Masking ability of CAD-CAM resin-matrix ceramics with different translucencies and thicknesses combined with four cement shades against varying background colors when facing veneer restorations.

BACKGROUND: To evaluate the comprehensive effect of translucency, thickness, cement shades, and background color on the masking ability of resin-matrix ceramic veneer restorations. METHODS: Resin-matrix ceramic specimens with 2 translucencies (LT, HT) and 3 thicknesses (0.5, 1.0, and 1.5 mm) were made of Upcera Hyramic (A2 shade). Cement specimens were made of Variolink N in 4 shades (yellow, white, transparent, and bleach XL). Five background specimens were made of IPS Natural Die Material in 5 shades (ND1, ND2, ND3, ND4, and ND5). Color coordinates of 120 subgroups (n = 5) of combined specimens composed of different ceramic, cement, and background specimens were obtained using a spectroradiometer. Color difference (ΔE00) compared with a 4-mm thick specimen of LT and HT ceramics was calculated and four-way ANOVA was used for statistical analysis (α = 0.05). RESULTS: Translucency, thickness, cement shade, background color, and their interaction had significant effects on ΔE00 (p < 0.001). ΔE00 values of HT groups were always higher than that of LT groups and were greater than 1.8 against all background colors. ΔE00 values of LT groups could be achieved to be less than 1.8 with appropriate thickness and cement shade. ΔE00 value decreased with increasing ceramic thickness. The effect of cement shade on ΔE00 had no obvious regularity, but ΔE00 values of bleach XL cement shade group were always lower than other cement shade groups under ND3 and ND5 background color. CONCLUSIONS: The masking ability of CAD-CAM resin-matrix ceramics can be simultaneously affected by translucency, thickness, cement shade, and background color. Resin-matrix ceramics with low translucency has a better masking ability than that with high translucency. The masking ability of CAD-CAM resin-matrix ceramics increase with increasing thickness. Cement shade has less impact on the final color of resin-matrix ceramic restorations.

Effect of Various Beverages on Adhesion of Repaired CAD/CAM Restorative Materials.

(1) Background: The purpose of this study was to determine the effect of commonly consumed beverages on the bond strength of three different computer-aided design-computer-aided manufacturing (CAD/CAM) resin-ceramic hybrid materials repaired with resin-based composite (RBC) materials. (2) Materials and Methods: Rectangular prism specimens (N = 138) measuring 6 mm × 5 mm × 2 mm were obtained from GC Cerasmart (GC), Lava Ultimate (LU), and Vita Enamic (VE) blocks. These blocks were polished and then subjected to thermal cycling (10,000 cycles, 5 °C to 55 °C). After the surface treatment was applied, the average surface roughness value was measured. All the surfaces were repaired with RBC. Thermal cycling was performed for the second time. Each group was then distributed into three subgroups according to the beverage used: tea (t), cola (c), and distilled water (0) (n = 15). The specimens were stored in these solutions for 28 days and then subjected to the shear bond strength (SBS) test. Statistical analysis was performed using a two-way ANOVA test with Bonferroni adjustment. (3) Results: The surface roughness of the materials presented no significant difference after different surface treatments (p > 0.05). No significant difference was observed among the materials (p > 0.05). Tea and cola presented similar SBS values (p > 0.05). Both were significantly lower than distilled water (p < 0.001, p < 0.001, respectively). (4) Conclusions: Consumption of beverages reduces the bond strength in surfaces repaired with RBC to CAD/CAM resin-ceramic hybrid materials. (5) Clinical Significance: Repairing damaged resin matrix dental restorations with RBC is advantageous in terms of time and cost by achieving adequate bond strengths. Frequently consumed beverages reduce the bond strength of repaired CAD/CAM resin-ceramic hybrid materials.

