Glass-ceramic Crowns Research Articles

Influence of cementation and cement type on the fracture load testing methodology of anterior crowns made of different materials

To evaluate the influence of cementation on fracture load of anterior crowns made of CAD/CAM-resin-blocks (ART), leucite-reinforced glass-ceramics (LRG), lithium disilicate ceramics (LIT), veneered zirconia (ZRO) and veneered alloy (DEG). Each crown group (n=15/subgroup) was cemented on the metal abutment as follows: i. using glass ionomer, ii. using self-adhesive resin cement, and iii. not cemented. Crowns were tested and analyzed with 2-way and 1-way ANOVA (Scheffé test), and Weibull statistics (p<0.05). Within LRG, self-adhesive cemented subgroup showed higher fracture load compared to other groups (p<0.001). Among DEG, lower results were measured for non-cemented crowns than for cemented (p<0.001). For ART, LIT and ZRO no influence of cementation was observed. For fracture load test methodology, metal ceramic crowns should be generally cemented. Glass-ceramic crowns should be cemented using adhesive cement. Cementation and cement type did not have an influence on the fracture load results for resin, zirconia or lithium disilicate crowns.

Influence of zirconia abutment preparation on the fracture strength of single implant lithium disilicate crowns after chewing simulation

The use of all-ceramic crowns over zirconia abutments is a well-established esthetic treatment option in implant dentistry; however, the effect of the mechanical processing due to abutment preparation has not been investigated under functional loading. The purpose of the study was to evaluate the influence of the zirconia abutment preparation depth and preparation mode on the fracture strength and fracture mode of lithium disilicate crowns after chewing simulation. Seventy single implant-supported lithium disilicate glass-ceramic crowns (IPS e.max Press, Ivoclar Vivadent) were adhesively cemented (Multilink Automix, Ivoclar Vivadent) onto zirconia abutments (ZirDesign, Astra Tech) using implants with a diameter of 4.5 mm and a length of 15.0 mm (Osseospeed, Astra Tech). Study design concerned the replacement of a maxillary central incisor (11.0 mm in height and 8.0 mm in width). Subgroups (n = 7) were subjected to dynamic loading (C) up to 1.2 × 10(6) loading cycles at 135° with 98N in a thermomechanical chewing simulator (Kausimulator, Willytech); followed by quasi-static loading at a cross-head speed of 0.5 mm/min until fracture in a universal testing machine (Z010/TN2S, Zwick). Additional subgroups were also subjected to quasi-static loading (S) at 135°. Lithium disilicate implant crowns were divided into five study groups (n = 14) according to the abutment preparation depth [A (control): 0.5 mm, B: 0.7 mm, C: 0.9 mm, and preparation mode [(No label): milling by the manufacturer, (P): copy-milling by the Celay System (Mikrona)]. All specimens survived dynamic loading and mean fracture strengths (N) after quasi-static loading were as follows: Group SA: 384 ± 84; Group CA: 403 ± 67; Group SB: 294 ± 95; Group CB: 374 ± 75; Group SC: 332 ± 52; Group CC: 373 ± 105; Group SPB: 332 ± 80; Group CPB: 499 ± 91; Group SPC: 380 ± 101; and Group CPC: 358 ± 54. Statistical analysis using multiple linear regression showed that both the preparation depth and mode had no influence on the fracture strength of the implant crowns (P > 0.05); however, fracture strength increased statistically significantly after 5 years chewing simulation (P = 0.01).

Randomized, Controlled Clinical Trial of Bilayer Ceramic and Metal‐Ceramic Crown Performance

