Computer-aided Design Manufacturing Research Articles

Effect of gastric acids on the mechanical properties of conventional and CAD/CAM resin composites - An in-vitro study

ObjectivesDental erosion in patients with gastroesophageal reflux disease (GERD) is a current and frequent condition that may compromise the mechanical properties and clinical durability of resin-based composites (RBCs). This study assessed the mechanical properties of conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) RBCs subsequent to simulated gastric acid aging. Materials and methodThree conventional and three CAD/CAM composites were assessed. They were divided into an experimental group (exposed to simulated gastric acid aging) and a control group (no aging). Both groups were analyzed for Vickers microhardness (VHN), wear and flexural strength over a period of six months. The failure rate probability for each RBC was calculated through the Weibull cumulative distribution function (m). Statistical analysis was conducted using repeated measures ANOVA, 3-way ANOVA, a non-parametric Kruskal-Wallis and U Mann-Whitney tests (α = 0.05). ResultsThe mechanical properties of all the RBCs dropped significantly after aging (p < 0.05). Lower VHN and flexural strength values, along with greater wear values were evident in the experimental groups, though the effects of the treatment varied between RBCs. The Weibull m of all the RBCs decreased over time. ConclusionConventional RBCs might show greater reduction in mechanical properties compared to CAD/CAM RBCs when exposed to gastric acid attack. Thus, CAD/CAM composites may represent a suitable choice for the treatment of patients presenting erosive issues.

Microstructural investigation of hybrid CAD/CAM restorative dental materials by micro-CT and SEM

ObjectivesAn increasing number of CAD/CAM (computer-aided design/computer-aided manufacturing) hybrid materials have been introduced to the dental market in recent years. In addition, CAD/CAM hybrid materials for additive manufacturing (AM) are becoming more attractive in digital dentistry. Studies on material microstructures using micro-computed tomography (µ-CT) combined with scanning electron microscopy (SEM) have only been available to a limited extent so far. MethodsOne CAD/CAM three-dimensional- (3D-) printable hybrid material (VarseoSmile Crown plus) and two CAD/CAM millable hybrid materials (Vita Enamic; Voco Grandio), as well as one direct composite material (Ceram.x duo), were included in the present study. Cylindrical samples with a diameter of 2mm were produced from each material and investigated by means of synchrotron radiation µ-CT at a voxel size of 0.65µm. Different samples from the same materials, obtained by cutting and polishing, were investigated by SEM. ResultsThe 3D-printed hybrid material showed some agglomerations and a more irregular distribution of fillers, as well as a visible layered macrostructure and a few spherical pores due to the printing process. The CAD/CAM millable hybrid materials revealed a more homogenous distribution of ceramic particles. The direct composite material showed multiple air bubbles and microstructural irregularities based on manual processing. SignificanceThe µ-CT and SEM analysis of the materials revealed different microstructures even though they belong to the same class of materials. It could be shown that µ-CT and SEM imaging are valuable tools to understand microstructure and related mechanical properties of materials.

Transfer accuracy of 3D printed versus CAD/CAM milled surgical guides for temporary orthodontic implants: A preclinical micro CT study

