Comparison of the fracture strength of endodontically treated teeth restored with polyether ether ketone, zirconia and glass-fibre post-core systems.

PURPOSE: This study aimed to compare the fracture resistance and fracture mode of maxillary central incisors restored with four different sizes and three different post-core systems. MATERIALS AND METHODS: One hundred and twenty maxillary incisors were endodontically treated and randomly divided into three groups (12 subgroups). Post cavities for the narrow subgroups were prepared with 1.4-mm-diameter drills in lengths of 7.5 mm (SN) and 10 mm (LN). Post cavities for the wide subgroups were prepared with 1.6-mm-diameter drills in lengths of 7.5 mm (SW) and 10 mm (LW) (n = 10). Group F was restored with glass-fibre post and composite resin core, Group P was restored with custom PEEK post-core and Group Z was restored with custom zirconia post-core. All posts were cemented with a dual-cure resin cement. Zirconia copings were cemented. Specimens were loaded on the palatal surface with a universal testing machine, and the fracture strengths of the teeth were statistically analysed using ANOVA and post hoc Tukey tests. RESULTS: Statistically significant differences existed between the fracture strengths of the post materials. The highest fracture strength was in Group F, and the lowest was in Group P. Evaluation of the fracture strengths of the post lengths and diameters demonstrated that the short-narrow group of Group Z had the lowest fracture strength (P < .05). The long-wide group of Group F showed the highest fracture resistance. In Group P, no statistically significant difference existed between the post-cores of different dimensions (P > .05). Irreparable fractures were observed mostly in Group Z, and decementation was more common in Group P. CONCLUSIONS: PEEK post-cores showed sufficient fracture strength for the anterior region, similar to the other two post-core materials. PEEK post-cores showed more decementation and repairable fractures at lower forces, while restoration failure was mostly catastrophic for glass-fibre and zirconia posts.

The effects of different surface treatments on the shear bond strengths of two dual-cure resin cements to CAD/CAM restorative materials.

PURPOSE: The aim of the present study was to investigate the effects of surface treatments on the bond strengths between polymer-containing restorative materials and two dual-cure resin cements. MATERIALS AND METHODS: In the present study, rectangular samples prepared from Lava Ultimate (LU) and Vita Enamic (VE) blocks were used. The specimen surfaces were treated using CoJet sandblasting, 50 µm Al2O3 sandblasting, % 9 HF (hydrofluoric) acid, ER,Cr:YSGG laser treatment, and Z-Prime. Dual-cure resin cements (TheraCem and 3M RelyX U 200) were applied on each specimen's treated surface. A micro-tensile device was used to evaluate shear bond strength. Statistical analysis was performed using the SAS 9.4v3. RESULTS: While the bond strength using TheraCem with LU or VE was not statistically significant (P=.164), the bond strength using U200 with VE was statistically significant (P=.006). In the TheraCem applied VE groups, Z-Prime and HF acid were statistically different from CoJet, Laser, and Sandblast groups. In comparison of TheraCem used LU group, there was a statistically significant difference between HF acid and other surface treatments. CONCLUSION: The bonding performance between the restorative materials and cements were material type-dependent and surface treatment had a large effect on the bond strength. Within the limitations of the study, the use of both U200 and TheraCem may be suggested if Z-prime was applied to intaglio surfaces of VE. The cementation of LU using TheraCem is suitable after HF acid conditioning of the restoration surfaces.

The effect of thickness and translucency of polymer-infiltrated ceramic-network material on degree of conversion of resin cements.

PURPOSE: The aim of the present study was to determine the degree of conversion of light- and dual-cured resin cements used in the cementation of all-ceramic restorations under different thicknesses of translucent (T) and high-translucent (HT) polymer-infiltrated ceramic-network (PICN) material. MATERIALS AND METHODS: T and HT PICN blocks were prepared at 0.5, 1.0, 1.5, and 2.0 mm thicknesses (n=80). Resin cement samples were prepared with a diameter of 6 mm and a thickness of 100 µm. Light-cured resin cement was polymerized for 30 seconds, and dual-cure resin cement was polymerized for 20 seconds (n=180). Fourier transform infrared spectroscopy (FTIR) was used for degree of conversion measurements. The obtained data were analyzed with ANOVA and Tukey HSD, and independent t-test. RESULTS: As a result of FTIR analysis, the degree of conversion of the light-cured resin cement prepared under 1.5- and 2.0-mm-thick T and HT ceramics was found to be lower than that of the control group. Regarding the degree of conversion of the dual-cured resin cement group, there was no significant difference from the control group. CONCLUSION: Within the limitation of present study, it can be concluded that using of dual cure resin cement can be suggested for cementation of PICN material, especially for thicknesses of 1.5 mm and above.

