The removal of three kinds of occlusal veneers by Er: Yag laser / 华西口腔医学杂志

OBJECTIVES@#This study aimed to remove occlusal veneers of varied thicknesses and compositions by Er:Yag laser in vitro and analyze the interfacial microstructure between veneers and tooth that irradiated by laser, by which experimental evidence could be provided to support the non-invasive removal of occlusal veneerby laser.@*METHODS@#Fresh mandibular premolars extracted for orthodontic requirements were collected for tooth preparation. Three kinds of ceramic materials (Vita Suprinity, Vita Mark Ⅱ, and Upcera Hyramic) were selected to fabricate occlusal veneer with different thicknesses (1.0, 1.5, and 2.0 mm). One week later, Er:Yag laser (2.5 W and 3.5 W) was used to irradiate and remove the occlusal veneer and recorded the timespan. After the removal operation, the micro-morphologies of samples were examined by scanning electron microscope.@*RESULTS@#Upcera Hyramic veneer failed to be removed (>20 min); the operation span at 2.5 W, Vita Suprinity (96.0 s±16.0 s) was longer than Vita MarkⅡ(84.5 s±19.5 s) in the 1.0 mm group (P<0.05), and Vita Suprinity (246.5 s±13.5 s) was longer than Vita MarkⅡ(170.0 s±14.0 s) in the 1.5 mm group (P<0.05). At 3.5 W, Vita Suprinity (381.0 s±24.0 s) was longer than Vita MarkⅡ(341.5 s±26.5 s) in the 2.0 mm group.@*CONCLUSIONS@#Increasing laser power could shorten the operation span and facilitate the removal of occlusal veneers with the same thickness and composition. The occlusal veneer was sustained when insufficient laser power was applied. With the same laser power and ceramic thickness, laser penetration could interfere with the integral of the ceramic structure when the laser interacted with the bonding layer. With the same ceramic composition and laser power, the operation span and laser power increased with the thickness of the occlusal veneer. However, the laser was incapable of removing occlusal resin veneer directly.

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.

Effect of two processing techniques used to manufacture lithium disilicate ceramics on the degree of conversion and microshear bond strength of resin cement / Efeito de duas técnicas de processamento utilizadas na fabricação da cerâmica de dissilicato de lítio no grau de conversão e na resistência de união ao microcisalhamento do cimento resinoso

ABSTRACT The aim of the current study was to compare the effect of two lithium disilicate ceramic processing techniques (pressing and CAD/CAM) on the degree of conversion of resin cement when it is photoactivated and the microshear bond strength of resin cement to ceramics. Two ceramic discs were manufactured: one by the Press technique and another by CAD/CAM technique. Five Variolink Veneer resin cement samples were photoactivated through each ceramic disc and subjected to attenuated total reflectance Fourier transform infrared spectroscopy to evaluate their degree of conversion. To evaluate microshear bond strength, 20 ceramic bars were prepared: 10 using the Press technique and 10 using the CAD/CAM technique. The bars were air abraded with 50-μm Al2O3 particles, treated with 10% hydrofluoric acid for 20 s and subjected to RelyX Ceramic Primer application. Adper Scotchbond Multi-Purpose Adhesive was applied to the bars and cured for 10 s. Two 1-mm-height plastic tubes were placed on each bar and filled with Variolink Veneer resin cement. Each cylinder was cured for 20 s. Then the plastic tubes were removed and the microshear bond strength of each cylinder was tested. Data for degree of conversion (%) and microshear bond strength (MPa) were subjected to Student's t-test (α = 0.05). Both degree of conversion of resin cement photoactivated through ceramic and microshear bond strength of resin cement to ceramic were statistically higher in the group in which ceramic was prepared by CAD/CAM technique (44.74% and 22.18 MPa) than in the group in which the ceramic was prepared by the Press technique (25.71% and 19.83 MPa). The lithium disilicate ceramic processing techniques affected the degree of conversion of resin cement when it is photoactivated through the ceramics and the microshear bond strength of resin cement to ceramics.