Comparison of the polishing effects of polyetheretherketone materials under different chairside polishing systems / 口腔疾病防治

Objective @# The polishing effects of different compositions of chairside polishing systems on polyetheretherketone (PEEK) were compared to provide a reference for the rational selection of polishing systems for this material in clinical settings. @*Methods @#A total of 108 specimens were made from ShushijieTMPEEK crown and bridge materials, Bio-PAEK® dental PEEK, and BioHPP® PEEK. Thirty-six specimens of each material were randomly divided into 6 groups on average based on their polishing technique: OptiDisc®, Super-Snap® Rainbow Technique Kit, VITA ENAMIC®Clinical Polishing Set, Sof-LexTM Diamond Polishing System, Visio.lign Finishing Kit for Composite Veneers, and CERAMAGE Polishing Kit, LavaTM Ultimate ceramic and VITA ENAMIC ceramics were set as the control groups, and 6 specimens were made in each material, polished by Sof-LexTM Diamond Polishing System and VITA ENAMIC® Polishing Set clinical, respectively, according to the manufacturers’ suggestions. The surface roughness (Ra value and Sa value) and gloss of each set were measured. The surface morphologies of the polished specimens were observed by scanning electron microscopy.@*Results @#Surface roughness (Ra value and Sa value) and gloss were mainly influenced by the type of polishing system, and they varied between PEEK material types. The Sof-LexTM Diamond Polishing System produced the highest surface roughness and the lowest gloss values for PEEK materials, while the Super-Snap® Rainbow Technique Kit, Visio.lign Finishing Kit for Composite Veneers and CERAMAGE Polishing Kit resulted in low surface roughness values. The Visio.lign Finishing Kit for Composite Veneers and CERAMAGE Polishing Kit exhibited high gloss values. Polishing paste particles were observed embedded on the surfaces of the PEEK materials polished by the Visio.lign Finishing Kit for Composite Veneers; the surfaces of specimens polished by the CERAMAGE Polishing Kit were smooth, without polishing paste particle residue. Using the same polishing system, the best polishing results were obtained with BioHPP® among the PEEK materials tested. The surface roughness values of the three tested PEEK materials polished by the CERAMAGE Polishing Kit were similar to those of the LavaTM Ultimate ceramic and VITA ENAMIC ceramic, but the gloss was higher than that of both. @*Conclusion @# CERAMAGE Polishing Kit was recommended for polishing all three tested PEEK materials, achieving a good polishing effect, with similar surface roughness and higher gloss characteristics comparable to those of polished computer-aided design and manufacturing (CAD/CAM) resin-matrix ceramics.

Clinical assessment of different implant-supported esthetic crown systems fabricated with semi-digital workflow: Two-year prospective study.

OBJECTIVE: To assess the clinical outcome of three esthetic implant-supported crown systems fabricated with semi-digital workflow and their influence on the clinical outcome of dental implants. MATERIAL AND METHODS: A total of 30 participants had received dental implants restoring missing maxillary first/second premolars. After 6 weeks, customized zirconia abutments were early loaded. Two months later, the definitive crowns were fabricated using semi-digital workflow and cemented. According to the crown material, 3 groups were randomly allocated; group (Z): ultrahigh-translucent monolithic zirconia, group (C): resin-matrix ceramic and group (P): polyetherketoneketone veneered with light-cured composite resin. Clinical outcomes including the survival and success rates were evaluated at baseline, 6, 12, 18, and 24 months. RESULTS: The survival rate for all studied groups was 100%, while their success rate was 100% for group (Z) and 90% for group (C) and group (P). Based on the functional implant prosthodontic score, a statistically significant difference was detected between group (Z) and group (P) (p < 0.001) as well as between group (C) and group (P) (p = 0.01). CONCLUSIONS: The zirconia group had the most favorable clinical behavior, while the polyetherketoneketone had the least. All crown systems had comparable success rates with similar values of the peri-implant marginal bone loss. CLINICAL SIGNIFICANCE: Using semi-digital workflow, ultrahigh-translucent monolithic zirconia, resin-matrix ceramic and polyetherketoneketone veneered with light-cured composite resin can be considered as favorable implant-supported crowns. The implant-supported crown system based on polyetherketoneketone veneered with light-cured composite resin is counted as a promising esthetic and restorative option.

