Dental ceramics: a review of new materials and processing methods

Abstract The evolution of computerized systems for the production of dental restorations associated to the development of novel microstructures for ceramic materials has caused an important change in the clinical workflow for dentists and technicians, as well as in the treatment options offered to patients. New microstructures have also been developed by the industry in order to offer ceramic and composite materials with optimized properties, i.e., good mechanical properties, appropriate wear behavior and acceptable aesthetic characteristics. The objective of this literature review is to discuss the main advantages and disadvantages of the new ceramic systems and processing methods. The manuscript is divided in five parts: I) monolithic zirconia restorations; II) multilayered dental prostheses; III) new glass-ceramics; IV) polymer infiltrated ceramics; and V) novel processing technologies. Dental ceramics and processing technologies have evolved significantly in the past ten years, with most of the evolution being related to new microstructures and CAD-CAM methods. In addition, a trend towards the use of monolithic restorations has changed the way clinicians produce all-ceramic dental prostheses, since the more aesthetic multilayered restorations unfortunately are more prone to chipping or delamination. Composite materials processed via CAD-CAM have become an interesting option, as they have intermediate properties between ceramics and polymers and are more easily milled and polished.

Bond strength of self-adhesive resin cements to deep dentin

Introduction and objective: Self-adhesive resin cements are applied in only one clinical step whose technique is considered less sensitive and of easy handling. However, there is some concern relating to a reliable and effective bonding to tooth structure, particularly when dentin is involved. The aim of this study was to evaluate microtensile bond strength of self-adhesive resin cements to deep dentin as well as to discuss some concepts involving these materials. Material and methods: Twenty-eight freshly extracted third molars were used. Their crowns were sectioned using a diamond disc (Isomet) to obtain occlusal deep dentin flat surfaces. The teeth were randomly assigned to four groups (n = 7): RelyX ARC/3M ESPE conventional resin cement (Group 1), and three self-adhesive resin cements - RelyX U100/3M ESPE (Group 2), Set/SDI (Group 3) and Maxcem/Kerr (Group 4). The products were applied according to the manufacturer's instructions. Tetric EvoCeram (Ivoclar Vivadent) blocks were used to simulate indirect restorations that were cemented onto the dentin surfaces. These blocks were sandblasted with oxide aluminum before adhesive procedures. The samples were stored in distilled water at 37±2°C for one week. Following, the samples were prepared for microtensile bond strength tests, which were performed at a crosshead speed of 1.0 mm/min until failure. Tensile bond strength data were calculated and the results were statistically analyzed by two-way ANOVA and Tukey test (p < 0.05). Results: The means (SD) (in MPa) were - Group 1: 14.7a (5.7); Group 2: 7.5b (2.3); Group 3: 5.6b (2.1); and Group 4: 4.7b (1.4). ANOVA showed significant differences and Tukey test identified differences among groups. Group 1 showed the highest bond strength mean. Bond strength mean of the other self-adhesive resin cements to dentin did not show statistical difference among them. Conclusion: Self-adhesive resin cements showed lower bond strength to dentin than RelyX ARC conventional resin cement. The highest bond strength mean of RelyX ARC is related to its mechanism of action. However, the mechanism of action involved in self-adhesive resin cements seems to be effective for clinical use if a proper prosthetic dental preparation is observed.

Resistência de união de sistemas adesivos autocondicionantes em dentina profunda / Bond strength of self-etching adhesive systems to deep dentin

Introdução e objetivo:: Os sistemas adesivos autocondicionantes têm sido largamente utilizados por dentistas e pesquisadores nos procedimentos adesivos de restaurações dentárias. O objetivo deste estudo foi avaliar a resistência de união ao microcisalhamento de sistemas adesivos autocondicionantes em dentina profunda. Material e métodos: Prepararam-se 50 terceiros molares humanos até obtenção de superfícies planas de dentina profunda (2 mm abaixo do limite amelodentinário do sulco central), abrasionadas com lixa de carbeto de silício n.º 600. As amostras foram aleatoriamente divididas em cinco grupos (n = 10), de acordo com os grupos experimentais: 1) adesivo convencional Syntac (controle), 2) adesivo autocondicionante One-Up Bond F Plus (um passo), 3) Hybrid Bond (um passo), 4) AdheSE (dois passos) – unidos ao compósito Tetric Ceram – e 5) Silorane System Adhesive (dois passos), unido ao compósito de baixa contração FiltekSilorane. Os materiais foram aplicados segundo orientações dos fabricantes e com uma matriz Tygon. Os corpos-de-prova foram armazenados em água destilada a 37±2ºC por uma semana. Determinou-se a resistência de união por meio da máquina universal de ensaios Zwick, a uma velocidade de 0,5 mm/minuto. Resultados: Os resultados obtidos em MPa (DP) foram analisados estatisticamente (Anova e teste de Tukey – p < 0,05) e apresentaram os seguintes dados: 2) 25,5 (4,4); 1) 24,9 (5,3); 3) 22,4 (8,1); 4) 21,5 (4,4) e 5) 18,1 (7,2). O teste de Tukey mostrou variações significativas entre os grupos 2 e 5, que não evidenciaram diferenças com os demais grupos testados. Conclusão: O adesivo Silorane e o compósito Filtek Silorane tiveram resistência de união similar à dos demais materiais, porém menor que o One-Up Bond F Plus, quando este foi utilizado com o Tetric Ceram. Os resultados sugerem que, em termos de resistência de união, os adesivos autocondicionantes podem ser uma boa alternativa nos procedimentos restauradores adesivos em dentina profunda.

Introduction and objecttiivee:: The self-etching adhesive systems have been widely used by dentists and researchers in the procedures of adhesive dental restorations. The purpose of this study was to evaluate the microshear bond strength of self-etching adhesive systems to deep dentin.Material and methods: Fifty freshly extracted human third molars were prepared using a diamond saw until obtaining flat surfaces of deep dentin (2 mm below the DEJ of central sulcus), wet-abraded with 600-grit SiC paper. The samples were randomly divided into five groups (n = 10) according to the experimental groups: 1) conventional adhesive Syntac (control), 2) one-step self-etching adhesive One-Up Bond F Plus, 3) onestep self-etching adhesive Hybrid Bond, 4) two-step self-etching adhesive AdheSE – bonded to Tetric Ceram resin composite; and the 5) two-step self-etching adhesive Silorane System Adhesive bonded to low shrinkage resin composite Filtek Silorane. The adhesives and the resin composite were applied according to the manufacturers’ instructions, and using a Tygon tubing mold. The samples were stored in distilled water at 37±2ºC for one week. Microshear bond strengths were determined using a Zwick universal testing machine at a crosshead speed of 0.5 mm/minute. Results: The results obtained in MPa (SD) were statistically analyzed (Anova and Tukey test, p < 0.05), and showed the following results: 2) 25,5 (4,4); 1) 24,9 (5,3); 3) 22,4 (8,1); 4) 21,5 (4,4) and 5) 18,1 (7,2). There was statistically significant variation between groups 2 and 5; which did not show difference to the other groups tested. Conclusion: The Silorane System Adhesive and the low shrinkage resin composite Filtek Silorane showed similar bond strength to Syntac, Hybrid Bond and AdheSE – bonded to Tetric Ceram resin composite; however, being lower than One-Up Bond F Plus bonded to Tetric Ceram. Regarding the bond strength, the results suggest that self-etching adhesive systems can...