Analyzing the clinical performance of restorative materials is important, as there is an expectation that these materials and procedures will restore teeth and do no harm. The objective of this research study was to characterize the clinical performance of metal-ceramic crowns, core ceramic crowns, and core ceramic/veneer ceramic crowns based on 11 clinical criteria. An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study. The following three types of full crowns were fabricated: (1) metal-ceramic crown (MC) made from a Pd-Au-Ag-Sn-In alloy (Argedent 62) and a glass-ceramic veneer (IPS d.SIGN veneer); (2) non-veneered (glazed) lithium disilicate glass-ceramic crown (LDC) (IPS e.max Press core and e.max Ceram Glaze); and (3) veneered lithia disilicate glass-ceramic crown (LDC/V) with glass-ceramic veneer (IPS Empress 2 core and IPS Eris). Single-unit crowns were randomly assigned. Patients were recalled for each of 3 years and were evaluated by two calibrated clinicians. Thirty-six crowns were placed in 31 patients. A total of 12 crowns of each of the three crown types were studied. Eleven criteria were evaluated: tissue health, marginal integrity, secondary caries, proximal contact, anatomic contour, occlusion, surface texture, cracks/chips (fractures), color match, tooth sensitivity, and wear (of crowns and opposing enamel). Numerical rankings ranged from 1 to 4, with 4 being excellent, and 1 indicating a need for immediate replacement. Statistical analysis of the numerical rankings was performed using a Fisher's exact test. There was no statistically significant difference between performance of the core ceramic crowns and the two veneered crowns at year 1 and year 2 (p > 0.05). All crowns were rated either as excellent or good for each of the clinical criteria; however, between years 2 and 3, gradual roughening of the occlusal surface occurred in some of the ceramic-ceramic crowns, possibly caused by dissolution and wear of the glaze. Statistically significant differences in surface texture (p= 0.0013) and crown wear (p= 0.0078) were found at year 3 between the metal-ceramic crowns and the lithium-disilicate-based crowns. Based on the 11 criteria, the clinical performance of ceramic-ceramic crowns was comparable to that of the metal-ceramic crowns after 2 years; however, gradual roughening occurred between years 2 and 3, which resulted in differences in surface texture and wear.

Effect of surface conditioning with airborne-particle abrasion on the tensile strength of polymeric CAD/CAM crowns luted with self-adhesive and conventional resin cements

Adhesively bonded, industrially polymerized resins have been suggested as definitive restorative materials. It is claimed that such resins present similar mechanical properties to glass ceramic. The purpose of this study was to assess the tensile strength of polymeric crowns after conditioning with 2 different protocols: luted with self-adhesive or with conventional resin cements to dental abutments. Human teeth were prepared for crowns and divided into 13 groups (N=312, n=24 per group). Polymeric crowns were CAD/CAM fabricated and divided into 3 groups depending on different surface conditioning methods: A) No treatment, B) airborne-particle abrasion with 50 μm alumina, and C) airborne-particle abrasion with 110 μm alumina. Thereafter, the crowns were luted on dentin abutments with the following cements: 1) RXU (RelyX Unicem, self-adhesive), 2) GCM (G-Cem, self-adhesive), 3) ACG (artCem GI, conventional), and 4) VAR (Variolink II, conventional). Glass ceramic crowns milled and cemented with dual-polymerized resin cement (Variolink II) served as the control group. The tensile strength was measured initially (n=12) and after aging by mechanical thermocycling loading (1 200 000 cycles, 49 N, 5°C to 50°C) (n=12). The tensile strength (MPa) of all crowns was determined by the pull-off test (Zwick/Roell Z010; Ulm, Germany, 1mm/min). Subsequently, the failure types were classified. Data were analyzed with 2-way and 1-way ANOVA followed by a post hoc Scheffé test and t test (α=.05). No adhesion of the tested cements was observed on unconditioned polymeric CAD/CAM crowns and those luted with VAR. Among the tested cements, GCM showed significantly higher values after airborne-particle abrasion with 110 μm (initial: 2.8 MPa; after aging: 1 MPa) than 50 μm alumina (initial: 1.4 MPa; after aging: 0 MPa). No significant effect was found between 50 and 110 μm particle size alumina in combination with the other 2 cements. After aging, the tensile strength of the crowns luted with GCM (50 μm: 0 MPa and 110 μm: 1 MPa) and ACG (50 μm: 1 MPa and 110 μm: 1.2 MPa) was significantly lower than those luted with RXU (50 μm: 1.9 MPa and 110 μm: 2 MPa). All airborne particle abraded polymeric CAD/CAM crowns (initial: 1.4-2.8; 0-2 MPa) showed significantly lower tensile strength values than the control group (initial: 7.3 MPa; after aging: 6.4 MPa). Although with all polymeric specimens, failure type was adhesive between the cement and the crowns, the control group showed exclusively cohesive failures within the ceramic. Airborne-particle abrasion before cementation of polymeric CAD/CAM crowns minimally improved the tensile strength. Both the failure types and the tensile strength values of adhesively luted glass ceramic crowns showed superior results to adhesively cemented polymeric ones. Although the tensile strength results were low, crowns cemented with RXU showed, after aging, the highest tensile strength of all other tested groups.