RESUMO O objetivo do presente estudo foi comparar o efeito de duas técnicas de processamento da cerâmica de dissilicato de lítio (prensada e CAD/CAM) no grau de conversão do cimento resinoso quando fotoativado e na resistência de união ao microcisalhamento do cimento resinoso às cerâmicas. Foram fabricados dois discos de cerâmica: um pela técnica prensada e outro pela técnica CAD/CAM. Cinco amostras de cimento resinoso Variolink Veneer foram fotoativadas através de cada disco cerâmico e submetidas à espectroscopia no infravermelho por transformada de Fourier com reflectância total para avaliar seu grau de conversão. Para avaliar a resistência de união ao microcisalhamento, foram preparadas 20 barras de cerâmicas: 10 utilizando a técnica prensada e 10 utilizando a técnica CAD/CAM. As barras foram tratadas com partículas de Al2O3 (50 μm), com ácido fluorídrico a 10% por 20 s e submetidas à aplicação do RelyX Ceramic Primer. Em seguida, o adesivo multiuso Adper Scotchbond foi aplicado nas barras e fotoativado por 10 s. Dois tubos de plástico de 1 mm de comprimento foram colocados em cada barra e preenchidos com cimento resinoso Variolink Veneer. Cada cilindro foi fotoativado por 20 s. Os tubos de plástico foram removidos e a resistência de união ao microcisalhamento de cada cilindro foi testada. Os dados de grau de conversão (%) e resistência de união ao microcisalhamento (MPa) foram submetidos ao teste t de Student (α = 0,05). Tanto o grau de conversão do cimento resinoso fotoativado através da cerâmica quanto a resistência de união do cimento resinoso à cerâmica foram estatisticamente maiores no grupo em que a cerâmica foi confeccionada pela técnica CAD/CAM (44,74% e 22,18 MPa) do que no grupo em que a cerâmica foi confeccionada pela técnica prensada (25,71% e 19,83 MPa). As técnicas de processamento de cerâmica dissilicada de lítio afetaram o grau de conversão do cimento resinoso quando fotoativado através das cerâmicas e a resistência de união do microcisalhamento do cimento resinoso às cerâmicas.

Microstructural and mechanical analysis of two CAD-CAM lithium disilicate glass-reinforced ceramics

Abstract The aim of this study was to analyze the structural, morphological and mechanical properties of two different lithium disilicate glass-reinforced ceramics for CAD-CAM systems (IPS e.max CAD and Rosetta SM). Five methodologies were used for both ceramics: microstructure (n = 2) was analyzed using x-ray diffraction (XRD); morphological properties (n = 2) were analyzed by scanning electron microscopy (SEM), with and without hydrofluoric etching; porosity (n = 3) was assessed using 3D micro-computed tomography (micro-CT); flexural strength was measured (n =1 0) using the three-point bending test; and bond strength was determined with self-adhesive resin cement (n = 10), using a microshear bond test. After performing all the tests, the data were analyzed using t-Student test and two-way ANOVA. All the tests used a significance level of α = 0.05. High peak positions corresponding to standard lithium metasilicate and lithium disilicate with similar intensities were observed for both ceramics in the XRD analysis. Morphological analysis showed that the crystalline structure of the two ceramics studied showed no statistical difference after acid etching. Additionally, no significant differences were recorded in the number or size of the pores for the ceramics evaluated. Moreover, no differences in flexural strength were found for the ceramic materials tested, or in the bond strength to ceramic substrates for the resin cements. Based on the study results, no significant differences were found between the two CAD-CAM lithium disilicate glass-reinforced ceramics tested, since they presented similar crystalline structures with comparable intensities, and similar total porosity, flexural strength and bond strength.

Hydrofluoric acid concentration, time and use of phosphoric acid on the bond strength of feldspathic ceramics

Abstract The objective of this study was to evaluate the influence of hydrofluoric acid (HF) concentration, etching time, and application of phosphoric acid (PA) followed by neutralization with sodium bicarbonate on the bond strength between a feldspar ceramic and resin cement. Thus, 80 blocks (10 x 12 x 2 mm) of glass ceramic (VM - Vita Mark II - Vita Zahnfabrik) were made and randomly assigned to eight groups (n = 10) according to the factors: HF concentration (5 and 10%), etching time (60 and 120 s), and use of phosphoric acid (PA) (with and without). According to the experimental group, 37% PA (Condac, FGM) was applied after HF etching for 60s. Afterwards, samples were immersed in sodium bicarbonate for 1 min then in an ultrasonic bath in distilled water (5 min) for cleaning. After surface bonding treatment, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block. The samples were then stored in water (37ºC) for 90 days and submitted to the shear bond test (50 KgF, 1 mm/min). Failure analysis was performed by stereomicroscope and scanning electron microscopy. Data (MPa) were analyzed with 3-way ANOVA and Tukey's test. Only the factor "HF concentration" was significant (p = 0.02). Most failures were of cohesive in ceramic (40%) and mixed types (42.5%). The 10% HF resulted in higher shear bond strength value than the 5% HF. Surface cleaning with phosphoric acid followed by sodium bicarbonate and HF time (60 or 120 seconds) did not influence the resin bond strength to feldspar ceramic.

