Three Self-Adhesive Resin Cements and Their Influence on the Marginal Adaptation of Zirconia-Reinforced Lithium Silicate Single Crowns: An In Vitro Scanning Electron Microscope Evaluation.

Background: In everyday dentistry, monolithic single crowns can be cemented with self-adhesive resin cements. The aim of this in vitro study was to evaluate how the marginal adaptation of full monolithic zirconia-reinforced lithium silicate (ZLS) single crowns is influenced by three different self-adhesive resin cements. Methods: Forty-five typodont teeth fully prepared for full monolithic crowns were divided into three groups (fifteen each) for the use of three different self-adhesive resin cements. A fourth control group (Temp-bond) was created by taking five teeth from each group before cementation with self-adhesive resin cements. All forty-five abutments were scanned using a Primescan intra-oral scanner (IOS), followed by computer-aided design (CAD) and computer-aided manufacturing (CAM) of zirconia-reinforced lithium silicate (ZLS) full crowns using a four-axis machine. Initially, the crowns of the control group were fixed to the abutments using Temp-bond, and the marginal gap was evaluated using a scanning electron microscope (SEM). After removing the control group crowns from the abutments, fifteen crowns in each group were cemented using a different self-adhesive resin cement and observed under SEM for evaluation of the marginal gap. A Kolmogorov-Smirnov test was performed, indicating no normal distribution (p < 0.05), followed by Mann-Whitney tests (α = 0.05). Results: The total mean marginal gap of the temp-bond control group was significantly lower compared to all three groups of self-adhesive resin cement (p < 0.0005). The total mean marginal gap of the G-cem ONE group was significantly lower compared to the TheraCem group (p < 0.026) and RelyX U200 group (p < 0.008). The total mean marginal gap of the TheraCem group was significantly higher than the G-cem ONE group (p < 0.026) but showed no significant difference with the RelyX U200 group (p > 0.110). Conclusions: All four groups showed a clinically acceptable marginal gap (<120 microns). Although all three groups of self-adhesive resin cement showed a significant increase in the marginal gap compared to the temp-bond control group, they were within the limits of clinical acceptability. Regarding the marginal gap, in everyday dentistry, it is acceptable to use all three self-adhesive resin cements, although the G-cem ONE group exhibited the lowest marginal gap for ZLS single crowns.

The Impact of Open versus Closed Computer-Aided Design/Computer-Aided Manufacturing Systems on the Marginal Gap of Zirconia-Reinforced Lithium Silicate Single Crowns Evaluated by Scanning Electron Microscopy: A Comparative In Vitro Study.

This study aimed to compare the impact of CAD/CAM closed systems and open systems on the marginal gap of monolithic zirconia-reinforced lithium silicate (ZLS) ceramic crowns, as both systems are used in everyday dentistry, both chair-side and laboratory. For the closed system, 20 plastic teeth were scanned by a Primescan intra-oral scanner (IOS), and for the open system, the same number of plastic teeth were scanned by Trios 4 IOS. For the closed system, CEREC software was used, and for the open system, EXOCAD software was used. All 40 ZLS crowns were grinded by the same four-axis machine and cemented with Temp-bond, followed by self-adhesive resin cement. For each type of cement, an evaluation of the marginal gap was conducted by scanning electron microscopy (SEM). Before comparisons between the groups, a Kolmogorov-Smirnov test was performed on the study variables showing a normal distribution (p > 0.05). Independent T tests (α = 0.05) and paired-sample T tests (α = 0.05) were used. The independent T test found no significant mean marginal gap differences in the zirconia-reinforced lithium silicate crowns bonded with Temp-bond and scanned by Primescan (28.09 µm ± 3.06) compared to Trios 4 (28.94 µm ± 3.30) (p = 0.401), and there was no significant mean marginal gap differences in zirconia-reinforced lithium silicate crowns bonded with self-adhesive resin cement (Gcem ONE) and scanned by Primescan (46.70 µm ± 3.80) compared to Trios 4 (47.79 µm ± 2.59) (p = 0.295). Paired-sample T tests showed significantly higher mean marginal gaps with Gcem ONE compared to Temp-bond for the total mean marginal gap when scanning with Primescan (p = 0.0005) or Trios 4 (p = 0.0005). In everyday dentistry, both closed systems (Primescan with Cerec) and open systems (Trios 4 with Exocad) can be used to achieve an acceptable (<120 µm) marginal gap for ZLS CELTRA® DUO single crowns. There is a significant difference between cementation with Temp-bond and Gcem ONE self-adhesive resin cement (p < 0.05).