Fatigue Resistance of 2 Different CAD/CAM Glass-Ceramic Materials Used for Single-Tooth Implant Crowns

To evaluate the fatigue resistance of 2 different CAD/CAM in-office monoceramic materials with single-tooth implant-supported crowns in functional area. A metal experimental model with a dental implant was designed to receive in-office CAD/CAM-generated monoceramic crowns. Laterally positioned axial dynamic loading of 300 N at 2 Hz was applied to implant-supported crowns machined from 2 different glass materials for 100,000 cycle. Failures in terms of fracture, crack formation, and chipping were macroscopically recorded and microscopically evaluated. Four of 10 aluminasilicate glass-ceramic crowns fractured at early loading cycles, the rest completed loading with a visible crack formation. Crack formation was recorded for 2 of 10 leucite glass-ceramic crowns. Others completed test without visible damage but fractured upon removal. Lack in chemical adhesion between titanium abutment and dental cement likely reduces the fatigue resistance of machinable glass-ceramic materials. However, relatively better fractural strength of leucite glass-ceramics could be taken into consideration. Accordingly, progress on developmental changes in filler composition of glass-ceramics may be promising. Machinable glass-ceramics do not possess sufficient fatigue resistance for single-tooth implant crowns in functional area.

CAD/CAM systems available for the fabrication of crown and bridge restorations

Dental biomaterials are widely used in all areas of routine dental practice. There are mainly two methods for their application. Firstly, dental biomaterials are placed into living tissues, such as teeth, to fill the space. Secondly, dental devices such as crown and bridge restorations and dentures are fabricated using various materials to restore the morphology and function of the dentition. Crown and bridge restorations are one of the main treatment methods used by general practitioners to achieve lifelike restoration of form and function. The recent introduction of osseointegrated implants has expanded the application of crown and bridge restorations for partially edentulous patients. Mechanical durability and precision fit are mandatory requirements for crowns and bridges. The development of various casting alloys and precise casting systems has contributed to the successful use of metal-based restorations. However, patient requests for more aesthetic and biologically 'safe' materials has led to an increased demand for metal-free restorations. There is also a growing demand to provide all-ceramic restorations more routinely. New materials such as highly sintered glass, polycrystalline alumina, zirconia based materials and adhesive monomers, will assist dentists to meet this demand. In addition, new fabrication systems combined with computer-assisted fabrication systems (dental CAD/CAM) and various networks are now available. Dental technology was centred on lost-wax casting technology but we now face a revolution in crown and bridge fabrication. This article reviews the history and recent status of dental CAD/CAM, the application of CAD/CAM fabricated tooth-coloured glass ceramic crowns, and the application of all-ceramic crowns and bridges using CAD/CAM fabricated zirconia based frameworks.

Evolution and clinical applications of esthetic ceramic materials in dentistry

The guest editor of this special supplement to JADA provides a brief overview of the evolution of all-ceramic materials in dentistry.

Effect of different ferrule designs on the fracture resistance and failure pattern of endodontically treated teeth restored with fiber posts and all-ceramic crowns

ObjectiveThis study investigated the effect of different ferrule heights on endodontically treated premolars.Materials and MethodsFifty sound mandibular first premolars were endodontically treated and then restored with 7-mm fiber post (FRC Postec Plus #1 Ivoclar-Vivadent) luted with self-polymerized resin cement (Multilink, Ivoclar Vivadent) while the coronal section was restored with hybrid composite core build-up material (Tetric Ceram, Ivoclar-Vivadent), which received all-ceramic crown. Different ferrule heights were investigated: 1-mm circumferential ferrule without post and core (group 1 used as control), a circumferential 1-mm ferrule (group 2), non-uniform ferrule 2-mm buccally and 1-mm lingually (group 3), non-uniform ferrule 3-mm buccally and 2-mm lingually (group 4), and finally no ferrule preparation (group 5). The fracture load and failure pattern of the tested groups were investigated by applying axial load to the ceramic crowns (n=10). Data were analyzed statistically by one-way ANOVA and Tukey’s post-hoc test was used for pair-wise comparisons (α=0.05).ResultsThere were no significant differences among the failure load of all tested groups (P<0.780). The control group had the lowest fracture resistance (891.43±202.22 N) and the highest catastrophic failure rate (P<0.05). Compared to the control group, the use of fiber post reduced the percentage of catastrophic failure while increasing the ferrule height did not influence the fracture resistance of the restored specimens.ConclusionsWithin the limitations of this study, increasing the ferrule length did not influence the fracture resistance of endodontically treated teeth restored with glass ceramic crowns. Insertion of a fiber post could reduce the percentage of catastrophic failure of these restorations under function.

