8-year multicenter retrospective study on partial laminate veneers.

Purpose This retrospective study aimed to evaluate the survival and success rates of ceramic partial laminate veneers. Scanning electron microscopy was used to evaluate fractures and marginal defects.Methods In total, 31 patients received 79 partial laminate veneers on the maxillary anterior teeth. After adhesive luting, restorations were evaluated by calibrated clinicians for up to eight years using modified United States Public Health Service (USPHS) criteria. In addition, epoxy resin replicas were fabricated from silicone impressions and analyzed using scanning electron microscopy. Survival analyses were performed using the Kaplan-Meier and log-rank tests (α = 0.05). Success was analyzed in percentages by comparing the baseline and last follow-up.Results The cumulative survival rates were 100% after 1 year; 95.9% (SE 2.8%) after 5 years; and 61.4% (SE 25.3%) after 8 years. No significant differences (P > 0.05) were observed between functional and non-functional restorations. Changes in the USPHS criteria evaluation were only observed for adaptation: 12.5% (SE 4.7%), marginal discoloration: 4.2% (SE 3.0%), color match: 4.2% (SE 3.0%), and fractures: 16.7% (SE 5.3%). Scanning electron microscopy evaluations revealed undetected initial cracks and deficiencies in the restorations.Conclusions Partial laminate veneers displayed good survival rates during the long-term follow-up. The main problems observed were related to the quality of the margins, color mismatch, and restoration integrity. However, in most cases, restoration replacement was not required.

Randomized clinical trial on the survival of lithium disilicate posterior partial restorations bonded using immediate or delayed dentin sealing after 3 years of function.

OBJECTIVES: The survival and success rate and the quality of survival of partial ceramic restorations bonded employing Immediate (IDS) or Delayed Dentin Sealing (DDS) in vital molar teeth were evaluated in a randomized clinical trial with within-subject comparison study. MATERIALS AND METHODS: 30 patients received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N = 60). The two teeth randomly received either IDS (test group, n = 30) or DDS (control group, n = 30). Partial ceramic restorations were luted (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. Evaluations were performed at 1 week, 12 months and 36 months post-operatively, using qualitative (FDI) criteria. Representative failures were evaluated microscopically (SEM) and by means of simplified qualitative fractography analysis. RESULTS: One absolute failure occurred in the DDS group due to (secondary) caries. The overall survival rate according to Kaplan-Meier after 3 years was 98.3% (FDI criteria score 1-4, n = 59) and the overall success rate was 85% (FDI criteria score 1-3, n = 51), with no significant difference between restorations in the IDS and DDS group (p = 0.32; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%). For the quality of the survival, no statistically significant differences were found between IDS and DDS (p = 0.7; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%) restorations on any follow-up timepoints for any of the FDI criteria (Wilcoxon, McNemar, p > 0.05). CONCLUSION: Adhesively luted partial ceramic restorations in vital molar teeth have a good prognosis, however IDS did not show any differences in success and survival rates after 3 years of function.

The Effect of Hydrofluoric Acid Concentration on the Bond Strength and Morphology of the Surface and Interface of Glass Ceramics to a Resin Cement.

The purpose of this study was to evaluate the influence of various concentrations of hydrofluoric acid (HF) on the surface/interface morphology and µ-shear bond strength (µSBS) between IPS Empress Esthetic (EST) (Ivoclar Vivadent) and IPS e.max Press (EMX) (Ivoclar Vivadent) ceramics and resin cement. Ceramic blocks were divided into 12 groups for each kind of ceramic. Six different HF concentrations were evaluated: 1%, 2.5%, 5%, 7.5%, 10%, and 15%. All groups were silanated after etching, and half of the specimens within each group received a thin layer of unfilled resin (UR). Three resin cement cylinders were prepared on each ceramic block for µSBS testing. The specimens were stored in distilled water at 37°C for 24 hours. The µSBS test was carried out in a universal testing machine at a crosshead speed of 0.5 mm/min until fracture. The data were submitted to three-way analysis of variance and multiple comparisons were performed using the Tukey post hoc test (p<0.05). The etched surfaces and bonded interfaces were evaluated using scanning electron microscopy. µSBS means (MPa) for 1%, 2.5%, 5%, 7.5%, 10%, and 15% HF concentrations were, respectively, 25.2, 27.2, 30.1, 31.4, 33.3, and 31.8. µSBS means with or without UR application measured 32.24 and 27.4, respectively; EST and EMX measured 29.8 and 29.9, respectively. For the HF concentrations, 10% and 15% showed higher µSBS means than did 1% and 2.5% (p<0.05); 7.5% was higher than 1% (p<0.05); and no statistical differences were found among the other concentrations (p>0.05). When evaluating UR, µSBS mean was significantly higher and better infiltration was observed on the etched surfaces. No statistical difference was found between the ceramics. The HF concentration and UR influenced the bond strength and surface/interface morphology.

Effects of chlorhexidine and fluoride on irradiated enamel and dentin.

The effectiveness of mouthwash protocols in preventing gamma irradiation therapy damage to the ultimate tensile strength (UTS) of enamel and dentin is unknown. It was hypothesized that the use of chlorhexidine and fluoride mouthwash would maintain the UTS of dental structures. One hundred and twenty teeth were divided into 2 groups: irradiated (subjected to 60 Gy of gamma irradiation in daily increments of 2 Gy) and non-irradiated. They were then subdivided into 2 mouthwash protocols used 3 times per day: 0.12% chlorhexidine, 0.05% sodium fluoride, and control group (n = 10). The specimens were evaluated by microtensile testing. The results of the Tukey test (p < 0.05) indicated that the gamma irradiation therapy significantly reduced the UTS of the enamel, crown, and root dentin. Macromolecular alterations were suggested by optical retardation data in dentin. Structural alterations, in both substrates, were detected by scanning electron microscopy analysis. Mouthwash with 0.12% chlorhexidine partially prevented the damage to the mechanical properties of the irradiated crown dentin, whereas the 0.05% sodium-fluoride-irradiated enamel showed UTS similar to that of non-irradiated enamel.

Effect of gamma irradiation on ultimate tensile strength of enamel and dentin.

The effect of gamma irradiation therapy on the ultimate tensile strength (UTS) of enamel and dentin in relation to prism orientation, dentin tubule orientation, and location is unknown. It was hypothesized that tubule and prism orientation, location, and irradiation have an effect on the UTS of dental structures. Forty human third molars were used, half of which were subjected to 60 Gy of gamma irradiation, in daily increments of 2 Gy. The specimens were evaluated by microtensile testing. Results showed that irradiation treatment significantly decreased the UTS of coronal and radicular dentin and of enamel, regardless of tubule or prism orientation. With or without irradiation, enamel was significantly stronger when tested parallel to its prismatic orientation. Coronal and radicular dentin of non-irradiated specimens presented significantly higher UTS when tested perpendicularly to tubule orientation. However, when the teeth were irradiated, the influence of tubule orientation disappeared, demonstrating that irradiation is more harmful to organic components.