Grandio Blocs Research Articles

Effect of CAD-CAM block thickness and translucency on the polymerization of luting materials.

This in-vitro study aimed to evaluate the degree of conversion (DC) of dual-cured luting cement (Bifix QM, VOCO) and flowable composite (Grandio Flow, VOCO) under lithium disilicate glass-ceramic (IPS e.max CAD, Ivoclar Vivadent) and hybrid ceramic (Grandio Blocs, VOCO; Cerasmart, GC) CAD-CAM blocks with different thicknesses. Contrast ratio (CR), translucency (TPab, TP00), and opalescence (OP) parameters of 30 disc-shaped CAD-CAM blocks (n = 5) prepared with two different thicknesses (1.5 and 2mm) and 8mm diameters were calculated using a spectrophotometer (VITA Easyshade V, Zahnfabrik). A total of 36 Bifix QM and Grandio Flow samples were prepared at 100μm thickness using a specific setup by polymerizing from the top of the blocks. Following immersion in distilled water at 37°C for 24h, luting materials were examined by Fourier Transform Infrared Spectroscopy for DC calculation. Data were analyzed using One-way ANOVA, Kruskal Wallis, Mann Whitney U, and Independent Samples t-tests (p < 0.05). It was observed that, as the block thickness increased TPab, TP00, and OP decreased, while CR increased. There was no significant difference between the DC of Bifix QM and Grandio Flow when 1.5mm blocks were used in all groups (p > 0.05). DC of Grandio Flow was significantly higher than Bifix QM under 2mm-IPS e.max CAD (p = 0.011). The translucency of the CAD-CAM blocks varies depending on their thickness. However, there was no significant difference in the DC of the luting materials depending on the block thickness. Further studies are needed on the use of flowable resin composites as luting material.

Comparative Analysis of Modern 3D-Printed Hybrid Resin-Ceramic Materials for Indirect Restorations: An In Vitro Study

The study investigated the impact of aging on surface roughness, color stability, and biocompatibility of hybrid resin-ceramic materials. A total of 225 specimens were produced from three three-dimensional (3D)-printed (HarzLabs Dental Sand Pro (HL), BEGO VarseoSmile Crown plus (BV), Voco V-Print c&amp;b temp (VV)) and one milled material (Voco Grandio Blocs (VG)). Specimens were grouped into untreated, polished, and glazed surfaces. 5000 thermal cycles simulated aging. Surface roughness and color stability were analyzed, and surface topography was observed using scanning electron microscopy (SEM). Biocompatibility was evaluated with L929 cells. Surface roughness differed significantly between untreated and other groups, with no changes before and after artificial aging. Untreated milled samples were significantly smoother than 3D-printed ones. SEM analysis revealed roughest surfaces in untreated 3D-printed specimens. Polished and glazed specimens were smoother than untreated ones. Color values showed significant differences between untreated and treated/aged groups. No material showed cytotoxicity. In summary, untreated VG was smoother than 3D-printed materials, but polishing and glazing reduced roughness to levels comparable to VG. Surface treatments induced color changes, with glazing causing more changes than polishing. Aging affected color stability and biocompatibility but not surface roughness. All materials showed acceptable color changes and good biocompatibility.

Characterization of 3D printed composite for final dental restorations.