Effect of Different Surface Treatments on Repair Bond Strength of CAD/CAM Resin-Matrix Ceramics.

The purpose of this study was to investigate the influence of different surface treatment methods on the micro-tensile bond strength (µTBS) of resin-matrix ceramic (RMC) blocks repaired with resin composite. Three different prefabricated RMC blocks including Lava Ultimate (LU), Grandio Blocs (GB), and Shofu Block HC (HC) were thermo-cycled and divided into five surface treatment groups: Control (C), bur grinding (G), airborne particle abrasion (APA), Er,Cr:YSGG laser irritation (LI), and APA combined with LI (APA+LI). After surface treatments, topographic alterations were examined by scanning electron microscopy. Then, Universal Adhesive (Single Bond Universal) was applied and repair was simulated with nanohybrid composite (Grandio SO). Bonded specimens were cut into 1 mm2 sized beams (n = 16) and a µTBS test was conducted by using a universal test machine. Fracture types were evaluated by using a stereomicroscope. The bond- strength data was evaluated by two-way ANOVA and Tukey post-hoc test (α = 0.05). The µTBS values were significantly affected by the surface treatment variable and the interaction terms of the variables (p ≤ 0.001). However, no significant effect of RMC type was detected (p > 0.05). Among all materials, GBAPA+LI indicated the highest µTBS value. Except for the GBC, all surface treatments showed clinically acceptable bond-strength values. However, the surface treatments applied to GB and LU before the repair processes increased the repair bond-strength values while causing a negative effect for HC. In addition, LI and APA+LI can be applied as an alternative route compared to other procedures recommended by the manufacturer for surface preparation in intraoral RMC repair.

Assessment of relative translucency and resultant color of contemporary resin-matrix ceramics indicated for laminate veneers and full crowns.

Background and Aims: Evaluation of the optical properties of restorative materials is an important parameter for identifying clinical success. The aim of this study was to compare the translucency of contemporary resin-matrix ceramics (RMCs) and to evaluate the effect of cement shade on the final color of RMCs indicated for laminate veneers and full crowns. Materials and Methods: A hundred A2 shade RMC specimens were fabricated by using Mazic Duro (MD), CAMouflage NOW (CN), KZR-CAD HR2 (KZR), Grandio Block (GB), and Brilliant Crios (BC) at 0.7-mm and 1.5-mm thicknesses (n = 10). A2 shade composite resin was used for the foundation structure. Twenty resin-cement specimens were prepared from A2 and translucent shades at 0.1-mm thickness. Interchangeably, the foundation-cement-resin matrix ceramic assemblies were created with optical gel. The color coordinates were recorded using a spectrophotometer. After calculating translucency parameter (TP00) and color difference (ΔE00) values, data were analyzed statistically (P = 0.05). Results: TP00 values were influenced by RMC type and thickness. TP00 values of RMCs can be listed in descending order as MD>GB = CN>BC=KZR. ΔE00 values were significantly influenced by all parameters and their interactions. MD exhibited higher ΔE00 values among tested RMCs. The effect of A2 cement was not perceived visually while TR cement demonstrated visually perceptible but clinically acceptable values for both laminate veneers and full crowns. As the material thickness decreased, the TP00 and ΔE00 values increased in all RMCs. Conclusions: Clinicians should carefully prefer cement shade and RMC material by contemplating their impact on the optical properties particularly when the restoration is thin.

The effect of resin cement shade and restorative material type and thickness on the final color of resin-matrix ceramics.