ObjectivesTemporary anchorage devices (TADs) have become an integral part of comprehensive orthodontic treatments. This study evaluated the transfer accuracy of three-dimensional (3D) printed and computer-aided design/computer-aided manufacturing (CAD/CAM) milled surgical guides for orthodontic TADs using micro-computed tomography (CT) imaging in a preclinical trial. MethodsOverall, 30 surgical guides were used to place TADs into typodonts; 3D printing and CAD/CAM milling were used to produce the guides. The virtual target positions of the TADs were compared to the real positions in terms of spatial and angular deviations using digital superimposition. Micro-CT imaging was used to detect the positions. To evaluate reliability, two investigators collected the measurements twice. Intra-rater and inter-rater correlations were tested. ResultsIn total, 60 palatal TADs were evaluated. The mean coronal deviations in the print group ranged from 0.15 ± 0.20 mm to 0.71 ± 0.22 mm, whereas in the mill group, they ranged from 0.09 ± 0.15 mm to 0.83 ± 0.23 mm. At the apical tip, the overall deviations in the print group ranged from 0.14 ± 0.56 mm to 1.27 ± 0.66 mm, whereas in the mill group, they ranged from 0.15 ± 0.57 mm to 1.09 ± 0.44 mm. The mean intra-class and inter-class correlation coefficients ranged from 0.904 to 0.987. No statistically significant differences were found between the groups. ConclusionsCAD/CAM milled guides yielded spatial and angular accuracies comparable to those of 3D printed guides with notable deviations in the vertical positioning of TADs. Clinical significanceDigital planning of orthodontic temporary implants combines clinical predictability and the safety of surrounding tissue. Therefore, the transfer accuracy of the guides is crucial. This preclinical study was the first to evaluate CAD/CAM milling for orthodontic guides and found its accuracy comparable to that of the current "gold standard".

Enhancing bonding of zirconia lithium silicate ceramics to dentin: The effect of surface treatment and resin cement

This laboratory study evaluated the influence of surface treatments on surface topography, and the bonding of CAD/CAM (computer-aided design computer-aided manufacturing) zirconia-containing lithium silicate (ZLS) surfaces to human dentin using various contemporary resin cements. Specimens from ZLS CAD/CAM blocks (Celtra™ Duo and Vita™ Suprinity) underwent three surface pretreatments: grinding only; 5 % hydrofluoric acid etching followed by application of a silane coupling agent, and a self-etching ceramic primer. The specimens were bonded to a flat exposed dentin surface using two etch-and-rinse and two self-adhesive resin cements, and then sectioned into microspecimens for microtensile bond strength (μTBS) testing. Failure modes of bonded surfaces, and ceramic surface roughness and topography were assessed. Results indicated that surface treatment was essential for ZLS-dentin bonding. Hydrofluoric acid and silane, along with the self-etching primer resulted in comparable strengths and outperformed the control group. Etch-and-rinse cements yielded significantly higher μTBS than self-adhesive cements. Significant differences in surface roughness and topography were observed among the treatment groups. Hydrofluoric acid exhibited the highest roughness parameters and most prominent surface changes. These findings highlight the importance of surface treatment for enhancing zirconia-containing lithium silicate bonding to dentin, and emphasize the critical role of the resin cement choice in optimizing dental restorative outcomes.

Assessment of CAD/CAM Fabrication Technologies for Post and Core Restorations—A Narrative Review

The primary objective of this study is to conduct a comprehensive review of the existing literature that discusses research on post and core restorations, covering aspects such as their composition, manufacturing methods, and clinical effectiveness. The methodology employed in this review encompasses the implementation of a well-defined search strategy, the establishment of criteria for inclusion and exclusion, and the selection of relevant studies to summarize their findings. To gather relevant literature published between 1993 and 2023, the research team conducted separate searches on PubMed, Web of Science, and Embase databases. In total, 168 titles were initially retrieved from these electronic databases. By applying the predefined exclusion criteria, the researchers identified 73 articles that specifically address the conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) technologies employed in post and core restorations. These treatments are commonly employed to restore teeth that have received endodontic therapy and subsequently experienced loss of dental structure. The development of computerized technology for the creation of customized posts and cores has emerged as a straightforward and efficient alternative to traditional methods. The review synthesizes papers discussing the techniques and materials involved in CAD/CAM-based construction of post and cores. It explores strategies for restoring endodontically treated teeth, highlighting both direct and indirect approaches. Commonly mentioned materials include zirconia, composite resin, and hybrid ceramics. Despite the limited literature on CAD/CAM post and core procedures, the review emphasizes the necessity of further research to assess long-term outcomes and efficacy. Additionally, it suggests including implications for future research and clinical recommendations to enhance the depth and practical relevance of the review.