This study evaluated the mechanical, optical, microstructural, surface, and adhesive behavior of a 3D printing resin comparing it with a machinable resin composite. Specimens of different sizes and shapes were either printed (Vitality, Smart Dent) or machinable (Grandio Blocs, Voco GmbH) resin composites with similar composition were prepared. Surface and mechanical characterization were performed with Knoop hardness, flexural strength (three-point-bending), and elastic modulus tests. The wear of the tested materials was evaluated against steatite antagonists. The optical properties stability (color change, ΔE00, and translucency, TP00) were observed after staining in red wine. In addition, the bond strength of the resin composites to two resin cement protocols were investigated with microshear bond strength tests at baseline and after thermocycling. Scanning electron microscope (SEM) coupled with Energy-Dispersive X-ray Spectroscopy (EDS) was used for microstructural and chemical characterization. Statistical analyses were performed with t- and ANOVA tests. Hardness values (132.76 (16.32) KH- Machinable and 35.87 (2.78) KH - Printed), flexural strength (172.17 (26.99) MPa - Machinable and 88.69 (8.39) MPa - Printed), color and translucency change (1.86 (0.31)/0.06 - Machinable and 3.73 (0.36)/9,16- Printed), and wear depth (24.97mm (3.60)- Machinable and 7.16mm (2.84) - Printed) were statistically different. Average Regarding bond strength, mean values (MPa) for non-aged and aged groups were respectively 21.76 (6.64) / 31.9 (12.66) for Bifix cement (Voco GmbH, Cuxhaven, Germany) and 26.75 (5.14) / 24.36 (6.85) for Variolink cement (Ivoclar Vivadent, Schaan, Liechtenstein) in Printed and 17.79 (3.89) / 9.01 (3.36) ) for Bifix cement and 22.09 (6.55) / 11.01 (3.77) for Variolink cement in Machinable materials. The material and aging factors did affect bond strength but the cement factor did not (p = 0.202). No statistical differences were observed for mean roughness (Ra) between materials. The better dispersion and larger size of the inorganic particles in the Machinable resin were contrasted with the clustered smaller particles of printed resin, under SEM. The mechanical properties and color stability of the machinable resin were superior to those of the printed resin, probably due to the greater amount and dispersion of inorganic particles in the Mach resin, but bond strength after aging was stronger and more stable in the printed resin. 3D-printed resin composites with similar compositions to machinable resin composites do not necessarily exhibit the same properties, which can impact clinical performance. Understanding these differences can assist manufacturers in improving their materials and help clinicians distinguish between materials appropriate for provisional and final restorations.

Exploring the optical behavior and relative translucency parameter of CAD-CAM resin-based composites, polymer-infiltrated ceramic network, and feldspar porcelain

ObjectivesTo evaluate and compare the optical properties and relative translucency parameter of CAD-CAM restorative materials. MethodsFour CAD-CAM materials were evaluated: Lava Ultimate (LU), Grandio Blocs (GB), VITA Enamic (VE), and VITA Mark II (VM). Disk-shaped samples in shade A2-HT were prepared (n = 10) and polished to 1.00 ± 0.01 mm of thickness. Scattering (S), absorption (K), albedo (a) coefficient, transmittance (T%), light reflectivity (RI), infinite optical thickness (X∞), and radiative transfer coefficients (μa, and μ′S) were calculated using Kubelka-Munk method and Thennadil's semi-empirical approach. Root Mean Square Error (RMSE) and Goodness of Fit (GFC) were used as performance optical behavior. Translucency differences were evaluated using the relative translucency parameter (RTP00) and 50:50 % translucency perceptibility and acceptability thresholds (TPT00 and TAT00). ResultsThe spectral distribution of S, K, T%, RI, and X∞ was wavelength-dependent. GFC and RMSE values indicated good spectral behavior matches and good comparative spectral values for RI in LU-GB, LU-VE, and GB-VE, and for K in VE-VM. VM displayed the highest scattering values across the wavelengths, while VE and VM showed lower absorption at shorter wavelengths. LU and GB had the highest transmittance. The X∞ values indicated that all 1.0 mm thick materials could be influenced by the background. No good spectral match and no good comparative spectral values were found between CAD-CAM materials and anterior bovine maxillary specimens. VM had the lowest RTP00 values with perceptible and unacceptable differences compared to CAD-CAM materials evaluated. SignificanceUnderstanding the optical behavior of different CAD-CAM materials was essential for guiding clinicians in material selection and optimizing their clinical performance. The findings confirm that the different compositions and microstructure impact the optical properties and translucency of CAD-CAM restorative materials.

Effects of two dentifrices on the surface properties and staining susceptibility of polymer-based materials.