Effect of Surface Conditioning and Taper Angle on the Retention of IPS e.max Press Crowns

The objective of this study was to evaluate the retentive strength of single-unit crowns with 10 degrees and 26 degrees taper angles cemented using two surface conditioning methods. Thirty-two freshly extracted sound human molars were divided into two groups (n = 16) and prepared in a standardized manner with 10 degrees and 26 degrees taper angles. All-ceramic (IPS e.max Press) single crowns were fabricated for the prepared teeth. The crowns were then subdivided into two groups (n = 8), according to type of surface conditioning for the intaglio surfaces. Half the groups were HF acid etched and silanized, and the other half were conditioned with tribochemical silica coating and silanization. The crowns were cemented using adhesive cement (Panavia F 2.0). Retentive strength was measured in a universal testing machine. No significant difference was found between the mean retention forces for both 10 degrees and 26 degrees taper angles when the crowns were conditioned either with silica coating (613 +/- 190 N and 525 +/- 90 N, respectively), or with hydrofluoric (HF) acid etching and silanization (550 +/- 110 N and 490 +/- 130 N for 10 degrees and 26 degrees, respectively) (p= 0.32). Neither the surface conditioning type, nor the taper angle affected the retentive strength of IPS e.max Press single-unit crowns when cemented adhesively. Since silica coating and silanization did not show significant differences from HF acid gel and silanization, the former can be preferred for conditioning intaglio surfaces of glass ceramic crowns to avoid the use of the hazardous compound HF acid gel chairside.

Influence of white and gray endodontic posts on color changes of tooth roots, composite cores, and all-ceramic crowns.

To evaluate whether post materials affect the color of roots, composite cores, and all-ceramic crowns. Forty extracted human incisors were divided into four groups. White posts made of zirconia (Zi) or glass fiber (Gf) and gray posts made of titanium (Ti) or carbon fiber (Cf) were randomly assigned to the roots. Composite cores and glass-ceramic crowns were made. The color of the roots, cores, and crowns was captured (Spectroshade). The mean color difference (mDeltaE) among the groups was calculated for the following comparisons: A--root: empty root versus post and core; B--root: post and core with and without cement; C--core: white versus gray posts and cores; D--lower third of crown versus original ceramic ingot; E--center of crown versus ingot. Statistical analysis was performed by ANOVA, Kruskal-Wallis, and Sheffe tests. White, as well as gray posts, induced little changes of the root color (A, B). Gray posts led to a significant discoloration of the cores (C: mDeltaEZi 2.0+/-0.7, mDeltaEGf 1.5+/-0.6, mDeltaETi 12.9+/-5.9, mDeltaECf 11.2+/-5.3; P<.0001, Kruskal-Wallis) resulting in a grayish discoloration of the crowns' lower thirds (D: mDeltaEZi 5.7+/-0.8, mDeltaEGf 6.0+/-1.2, mDeltaETi 3.5+/-1.1, mDeltaECf 3.9+/-0.9; P<.0001, Kruskal-Wallis). In the center of the crowns, all posts and cores induced a similar color difference (E). A grayish gingival shadowing cannot be reduced with white posts. In combination with glass-ceramic crowns, white posts and cores are esthetically beneficial.