PURPOSE: This study aims to evaluate the effects of cement shade, restorative material type, and thickness on the final color of resin-matrix ceramics. METHODS: Ninety A2 shade resin-matrix ceramic specimens were prepared from Vita Enamic, GC Cerasmart, and Lava Ultimate at 0.5 and 1.0 mm thicknesses. Sixty resin cement disks were fabricated from different shades (A1, A3O, B05, and TR) of RelyX Ultimate at 0.1 mm thickness. CIE color coordinates were measured using a spectrophotometer, and color differences (∆E00) were calculated. Data were statistically analyzed (P =0.05). RESULTS: The ΔE00 values were influenced by the cement shade, restorative material type, thickness, and their interactions (P < 0.05). A3O cement caused clinically unacceptable values for all groups at 0.5 mm thickness and GC at 1.0 mm thickness. A1 and TR cement shades demonstrated visually perceptible but clinically acceptable values, except for VE-A1 and LU-A1 at 0.5 mm thickness. The ∆E00 values of the B05 cement shade were lower than the visually perceptible threshold for both thicknesses except for GC at 0.5 mm thickness. CONCLUSION: The shade of the resin cement and the type and thickness of the resin-matrix ceramic material significantly affected the resulting final color. To provide a shade matching with natural dentition and to obtain esthetic restorations, especially for the anterior teeth, the resin cement shade and resin-matrix ceramic material should be carefully selected.

Micro-shear bond strengths of resin-matrix ceramics subjected to different surface conditioning strategies with or without coupling agent application.

PURPOSE: This study aimed to assess the influence of various micromechanical surface conditioning (MSC) strategies with or without coupling agent (silane) application on the micro-shear bond strength (µSBS) of resin- matrix ceramics (RMCs). MATERIALS AND METHODS: GC Cerasmart (GC), Lava Ultimate (LU), Vita Enamic (VE), Voco Grandio (VG), and Brilliant Crios (BC) were cut into 1.0-mm-thick slices (n = 32 per RMC) and separated into four groups according to the MSC strategy applied: control-no conditioning (C), air-borne particle abrasion with aluminum oxide particles (APA), 2W- and 3W-Er,Cr:YSGG group coding is missing. The specimens in each group were further separated into silane-applied and silane-free subgroups. Each specimen received two resin cement microtubules (n = 8 per subgroup). A shear force was applied to the adhesive interface through a universal test machine and µSBS values were measured. Data were statistically analyzed by using 3-way ANOVA and Tukey HSD test. Failure patterns were scrutinized under stereomicroscope. RESULTS: RMC material type, MSC strategy, and silanization influenced the µSBS values (P<.05). In comparison to the control group, µSBS values increased after all other MSC strategies (P<.05) while the differences among these strategies were insignificant (P>.05). For control and APA, there were insignificant differences between RMCs (P>.05). The silanization decreased µSBS values of RMCs except for VE. Considerable declines were observed in GC and BC (P<.05). CONCLUSION: MSC strategies can enhance bond strength values at the RMC - cement interface. However, the choice of MSC strategy is dependent on RMC material type and each RMC can require a dedicated way of conditioning.

How will surface conditioning methods influence the translucency and color properties of CAD-CAM resin-matrix ceramics with different thicknesses?

OBJECTIVE: It was aimed to evaluate the effect of various surface-conditioning methods on the translucency and color properties of resin-matrix ceramics (RMCs) with different types and thicknesses. MATERIALS AND METHODS: Rectangle-shaped RMCs were prepared from Voco Grandio, Brilliant Crios, Lava Ultimate, GC Cerasmart, and Vita Enamic blocks at 0.5 and 1.0 mm thicknesses. Specimens were divided into four groups: control, airborne-particle abrasion (APA), 2 and 3 W Er, Cr:YSGG laser irradiations (L2W , L3W ) (n = 15). The color values of specimens were recorded before and after surface-conditioning using a spectrophotometer. The translucency parameter (RTP00 ) and color difference (ΔE00 ) values were calculated. Data were statistically analyzed using three-way ANOVA and Tukey post hoc tests. RESULTS: The translucencies of RMCs decreased after all surface-conditioning procedures. L caused more decline in translucency of materials than APA. All ΔE00 values were under the acceptability threshold except for APA-applied Voco Grandio at 0.5 mm. Differences in ΔE00 values between APA and L3W groups were significant (P˂0.05); while differences between L2W and L3W groups were insignificant (P > .05). In all experimental groups, ΔE00 values decreased with increasing thickness of RMCs. CONCLUSIONS: L and APA significantly affected the translucency and color properties of RMCs. APA was found more favorable than L. CLINICAL SIGNIFICANCE: Clinicians should carefully use surface conditioning methods, considering their impact on the optical characteristics of RMCs, especially when the restoration is thin.