This study examined the effect of whitening and abrasive regular dentifrices on the surface characteristics and stain susceptibility of polymer-based CAD-CAM blocks subjected to artificial toothbrushing abrasion (TB). Two resin composite blocks [CeraSmart (CS) and Grandio Blocs (GB)], one polymer-infiltrated ceramic [Vita Enamic (VE)], and one direct resin composite [GrandioSO (RC)] were used to produce 60 specimens. The baseline mass, gloss, roughness, Vickers hardness (Hv), and color were measured after 7 days of water storage. The specimens were then separated into three TB treatment groups (n = 5): water control (C), regular daily dentifrice (R), and whitening dentifrice (W). Measurements were repeated post-TB (20,000 cycles). All specimens were immersed in coffee, and the CIE ΔE00 was measured after 1, 7, and 14 days. Two-way, one-way ANOVA, and Tukey's post hoc tests were performed to determine any significant differences between the materials and TB groups. To determine the stain resistance, repeated measures of ANOVA, one-way ANOVA, and Tukey's post hoc tests were used (α = 0.05). The R and W mass changes were minimal (-3.77 to 3.16g%). W reduced the gloss of all the materials by 12.6%-65%. All materials in W were slightly rougher (Ra, 0.107-0.144 μm) than those in R (Ra, 0.049-0.072 μm). The ΔE00 ranged from 0.6 to 1.6 in W and 0.4 to 1.4 in R. VE was the hardest material at baseline (Hv = 362), whereas brushing and staining lowered Hv in all TB groups (282.8-300.6). After brushing in W, VE, and RC were more susceptible to coffee stains than were CS and GB. The whitening dentifrice roughened CAD-CAM specimens, reducing gloss, yet lightened some materials. Polymer-infiltrated ceramic and direct resin composite specimens brushed with abrasive regular or whitening dentifrice resulted in more intense staining than the CAD-CAM resin composites.

Effect of surface treatment strategies on bond strength of additively and subtractively manufactured hybrid materials for permanent crowns

ObjectivesThe purpose of this study is to evaluate the bond strength of different computer-aided design / computer-aided manufacturing (CAD/CAM) hybrid ceramic materials following different pretreatments.MethodsA total of 306 CAD/CAM hybrid material specimens were manufactured, n = 102 for each material (VarseoSmile Crownplus [VSCP] by 3D-printing; Vita Enamic [VE] and Grandio Blocs [GB] by milling). Each material was randomly divided into six groups regarding different pretreatment strategies: control, silane, sandblasting (50 μm aluminum oxide particles), sandblasting + silane, etching (9% hydrofluorics acid), etching + silane. Subsequently, surface roughness (Ra) values, surface free energy (SFE) were measured. Each specimen was bonded with a dual-cured adhesive composite. Half of the specimens were subjected to thermocycling (5000 cycles, 5–55 °C). The shear bond strength (SBS) test was performed. Data were analyzed by using a two-way analysis of variance, independent t-test, and Mann-Whitney-U-test (α = 0.05).ResultsMaterial type (p = 0.001), pretreatment strategy (p < 0.001), and the interaction (p < 0.001) all had significant effects on Ra value. However, only etching on VSCP and VE surface increased SFE value significantly. Regarding SBS value, no significant difference was found among the three materials (p = 0.937), while the pretreatment strategy significantly influenced SBS (p < 0.05). Etching on VSCP specimens showed the lowest mean value among all groups, while sandblasting and silane result in higher SBS for all test materials.ConclusionsThe bond strength of CAD/CAM hybrid ceramic materials for milling and 3D-printing was comparable. Sandblasting and silane coupling were suitable for both millable and printable materials, while hydrofluoric etching should not be recommended for CAD/CAM hybrid ceramic materials.Clinical relevanceSince comparable evidence between 3D-printable and millable CAD/CAM dental hybrid materials is scarce, the present study gives clear guidance for pretreatment planning on different materials.

Mechanical Properties of Direct Composite Resins and CAD/CAM Composite Blocks

The widespread application of CAD/CAM technology in contemporary dentistry led to the development of promising restorative materials, such as resin composite blocks (RCBs). Thus, the present study aims to evaluate the mechanical properties of RCBs, comparing this material to the direct composite resin from the same manufacturer. Samples retrieved from three CAD/CAM resin composite blocks (Tetric CAD (TC), Ivoclar Vivadent, Grandio blocs (GB), VOCO GmbH and Brilliant Crios (BC), Coltene/Whaledent) and four direct composite resins (Tetric EvoCeram (TEC), Ivoclar Vivadent, GrandioSO (GS), VOCO GmbH, Brilliant EverGlow Translucent (BET) and Universal Shade (BEU), Coltene/Whaledent) were submitted to three-point bending flexural test and Vickers microhardness test. The resulting data of the flexural strength were analyzed using one-way ANOVA considering Bonferroni correction for post hoc tests (α = 0.05). The flexural modulus and Vickers microhardness results were analyzed using Welch’s ANOVA considering Games–Howell correction for post hoc tests (α = 0.05). Regarding results, flexural strength and flexural modulus values ranged from 81.1 MPa (BEU) to 246.5 MPa (GB) and 10.6 GPa (BEU) to 20.3 GPa (GB), respectively. GS (121.2) and GB (136.2) groups were associated with the highest microhardness values. According to the post hoc tests, statistically significant differences in flexure strength were found in RCBs (BC, GB, and TC) compared to all direct composite resins. Flexural modulus and Vickers microhardness of RCBs (BC, GB, TC) were also significantly different from the direct composite resin (BET, BED, and TEC), except when comparing GS and GB for microhardness. In conclusion, differences between RCBs and direct composite resins were observed regarding flexural strength, flexural modulus, and microhardness, revealing that RCBs have enhanced mechanical properties compared to direct composite resins.

