Different CAD/CAM-processing routes for zirconia restorations: influence on fitting accuracy.

The aim of the present in vitro study was to evaluate the influence of different processing routes on the fitting accuracy of four-unit zirconia fixed dental prostheses (FDPs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM). Three groups of zirconia frameworks with ten specimens each were fabricated. Frameworks of one group (CerconCAM) were produced by means of a laboratory CAM-only system. The other frameworks were made with different CAD/CAM systems; on the one hand by in-laboratory production (CerconCAD/CAM) and on the other hand by centralized production in a milling center (Compartis) after forwarding geometrical data. Frameworks were then veneered with the recommended ceramics, and marginal accuracy was determined using a replica technique. Horizontal marginal discrepancy, vertical marginal discrepancy, absolute marginal discrepancy, and marginal gap were evaluated. Statistical analyses were performed by one-way analysis of variance (ANOVA), with the level of significance chosen at 0.05. Mean horizontal discrepancies ranged between 22 µm (CerconCAM) and 58 µm (Compartis), vertical discrepancies ranged between 63 µm (CerconCAD/CAM) and 162 µm (CerconCAM), and absolute marginal discrepancies ranged between 94 µm (CerconCAD/CAM) and 181 µm (CerconCAM). The marginal gap varied between 72 µm (CerconCAD/CAM) and 112 µm (CerconCAM, Compartis). Statistical analysis revealed that, with all measurements, the marginal accuracy of the zirconia FDPs was significantly influenced by the processing route used (p < 0.05). Within the limitations of this study, all restorations showed a clinically acceptable marginal accuracy; however, the results suggest that the CAD/CAM systems are more precise than the CAM-only system for the manufacture of four-unit FDPs.

Influence of cooling rate on zirconia/veneer interfacial adhesion.

Slow cooling firing schedules have recently been introduced by some manufacturers to reduce chipping complications in zirconia-based core/veneer composites. The aim of this study was to test the hypothesis that these firing schedules may influence the bond strength between the zirconia core and veneering ceramic. Four different veneering ceramics recommended for zirconia (Lava Ceram, Triceram, VM9 and Zirox) were fired onto rectangular shaped Y-TZP specimens (Lava Frame) and cooled using a rapid or a slow cooling rate. The resulting bilayer specimens were notched, loaded in a four-point bending test and load-displacement curves were recorded. The critical load to induce stable crack extension at the core/veneer interface was determined, in order to calculate the strain energy release rate (G, Jm⁻²). Additionally, dilatometric measurements of the veneering ceramics were performed to determine the coefficient of thermal expansion (α, ppm.K⁻¹) between 50 and 450°C (α1) and in the temperature region above the glass transition temperature (α2). Discrepancies between α2 and α1 (Δα) were calculated. For all core/veneer compositions G values were lower for the slowly cooled specimens than for the rapidly cooled specimens. Significant differences with respect to the firing schedule were found in the Triceram and VM9 groups (P<0.05). The reductions in G values correlated with Δα. The bond strength between the zirconia core and the veneer decreased with the slow cooling rate. These results indicate that slow cooling of zirconia restorations may increase the risk of adhesive delamination failures between the core and veneer.

Comparative analysis of slot dimension in lingual bracket systems.

BACKGROUND: Orthodontic treatment with fixed appliances requires - among others - the correct clinical expression of torque, which depends on the precise fitting of archwire and slot. Especially in the lingual technique torque problems become clinically more evident than in labial appliances also with respect to the vertical alignment of teeth due to different distances from the center of resistance. The purpose of the present study was to compare the preciseness of slot dimensions of different lingual bracket systems. METHODS: Three lingual bracket systems were included in the study (7th Generation and STb, Ormco, Glendora, CA, USA; Incognito, TOP-Service/3 M Unitek, Monrovia, CA, USA). Non destructive analysis of vertical slot dimensions was performed using precision pin gauges (Azurea, Belprahon, Switzerland) that were tapered in increments of 0.002 mm (0.00008 inch). The sizes of 240 incisor and canine brackets were measured per system (total: 720). Data were compared using one-way ANOVA. A p-value < 0.05 was considered statistically significant. RESULTS: Average slot dimensions were 0.467 mm +/- 0.007 mm (0.0184 inch +/- 0.0003 inch) for the 7th Generation bracket system, 0.466 mm +/- 0.004 mm (0.0183 inch +/- 0.0001) inch for the STb bracket system and 0.459 mm +/- 0.004 mm (0.0181 inch +/- 0.0001) inch for the Incognito bracket system. Differences between systems were statistically significant (p < 0.05). CONCLUSIONS: The analyzed bracket systems for lingual treatment exhibited significant differences in slot dimension that will clinically result in torque play. These aspects must be considered in lingual orthodontic treatment.