Effect of endodontic access simulation on the fracture strength of lithium-disilicate and resin-matrix ceramic CAD-CAM crowns.

OBJECTIVES: The purpose of this in vitro study was to compare the effect of simulated endodontic access preparation on the failure loads of lithium disilicate crowns and resin-matrix ceramic (RMC) crowns. MATERIALS AND METHODS: Eighty maxillary first premolar crowns were manufactured by using four different CAD/CAM blocks (n = 20): lithium disilicate (LD; IPS e.max CAD), resin nanoceramic (RNC; Lava Ultimate), flexible nanaoceramic (FNC; GC Cerasmart), and polymer-infiltrated ceramic (PIC; VITA Enamic). Half of each group was accessed and repaired to simulate endodontic treatment. After cyclic loading, all specimens were loaded to failure. Data were analyzed with two-way ANOVA followed by Tukey-HSD test (α = .05). RESULTS: The load to failure results showed significant differences for material types (P < .001), but not for endodontic access simulation (P = .09). The highest and lowest mean failure loads were obtained for LD (1546 N) and PIC (843 N), respectively. CONCLUSION: The endodontic access preparation was not found to affect the fracture strength of LD and RMC crowns. The LD showed higher fracture strength than RMC crowns. Even though significant differences were noted for failure loads regarding different crown materials, all could reasonably withstand masticatory forces. CLINICAL SIGNIFICANCE: The endodontic access preparation through a restoration is known to be a common challenge in clinical practice. Maintaining a repaired LD or RMC crown is feasible and replacement may not be necessary.

In vivo wear determination of novel CAD/CAM ceramic crowns by using 3D alignment.

PURPOSE: To determine wear amount of single molar crowns, made from four different restoratives, and opposing natural teeth through computerized fabrication techniques using 3D image alignment. MATERIALS AND METHODS: A total of 24 single crowns (N = 24 patients, age range: 18 - 50) were made from lithium disilicate (IPS E-max CAD), lithium silicate and zirconia based (Vita Suprinity CAD), resin matrix ceramic material (Cerasmart, GC), and dual matrix (Vita Enamic CAD) blocks. After digital impressions (Cerec 3D Bluecam, DentsplySirona), the crowns were designed and manufactured (Cerec 3, DentsplySirona). A dual-curing resin cement was used for cementation (Variolink Esthetic DC, Ivoclar). Then, measurement and recording of crowns and the opposing enamel surfaces with the intraoral scanner were made as well as at the third and sixth month follow-ups. All measurements were superimposed with a software (David-Laserscanner, V3.10.4). Volume loss due to wear was calculated from baseline to follow-up periods with Siemens Unigraphics NX 10 software. Statistical analysis was accomplished by Repeated Measures for ANOVA (SPSS 21) at = .05 significance level. RESULTS: After 6 months, insignificant differences of the glass matrix and resin matrix materials for restoration/enamel wear were observed (P>.05). While there were no significant differences between the glass matrix groups (P>.05), significant differences between the resin matrix group materials (P<.05) were obtained. Although Cerasmart and Enamic were both resin matrix based, they exhibited different wear characteristics. CONCLUSION: Glass matrix materials showed less wear both on their own and opposing enamel surfaces than resin matrix ceramic materials.