Effect of hydrofluoric acid concentration and etching time on resin-bond strength to different glass ceramics

Abstract: The objective of this study was to evaluate the effect of the hydrofluoridric acid (HF) concentration and time of acid conditioning on bond strength of three glass ceramics to a resin cement. Thus, fifty blocks (10 mm x 5 mm x 2 mm) of each ceramic (LDCAD: IPS e.max CAD; LCAD: IPS Empress CAD and LDHP: IPS e.max Press) were made and embedded in acrylic resin. The surfaces were polished with sandpaper (#600, 800, 1000, and 1200 grits) and blocks were randomly divided into 15 groups (n = 10) according to the following factors: Concentration of HF (10% and 5%), conditioning time (20 s and 60 s) and ceramic (LDCAD, LDHP, and L). After conditioning, silane (Prosil / FGM) was applied and after 2 min, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block using a Teflon strip as matrix and light cured for 40 s (1,200 mW/cm2). Then, the samples were thermocycled (10,000 cycles, 5/55°C, 30s) and submitted to the shear bond test (50 KgF, 0.5 mm/min). The data (MPa) were analyzed with 3-way ANOVA and Tukey's test (5%). Failure analysis was performed using a stereomicroscope (20x) and a scanning electron microscope (SEM). ANOVA revealed that the "concentration" factor (p = 0.01) and the interaction "acid concentration X ceramic" (p = 0.009) had a significant effect, however, the "ceramic" (p = 0.897) and "conditioning time" (p = 0.260) factors did not influence the results. The LDHP10%60s (10.98 MPa)aA* group presented significantly higher bond strength than LDHP10%20s (6.57 MPa)bA, LCAD5%20s (6,90 ±3,5)aB and LDHP5%60s (5.66 ± 2,9MPa)aA* groups (Tukey). Failure analysis revealed that 100% of specimens had mixed failure. In conclusion, etching with 5% HF for 20 seconds is recommended for lithium disilicate and leucite-reinforced CAD/CAM ceramics. However, for pressed lithium disilicate ceramic, 10% HF for 60 s showed significantly higher bond strength to resin cement.

Brittleness index and its relationship with materials mechanical properties: Influence on the machinability of CAD/CAM materials

Abstract: The aim of this study is to evaluate the machinability of four CAD/CAM materials (n = 13) assessed by brittleness index, Vickers hardness, and fracture toughness and interaction among such mechanical properties. The materials selected in this in vitro study are Feldspathic ceramic [FC], Lithium-disilicate glass ceramic [LD], leucite-reinforced glass ceramic [LR], and nanofilled resin material [RN]. Slices were made from the blocks following original dimensions 14 × 12 × 3 mm (L × W × H), using a precision slow-speed saw device and then surfaces were regularized through a polishing device. Brittleness index and fracture toughness were calculated by the use of specific equations for each one of the properties. The Vickers hardness was calculated automated software in the microhardness device. One-way Anova and Pearson's correlation were applied to data evaluation. LD obtained the highest values for brittleness index and was not significantly different from FC. LR presented statistically significant difference compared with RN, which had the lowest mean. Vickers hardness showed LD with the highest average, and no statistical difference was found between FC and LR. RN presented the lowest average. Fracture toughness showed FC and LR not statistically different from each other, likewise LD and RN. The brittleness index, considered also as the machinability of a material, showed within this study as positively dependent on Vickers hardness, which leads to conclusion that hardness of ceramics is related to its milling capacity. In addition, fracture toughness of pre-sintered ceramics is compared to polymer-based materials.

Correspondence between try-in pastes and resin cements, and color stability of bonded lithium disilicate disks

Abstract: This study investigates the color correspondence of resin cements and try-in pastes, and the color stability of bonded lithium disilicate ceramic disks. Resin composite disks were fabricated (n = 36) to serve as the background for lithium disilicate disks prepared in two thicknesses (0.5 and 1.0 mm, n = 18 each). Two brands were used for try-in and cement procedures: Variolink Veneer and AllCem Veneer. For baseline, water was applied between the ceramic disks and their respective backgrounds to achieve the control group. This set was subjected to color measurement using an intraoral measurement device (T0). The try-in was inserted between background and ceramic, and this set was subjected to color measurement (T1). After adhesive procedures, the ceramic disk was placed under cement, and color measurement was performed with uncured cement (T2) and 24 h after light-curing (T3). Each set was immersed in distilled water and thermal-cycled, with color measurement being performed after 10,000 (T4) and 20,000 (T5) cycles. Color differences were calculated by CIELab (rEab) and CIEDE2000 (rE00). Data were analyzed by two-way ANOVA for repeated measurements and Tukey's test (α=5%). There was color correspondence of try-in and resin cement for the Variolink system, regardless of the ceramic thickness (p > 0.05). For the AllCem system, the thickness significantly influenced the color measurement (p < 0.001). The Variolink system also demonstrated color stability after 20,000 thermal cycles with rEab < 3.46 and rE00 < 2.25. It was concluded that the color correspondence between a try-in and its respective cement may vary according to resin cement composition.