Fracture strength of endocrowns after thermomechanical aging.

This in-vitro study aimed to evaluate the fracture strength (FS; N) of composite, feldspathic, and glass-ceramic computer-aided design/computer-aided manufacturing (CAD/CAM) endocrowns after thermomechanical aging. Seventy non-carious human molars were randomly divided into seven groups, according to the CAD/CAM material used for endocrown fabrication. Intact molars without cavity preparations were used as control (n = 10). Following endodontic treatment, standardized endocrown cavities were prepared and endocrowns were fabricated using composite (Cerasmart270, CS and Grandio Blocs, GB), fired and milled zirconia-reinforced lithium silicate (Celtra Duo, CD), leucite-reinforced feldspar ceramic (LRF Initial, LRF), and feldspathic (Cerec Blocks, CE) materials which were luted with universal adhesive (Futurabond U; Voco) and dual-cure resin cement (Bifix QM). Following thermocycling for 20,000 cycles and 480,000 load cycles in a chewing simulator (CS-4.2, SD Mechatronik), FS was evaluated (Instron). Data were analyzed with one-way ANOVA and post hoc Tukey's tests (p < 0.05). FS was significantly influenced by the tested material (p = 0.00). CS had the highest FS, which was not significantly different from intact molars and fired CD (p > 0.05). There were no significant differences in FS between LRF, GB, and CD, which were significantly higher than CE. Most of the failure modes of CS, CD, and GB were repairable, whereas those of CE were irreparable. All the tested materials withstood clinically relevant axial forces. Composite endocrowns exhibited more favorable fracture pattern, whereas feldspathic and leucite-reinforced feldspar ceramic endocrowns exhibited mostly irreparable fractures.

Aging and Fracture Resistance of Implant-Supported Molar Crowns with a CAD/CAM Resin Composite Veneer Structure.

Chipping of implant-supported molar crowns (iSCs) is a frequently reported complication. This study aimed to investigate the in-vitro aging and fracture resistance of iSCs with a CAD/CAM resin composite veneer structure fabricated with the Rapid Layer Technology (RLT) approach. Eight iSCs per group were fabricated by using two different CAD/CAM resin composites (Shofu Block HC: SH; Grandio blocs: GB) for veneer structures, and zirconia (ZrO2), polyetheretherketone (PEEK), and cobalt-chromium (CoCr; control) as framework materials. The surfaces to be bonded were sandblasted, cleaned in an ultrasonic bath, and a coupling agent was applied. A self-adhesive resin luting composite was used to adhesively lute the veneer structures to the frameworks. The crowns were semi-permanently cemented to the abutments. After storage in deionized water, iSCs were loaded in a chewing simulator (TCML, 10,000 thermal cycles 5 °C to 55 °C for 20 s, 1.2 million, loading force 50 N). Four ZrO2 and one CoCr crown did not survive the TCML. The fracture force was determined after 24 h storage in deionized water and yielded values of ≥974 N. Lowest fracture forces were yielded in the PEEK-SH group in comparison to CoCr or ZrO2 groups (p ≤ 0.031). For identical framework materials, no significant influence of the veneering material was observed. All PEEK-GB frameworks fractured, and chipping occurred for ZrO2-SH and all CoCr frameworks. PEEK-SH and ZrO2-GB presented both chipping and framework fractures. Within the limitations of this in-vitro study, the RLT with a CAD/CAM resin composite veneer structure might be a promising approach to veneer iSCs. Yet, the choice of the CAD/CAM resin composite and of the framework material determine the fracture resistance.