The impact of cement mixing and storage errors on the risk of failure of glass–ceramic crowns

This study evaluated the impact of different mixing ratios and wrongly stored blends of dual-curing composite cements on Empress2 glass-ceramic crowns by means of a flexural strength test and a fracture resistance test. Thermally damaged blends and fresh blends were mixed using different mixing ratios of dual-curing Panavia F and Variolink II composite cement (2:1; 1:1; 1:1.5; 1:1.75; base/catalyst). Sixteen groups of rectangular beams of both cements (two blends, four ratios, chemical-curing, light-curing) were constructed. Their flexural strength was determined in a three-point bending test. Furthermore, 64 Empress2 all-ceramic crowns were luted onto human molars, again using fresh and thermally damaged blends as well as different mixing ratios of the luting agents. After aging, fracture resistance was investigated. The flexural strength of dual-curing composite cements was influenced to a statistically significant extent by mixing ratios and storage conditions. In particular, the chemical curing mode of these cements was affected by the thermal damage of the blends. However, this study could not demonstrate a significant impact on the fracture resistance of Empress2 glass-ceramic crowns when different mixing ratios or wrongly stored cements were used. Dual-curing composite luting agents seem to tolerate a wide range of mixing errors, but their chemical curing mode may be affected by storage errors.

A systematic review of the survival and complication rates of all‐ceramic and metal–ceramic reconstructions after an observation period of at least 3 years. Part I: single crowns

AbstractObjectives: The objective of this systematic review was to assess the 5‐year survival rates of all‐ceramic single crowns and to compare it with the survival rates of metal–ceramic crowns and to describe the incidence of biological and technical complications.Methods: An electronic Medline and Dental Global Publication Research System search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on all‐ceramic and metal–ceramic crowns with a mean follow‐up time of at least 3 years. Patients had to have been examined clinically at the follow‐up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Annual failure rates were analyzed using standard and random‐effects Poisson regression models to obtain summary estimates of survival proportions.Results: The search provided 3473 titles and 177 abstracts. Full‐text analysis was performed for 86 articles, resulting in 34 studies that met the inclusion criteria. In meta‐analysis, the 5‐year survival of all‐ceramic crowns was estimated at 93.3% (95% confidence interval (CI): 91.1%–95%) and 95.6% (95% CI: 92.4%–97.5%) for metal–ceramic crowns.All‐ceramic crowns were also analyzed according to the material utilized. Densely sintered alumina (Procera®technique) crowns showed the highest 5‐year survival rate of 96.4%, followed by reinforced glass–ceramic crowns (Empress®technique) and InCeram‐crowns with survival rates of 95.4% and 94.5%, respectively. A significantly lower survival rate of 87.5% was calculated for glass–ceramic crowns after 5 years.All‐ceramic crowns were also grouped and analyzed regarding the position in the mouth. All four types of all‐ceramic crowns showed lower survival rates when seated on posterior teeth. Moreover, for glass–ceramic crowns (84.4%) and InCeram‐crowns (90.4%), this difference reached statistical significance (P=0.009, P=0.028).Conclusion: Based on the present systematic review, all‐ceramic crowns, when used for anterior teeth, showed survival rates at 5 years comparable to those seen for metal–ceramic crowns.When used for posterior teeth, the survival rates at 5 years of densely sintered alumina crowns (94.9%) and reinforced glass–ceramic crowns (93.7%) were similar to those obtained for metal–ceramic crowns. Furthermore, lower survival rates of 90.4% and 84.4% can be expected for InCeram crowns and glass–ceramic crowns when utilized for premolars and molars.

The effect of a layer of resin luting agent on the biaxial flexure strength of two all-ceramic systems

The influence of a layer of resin luting agent on the longevity of glass-ceramic crowns has been demonstrated in some laboratory and clinical studies. The mechanisms of glass-ceramic crown failure and the influence of the resin luting agent layer are still not clearly understood. The objectives of this study were to examine the difference in biaxial flexure strength between 2 glass-ceramic dental materials and to examine the influence of a layer of resin luting agent on the characteristic strength of these materials. Thirty-seven disks, 15 mm x 1.5 mm, each of IPS Empress and IPS Empress2, were fabricated according to the manufacturer's recommendations. The surface of each disk underwent acid etching and silanation. The disks from each group were arbitrarily divided into 2 subgroups. One subgroup of each material type was selected to receive a thin (approximately 0.1 mm) layer of resin luting agent (Nexus 2), whereas the other subgroups remained unaltered. Each disk was loaded, with the treated surface down, using a ball-on-ring biaxial configuration in a universal testing machine. The failure loads (N) were recorded, and the biaxial flexure strength for each disk was calculated. Characteristic Weibull parameters and a +/-95% confidence interval were determined. A 2-way analysis of variance (alpha=.05) on transformed fracture strength data was used to determine significant differences between groups. The Weibull characteristic strength of IPS Empress2 (213 MPa) was 75% higher than IPS Empress (122 MPa). The results also show that the application of a thin layer of resin luting agent significantly increased (P <.001) the characteristic strength of both IPS Empress and IPS Empress2 by 45.6% and 47.6%, respectively. The higher strength of the resin-coated specimens cannot be explained in terms of standard fracture mechanics alone. Results suggested that IPS Empress had significantly lower characteristic strength than IPS Empress2. A relatively thin layer of resin luting agent bonded to both IPS Empress and IPS Empress2 significantly increased the characteristic strength of the ceramics.