Analysis of enamel and material wear by digital microscope: an in-vitro study

Abstract: The objective of the study was to analyze the surface area (SA) of the wear caused by simulated chewing on human enamel and opposing restorative material, namely: composite resin (CR), porcelain fused to metal (PFM), lithium disilicate (LD), or monolithic zirconia (MZr). Forty-eight premolars were selected as enamel specimens and divided randomly into 4 groups (n = 48; n =12) used as antagonists in chewing simulation (250,000 loading cycles) against one of the four selected test materials. Enamel and material specimens were scanned and evaluated under digital microscope, and wear SA (mm2) were recorded. Descriptive statistics, paired t-test, one-way ANOVA, and post-hoc Tukey-HSD tests were used for statistics (p < 0.05). The smallest and largest SA were exhibited by enamel against LD (0.80 mm2) and PFM (1.74 mm2), respectively. PFM (3.48 mm2) showed the largest SA and CR (2.28 mm2) showed the smallest SA. Paired t-test for SA values showed significant difference (p < 0.05) in all wear comparisons between materials and enamel antagonists. The wear of materials were greater than that of their respective enamel antagonists (p < 0.05). One-way ANOVA of the logarithmic means of wear SA revealed significant differences (P<0.05). Post-hoc Tukey test revealed significance for PFM (p < 0.05) with other materials. Wear of all test materials was greater compared to the wear of enamel antagonists. PFM and LD caused the largest and the smallest enamel wear, respectively. CR, LD, and MZr are more resistant than PFM to wear after simulated chewing against enamel.

Influence of the composition and shades of ceramics on light transmission and degree of conversion of dual-cured resin cements

Abstract Objective Since the transmittance of ceramics can influence the degree of conversion (DC) of resin cements, ceramics composition and shade should be considered in the selection of resin cement. This in vitro study aimed to evaluate the effect of the transmittance of different composition, opacities and shades of ceramics on the degree of conversion of two dual-cured resin cements. Methodology Sixty discs were prepared from low translucency (LT) and medium opacity (MO) lithium disilicate ceramic, and zirconia ceramic (Z). Each group was subdivided into 5 subgroups (n=4) in shades A2, A3.5, B2, C2 and D3. The transmittance measurement was performed in a spectrophotometer. The Variolink II and Rely X U200 resin cements were photoactivated by LED (1400 mW/cm2) for 40 s through the ceramic discs and without the discs (control group). The DC was measured with infrared FTIR spectroscopy, immediately after light activation. Data were analyzed with Kruskall-Wallis and one-way ANOVA, following post-hoc comparisons by Tukey test and Pearson's correlation test (P<0.05). Results LT ceramic exhibited higher transmittance values compared to MO and Z ceramics. LTA2 and LTB2 showed statistically higher transmittance values compared to MOA2, MOA3.5 and ZA3.5. For Variolink II, the ceramic interposition did not influence the DC, since there were no statistical differences between groups with ceramic interposition and the control group. For Rely X U200 cement, the interposition of some ceramics types/shades (LTA3.5, MOA2, MOA3.5 and ZA3.5) significantly decreased the DC values compared to control group. A positive correlation was found between the ceramic transmittance and DC values of both tested cements. Conclusions. The transmittance and DC values of the cements were influenced by composition and shades of the ceramics. The higher the transmittance of ceramics, the higher the DC values for both cements.

Fatigue survival and damage modes of lithium disilicate and resin nanoceramic crowns

Abstract Polymer-based composite materials have been proposed as an alternative for single unit restorations, due to their resilient and shock absorbing behavior, in contrast to the brittleness of ceramic materials that could result in failure by fracture. Objective: To evaluate the fatigue strength and damage modes of monolithic posterior resin nanoceramic and lithium disilicate glass ceramic crowns. Methodology: Twenty-six resin nanoceramic (RNC) and lithium disilicate glass ceramic (LD) 2 mm monolithic crowns (n=13) were cemented on composite resin replicas of a prepared tooth and subjected to cyclic load with lithium disilicate indenters for 2 million cycles. Specimens and indenters were inspected every 500,000 cycles and suspended when presenting fractures or debonding. Surviving specimens were embedded in epoxy resin, polished and subsurface damage was analyzed. Specimens presenting fractures or severe subsurface damage were considered as failures. Survival data was subjected to Fisher's exact test; damage modes were subjected to Mann-Whitney test (p<0.05). Results: There were no debonding, cohesive or catastrophic failures. Considering subsurface damage, 53.8% of RNC and 46.2% of LD crowns survived the fatigue test, presenting no statistical difference. Chief damage modes were radial cracks for RNC and inner cone cracks for LD, presenting no statistical difference. Conclusions: The results suggest that if debonding issues can be resolved, resin nanoceramic figures can be an alternative to posterior crowns. Although distinct, damage modes revealed potential to cause bulk fracture in both glass ceramic and resin nanoceramic crowns.