The effect of in-office bleaching agents on the Vickers hardness and surface topography of polished and unpolished CAD/CAM composite materials

In-office bleaching, using hydrogen peroxide, is effective to remove dental enamel stains. However, bleaching agents can deteriorate surface properties of CAD-CAM materials. This in vitro study aimed to investigate the effect of in-office bleaching agents on Vickers hardness and surface topography of polished and unpolished dental CAD-CAM composite materials (Grandio blocs, Lava Ultimate, BRILLIANT Crios, Cerasmart), and a polymer-infiltrated ceramic network block (Vita Enamic). The specimens were randomly divided into two groups: unpolished or polished. The micro-hardness and surface topography of each group were measured before bleaching, after a 60 min bleaching period, and 24-h and one-month post-bleaching. In-office bleaching significantly influenced the Vickers hardness of both the polished and unpolished CAD/CAM composite blocks, with Vita Enamic exhibiting the least hardness stability among all groups. Furthermore, in-office bleaching significantly influenced the surface roughness of unpolished CAD/CAM composite blocks. There was a significant difference in hardness reduction between the polished and unpolished specimens for most of the investigated materials at different time points. The bleaching did not influence the surface roughness of the investigated polished group, except for Vita Enamic and Lava Ultimate. However, it did influence the surface roughness of the investigated materials in the unpolished group.

Performance of direct and indirect onlay restorations for structurally compromised teeth

Research is lacking on the restoration of structurally compromised posterior teeth using direct composite resin or indirect restorations. The purpose of this in vitro study was to measure the fracture resistance and microleakage of different onlay restorations fabricated by using conventional and digital computer-aided design and computer-aided manufacturing (CAD-CAM) to restore structurally compromised teeth. Mandibular molars (n=54) were prepared for onlay restorations. Teeth were allocated to 3 groups (n=18) according to the type of restoration materials, nanohybrid composite resin (Grandio blocs), resin hybrid ceramic (SHOFU Block HC), and fiber-reinforced composite resin (everX Posterior). Onlays were bonded using a dual-polymerized adhesive resin cement. All specimens were thermocycled, followed by cyclic loading. Based on the type of investigation conducted, fracture resistance, and microleakage test, each group was then divided into 2 equal subgroups (n=9). The collected data were statistically analyzed with the chi-square of the Fischer exact test (α=.05). Fracture resistance testing revealed a statistically significant difference between groups (P<.001). The fiber-reinforced composite resin demonstrated the highest fracture resistance, with statistically significantly less microleakage compared with the other groups (P=.013). Direct fiber-reinforced composite resin could be considered a suitable alternative to CAD-CAM composite resin for the restoration of structurally compromised teeth.

Comparison of the Surface Properties of 3D-printed Permanent Restorative Resins and Resin-based CAD/CAM Blocks.

This study aimed to investigate the surface roughness, microhardness, and color changes of resin-based computer-aided design/computer-aided manufacturing (CAD/CAM) blocks and 3D-printed permanent resins in different beverages. Resin-based CAD/CAM blocks (Cerasmart 270 and Grandio Blocs) and 3D-printed permanent restorative resins (Crowntec and Permanent Crown) were used in this study. A total of 96 specimens were prepared from CAD/CAM blocks and 3D-printed permanent resins. The initial surface roughness, microhardness, and shade value of the specimens were measured. Then, the specimens prepared from each material were divided into three subgroups (n=8) and immersed in tea, coffee, and distilled water for 30 days. After the specimens were immersed in the beverages, the surface roughness, microhardness, and tone values were measured again. The data were statistically analyzed using a two-way analysis of variance test (p<0.05). No statistically significant difference was found in the surface roughness values of the resin-based CAD/CAM blocks and 3D-printed resins (p<0.05). Resin-based CAD/CAM blocks showed statistically significantly higher microhardness than 3D-printed permanent resins (p<0.05). Although the color changes in 3D-printed resins in tea and coffee were similar to those in resin-based CAD/CAM blocks on the first and seventh days, more color changes appeared in the 3D-printed resins after 30 days. The surface roughness and microhardness values of the specimens submerged in tea, coffee, and distilled water showed no statistically significant changes (p<0.05). Although the surface roughness of 3D-printed permanent resins was similar to that of resin-based CAD/CAM blocks, they had a lower microhardness value. Moreover, 3D-printed permanent resins showed more color changes in tea and coffee.