Three-axis load analysis of high-speed handpiece on dental training teeth and computer-aided design/computer-aided manufacturing blocks

This study aimed to evaluate and compare the mechanical properties of dental training teeth with subtractive and additive computer-aided design/computer-aided manufacturing (CAD/CAM) materials used to fabricate dental simulation models. Therefore, the three-axis load generated during cutting movements, including drilling and milling performed using a dental handpiece, was measured and compared. The samples were cut vertically downward by 1.5 mm, horizontally by 6 mm, and vertically upward at a constant speed (1 mm/s), while the rotational speed of the bur was maintained at 200,000 rotations per minute. A three-axis load cell was used to measure the X-, Y-, and Z-axis loads on the specimen. The median value of the X-, Y-, and Z-axis measurements and the resultant load during the vertical-downward, horizontal, and vertical-upward movements were compared using a one-way analysis of variance and Tukey's post hoc test. For vertical downward movement, the drilling force of the dental training teeth was lower than that of Vita Enamic® and similar to that of Lava™ Ultimate. In contrast to subtractive CAD/CAM blocks, the drilling force of the dental training teeth was higher than that of 3D-printed resin blocks. Regarding horizontal movement, the milling force of dental training teeth was lower than that of Vita Enamic®. In contrast, the milling force of Nissin was similar to that of Lava™ Ultimate, while that of Frasaco was lower. Furthermore, compared to additive CAD/CAM blocks, the milling force of the dental training teeth was higher than that of 3D-printed resin blocks. Regarding vertical upward movement, the resultant loads of dental training teeth was lower than that of Vita Enamic®. Similarly, the resultant load of Nissin was similar to that of Lava™ Ultimate, while that of Frasaco was lower. Additionally, compared to additive CAD/CAM blocks, the resultant loads of the dental training teeth were similar to those of the 3D-printed resin blocks.

Translucency and Color Difference of Monolithic Zirconia Restorations: The Effect of Surface Finishing on Background Color

Aim: This study evaluates the effect of different surface finishing procedures on the color and translucency values of monolithic zirconia materials on three different colored composite backgrounds. Materials and Methods: Sixty monolithic zirconia blocks of three different translucency levels were prepared in vitro using computer-aided design/computer-aided manufacturing (CAD/CAM) systems. The correlation between repeat measurements was 0.5, resulting in a sample size of nine samples per group to detect a medium effect size, f = 0.25. Half of the zirconia blocks in each group were subjected to glazing, while the other half were polished ( n = 10). Composite blocks of three different colors were prepared to simulate dental substrates, and the zirconia specimens were placed on these composite backgrounds. The color parameters of the specimens were measured using a spectrophotometer on gray, black, and white backgrounds. Three-way repeated measure ANOVA was used to assess the interaction between the three independent variables (zirconia brand, surface finishing technique, and background color) and the effects of each tested variable on the changes in color and translucency. Results: The surface finishing techniques had a significant effect on the color and translucency of the monolithic zirconia materials. Glazing resulted in higher color differences and lower translucency values compared to polishing. For backgrounds of the same color, no significant differences were detected between the glazed zirconia groups for the same condition ( p &gt; .016). Conclusion: Overall, the study demonstrated the importance of selecting the appropriate surface finishing technique and translucency property of the monolithic zirconia materials to obtain the optimal esthetic results in dental restorations.

Evaluation of the clinical application of personalized 3D printing and CAD/CAM resin crowns to replace stainless steel crowns in paediatric dentistry.

Children with dental caries are treated with stainless steel metal crowns (SSC), but the aesthetics and precision still need to be improved. Currently, both 3D-printed resin crowns (PRC) and computer-aided design/computer-aided manufacture (CAD/CAM) resin crowns (CRC) meet the clinical requirements for crown applications in terms of strength, production time, cost, and aesthetics. This study replaced SSC with customized resin crowns by 3D printing and CAD/CAM. In this study, PRC, CRC, and SSC were used for incisor and molar restorations, and 60 crowns were made with 10 for each group. The fabrication efficiency, surface characteristics, marginal fit, and stability of the two different crowns were evaluated. PRC and CRC show superior color and surface characteristics, though production times are longer (5.3-12.4 times and 3.3-9.1 times, respectively) than for SSC (p < .05). They, however, can be completed within 80 min. Edge gaps for PRC and CRC are significantly lower (13.0-19.2 times and 13.0-13.7 times) than for SSC (p < .05). All materials exhibit good stability. The 3D-PRCs and CAD/CAM resin crowns may replace SSCs as a potential choice for clinical child caries.