Comparison between Conventional and Digital Impressions for Determining Axes and Distances of Three Implants in Straight and Curved Lines: An In Vitro Study.

Background: In this study, we aimed to compare the effects of conventional and digital impressions on several parameters (inter-implant distance, intra-implant distance, inter-implant axis, and intra-implant axis) of three implants in curved lines and straight lines by using a laboratory scanner (LBS) versus an intra-oral scanner (IOS). Methods: Two 3D models were fabricated using a printer, each model with three internal hex implants analogues at the positions of 15#,16#,17# (straight line) and 12#,13#,14# (curved line). Standard intra-oral scan bodies (ISBs) were used, and the two models were scanned using 7 Series dental wings (LBS, reference model), followed by ten scans with Primescan (digital method). Standard Tessellation Language (STL) files were created. Five polyether impressions were taken from each model (straight and curved), and gypsum type 4 models were poured; each model was scanned five times to create a total of 25 STL files for each group (conventional method). The comparison between all the STL files (conventional and digital) was made by superimposition of the STL files on the STL reference model laboratory file using a 3D analyzing software. A Kolmogorov-Smirnov test was performed, followed by Mann-Whitney tests and Wilcoxon signed-rank tests. (p < 0.05). Results: For the conventional method, the mean errors were significantly higher for the curved line model (12-14) compared to the straight line model (15-17) for most parameters (p < 0.05). For the digital method, the mean errors were significantly higher for the curved-line model (12-14) compared to the straight line model (15-17) in half of the parameters (p < 0.05). Within the curved line model (12-14) and the straight line model (15-17), the mean errors between the conventional method and the digital method were not significant for most variables. Conclusions: The difference between curved lines and straight lines has an impact on the mean error of the conventional method. Both methods are reliable for straight and curved lines in partially dentate situations.

SEM Evaluation of the Marginal Gap of Zirconia-Reinforced Lithium Silicate Full Crowns and the Effect of Post Crystallization: An In Vitro Study.

BACKGROUND: This study compared the influence of crystallization on marginal gap adaptation by using computer-aided design and manufacturing (CAD-CAM) for producing monolithic zirconia-reinforced lithium silicate (ZLS) ceramic crowns. METHODS: A total of 25 plastic teeth were scanned using a Primescan intra-oral scanner (IOS), and ZLS crowns were ground. For each unit (abutment and crown), the marginal gap was evaluated pre crystallization and post crystallization at four regions of interest through the use of a scanning electron microscope (SEM). To compare the marginal gap between the two groups, a Kolmogorov-Smirnov test performed on the study variables indicated a normal distribution (p > 0.05) followed by paired samples T-tests (α = 0.0005). RESULTS: After crystallization, there were significantly higher circumferential marginal gaps (CMGs) for all four surfaces (distal (p = 0.0005), mesial (p = 0.0005), palatal (p = 0.0005), and buccal (p = 0.0005)). The total mean marginal gap (MMG) revealed a significantly higher result for the post-crystallization group (79.82 ± 7.86 µm) compared to the pre-crystallization group (24.25 ± 5.49 µm). CONCLUSIONS: The post-crystallization group showed a significantly higher marginal gap compared to the pre-crystallization group in all parameters, but both groups were in the clinically accepted threshold (<120 microns). In terms of the marginal gap, it is arguable whether to carry out post-crystallization for CELTRA® DUO crowns and achieve better mechanical properties but significantly increase the marginal gap.

Analysis of Strain Distribution in Common Clinical Designs of Posterior Implant-Supported Fixed Partial Restorations: Comparison between Six Configurations.