New material perspective for endocrown restorations: effects on mechanical performance and fracture behavior

Abstract The aim of this study was to investigate the mechanical performance and the fracture behavior of endocrown restorations prepared using distinct restorative materials. A total of 42 sound molars with similar crown size and shape were cut at 2 mm above the cementoenamel junction and endodontically treated. They were categorized according to the restorative material used to fabricate endocrown restorations (n=7), namely, conventional composite (Filtek™ Z350 XT), bulk fill composite (Filtek™ Bulk Fill), conventional composite modeled using resin adhesives (SBMP: Scotchbond™ Multipurpose Adhesive; or SBU: Scotchbond™ Universal Adhesive), and IPS e.max lithium disilicate (Ivoclar Vivadent; positive control). Unprepared sound teeth were used as negative control. All endocrowns were bonded using a self-adhesive cement (Rely-X™ U200). The teeth were submitted to fatigue (Byocycle) and fracture (EMIC DL500) testing. Load-to-fracture (in N) and work-of-fracture (Wf, in J/m2) values were analyzed by ANOVA (p < 0.05). The endocrowns did not fracture or de-bond upon fatigue, showing similar load-to-fracture and work-of-fracture values, regardless of the restorative material (p > 0.05). The endocrowns fabricated by combining Z350 and SBMP had the least harsh fractures, in contrast to endocrowns prepared using Z350 only, which exhibited an equilibrium between repairable and irrepairable fractures. The e.max endocrowns exhibited more aggressive failures (root fracture) than other groups, resulting in higher rates of irrepairable fractures. In conclusion, dental practitioners may satisfactorily restore severely damaged nonvital teeth using the endocrown technique. Composite endocrowns prepared using resin adhesive as modeler liquid or using bulk fill material may result in less aggressive failures, thus providing a new material perspective for endocrown restorations.

Adhesion to a lithium disilicate glass ceramic etched with hydrofluoric acid at distinct concentrations

Abstract This study evaluated the effect of different hydrofluoric acid (HF) concentrations on the bond strength between a lithium disilicate-based glass ceramic and a resin cement. Eighty ceramic-blocks (12×7×2 mm) of IPS e.Max CAD (Ivoclar Vivadent) were produced and randomly assigned to 8 groups, considering 2 study factors: HF concentration in 4 levels, i.e., 1% (HF1), 3% (HF3), 5% (HF5), and 10% (HF10), and storage in 2 levels, i.e., baseline (tests were performed 24 h after cementation), and aged (storage for 150 days + 12,000 thermal-cycles at 5°C and 55°C). Acid etching (20 s) was performed, followed by washing, drying, and silanization. Four resin cement cylinders (ϕ= 0.96 mm) were built-up from starch matrices on each ceramic sample (n= 40). Additional ceramic samples were etched and analyzed for contact angle, micro-morphology, and roughness. In baseline condition (without aging), the HF3, HF5, and HF10 groups showed similar bond strength values (13.9 - 15.9 MPa), and HF1 (11.2 MPa) presented lower values than HF5, being that statistically different (p= 0.012). After aging, all the mean bond strengths statistically decreased, being that HF3, HF5, and HF10 (7.8 - 11 MPa) were similar and higher than HF1 (1.8 MPa) (p= 0.0001). For contact angle, HF3, HF5, and HF10 presented similar values (7.8 - 10.4°), lower than HF1 and CTRL groups. HF5 and HF10 presented rougher surfaces than other conditions. For better bond strength results, the tested ceramic may be etched by HF acid in concentrations of 3%, 5%, and 10%.