Comparing the effectiveness of computer-aided design/computer-aided manufacturing (CAD/CAM) of insoles manufactured from foam box cast versus direct scans on patient-reported outcome measures: a protocol for a double-blinded, randomised controlled trial

IntroductionCustom insoles are a routine treatment for many foot pathologies, and the use of computer-aided design and computer-aided manufacturing (CAD/CAM) is well established within clinical practice in the UK. The...

Deformation and retentive forces variations of the additively manufactured cobalt-chromium and titanium alloys dental clasps

This in vitro study aimed to evaluate the additive manufacturing (AM) of cobalt chromium Co-Cr and titanium Ti alloy clasps for clinical use. After scanning the Ni-Cr die of the first molar, Akers' clasps were designed using computer-aided design/ computer-aided manufacturing (CAD/CAM). The clasps were manufactured from Co-Cr-W dental alloy and Ti-6Al-4V alloy powder using AM machines. Then, they were divided into two groups. The initial retentive force of the clasps was measured using a universal testing machine. Cyclic loading of the clasps was carried out by a specially designed insertion-removal testing apparatus in wet condition up to 5000 cycles. Retentive force was measured at 1000, 2000, 3000, 4000, and 5000 cycles. Moreover, the intaglio surface of each clasp was scanned using the scanner; and superimposition between the pre- and post-cycling clasp files was performed to evaluate deformation after cyclic loading. The fitting surfaces of retentive clasp tips were examined with a scanning electron microscope (SEM). Finally, it has been found that the initial retentive force for the Co-Cr group was 10.81 ± 0.37 N, and for the Ti group was 5.41 ± 0.18 N. Additionally, during the testing periods, both Co-Cr and Ti clasps continued to lose retentive force within the cycles of placement and removal. This effect was more prominent in the Co-Cr than in the Ti clasps. The distances between pre- and post-cycling in the retentive arm were −0.290 ± 0.11 mm and −0.004 ± 0.01 mm in Co-Cr and Ti alloys, respectively, and in the reciprocal arm were −0.072 ± 0.04 mm and −0.032 ± 0.04 mm in Co-Cr and Ti alloys, respectively. The retentive force required to remove the Ti clasps was found to be significantly lower than those required to dislodge the Co-Cr clasps. Co-Cr and Ti clasps lost significant amounts of retentive force from the initial use to the 3.5-year periods of simulated clinical use.

Biofilm Formation on Hybrid, Resin-Based CAD/CAM Materials for Indirect Restorations: A Comprehensive Review.

Hybrid materials are a recent addition in the field of restorative dentistry for computer-aided design/computer-aided manufacturing (CAD/CAM) indirect restorations. The long-term clinical success of modern dental restorative materials is influenced by multiple factors. Among the characteristics affecting the longevity of a restoration, the mechanical properties and physicοchemical interactions are of utmost importance. While numerous researchers constantly evaluate mechanical properties, the biological background of resin-based CAD/CAM biomaterials is scarcely investigated and, therefore, less described in the literature. This review aims to analyze biofilm formation on the surfaces of novel, hybrid, resin-based CAD/CAM materials and evaluate the methodological protocols followed to assess microbial growth. It is demonstrated that the surface structure, the composition and the finishing and polishing procedures on the surface of a dental restorative material influence initial bacterial adhesion; however, most studies focus on in vitro protocols, and in vivo and/or in situ research of microbiomics in CAD/CAM restorative materials is lacking, obstructing an accurate understanding of the bioadhesion phenomenon in the oral cavity.

Comparative Analysis of the Mechanical Properties and Biocompatibility between CAD/CAM and Conventional Polymers Applied in Prosthetic Dentistry.