Effects of overdenture attachment systems with different working principles on stress transmission: A three-dimensional finite element study.

PURPOSE: The aim of the present study was to compare the stress distributions on the dental implants, abutments, and bone caused by different overdenture attachment types under functional chewing forces. MATERIALS AND METHODS: The 3D finite element models of the mandible, dental implants, attachment types, and prostheses were prepared. In accordance with a conventional dental implant supported overdenture design, the dental implants were positioned at the bone level in the canine teeth region bilaterally. A total of eight models using eight different attachment systems were used in this study. All the models were loaded to simulate chewing forces generated during the centric relationship (450 N), lateral movement (400 N), protrusive movement (400 N), and also in the presence of a food mass unilaterally (200 N). Stress outputs were obtained as the maximum principal stress and the equivalent von-Mises stress. RESULTS: In all attachment types, higher stress values were observed in the abutments, dental implants, and bone in the magnet attachments in different loading conditions. The highest stress values were observed among the magnet systems in the components of the Titanmagnetics model in all loading conditions (stresses were 15.4, 17.7, and 33.1 MPa on abutment, dental implant, and bone, respectively). The lowest stress value was observed in the models of Zest and O-Ring attachments. CONCLUSION: The results of the present study implied that attachment types permitting rotation and tolerating various angles created lower stresses on the bone, dental implants, and abutments.

Use of a new skin colour measurement method for the investigation of relationship between skin and tooth colour.

PURPOSE: There is conflicting information about the relationship between tooth color and skin color in the literature. The aim of the present study was evaluation of the correlation between L, a, b values of skin and tooth shade using a new skin color measurement method. MATERIALS AND METHODS: CIELab values of teeth were obtained through measurements from the middle third of the labial surfaces on central incisors of individuals using a clinical spectrophotometer. CIELab values of the skin were measured through facial images using a software which was manufactured for present study. A statistical analysis program (SAS 9.4) was used for the analysis of the data. Kolmogorov-Smirnow test, t-test, and multivariate regression analysis were used to evaluate the data (α=0.05). RESULTS: Correlations between variables revealed that while the lowest and statistically insignificant correlations were observed with a* values of the skin, significant correlations did not exceed moderate level (p < .05). When considering regression analysis results, b* values of the skin had a statistically significant effect in describing b* values of the tooth, while L* and a* values of the skin were observed to be insufficient in describing L* and a* values of the teeth. CONCLUSION: Results of this study suggest that different significant correlations were observed between the skin and tooth color for different L*, a*, and b parameters (p <0.05 and p <0.01). The results indicated that skin color can be used for tooth color selection in case of loss of natural teeth or when discoloration is present on existing teeth.

Discoloration and translucency changes of CAD-CAM materials after exposure to beverages.

STATEMENT OF PROBLEM: Color and translucency changes of recently introduced composite resin blocks after long-term exposure to various staining agents have not been fully investigated. PURPOSE: The purpose of this in vitro study was to evaluate the color stainability and translucency changes of computer-aided design and computer-aided manufacturing (CAD-CAM) materials immersed in beverages with staining potential. MATERIAL AND METHODS: Three types of CAD-CAM blocks were used: 3M Lava Ultimate (LU), GC Cerasmart (CS), and VITA Enamic (VE). Forty-five rectangular specimens (1.5-mm thickness) of each product were prepared. The specimens were divided into 3 subgroups (n=15 in each) according to the immersion beverage. The specimens were then immersed in distilled water, red wine, and coffee for 30 days. Color parameters (ΔE00), the translucency parameter, and the contrast ratio were determined after 24 hours and 1 month. The Kruskal-Wallis and Mann-Whitney U tests and the Wilcoxon, Freidman, and repeated measurement ANOVA tests were used for statistical analysis (α=.05). RESULTS: None of the materials showed clinically perceptible color changes except CS specimens immersed in coffee for 24 hours. The materials immersed in red wine and coffee for 1 month showed greater discoloration than those immersed in water (P<.05). The LU immersed in red wine showed the highest translucency changes, and VE was more resistant to translucency changes, as compared with the other materials tested. The contrast ratio values of the LU material were higher than those of the CS and VE materials in all the beverages. CONCLUSIONS: The red wine and coffee caused significant changes in the color and translucency of these novel CAD-CAM materials after a long immersion period.

Effect of Different Surface Treatments on Bond Strength of Resin Cement to a CAD/CAM Restorative Material.