Resumo Este estudo avaliou o efeito de diferentes concentrações de ácido fluorídrico (HF) na resistência de união entre uma cerâmica vítrea à base de dissilicato de lítio e um cimento resinoso. Oitenta blocos cerâmicos (12×7×2 mm) de IPS e.Max CAD (Ivoclar Vivadent) foram produzidos e distribuídos aleatoriamente em 8 grupos, considerando 2 fatores de estudo: concentração de HF em 4 níveis, isto é, 1% (HF1), 3% (HF3), 5% (HF5), e 10% (HF10), e armazenamento em 2 níveis, isto é, condição inicial (testes foram realizados 24 h após a cimentação), e envelhecidos (150 dias de armazenamento + 12.000 ciclos térmicos a 5°C e 55°C). Condicionamento ácido (20 s) foi realizado, seguido por lavagem, secagem e silanização. Quatro cilindros de cimento resinoso (ϕ= 0.96 mm) foram construídos a partir de matrizes de amido em cada amostra cerâmica (n= 40). Amostras cerâmicas adicionais foram condicionadas e analisadas quanto ao ângulo de contato, micro-morfologia e rugosidade. Na condição inicial (sem envelhecimento), os grupos HF3, HF5, e HF10 mostraram valores de resistência de união similares (13.9 - 15.9 MPa), e HF1 apresentou valores menores que HF5, sendo estatisticamente diferente (p= 0.012). Após o envelhecimento, todas as médias de resistência de união diminuíram estatisticamente, sendo que HF3, HF5 e HF10 foram similares e maiores que HF1 (p= 0.0001). Para o ângulo de contato, HF3, HF5 e HF10 apresentaram valores similares (7.8 - 10.4°), menores que os grupos HF1 e CTRL. HF5 e HF10 apresentaram superfícies mais rugosas que as outras condições. Para melhores resultados de resistência de união, a cerâmica testada pode ser condicionada com ácido fluorídrico nas concentrações de 3%, 5% e 10%.

Feldspar ceramic strength and the reinforcing effect by adhesive cementation under accelerated aging

Abstract This study evaluated the effect of the accelerated artificial aging (AAA) on feldspar ceramic strength and the reinforcing effect promoted by adhesive cementation with resin luting agent. One hundred twenty feldspar ceramic disks were obtained. Sixty disks were acid-etched, silanized, and coated with an experimental resin luting agent simulating the adhesive luting procedures. Four groups were created (n=30): uncoated ceramic (control group), uncoated ceramic submitted to AAA, ceramic coated with resin luting agent, and coated ceramic submitted to AAA. Biaxial flexural testing with ball-on-ring setup was carried out. Biaxial flexural strength (s bf , MPa), characteristic strength (s 0 , MPa), and Weibull modulus (m) were calculated for axial positions z=0 (ceramic surface) and z=−t2 (luting agent surface). Data of s bf at positions z=0 and z=-t2 were separately submitted to statistical analyses (a=0.05). The uncoated ceramic submitted to AAA had no significant difference in s bf and s 0 compared with the control group. Resin coating of the ceramic increased s bf and s 0 at z=0. The AAA increased the s bf and s 0 for the resin-coated ceramic specimens at z=0 and also the s 0 at axial position z=-t2. The structural reliability at z=0 and z=-t2 was not influenced by the variables tested. In conclusion, resin coating improved the mechanical strength of the feldspar ceramic. The AAA procedure was not effective in aging the uncoated or resin-coated feldspar ceramic specimens.

Resumo Este estudo avaliou o efeito do envelhecimento artificial acelerado (EAA) na resistência da cerâmica feldspática e o reforço promovido pela cimentação adesiva com cimento resinoso. Cento e vinte discos de cerâmica feldspática foram obtidos. Sessenta discos foram condicionados com ácido, silanizados, e recobertos com um cimento resinoso experimental simulando os procedimentos de cimentação adesiva. Quatro grupos foram criados (n=30): cerâmica sem recobrimento (grupo controle), cerâmica sem recobrimento submetida ao EAA, cerâmica recoberta com cimento resinoso, cerâmica recoberta com cimento resinoso submetida ao EAA. O teste de resistência à flexão biaxial foi realizado utilizando o dispositivo pistão-anel. Resistência à flexão biaxial (s fb , MPa), resistência característica (s 0 , MPa), e módulo de Weibull (m) foram calculados para as posições axiais z=0 (superfície da cerâmica) e z=−t2 (superfície do cimento). Os dados de s fb em z=0 e z=−t2 foram submetidos a análises estatísticas separadamente (a=0,05). A cerâmica não recoberta submetida ao EAA não teve diferença significante na s fb e s 0 comparada com o grupo controle. O recobrimento com cimento resinoso da cerâmica aumentou a s fb e s 0 em z=0. O EAA aumentou a s fb e s 0 para os espécimes de cerâmica recobertos com cimento resinoso em z=0 e também a s 0 em z=−t2. A confiabilidade em z=0 e z=−t2 não foi influenciada pelas variáveis testadas. Concluindo, o recobrimento com cimento resinoso melhorou a resistência mecânica da cerâmica feldspática. O procedimento de EAA não foi efetivo em envelhecer os espécimes de cerâmica feldspática recobertos ou não com cimento resinoso.