Modern media often portray CAD/CAM technology as widely utilized in the fabrication of dental prosthetics. This study presents a comparative analysis of the mechanical properties and biocompatibility of CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) polymers and conventional polymers commonly utilized in prosthetic dentistry. With the increasing adoption of CAD/CAM technology in dental laboratories and practices, understanding the differences in material properties is crucial for informed decision-making in prosthodontic treatment planning. Through a narrative review of the literature and empirical data, this study evaluates the mechanical strength, durability, esthetics, and biocompatibility of CAD/CAM polymers in comparison to traditional polymers. Furthermore, it examines the implications of these findings on the clinical outcomes and long-term success of prosthetic restorations. The results provide valuable insights into the advantages and limitations of CAD/CAM polymers, informing clinicians and researchers about their suitability for various dental prosthetic applications. This study underscores the considerable advantages of CAD/CAM polymers over conventional ones in terms of mechanical properties, biocompatibility, and esthetics for prosthetic dentistry. CAD/CAM technology offers improved mechanical strength and durability, potentially enhancing the long-term performance of dental prosthetics, while the biocompatibility of these polymers makes them suitable for a broad patient demographic, reducing the risk of adverse reactions. The practical implications of these findings for dental technicians and dentists are significant, as understanding these material differences enables tailored treatment planning to meet individual patient needs and preferences. Integration of CAD/CAM technology into dental practices can lead to more predictable outcomes and heightened patient satisfaction with prosthetic restorations.

Comparative analysis of stress distribution in residual roots with different canal morphologies: evaluating CAD/CAM glass fiber and other post-core materials

BackgroundThe selection of post-core material holds significant importance in endodontically treated teeth, influencing stress distribution in the dental structure after restoration. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) glass fiber post-core possesses a better adaptation for different root canal morphologies, but whether this results in a more favorable stress distribution has not been clearly established.Materials and methodsThis study employed finite element analysis to establish three models of post-core crown restoration with normal, oversized, and dumbbell-shaped root canals. The three models were restored using three different materials: CAD/CAM glass fiber post-core (CGF), prefabricated glass fiber post and resin core (PGF), and cobalt-chromium integrated metal post-core (Co-Cr), followed by zirconia crown restoration. A static load was applied and the maximum equivalent von Mises stress, maximum principal stress, stress distribution plots, and the peak of maximum displacement were calculated for dentin, post-core, crown, and the cement acting as the interface between the post-core and the dentin.ResultsIn dentin of three different root canal morphology, it was observed that PGF exhibited the lowest von Mises stresses, while Co-Cr exhibited the highest ones under a static load. CGF showed similar stress distribution to that of Co-Cr, but the stresses were more homogeneous and concentrated apically. In oversized and dumbbell-shaped root canal remnants, the equivalent von Mises stress in the cement layer using CGF was significantly lower than that of PGF.ConclusionsIn oversized root canals and dumbbell-shaped root canals, CGF has shown good performance for restoration of endodontically treated teeth.Clinical relevanceThis study provides a theoretical basis for clinicians to select post-core materials for residual roots with different root canal morphologies and should help to reduce the occurrence of complications such as root fracture and post-core debonding.

Bonding Pretreatment of Aesthetic Dental CAD-CAM Materials through Surface Etching with a Mixed Aqueous Solution of Ammonium Fluoride and Ammonium Hydrogen Sulfate.

