles of thermocycling were applied. The analyses were conducted after 24 hours, 7 days, and 30 days of water immersion. Water absorption and water solubility results were analyzed by two-way ANOVA and Tukey post-hoc tests. Besides, microhardness data were compared by Kruskal-Wallis and Mann-Whitney U tests (P.05). CONCLUSION: Surface finishing and polishing procedures might negatively affect physical properties of hybrid ceramic materials. Nevertheless, immersion periods do not affect the microhardness of the materials. Final polishing by using diamond polishing paste can be recommended for all CAD/CAM materials.

Comparative color and surface parameters of current esthetic restorative CAD/CAM materials

PURPOSE: The purpose of this study was to derive and compare the inherent color (hue angle, chroma), translucency (TP(SCI)), surface gloss (ΔE* SCE-SCI), and surface roughness (Ra) amongst selected shades and brands of three hybrid CAD/CAM blocks [GC Cerasmart (CS); Lava Ultimate (LU); Vita Enamic (VE)]. MATERIALS AND METHODS: The specimens (N = 225) were prepared into square-shaped (12 × 12 mm2) with different thicknesses and shades. The measurements of color, translucency, and surface gloss were performed by a reflection spectrophotometer. The surface roughness and surface topography were assessed by white light interferometry. RESULTS: Results revealed that hue and chroma values were influenced by the material type, material shade, and material thickness (P CS > VE, whereas the order of chroma was VE > CS > LU. TP(SCI) results demonstrated a significant difference in terms of material types and material thicknesses (P ≤ .001). TP(SCI) values of the tested materials were ordered as LU > CS > VE. ΔE* SCE-SCI and Ra results were significantly varied amongst the materials (P VE ≥ CS, whereas the order of Ra was CS ≥ VE > LU. CONCLUSION: Nano-ceramic and polymer-infiltrated-feldspathic ceramic-network CAD/CAM materials exhibited different optical, inherent color and surface parameters.