The configuration of implant-supported prostheses is considered to influence the magnitude of stress concentrations, affecting their survival rate. The purpose of this study is to determine, through strain gauge measurements during load application, the dispersion and magnitude of strain concentrations in different implant-supported prosthesis designs. All designs matched those commonly used in posterior partially edentulous states. Three implants were inserted into an epoxy resin model (PLM-4B Vishay Measurements Group Inc., Raleigh, NC, USA), allowing for the delivery of three- and four-unit crowns in different cemented configurations. Loads were applied at vertical and oblique directions over the cast crowns in six different configurations representing various posterior partially edentulous restorations. The readings from the strain gauges adhered to the implant necks' presented data on implant strain. Prostheses including cantilevers showed the highest strain among the three-unit prostheses within the prosthetic complex, and three single units showed the least (8133 µs vs. 201 µs, respectively). Angulated load application also had a role in amplifying the strains recorded, resulting in total strains of between 3.5 and 20 times higher than during vertical loading in all configurations. It can be concluded that the configuration of implant-fixed partial prosthesis changes the loads engaging the restoration, the implant, and, probably, the supporting bone.

The Influence of Laboratory Scanner versus Intra-Oral Scanner on Determining Axes and Distances between Three Implants in a Straight Line by Using Two Different Intraoral Scan Bodies: A Pilot In Vitro Study.

BACKGROUND: The purpose of this in vitro study was to compare the inter-implant distance, inter-implant axis, and intra-implant axis of three implants in a straight line by using a laboratory scanner (LBS) versus an intra-oral scanner (IOS) with two different intra-oral scan bodies (ISBs). METHODS: A 3D model was printed with internal hex implant analogs of three implants in positions 15#, 16#, and 17#. Two standard intra-oral scan bodies (ISBs) were used: MIS ISB (two-piece titanium) and Zirkonzhan ISB (two-piece titanium). Both ISBs were scanned using 7 Series dental wings (LBS) and 30 times using Primescan (IOS). For each scan, a stereolithography (STL) file was created and a comparison between all the scans was performed through superimposition of the STL files by using 3D analysis software (PolyWorks® 2020; InnovMetric, Québec, QC, Canada). A Kolmogorov-Smirnov test was performed followed by a Mann-Whitney test (p < 0.05). RESULTS: The change in inter-implant distance for the MIS ISB was significantly lower compared to the ZZ (p < 0.05). The change in intra-implant angle was significantly lower for the ZZ ISB compared to MIS (p < 0.05). The changes in inter-implant angle between the mesial and middle and between the middle and distal were significantly lower for MIS compared to ZZ in contrast to mesial to distal, which was significantly higher (p < 0.05). CONCLUSIONS: Both ISBs showed differences in all the parameters between the LBS and the IOS. The geometry of the scan abutment had an impact on the inter-implant distance as the changes in the inter-implant distance were significantly lower for the MIS ISB. The changes in the intra-implant angle were significantly lower for the ZZ ISB. There is a need for further research examining the influence of geometry, material, and scan abutment parts on the trueness.

The Light Reflection Changes of Monolithic Zirconia and Lithium Disilicate after Using Two External Staining Kits following by Thermocycling.

BACKGROUND: The purpose of the study was to evaluate the changes of light reflection% on two materials (monolithic zirconia and lithium disilicate) after using two external staining kits following by thermocycling. METHODS: Specimens were sectioned from monolithic zirconia (n = 60) and lithium disilicate (n = 60) then divided into six groups (n = 20). Two different types of external staining kits were used and applied to the specimens. The light reflection% was measured before staining, after staining and after thermocycling using a spectrophotometer. RESULTS: The light reflection% of zirconia was significantly higher compared to lithium disilicate at the beginning of the study (p = 0.005), after staining with kit 1 (p = 0.005) and kit 2 (p = 0.005) and after thermocycling (p = 0.005). For both materials, the light reflection% was lower after staining with Kit 1 compared to kit 2 (p < 0.043). After thermocycling, the light reflection% of lithium disilicate increased (p = 0.027) and was unchanged with Zirconia (p = 0.527). CONCLUSIONS: There is a difference between the materials regarding light reflection% as the monolithic zirconia showed higher light reflection% comparing lithium disilicate throughout the entire experiment. For lithium disilicate, we recommend using kit 1 as we found that, after thermocycling, the light reflection% of kit 2 was increased.

Development and Validation of a Questionnaire Evaluating the Impact of Prosthetic Dental Treatments on Patients' Oral Health Quality of Life: A Prospective Pilot Study.