PURPOSE: To investigate the effects of various surface treatment methods on the shear bond strength of self-adhesive resin cement to a novel CAD/CAM hybrid ceramic material. MATERIALS AND METHODS: A novel hybrid ceramic restorative material (Vita Enamic) was used in this study. Sixty resin block specimens were prepared and separated into six groups for each surface treatment method (n = 10); group 1: control group, no treatment applied; group 2: sandblasted by 30 µm silicate-coated alumina particles (CoJet Sandblasting); group 3: 50 µm Al2 O3 sandblasting; group 4: 10% hydrofluoric acid; group 5: no surface treatment + universal adhesive (3M Single Bond Universal); group 6: 200 mJ, 10 Hz 2W Er,Cr:YSGG laser treatment. For each specimen, surface roughness measurements in noncontact mode were taken after the surface treatments using a portable surface texture-measuring machine. A self-adhesive resin cement (3M U200) was applied on every surface treated with the help of a cylindrical mold (2 × 4 mm) and was filled gradually. Shear bond strength was measured using a universal test machine, and one-way ANOVA and a Duncan test (p = 0.05) were used to analyze the data. RESULTS: Mean values of the shear bond strength varied between 7.75 and 10.73 MPa. Bond strength values were enhanced by all surface treatment methods compared to the control group. The difference between group 5 and the control group (p < 0.05) was statistically significant, whereas there were no considerable differences between other treatment methods. CONCLUSION: Surface treatments of hybrid ceramic resin blocks could enhance the bond strength to resin cement; however, using Single Bond Universal without surface treatment showed a higher bond strength value.

Assessing staining resistance of a CAD/CAM interpenetrating network composite material.

BACKGROUND: Color change of dental materials over time because of staining agents has important effects on the long-term prognosis of dental esthetic treatments. In the present study, staining resistance of an interpenetrating network composite material with different translucency levels (translucent and high translucent) and various surface procedures for finishing were investigated. METHODS: Same shade CAD/CAM interpenetrating network composite specimens having two different translucency levels were prepared using by a water cooling cutting saw. Specimens were grouped and different finishing procedures were performed. Then, specimens were kept in distilled water, red wine and coffee for different periods. Color was evaluated before and after exposure to staining liquids using a clinical spectrophotometer. RESULTS: In the 7 days Glaze group (ΔE00 > 2.2), color difference was only perceivable in the specimens kept in red wine. In the 28 days red wine high translucent groups, only the high translucent Clinical group showed a clinically acceptable (ΔE00 < 2.2) color change. In the translucent groups kept in red wine, only the translucent Glaze group showed a clinically perceivable color change (ΔE00 > 2.2). In the 28 day measurements, all the translucent groups showed a clinically perceivable color change (ΔE00 > 2.2). Of the translucent groups kept in coffee for 28 days, it was observed that only the translucent Clinical group demonstrated a clinically non-perceivable color change (ΔE00 < 2.2). CONCLUSIONS: All the translucent groups kept in red wine showed a clinically perceivable color change after 28 days. Only the high translucent Clinical Kit group showed a clinically acceptable color change. Among high translucent and translucent specimens kept in coffee only the translucent Clinical group showed a clinically acceptable color change after 28 days.

Assessment the Bond Strength of Ceramic Brackets to CAD/CAM Nanoceramic Composite and Interpenetrating Network Composite after Different Surface Treatments.

Adult orthodontics may confront problems related to the bonding performance of orthodontic brackets to new generation restorative materials used for crown or laminate restorations. The aim of the present study was to investigate the shear bond strength of ceramic brackets to two new generation CAD/CAM interpenetrating network composite and nanoceramic composite after different surface treatments. Er,Cr:YSGG Laser, hydrofluoric acid (9%), sandblasting (50 µm Al2O3), and silane were applied to the surfaces of 120 CAD/CAM specimens with 2 mm thickness and then ceramic brackets were bonded to the treated surfaces of the specimens. Bond strength was evaluated using the shear bond strength test. According to the results, CAD/CAM block types and surface treatment methods have significant effects on shear bond strength. The lowest bond strength values were found in the specimens treated with silane (3.35 ± 2.09 MPa) and highest values were found in the specimens treated with sandblast (8.92 ± 2.77 MPa). Sandblasting and hydrofluoric acid surface treatment led to the most durable bonds for the two types of CAD/CAM blocks in the present study. In conclusion, different surface treatments affect the shear bond strength of ceramic brackets to CAD/CAM interpenetrating network composite and nanoceramic composite. Among the evaluated treatments, sandblasting and hydrofluoric acid application resulted in sufficient bonding strength to ceramic brackets for both of the CAD/CAM materials.