Evaluation of shear bond strength and shear stress on zirconia reinforced lithium silicate and high translucency zirconia

This study evaluated the shear stress distribution on the adhesive interface and the bond strength between resin cement and two ceramics. For finite element analysis (FEA), a tridimensional model was made using computer-aided design software. This model consisted of a ceramic slice (10x10x2mm) partially embedded on acrylic resin with a resin cement cylinder (Ø=3.4 mm and h=3mm) cemented on the external surface. Results of maximum principal stress and maximum principal shear were obtained to evaluate the stress generated on the ceramic and the cylinder surfaces. In order to reproduce the in vitro test, similar samples to the computational model were manufactured according to ceramic material (Zirconia reinforced lithium silicate - ZLS and high translucency Zirconia - YZHT), (N=48, n=12). Half of the specimens were submitted to shear bond test after 24h using a universal testing machine (0.5 mm/min, 50kgf) until fracture. The other half was stored (a) (180 days, water, 37ºC) prior to the test. Bond strength was calculated in MPa and submitted to analysis of variance. The results showed that ceramic material influenced bond strength mean values (p=0.002), while aging did not: YZHT (19.80±6.44)a, YZHTa (17.95±7.21)a, ZLS (11.88±5.40)b, ZLSa (11.76±3.32)b. FEA results showed tensile and shear stress on ceramic and cylinder surfaces with more intensity on their periphery. Although the stress distribution was similar for both conditions, YZHT showed higher bond strength values; however, both materials seemed to promote durable bond strength.

Influence of ceramic material, thickness of restoration and cement layer on stress distribution of occlusal veneers

Abstract The aim of this study was to evaluate stress distribution in an occlusal veneer according to the restorative material, restoration thickness, and cement layer thickness. A tridimensional model of a human maxillary first molar with an occlusal veneer preparation was constructed using a modeling software of finite element analysis. The model was replicated 9 times to evaluate the factors: restoration thickness (0.6, 1.2, and 1.8 mm) and cement layer thickness (100, 200, and 300 μm). Then, each model received different restorative materials (High Translucency Zirconia - [YZHT], Lithium Disilicate - [LD], Zirconia Reinforced Lithium Silicate - [ZLS], Feldspathic - [F], and Hybrid Ceramic - [HC]), totaling forty-five groups. An axial load (600 N) was applied on the occlusal face for static structural analysis. Solids were considered isotropic, homogeneous, and linearly elastic. Contacts were considered perfectly bonded. Fixation occurred in the dental root and a mechanical static structural analysis was performed. Descriptive statistical analysis and one-way ANOVA (α =10%) were performed for tensile stress peak values in the restoration and cement layer. The difference between groups was compared using the Tukey's test with 10% significance to match the percentage of the mesh convergence test. According to the results, the cement layer thickness did not influence stress distribution in the restoration (p ≥ 0.10). The thicker the restoration, the higher the tensile stress concentration in the restoration. The graphs showed higher stress concentration in the YZHT, followed by LD, F, ZLS, and HC. Also, the restorative material influenced stress concentration on the cement layer, which decreased according to the sequence HC>YZHT>ZLS>LD>F. HC stood out for causing the least stress concentration in the restoration. Cement layer thickness did not interfere in the mechanical performance of the restorations.

Fatigue strength of several dental ceramics indicated for CAD-CAM monolithic restorations

Abstract This in vitro study evaluated the fatigue strength of different ceramic materials indicated for monolithic restorations. Disc-shaped specimens were made according to ISO 6872 from five different ceramic materials: feldspathic ceramic (FC), polymer-infiltrated ceramic network (PIC), lithium disilicate glass-ceramic (LD), zirconia-reinforced lithium silicate glass-ceramic (ZLS), and high translucent tetragonal zirconia polycrystals doped by yttrium (YZ-HT). After obtaining the mean of each material (n = 5) from monotonic load-to-failure tests, specimens (n = 20) were subjected to fatigue tests (staircase method) using a biaxial flexural setup (piston-on-three-balls), to determine the fatigue strength. The parameters used for fatigue tests were: 100,000 cycles at 10 Hz, initial load of ~ 60% of mean load-to-failure, and step size of 5% of the initial load (specific for each ceramic material). Kruskal-Wallis and Bonferroni's test (α = 0.05) were used to analyze the fatigue strength data. Fatigue strength (MPa) of the materials was statistically different among each other as follows: YZ-HT (370.2 ± 38.7) > LD (175.2 ± 7.5) > ZLS (152.1 ± 7.5) > PIC (81.8 ± 3.9) > FC (50.8 ± 1.9). Thus, it can be concluded that, in terms of fatigue, high translucent polycrystalline zirconia is the best choice for monolithic restorations as it bears the highest load before cracking/fracturing.