In vivo fracture resistance of implant-supported all-ceramic restorations

Statement of problem Because of their specific mechanical properties, all-ceramic restorations demonstrate a lower fracture resistance than ceramic restorations supported by metal substructures. However, advances have been made in the fabrication of high-strength all-ceramic abutments for anterior implants. No previous study has compared the fracture loads between 2 different all-ceramic abutments restored by glass-ceramic crowns. Purpose The purpose of this in vitro investigation was to quantify the fracture load of implanted-supported Al 2O 3 and ZrO 2 abutments restored with glass-ceramic crowns. Material and methods Two ceramic abutments were tested: an Al 2O 3 abutment (CerAdapt) and a ZrO 2 abutment (Wohlwend Innovative). The abutments (n = 10) were placed on Brånemark dental implants and prepared for restoration with glass-ceramic crowns (IPS Empress). After fabrication, in accordance with the manufacturer's guidelines, the crowns were bonded to the all-ceramic abutments with a dual-polymerizing resin luting agent. The fracture loads (N) were determined by force application at an angle of 30 degrees by use of a computer-controlled universal testing device. The data were analyzed with the unpaired t test (α=.05). Results Statistical analysis showed significant differences between both groups ( P=.001) of all-ceramic abutments, with mean fracture load values of 280.1 N (± 103.1) for the Al 2O 3 abutments and 737.6 N (± 245.0) for the ZrO 2 abutments. Conclusion Within the limitations of this study, both all-ceramic abutments exceeded the established values for maximum incisal forces reported in the literature (90 to 370 N). The ZrO 2 abutments were more than twice as resistant to fracture as the Al 2O 3-abutments.

Long-term clinical results of galvano-ceramic and glass-ceramic individual crowns

Statement of Problem: Alternatives to metal-ceramic restorations should possess clinical durability before being recommended to the dentist. Longitudinal clinical studies are required for evaluation so innovative types of restorations can meet the expectations of dentists and patients. Purpose: This study compared the performance of galvano-ceramic restorations (Auvo Galvano Crown [ACG]) and glass-ceramic individual crowns (Dicor) based on longitudinal clinical trials. Material and Methods: A total of 769 galvano-ceramic single crowns (AGC) in 322 patients and 173 glass-ceramic individual crowns (Dicor) in 88 patients were reviewed for 8 years and a maximum of 11 years, respectively, after cementation. Risk of fracture was determined with use of a survival analysis (Kaplan and Meier). Results: Partial ceramic cracking was observed at the time of the last recording of data in 11 galvano-ceramic crowns, 8 of the units remained in place. Two crowns became dislodged and 1 tooth exhibited a fractured root, despite an intact crown. One restoration was removed because of hypersensitivity and 1 with partial ceramic fracture. Forty-two of the glass-ceramic crowns were completely fractured. After a comparable 7 years under risk, 96.5% (±3.4; 95% confidence interval) of the galvano-ceramic premolar and molar crowns and 92% (± 8.5) of crowns placed on incisors and canines crowns were intact. The corresponding data for the glass-ceramic restorations were only 70% (± 10.6) in posterior and 82.7% (± 8.1) in anterior quadrants. Conclusion: Long-term results of electroformed individual crown restorations were superior to glass-ceramic restorations. (J Prosthet Dent 2000;83:530-4.)

Effect of surface etching on the flexure strength and fracture toughness of Dicor disks containing controlled flaws.