Shear Bond Strength of Repaired CAD/CAM Resin-Based Composite Materials Submitted to Er:YAG Laser Treatments at Different Powers

This study aimed to investigate the effects of different powers of Er:YAG laser irradiation on the shear bond strength (SBS) of repaired CAD/CAM resin-based composite materials. A total of 180 CAD/CAM resin-based composite specimens (5 × 5 × 2 mm) were obtained (Shofu Block HC—SB; Grandio Blocs—GB). They were allocated into six groups according to surface pretreatment methods: no surface pretreatment (control), hydrofluoric acid (HF), diamond bur and 3 W, 5 W, and 7 W Er:YAG lasers (20 Hz) (n = 15). Silane and universal adhesive were applied. The repair procedure was completed with nano-ceramic composite resin (Ceram-X Sphere TEC-One). The samples were thermocycled for 10,000 cycles (5–55 °C). The SBS was evaluated with a universal test machine (1 mm/min). A 3D optic profilometer was used to assess the surface topography. Statistical analysis was performed with a two-way ANOVA and Bonferroni tests (p &lt; 0.05). For SB samples, HF and diamond bur caused significantly higher SBSs than 3 W and 7 W lasers, while for GB samples, they led to a significantly higher SBS than all laser treatments. For SB samples, the 5 W laser led to the highest SBS, while for GB samples, the 7 W laser caused the highest SBS (p &lt; 0.05). For both blocks, adhesive failure was more common for the 3 W laser, and a decrease in adhesive failures and an increase in mixed failures were observed with increasing laser irradiation. The 3D optic profilometer revealed that smoother surfaces were obtained with the 3 W laser than other laser irradiation at different powers. Pretreatment with increasing Er:YAG laser powers led to similar bond strengths to hydrofluoric-acid- and diamond-bur-treated CAD/CAM resin-based composite materials. A more powerful laser treatment is required to provide a higher bond strength for restorative materials containing a higher inorganic ceramic content.

In vitro evaluation of CAD/CAM composite materials

ObjectivesThe purpose of this in vitro study was to evaluate the microstructural, elemental and mechanical properties of contemporary computer-aided-design/computer-aided manufacturing (CAD/CAM) resin based composite (RBC) materials. MethodsSix CAD/CAM RBC materials [Brilliant CRIOS (Coltene Whaledent AG), Cerasmart (GC), Lava Ultimate (3M ESPE), Tetric CAD (Ivoclar Vivadent), Shofu Block HC (Shofu), Grandio Blocs (VOCO GmbH)] were tested. Ten rectangular blocks (14 Χ 12 Χ 18 mm) for each material, after metallographic grinding and polishing, were subjected to Instrumented Indentation Testing (ΙIT). Martens Hardness (HM), Indentation Elastic Modulus (EIT), Elastic (ηIT) and Creep indices (CIT) were determined according to formulas provided by ISO 14577. The diagonal length of each indentation was measured and HV was determined. The results of HM, EIT, ηΙΤ, HV, and CIT were statistically analyzed by one-way ANOVA and Tukey post hoc test employing the material as a discriminating variable (a = 0.05), while the possible correlations were determined by Spearman's correlation test. One specimen from each group was examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). ResultsBackscattered Electron images and EDX analysis demonstrated differences in size, shape and type of fillers along with elemental composition among materials tested. Statistical significant differences were identified for all mechanical properties tested. Grandio Blocs had the significantly higher HM (953±7 N/mm2), HV (136±1) and EIT (23±1 GPa) followed by Lava Ultimate (ΗM=674±25 N/mm2, HV=105±2, EIT=15±1 GPa). Elastic index ranged from 41% to 52%, with Shofu Block demonstrating the significantly highest ηIT (52 ± 1%) values. Cerasmart had significantly higher CIT value (8.4 ± 0.1%) than all other materials tested, while Grandio Blocs and Lava Ultimate had the lowest ones. Spearman's correlation revealed that all mechanical properties tested exhibited correlations with each other, apart from ηΙΤ. ConclusionsThe results showed that the CAD/CAM materials tested have differences in their microstructure, elemental composition and mechanical properties. Clinical significanceThe RBCs tested showed significant differences in mechanical properties and thus differences in clinical performance are anticipated. RBCs with increased filler loading had the most favorable combination of hardness, elastic modulus and creep index indicating that these materials may have better clinical performance under intraoral loading conditions.

