Wear resistance of CAD/CAM one-piece screw-retained hybrid-abutment-crowns made from different restorative materials.

INTRODUCTION: The aim of this study was to measure the wear progress of three high performance polymers (HPP) materials as well as that of zirconia after artificial aging (simulated 2.5- and 5-year of clinical service with thermo-mechanical loading) and compare it with the well-documented wear of lithium disilicate. METHODS: Forty implants were used to restore a maxillary first premolar, where the abutment and the crown were manufactured as hybrid-abutment-crown and connected to the implant using a titanium insert. The implants were randomly divided, according to the restorative materials used, into five groups: 3Y-TZP zirconia (Z), lithium disilicate (L), ceramic-reinforced polyetheretherketon (P), nano-hybrid composite resin (C) and polymer-infiltrated ceramic-network (E). All hybrid-abutment-crowns were produced using CAD/CAM technology. A design of a maxillary first premolar was created with an angle of 120° between the buccal and palatal cusps, which were designed as planes. The restorations were adhesively luted onto the titanium inserts, according to the manufacturers' recommendations for each material individually, by means of dual-curing luting resin with the exception of group P, where the blocks were pre-fitted (heat-pressed) with an integrated titanium insert. The suprastructures were assembled onto the implants through titanium screws. The screw channels were sealed with Teflon tape and composite resin filling material that was polished to high-gloss. All specimens underwent 1 200 000 thermo-dynamic loading cycles with 49 N in a dual-axis chewing simulator. Elastomeric impressions were made for all specimens after 600 000 and after 1 200 000 cycles. The corresponding impressions were imaged using a laser scanning microscope and then 3D-analyzed using the software (Geomagic Wrap) to measure the volume loss of the wear area for all specimens. Statistical analysis was performed using Wilcoxon-Test regarding the two different time measurements for each material. For the analysis of the material variable, Kruskal-Wallis test was conducted followed by Mann-Whitney test. RESULTS: Group Z showed statistically the lowest volume loss compared to the other test materials, both after 600 000 and 1 200 000 cycles of artificial aging, with a median value of 0.002 mm3 volume loss after 1 200 000 cycles. In contrast, group E showed the highest volume loss with median values of 0.18 and 0.3 mm3 after 600 000 and 1 200 000 cycles, respectively. Artificial aging had significantly negative effect on the volume loss for all test materials. In addition, the choice of material had statistical influence on the outcome. CONCLUSION: Monolithic zirconia ceramic demonstrated lower wear than that reported for enamel after simulated 5-year of clinical service, whereas all other test materials showed higher volume loss after artificial aging.

The influence of the restorative material on the mechanical behavior of screw-retained hybrid-abutment-crowns.

BACKGROUND: The use of polymers in implant dentistry is gaining popularity, as they might have several advantages due to their shock absorption capacity. PURPOSE: The aim of this study was to evaluate the performance and fracture strength of three resilient shock-absorbing polymer-based materials as well as the widely used ceramics as one-piece screw-retained implant-supported hybrid-abutment-crowns. MATERIALS AND METHODS: Forty custom-made CAD/CAM one-piece screw-retained restorations were milled out of 5 different monolithic materials (n = 8); Z: 3Y-TZP zirconia, L: lithium disilicate, P: ceramic-reinforced polyetheretherketone (PEEK), C: nano-hybrid composite resin and E: polymer-infiltrated ceramic-network. Specimens were subjected to dynamic loading for 1,200,000 cycles with integrated thermal cycling. The surviving specimens were subjected to quasi-static loading until failure. Shapiro-Wilk test was used to test for normality, and Levene test was conducted to test the homogeneity of variance. One-way ANOVA test followed by Tukey's post-hoc test were used to detect statistically significant differences between groups. RESULTS: All specimens withstood 1,200,000 cycles of thermo-dynamic loading with no signs of cracks or screw loosening. The median values of fracture strength varied from a minimum of 670 N for group E to a maximum of 2645 N for group Z. CONCLUSIONS: Fracture strength of screw-retained hybrid-abutment-crowns is influenced by the material used. Zirconia showed superior results. However, its fracture strength was comparable to that of PEEK, which additionally enjoys a shock absorbing property.

Efficacy of Different Surface Treatments for Intraoral Repair of Veneered Zirconia Frameworks.

PURPOSE: To evaluate the efficacy of different surface treatments on the repair of veneered zirconia ceramics. MATERIALS AND METHODS: Forty-eight zirconia disks were divided into three groups according to the method of surface treatment: polished surface, air abraded, or ground using a special silicon carbide bur (SiC Grinding Bur). All specimens were primed using a primer containing MDP (Cimara Zircon, Voco) and then bonded to composite in Plexiglas tubes using dual-curing adhesive resin (Bifix QM, Voco). Each of the three groups was further divided into two subgroups (n = 8) stored either in water at 37°C for 3 days without thermocycling or stored in water at 37°C for 150 days with an additional 37,500 thermocycles between 5°C and 55°C. After storage, tensile bond strength (TBS) was measured in a universal testing machine. RESULTS: After 3 days of storage, silicon carbide bur and air-abraded groups showed high TBS that ranged from 32.7 to 41.0 MPa (p ≤ 0.05). After 150 days of storage with thermocycling, the air-abraded group showed the most durable TBS (34.8 MPa), while the silicon carbide bur group showed a significant reduction in TBS (21.2 MPa); in the polished control group, specimens all debonded spontaneously during storage (p ≤ 0.05). CONCLUSION: Repair of zirconia ceramic after chipping of its veneers showed durable TBS when surface conditioning with air abrasion or roughening of the zirconia surface with a silicon carbide bur was provided.

Reducing the effect of polymerization shrinkage of temporary fixed dental prostheses by using different materials and fabrication techniques.

OBJECTIVE: The aim of this laboratory study was to evaluate the horizontal and vertical effects of the polymerization shrinkage of three-unit temporary fixed dental prostheses (FDPs) on the position of the prepared teeth. In addition, the reduction of these effects by using different fabrication techniques was evaluated. METHODS: A total of 192 temporary FDPs were fabricated using one methacrylate (MA) and two dimethacrylate (DMA) materials. Each material group (n=64) was divided into two groups according to the fabrication methods (M1: curing on the prepared teeth, M2: curing in a silicone mold). Each fabrication group was divided into four subgroups (n=8) according to the relining method used (B: no relining, S: spacer foil 300µm, DG: grinding-out with 500µm cutting depth, and FG: free grinding). The experimental apparatus consisted of two abutment teeth lowered at right angles into a silicone mold. One prepared tooth was embedded in silicone to simulate the periodontium and permit slight horizontal tooth movement. The dimensional changes were recorded with an optical microscope. The test images were superimposed and measured using image analysis software. RESULTS: The statistical analysis showed that there were significantly higher horizontal changes for the MA than the DMA resins in M1, while there was none in M2. Regarding the vertical changes, there were significant differences between the baseline group and all relining and fabrication groups in all materials. SIGNIFICANCE: Relining of directly fabricated temporary FDPs significantly reduces the effect of polymerization shrinkage and thus secures the position of the prepared teeth.