Hydrofluoric acid (HF) is commonly used as an etchant for the pretreatment of dental computer-aided design/computer-aided manufacturing (CAD-CAM) materials, such as glass-ceramics and resin composites. Despite its effectiveness, the harmful and hazardous nature of HF has raised significant safety concerns. In contrast, ammonium fluoride (AF) is known for its relatively low toxicity but has limited etching capability. This study explored the potential of ammonium hydrogen sulfate (AHS), a low-toxicity and weak acid, to enhance the etching ability of aqueous AF solutions for the bonding pretreatment of CAD-CAM materials. This study investigated five types of aesthetic CAD-CAM materials: lithium disilicate glass, feldspathic porcelain, polymer-infiltrated ceramic networks, resin composites, and zirconia. Seven experimental etchants were prepared by varying the amount of AHS added to aqueous AF solutions, with each etchant used to etch the surfaces of the respective CAD-CAM materials. The treated surfaces were analyzed using scanning electron microscopy and confocal laser scanning microscopy. Additionally, the shear bond strength (SBS) of the CAD-CAM materials treated with a luting agent (resin cement) was evaluated. The results indicated that the AF1/AHS3 (weight ratio AF:AHS = 1:3) etchant had the most substantial etching effect on the surfaces of silica-containing materials (lithium disilicate glass, feldspathic porcelain, polymer-infiltrated ceramic networks, and resin composites) but not on zirconia. The SBS of the materials treated with the AF1/AHS3 etchant was comparable to that of the commercial HF etchant. Hence, an AF/AHS mixed solution could effectively etch silica-containing CAD-CAM materials, thereby enhancing their bonding capabilities.

Impact of CAD/CAM Material Thickness and Translucency on the Polymerization of Dual-Cure Resin Cement in Endocrowns.

The objective of this study is to evaluate the impact of the thickness and translucency of various computer-aided design/computer-aided manufacturing (CAD/CAM) materials on the polymerization of dual-cure resin cement in endocrown restorations. Three commercially available CAD/CAM materials-lithium disilicate glass (e.max CAD), resin composite (CERASMART), and a polymer-infiltrated ceramic network (ENAMIC)-were cut into plates with five different thicknesses (1.5, 3.5, 5.5, 7.5, and 9.5 mm) in both high-translucency (HT) and low-translucency (LT) grades. Panavia V5, a commercial dual-cure resin cement, was polymerized through each plate by light irradiation. Post-polymerization treatment was performed by aging at 37 °C for 24 h under light-shielding conditions. The degree of conversion and Vickers hardness measurements were used to characterize the polymerization of the cement. The findings revealed a significant decrease in both the degree of conversion and Vickers hardness with increasing thickness across all CAD/CAM materials. Notably, while the differences in the degree of conversion and Vickers hardness between the HT and LT grades of each material were significant immediately after photoirradiation, these differences became smaller after post-polymerization treatment. Significant differences were observed between samples with a 1.5 mm thickness (conventional crowns) and those with a 5.5 mm or greater thickness (endocrowns), even after post-polymerization treatment. These results suggest that dual-cure resin cement in endocrown restorations undergoes insufficient polymerization.

Evaluation of Bond Strength of Three Glass Fiber Post-systems Cemented to Large Root Canals.

The aim of this study was to evaluate the push-out bond strength and the failure mode of single adjustable posts (SPLENDOR SAP), anatomical posts (AP), or computer-aided design/computer-aided manufacturing (CAD-CAM) posts cemented to flared root canal dentin with self-adhesive dual-cure resin cement. Thirty single-rooted premolars received endodontic treatment with gutta-percha and a calcium hydroxide-based endodontic cement. After 24 hours, the canal spaces were enlarged with burs. The tooth specimens were divided equally into three groups (n=10), according to the glass fiber post (GFP) system: AP-prefabricated GFP (Reforpost #2, Angelus) was relined with composite resin (Filtek Z350 XT, 3M ESPE); SPLENDOR SAP-GFP was used with a glass fiber sleeve to adjust the adaptation (Splendor SAP, Angelus); and CAD-CAM-a resin pattern was obtained and scanned to produce a CAD-CAM GFP (Fiber CAD Lab, Angelus) milled using a subtractive technique. The three GFP systems were cemented with self-adhesive resin cement (Rely X U200, 3M ESPE). The roots were fixed to an acrylic resin plate used to section them into specimens of cervical, middle, and apical thirds. Then, the slices were attached to a universal testing machine to perform the push- out test at a speed of 0.5 mm/min and a load of 50 Kgf. The posttest specimens were examined under a stereoscopic microscope to evaluate the failure mode. The bond strength variable was analyzed using a generalized linear model, following a split-plot design. Failure mode analysis was performed using Fisher exact test. The significance level adopted was 5%. There was no significant difference among the GFP systems or among the thirds, in terms of bond strength (p>0.05), nor was there any significant association between the systems and the failure mode (p>0.05). Most specimens presented mixed or adhesive failure between resin cement and dentin. It was concluded that the bond strength to flared root dentin was not influenced by the GFP system or the root third.