In vivo wear determination of novel CAD/CAM ceramic crowns by using 3D alignment

PURPOSE: To determine wear amount of single molar crowns, made from four different restoratives, and opposing natural teeth through computerized fabrication techniques using 3D image alignment. MATERIALS AND METHODS: A total of 24 single crowns (N = 24 patients, age range: 18 – 50) were made from lithium disilicate (IPS E-max CAD), lithium silicate and zirconia based (Vita Suprinity CAD), resin matrix ceramic material (Cerasmart, GC), and dual matrix (Vita Enamic CAD) blocks. After digital impressions (Cerec 3D Bluecam, DentsplySirona), the crowns were designed and manufactured (Cerec 3, DentsplySirona). A dual-curing resin cement was used for cementation (Variolink Esthetic DC, Ivoclar). Then, measurement and recording of crowns and the opposing enamel surfaces with the intraoral scanner were made as well as at the third and sixth month follow-ups. All measurements were superimposed with a software (David-Laserscanner, V3.10.4). Volume loss due to wear was calculated from baseline to follow-up periods with Siemens Unigraphics NX 10 software. Statistical analysis was accomplished by Repeated Measures for ANOVA (SPSS 21) at = .05 significance level. RESULTS: After 6 months, insignificant differences of the glass matrix and resin matrix materials for restoration/enamel wear were observed (P>.05). While there were no significant differences between the glass matrix groups (P>.05), significant differences between the resin matrix group materials (P<.05) were obtained. Although Cerasmart and Enamic were both resin matrix based, they exhibited different wear characteristics. CONCLUSION: Glass matrix materials showed less wear both on their own and opposing enamel surfaces than resin matrix ceramic materials.

Contemporary Dental Ceramic Materials, A Review: Chemical Composition, Physical and Mechanical Properties, Indications for Use.

BACKGROUND: The high esthetic expectations from the prosthodontic restorations have directed the qualitative development of the materials towards the all-ceramic materials that are capable of replacing porcelain-fused-to-metal systems. AIM: This article reviews the literature covering the contemporary all-ceramic materials and systems with a focus on the chemical composition and materials' properties; also it provides clinical recommendations for their use. RESULTS: The glass-matrix ceramics and polycrystalline ceramics are presented, as well as recently introduced machinable materials, all-zirconia and resin-matrix ceramics. The specific properties of zirconia, such as transformation toughening, stabilisation of the crystallographic structure, low-temperature degradation and factors affecting the zirconia's ageing, are emphasised. CONCLUSION: The favourable properties of the resin-matrix ceramics, such as modulus of elasticity similar to dentin, shock-absorbing characteristics and high resilience and fracture resistance, are also covered in this article.

Shear Bond Strength of Nanohybrid Composite to the Resin Matrix Ceramics After Different Surface Treatments.

OBJECTIVE: The purpose of this study was to evaluate the effects of different surface treatments on the shear bond strength (SBS) of a composite resin to the various resin matrix ceramics (RMC). BACKGROUND: Clinical applications of physical and chemical surface conditioning methods may be required for RMC to optimize the adhesion of additional resin materials. MATERIALS AND METHODS: Ninety-nine RMC specimens (6 × 6 × 2 mm) were prepared from a resin nanoceramic (RNC), a polymer-infiltrated hybrid ceramic (PIHC), and a flexible hybrid ceramic (FHC) block with a cutting machine under copious water. All specimens divided randomly into three surface treatment subgroups (n = 11): (1) untreated (Cnt), (2) tribochemical silica coated (Tbc), and (3) neodymium-doped yttrium aluminum garnet (Nd:YAG) laser irradiated with 3 W (150 mJ/pulse, 20 Hz) for 20 sec. A nanohybrid composite resin was layered with a disc-shape mold (2 × 3 mm) onto the ceramics and submitted to thermal cycling (3000 cycles, 5-55°C). The SBS test of specimens was performed using a universal testing machine. Data were statistically analyzed with two-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). RESULTS: The type of RMC, surface treatments, and their interactions was statistically significant on SBS, according to the ANOVA (p < 0.05). Both the Tbc and Lsr surface treatments significantly increased the SBS values of FHC (p < 0.001), while significant increases were observed only for Lsr0applied RNC and Tbc applied PIHC groups (p < 0.001). CONCLUSIONS: The tribochemical silica coating and laser irradiation techniques may be suitable for improving the surface topography of specific types of RMC. While the same surface treatment technique may not provide similar successful results for all types of RMC, it is recommended to choose the most effective and reliable technique for clinical application.