Fatigue Failure Load of Restored Premolars: Effect of Etching the Intaglio Surface of Ceramic Inlays With Hydrofluoric Acid at Different Concentrations.

The aim of this study was to evaluate the effect of etching, with different hydrofluoric acid concentrations at the intaglio surface of feldspathic ceramic inlays, on the fatigue failure load of restored premolars. A total of 60 upper premolars were embedded in plastic cylinders with acrylic resin (up to 3 mm below the cement-enamel junction) and prepared using a device specially designed for that purpose. Teeth were randomly assigned to three groups (n=20): HF1, HF5, and HF10 (etching with hydrofluoric acid for 60 seconds at concentrations of 1%, 5%, and 10%, respectively). Preparations were scanned and restorations were milled by a computer-aided design / computer-aided manufacturing system. The inner surfaces of the inlays were etched and received an application of a silane coupling agent; the dentin and enamel were treated appropriately for the luting system (RelyX ARC, 3M-ESPE). The restorations were cemented and the fatigue failure load (in N) was determined using the staircase method (10 Hz; 105 cycles in each step). The initial load (585.5 N) was applied on the slopes of the cusps (labial and palatal/lingual, simultaneously) through a cylinder attached to the test machine (Instron ElectroPuls E3000). The tested samples were analyzed under a stereomicroscope for failure analysis. Fatigue data were analyzed by one-way analysis of variance. There was no statistical difference among the fatigue failure loads (in N): HF1 (448.5±79.1), HF5 (360.7±55.4), and HF10 (409.5±121.1). Regarding the fracture mode, there was a predominance of interfacial fracture (50%), followed by cusp fracture (34.6%). It may be concluded that the etching with hydrofluoric acid at the tested concentrations (1%, 5%, and 10%) does not influence the fatigue failure load of feldspathic ceramic inlays cemented on premolars.

Low-temperature degradation of Y-TZP ceramics: A systematic review and meta-analysis.

The aim of this study was to systematically review the literature to assess if low-temperature degradation (LTD) simulation in autoclave promotes deleterious impact on the mechanical properties and superficial characteristics of Y-TZP ceramics compared to the non-aged protocol. The MEDLINE via PubMed electronic database was searched with included peer-reviewed publications in English language and with no publication year limit. From 413 potentially eligible studies, 49 were selected for full-text analysis, 19 were included in the systematic review with 12 considered in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Statistical analysis was performed using RevMan 5.1, with random effects model, at a significance level of p<0.05. Descriptive analysis of monoclinic phase content data showed that aging in autoclave promotes an increase in m-phase content (ranging from 0% up to 13.4% before and 2.13% up to 81.4% after aging) with intensity associated to the material susceptibility and to the aging parameters (time, pressure and temperature). Risk of bias analysis showed that only 1 study presented high risk, while the majority showed medium risk. Five meta-analyzes (factor: aging×control) were performed considering global and subgroups analyzes (pressure, time, temperature and m-phase % content) for flexural strength data. In the global analysis a significant difference (p<0.05) was observed between conditions, favoring non-aging group. Subgroup analysis revealed statistical difference (p<0.05) favoring non-aging, for aging time >20h. However, for shorter aging times (≤20h), there was no difference between groups. Pressure subgroup analysis presented a statistical difference (p<0.05) only when a pressure ≥2bar was employed, favoring non-aging group. Temperature subgroup analysis showed a statistical difference (p<0.05) only when temperature=134°C was used, favoring the non-aging group. M-phase % content analysis presented statistical difference (p<0.05) when more than 50% of m-phase content was observed, favoring non-aging group. High heterogeneity was found in some comparisons. Aging in autoclave promoted low-temperature degradation, impacting deleteriously on mechanical properties of Y-TZP ceramics. However, the effect of LTD depends on some methodological parameters indicating that aging time higher than 20h; pressure ≥2bar and temperature of 134°C are ideal parameters to promote LTD effects, and that those effect are only observed when more than 50% m-phase content is observed.