OBJECTIVES: the aims of this study were the development of a novel questionnaire to assess the impact of prosthetic treatments on oral health-related quality of life (OHRQoL) and the performance of a prospective pilot study. BACKGROUND: the currently preferred OHRQoL measurement tool is the oral health impact profile-49 (OHIP-49), a self-report questionnaire which mainly focuses on general effects related to oral health. MATERIALS AND METHODS: A total of 24 adult participants (9 females and 15 males) were recruited and asked to complete the novel questionnaire twice: once before the prosthetic treatment began and 4-6 weeks post-treatment. The assessment of the change in OHRQoL was based on the differences in participants' answers before and after treatment. Data were analyzed using ANOVA with a repeated-measures method and t-tests. The reliability of the questionnaire was tested using Cronbach's alpha and intraclass coefficient (ICC). RESULTS: The questionnaire was found to be reliable (α ≥ 0.6), with "social disability" having the highest score (α = 0.868). All domains showed an improvement (α < 0.005) in OHRQoL scores after treatment. CONCLUSIONS: the novel questionnaire tested in this study was found to be reliable and convenient to use, and demonstrated that prosthetic treatments have a significant positive effect on OHRQoL post-treatment scores.

Effect of Two Traditional Polyacrylic Acid Conditioners and 2% Chlorhexidine Digluconate on Cavosurface Microleakage of Glass Ionomer Restorations.

OBJECTIVES: A lack of appropriate adhesiveness is one of the biggest problems in restorative dentistry today and the main cause of microleakage. This is especially true in pediatric dentistry where moisture control is more difficult to achieve. Glass ionomer restorative materials increase adhesion and decrease microleakage given their chemical adhesion to the remaining tooth substance. Pretreatment improves the adhesion quality. The aim of this study was to assess the microleakage of Glass ionomer restorative materials following application of 20% polyacrylic acid, 10% polyacrylic acid or 2% chlorhexidine digluconate in Class V cavities. STUDY DESIGN: Two Class V preparations were prepared on the buccal and lingual surfaces of 24 extracted human molars. The gingival wall was set below or above the CEJ. The teeth were divided into 2 groups. Group 1 was treated with 20% polyacrylic acid or 10% polyacrylic acid. Group 2 was treated with 10% polyacrylic acid or 2% chlorhexidine digluconate. Microleakage was evaluated using a light-reflecting stereomicroscope and stain penetration test. RESULTS: Two percent chlorhexidine digluconate was as efficient as the other conditioners. No statistically significant differences were found among the three types of conditioners. Dye penetration was significantly greater into dentin than into enamel among all three conditioners in both groups (P<0.001). CONCLUSION: Two percent chlorhexidine digluconate, with its known added advantages, can be used as a pretreatment conditioner in GI restorations.

Tetracycline impregnation affects degradation of porcine collagen matrix in healthy and diabetic rats.

OBJECTIVES: The present study evaluated the degradation of collagen matrix (CM) immersed in tetracycline (TTC) or phosphate-buffered saline (PBS) in diabetic and normoglycemic rats. MATERIALS AND METHODS: Diabetes was induced in 15 rats by systemic streptozotocin (STZ) (experimental); 15 healthy rats served as controls. One day before implantation 60 CM disks, 5 mm in diameter, were labeled with biotin: 30 were immersed in tetracycline (TTC) and 30 in PBS. One disk of each type was implanted subdermally in each rat. Animals were euthanized after 3 weeks, and tissue specimens containing the disks were prepared for histologic analysis. Horseradish peroxidase (HRP)-conjugated streptavidin was used to detect the remaining biotinylated collagen. Residual collagen area within the CM disks was analyzed and compared to baseline. RESULTS: Diabetes significantly increased the CM degradation. Immersion of the CM disks in a 50-mg/mL TTC solution before implantation decreased its degradation both in diabetic and normoglycemic rats. CONCLUSIONS: Diabetes significantly increases collagen matrix degradation; immersion of collagen matrix in TTC before implantation decreases its degradation in both diabetic and normoglycemic conditions. CLINICAL RELEVANCE: Immersion of medical collagen devices in TTC may be an effective means to decrease their resorption rate and increase their effectiveness, especially in situations with increased degradation such as diabetes.