Effect of cavity preparation design and ceramic type on the stress distribution, strain and fracture resistance of CAD/CAM onlays in molars

Abstract Objective This study aimed to evaluate the effect of the cavity preparation and ceramic type on the stress distribution, tooth strain, fracture resistance and fracture mode of human molar teeth restored with onlays. Material and Methods Forty-eight molars were divided into four groups (n=12) with assorted combinations of two study factors: BL- conventional onlay preparation with boxes made from leucite ceramic (IPS-Empress CAD, Ivoclar Vivadent); NBL- conservative onlay preparation without boxes made from leucite ceramic; BD- conventional onlay preparation with boxes made from lithium disilicate glass ceramic (IPS e.max CAD, Ivoclar Vivadent); NBL- conservative onlay preparation with boxes made from lithium disilicate glass ceramic cuspal deformation (µS) was measured at 100 N and at maximum fracture load using strain gauge. Fracture resistance (N) was measured using a compression test, and the fracture mode was recorded. Finite element analysis was used to evaluate the stress distribution by modified von Mises stress criteria. The tooth strain and fracture resistance data were analyzed using the Tukey test and two-way ANOVA, and the fracture mode was analyzed by the chi-square test (α=0.05). Results The leucite ceramic resulted in higher tooth deformation at 100 N and lower tooth deformation at the maximum fracture load than the lithium disilicate ceramic (P<0.001). The lithium disilicate ceramic exhibited higher fracture resistance than the leucite ceramic (P<0.001). The conservative onlay resulted in higher fracture strength for lithium disilicate ceramic. Finite element analysis results showed the conventional cavity preparation resulted in higher stress concentration in the ceramic restoration and remaining tooth than the conservative onlay preparation. The conservative onlays exhibited increased fracture resistance, reduced stress concentration and more favorable fracture modes. Conclusion Molars restored with lithium disilicate CAD-CAM ceramic onlays exhibited higher fracture resistance than molars restored with leucite CAD-CAM ceramic onlays.

The marginal fit of lithium disilicate crowns: Press vs. CAD/CAM

Abstract: This study aimed to compare the vertical marginal gap of teeth restored with lithium disilicate crowns fabricated using CAD/CAM or by pressed ceramic approach. Twenty mandibular third molar teeth were collected after surgical extractions and prepared to receive full veneer crowns. Teeth were optically scanned and lithium disilicate blocks were used to fabricate crowns using CAD/CAM technique. Polyvinyl siloxane impressions of the prepared teeth were made and monolithic pressed lithium disilicate crowns were fabricated. The marginal gap was measured using optical microscope at 200× magnification (Keyence VHX-5000, Japan). Statistical analysis was performed using Wilcoxon test. The lithium disilicate pressed crowns had significantly smaller (p = 0.006) marginal gaps (38 ± 12 μm) than the lithium disilicate CAD/CAM crowns (45 ± 12 μm). This research indicates that lithium disilicate crowns fabricated with the press technique have measurably smaller marginal gaps compared with those fabricated with CAD/CAM technique within in vitro environments. The marginal gaps achieved by the crowns across all groups were within a clinically acceptable range.

The effect of hydrofluoric acid and resin cement formulation on the bond strength to lithium disilicate ceramic

Abstract To investigate how the hydrofluoric acid (HF) concentrations applied to a lithium disilicate glass-ceramic (EMX) affects the surface morphology and microtensile bond strength (μTBS) of ceramics to dentin, using light-cured resin cements with or without UDMA. Sixty-three EMX square ceramic blocks were etched for 20 seconds using different HF concentrations (1%, 5% and 10%) and luted to dentin using two types of resin cement combinations: BisGMA/TEGDMA and BisGMA/TEGDMA/UDMA (n = 10). Each bonded EMX-dentin block was sectioned to obtain 1 mm2 sticks for μTBS evaluation. Half of the sticks were tested after 24 hours and the other half was assessed after 6 months of water storage. Data were statistically assessed using split-plot three-way ANOVA and multiple comparisons were performed using the Tukey's post hoc test (α = 0.05). One EMX sample from each HF concentration was analyzed using field-emission scanning electron microscope (FE-SEM) to characterize the etching pattern. According to the FE-SEM images, increasing the concentration of HF from 1 to 5 and then to 10% led to increased removal of glassy matrix and greater exposure of lithium disilicate crystals. The 10% HF concentration yielded higher μTBS when compared to 1% for BisGMA/TEGDMA formulation (p < 0.05); whereas HF 1% and 5% showed similar μTBS values when compared to 10% HF for BisGMA/TEGDMA/UDMA resin matrix (p > 0.05) at both storage times. Water aging decreased the μTBS values (p < 0.05), except when 10% HF was associated with BisGMA/TEGDMA resin cement. Resin cement formulation and hydrofluoric acid concentrations can interfere with the immediate and long-term glass-ceramic bond strength to dentin.