Previous studies have shown an increase in the failure load of Dicor glass-ceramic crowns of up to 97% when they were etched with NH4HF2 and luted with a resin-based cement compared with the use of unetched crowns luted with zinc phosphate cement. The objective of this study was to evaluate the effect of the acid-etch treatment on the flexure strength and fracture toughness of Dicor glass-ceramic specimens containing controlled flaws. Annealed disks were divided into two groups of 14 each, and microcracks were induced in the surface with a Vickers indenter. Seven specimens from each sample set were etched with 10% NH4HF2 (Dicor etching gel) and were fractured in air using a piston-on-three-ball biaxial fixture. Fracture toughness values were determined from the flexure strengths and fractographic measurements of fracture-initiating flaws. Analysis of data by ANOVA and the Tukey's Studentized Range Test revealed no significant difference (p > 0.05) in the mean flexure strength or fracture toughness of the etched and unetched samples within group A or group B. For the sample groups tested, flaw modification by etching had no effect on the flexure strength or on the fracture toughness of Dicor specimens containing controlled flaws.

Strength of a dental glass-ceramic after surface coating

Clinical evidence suggests that using a resin luting agent rather than a traditional cement reduces the fracture incidence of glass-ceramic crowns. There is some evidence from stress analysis and fractography to indicate that fracture failure is typically initiated from their internal surface. The objective of this study was to determine if surface treatments and cement coatings of the fracture-initiating surface affected fracture stresses of ceramic discs in vitro. Glass-ceramic discs were cast, crystallized, and given various treatments. The discs were fractured with a ball-on-ring of balls biaxial fixture in air. The maximum stresses at the ceramic-coating interface were calculated using the bi-layer material equations. ANOVA and Tukey's multiple range test revealed that resin coating the fracture-initiating surface increased the biaxial fracture strength of the glass-ceramic discs by 33%. The effect was not reduced by short-term water storage. Etching alone did not significantly alter strength. The results suggest that crack-bridging is the most likely mechanism for the strengthening. Selecting techniques and materials that are likely to enhance crack-bridging may be a practical method of improving the performance of ceramic dental restorations.

Castable glass ceramic crowns and their reaction to endodontic therapy

The purpose of this investigation was to determine how castable glass (Dicor) crowns would react to both cold testing and endodontic access intervention. Full crown preparations were made on six extracted maxillary teeth. The teeth were then forwarded to Dentsply International, York, Pa. Six castable glass crowns were fabricated to fit these teeth and returned to us. Subsequently the teeth were dried and the crowns were cemented. Scanning electron micrographs of the cemented crowns were made, and endodontic access openings were drilled. The teeth were also cold tested with standard methods. The teeth were then again subjected to scanning electron microscopy to determine any changes the crowns might have undergone. One crown cracked around the gingival collar as scanning electron microscopy was performed. The other crowns did not exhibit any problems such as cracking or crazing from either the access openings or the cold testing.

Three-dimensional finite element analysis of glass-ceramic dental crowns

Because of the improved esthetic potential of glass-ceramic crowns as dental restorations, they are sometimes preferred over metal-ceramic crowns for restoration of anterior teeth. Because of their relatively high strength, these ceramic crowns are also frequently used for restoration of posterior teeth. However, due to the larger magnitude of biting forces on posterior teeth, intraoral fracture of all-ceramic crowns tends to occur more frequently in posterior crowns (Moffa, 1988). The objective of this study was to determine the relative influence of load orientation and the occlusal thickness of posterior ceramic crowns on the stress distribution which develops under these loading and design conditions. Three-dimensional finite element models for a molar crown were developed to determine the stress distribution under simulated applied loads. Glass-ceramic crowns with occlusal thicknesses of 0.5, 1.5, and 3.0 mm were considered. The largest principal tensile stresses induced in ceramic due to a distributed load of 600 N applied in a cuspal region were approximately 12 and 182 MPa for vertical and horizontal loading orientations, respectively. Stresses which developed in the facial and lingual marginal regions were primarily compressive under vertical loads. However, tensile stresses developed when the load was applied horizontally. Differences in stress distribution within crowns with the three occlusal thicknesses occurred only near the site of loading. Because of the relatively large failure rates of ceramic crowns in the posterior regions, these restorations should be strengthened by improvement in design, composition, and thermal processing conditions. Before any significant progress is made in these areas, these restorations should be used for the anterior teeth. The results of this study suggest that orientation of the applied load has a more important effect on development of large tensile stresses than the occlusal thickness of ceramic.

Strength evaluation of castable glass ceramic crown and castable glass ceramic bridge

Strength evaluation of castable glass ceramic crown and castable glass ceramic bridge