Effect of thermocycling on surface topography and fracture toughness of milled and additively manufactured denture base materials: an in-vitro study

BackgroundStudies investigating thermocycling effect on surface topography and fracture toughness of resins used in digitally manufactured denture bases are few. The study aimed to assess the impact of thermocycling on surface topography and fracture toughness of materials used for digitally manufactured denture bases.MethodsWater sorption, solubility, hardness, surface roughness, and fracture toughness of both three-dimensional (3D)-printed and computer-aided design, computer-aided manufacturing (CAD-CAM) milled specimens (n = 50) were assessed both prior to and following 2000 thermocycles, simulating 2 years of clinical aging. Surface hardness (n = 10) was measured using a Vickers hardness testing machine, surface roughness (n = 10) was determined by a contact profilometer, and fracture toughness (n = 20) was measured using the 3-point bend test, then studying the fractured surfaces was done via a scanning electron microscope (SEM). Prior to and following thermocycling, water sorption and solubility (n = 10) were assessed. Normally distributed data was tested using two-way repeated ANOVA and two-way ANOVA, while Mann Whitney U test and the Wilcoxon signed ranks test were used to analyze data that was not normally distributed (α < 0.05).ResultsFollowing thermocycling, Vickers hardness and fracture toughness of both groups declined, with a significant reduction in values of the 3D-printed resin (P < .001). The 3D-printed denture base resins had a rougher surface following thermocycling with a significant difference (P < .001). The sorption and solubility of water of both materials were not affected by thermocycling.ConclusionsBefore and after thermocycling, milled specimens had lower surface roughness and a greater degree of hardness and fracture toughness than 3D-printed specimens. Thermocycling lowered hardness and fracture toughness, and increased surface roughness in both groups, but had no effect on water sorption and solubility.

The Surface Roughness of Contemporary Indirect CAD/CAM Restorative Materials That Are Glazed and Chair-Side-Finished/Polished.

The surface roughness (Ra) of indirect computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated dental restorations is crucial for their long-term durability. This study intended to evaluate the Ra of five different types of contemporary indirect CAD/CAM restorative materials with varying compositions that were glazed and finished/polished. A total of 75 specimens, disc-shaped (10 mm × 2 mm), were obtained from five materials (n = 15) (Tetric CAD, IPS e.max CAD, IPS e.max ZirCAD, CELTRA Duo, and Vita Enamic) and fabricated by CAD/CAM. One of the two surfaces for each specimen was subjected to glazing, while the other surface was subjected to finishing/polishing. The Ra of the two surfaces in micrometers (μm) was evaluated using a Profilometer, while the surface topography was examined using a scanning electron microscope. Using SPSS, the Kruskal-Wallis, post hoc Conover, and Mann-Whitney tests were used to statistically evaluate the data. A comparison of the Ra for the finished/polished surfaces of the five test materials showed significant differences (p < 0.0001). Among the finished/polished surfaces, the mean rank values of Vita Enamic were significantly higher than the other four test materials (p < 0.0001). A comparison of the Ra of glazed surfaces among the five study materials revealed significant differences (p < 0.0001). The Ra for the IPS e.max ZirCAD material was significantly higher than the rest of the four materials (p < 0.001). A comparison of the Ra for two types of surface conditioning within each of the five test materials showed a significant difference (p < 0.05). Only for IPS e.max ZirCAD was the Ra of the glazed surface significantly higher than the finished/polished surface (p < 0.0001). Significant variations in the surface roughness (Ra) were exhibited between the finished/polished and glazed surfaces of the five test materials. Hybrid ceramics showed the highest Ra values for the finished/polished surfaces, and zirconia exhibited the highest Ra values among the glazed surfaces among the tested materials. The Ra values of either finished/polished or glazed surfaces of the test materials were within the clinically acceptable range (0.2-0.5 μm), except for the glazed surface of the zirconia ceramics (0.84 μm).