Comparing the precision of panoramic radiography and cone-beam computed tomography in avoiding anatomical structures critical to dental implant surgery: A retrospective study.

PURPOSE: The aim of this study was to evaluate the correlations between measurements made using panoramic radiography and cone-beam computed tomography (CBCT) based on certain anatomical landmarks of the jaws, with the goal of preventing complications due to inaccurate measurements in the pre-surgical planning phase of dental implant placement. MATERIALS AND METHODS: A total of 56 individuals who underwent panoramic radiography and a CBCT evaluation before dental implant surgery were enrolled in the study. Measurements were performed to identify the shortest vertical distance between the alveolar crest and neighboring anatomical structures, including the maxillary sinus, nasal floor, mandibular canal, and foramen mentale. The differences between the measurements on panoramic radiography and CBCT images were statistically analyzed. RESULTS: Statistically significant differences were observed between the measurements on panoramic radiography and CBCT for all anatomical structures (P<.05). The correlation coefficients (r) between the paired samples obtained from panoramic radiography and CBCT were closely correlated (P<.05), with r values varying from 0.921 and 0.979 for different anatomical regions. CONCLUSION: The results of this study support the idea that panoramic radiography might provide sufficient information on bone height for preoperative implant planning in routine cases or when CBCT is unavailable. However, an additional CBCT evaluation might be helpful in cases where a safety margin cannot be respected due to insufficient bone height.

Effects of different surface finishing procedures on the change in surface roughness and color of a polymer infiltrated ceramic network material.

PURPOSE: Polymer infiltrated ceramic network (PICN) materials, also called hybrid ceramics, are new materials in dental market. The manufacturer of the PICN material VITA Enamic suggests 3 different finishing procedures for this new material. In the present study, surface roughness and color differences caused from different finishing procedures of VITA Enamic were investigated. MATERIALS AND METHODS: 120 specimens were prepared in dimensions 2 × 10 × 12 mm from VITA Enamic hybrid ceramic blocks with 'high translucency' and 'translucency 2M2' shades. The specimens were divided into 8 groups. For each group, different finishing procedures suggested by the manufacturer were performed. Surface roughness values were determined by a tactile portable profilometer. Color changes were evaluated using a clinical spectrophotometer. The data were analyzed using one-way ANOVA and Tukey's post-hoc comparison. The significance level was set at α=0.05. RESULTS: The roughest surfaces were observed in Glaze Groups. Their surface roughness values were similar to that of the control group. Clinical Kit and Technical Kit groups did not show a statistically significant difference regarding surface roughness (P>.05). The largest color difference regarding ΔE00 was observed in Clinical Kit finishing groups. There were also statistically significant color changes between the groups (P<.05). However, all the groups showed clinically acceptable color change (ΔE00<2.25) except Clinical Kit Groups (ΔE00>2.25). CONCLUSION: Within the limitations of the present study, it may be suggested that finishing the VITA Enamic restorations by Technical Kit instead of Glaze and Clinical Kit gives better clinical performance in regard to surface roughness and shade matching.

Comparison of mandibular bone mineral density in osteoporotic, osteopenic and normal elderly edentulous subjects measured by the dual-energy X-ray absorptiometry technique.

OBJECTIVE: The aim of this study was to compare the mandibular body bone mineral density according to bone mineral density status of spine and femur measured by dual-energy X-ray absorptiometry (DXA) technique in elderly edentulous individuals. BACKGROUND: One of the factors that affect the survival rate of implants is bone mineral density (BMD) of the jaws. MATERIALS AND METHODS: Fifty edentulous elderly patients' (27 women and 23 men) spine, femur and the mandibular body BMDs were measured using DXA technique. BMD scans of the AP lumbar spine (L2-L3) and femur were classified using World Health Organisation criteria for bone mass. RESULTS: There was a statistically significant difference between the normal femur group's-osteoporosis group's mandibular body BMD (p = 0.001) and femoral osteopaenia group's-osteoporosis group's mandibular body BMD (p < 0.001). The femoral osteoporosis group's mandibular body BMDs were lower than those of both the normal femoral and the femoral osteopaenia group subjects'. CONCLUSION: Classification of edentulous mandibles according to low and high bone mineral densities is a problem in implant dentistry. The results of this study demonstrated that femoral bone mineral density status may be used to provide preliminary information about the bone mineral density of the mandibular body region in elderly edentulous subjects.