Effect of Thermo-mechanical Cycling on Fracture Resistance of Different CAD/CAM Crowns: An In Vitro Study.

To evaluate the effect of thermo-mechanical cycling (TMC) on fracture resistance of different computer-aided design/computer-aided manufacture (CAD/CAM) crowns. A total of 42 CAD/CAM crowns were fabricated on epoxy resin maxillary first premolar teeth and divided into three groups (n = 14) according to the material used: IPS e.max CAD (Ivoclar Vivadent) lithium disilicate (LD), Vita ENAMIC (VE) (VITA Zahnfabrik), Tetric CAD (Ivoclar Vivadent). Also, each group was subdivided into two equal subgroups according to TMC (n = 7). Subgroups (O) without TMC and subgroup (W) with TMC (5-55°C, 30 second, 75,000 cycles). All samples in each group were cemented with a universal bond (Tetric N bond universal) and adhesive resin cement (Variolink Esthetic DC) (Ivoclar Vivadent). Subsequently, the samples were loaded to failure in a universal testing machine at a crosshead speed of 1 mm/min, and the fracture pattern and the fracture resistance in each group were recorded. Fracture resistance was analyzed by one-way analysis of variance (ANOVA) test, followed by Tukey's post hoc test for pairwise comparison. Fracture resistance showed a significant difference between the tested groups before and after TMC; IPS e.max CAD has the highest value (1233.35 ± 97.72, 1165.73 ± 199.54 N) followed by Tetric CAD (927.62 ± 42.5, 992.04 ± 53.46 N) and Vita ENAMIC has lowest value (506.49 ± 74.24, 354.69 ± 90.36 N). Thermo-mechanical cycling affected the fracture resistance of both polymer-based CAD/CAM crowns. For dental practitioners, both IPS e.max CAD and Tetric CAD can be used clinically for posterior teeth, providing satisfactory results and resistance to fracture. How to cite this article: Elmokadem MI, Haggag KM, Mohamed HR. Effect of Thermo-mechanical Cycling on Fracture Resistance of Different CAD/CAM Crowns: An In Vitro Study. J Contemp Dent Pract 2024;25(1):29-34.

Zirconia CAD-CAM Crowns Behavior after Intraoral Digital Impression in Normal versus Dysfunctional Patients: 3 Years Retrospective Study

Abstract Objectives The aim of this study was to evaluate the clinical performance and possible complications of single zirconia crowns fabricated using an intraoral digital computer-aided design-computer-aided manufacturing (CAD-CAM) protocol in normal and dysfunctional patients after 3 years of follow-up. Materials and Methods Seventy patients were included in this study. The teeth were prepared with a knife-edge marginal design, and temporary crowns were placed. Digital impressions were taken using optical scanning, and the frameworks were milled using the same technology. The veneering process was performed by the same dental technician. The occlusal corrections were made before cementation. The outcomes were evaluated in terms of survival, failures, and complications. The marginal adaptation of the crowns was also assessed. Results The digital protocol for single zirconia crowns resulted in satisfactory outcomes, with high rates of survival and minimal complications after 3 years of follow-up. The marginal adaptation of the crowns was excellent, with 93% of the restorations achieving the ideal marginal adaptation, while 7% had minor deviations. Parafunctions were found in 41.9% of the prosthetic rehabilitation, but no significant differences were observed between the normal and dysfunctional groups regarding the survival and complications of the crowns. Conclusion The digital protocol for single zirconia crowns is a reliable and predictable treatment option, even for patients with parafunction, when proper occlusal corrections are performed before cementation. The use of intraoral digital CAD-CAM technologies with optical impressions can simplify procedures, reduce the workflow time, and minimize the variables linked to the human factor.