The influence of different storage media on Vickers hardness and surface roughness of CAD/CAM resin composites

IntroductionThis study examined Vickers hardness as well as surface characteristics of different computer-aided design/computer-aided manufacturing (CAD/CAM) resin composites prior to and after storage in various media.Materials and methodsCAD/CAM resin composite blocks (Grandio Blocs (GB), Lava Ultimate (LU), Brilliant Crios (BC), Cerasmart (GC), Shofu Block HC (SB), Tetric CAD (TC), Luxacam Composite (LC); incl. different translucency variants) were prepared, polished and surface free energy was determined. The specimens were divided into four groups: dry conditions for 24 h (25 °C), demineralized water (37 °C), Pepsi Cola (37 °C) and 75% ethanol (37 °C). After seven and 28 days of storage, Vickers hardness was determined. Surface roughness was measured after the entire storage period.Results and discussionVickers hardness was in the range of about 150 HV for GB, around 115 HV for LU, and 80–100 HV for BC, GC, SB, TC and LC. Only minor differences (total: 50.2 (6.4)–56.2 (3.2) mN/m) in surface free energy could be detected. No relationship was observed between surface free energy and filler content. However, a correlation between filler content and Vickers hardness was evident. Artificial aging caused a decrease of Vickers hardness (up to −40 HV or 35%) depending on storage media, duration and material. The changes in surface texture after immersion in different media were below a value of ΔSa = 0.015 µm.ConclusionArtificial aging of CAD/CAM resin composites leads to a significant decrease of Vickers hardness for most materials, while only small changes in surface roughness were identified.Graphical

Effect of aging on color, gloss and surface roughness of CAD/CAM composite materials

ObjectivesTo assess the effect of aging procedures on color, gloss and surface roughness of CAD/CAM composite materials. Methods6 CAD/CAM composite materials (Brilliant CRIOS, Cerasmart, Lava Ultimate, Tetric CAD, Shofu Block HC, Grandio Blocs) were tested. 10 CAD/CAM fabricated specimens of each material polished according to manufacturers’ recommendations, were subjected to one of the following aging procedures; immersion in coffee (30 days, 37οC), water thermocycling (5000 cycles, 5–55 °C) and photoaging (150,000 kJ/m2). Color, gloss and surface roughness measurements were performed before and after aging and the respective changes were calculated. Kruskal-Wallis tests, paired t-tests, one-way ANOVA and Bonferroni post-hoc tests were used for statistical analysis (a = 0.05). ResultsColor changes ranged from 3.03 to 4.13 after coffee immersion, from 1.33 to 2.55 after thermocycling and from 1.02 to 2.75 after photoaging. No statistically significant differences for ΔE*ab were found among materials after coffee immersion and thermocycling (p>0.05). Gloss changes ranged from -5.7 to -1.6 GU after coffee immersion, from -2.3 to 0.1 GU after thermocycling and from -4.4 to 0.5 GU after photoaging. No significant differences in gloss changes were found among materials after aging (p>0.05). Tetric CAD demonstrated the significantly lower gloss and the higher surface roughness after polishing. Except for gloss after thermocycling, aging procedures caused significant alteration of gloss and surface roughness parameters from baseline levels. ConclusionsAging procedures caused perceptible but acceptable color changes and small but visible gloss changes, while surface roughness parameters of the tested CAD/CAM composite materials were significantly affected by aging. Clinical significanceAging procedures affected CAD/CAM composite materials indicating that these materials may be prone to color and surface alterations in the oral environment that could compromise the esthetics and the performance of the restorations. Clinical studies are needed to investigate the long-term behavior of the newly introduced CAD/CAM materials.

Effect of acidic media on flexural strength and fatigue of CAD-CAM dental materials.

To investigate the effect of acidic media, including beverages and gastric fluids on flexural strength and fatigue of CAD-CAM materials. Four CAD-CAM materials (high-translucency zirconia (Ceramill Zolid HT+), lithium disilicate (IPS e-max CAD), hybrid ceramic (Vita Enamic), and nanohybrid resin composite (Grandio Blocs) were prepared and immersed in one of five media (gastric HCl, white wine, Coca-Cola, orange juice, and artificial saliva) in an incubator (37℃, 24h). Surface topography and roughness were obtained using a scanning electron microscope (SEM) and a stylus contact profilometer, respectively. Initial 3-point flexural strength was measured for half of the bars (n=20/gp) using a universal testing machine (0.5mm/min). The other bars underwent 106 cyclic fatigue loadings before measurement of residual 3-point flexural strength. Data were statistically analyzed (two-way and three-way ANOVA, Tukey's post-hoc, p<0.05). Weibull distributions were plotted for reliability analysis. Zirconia bars has the highest initial flexural strengths followed by lithium disilicate, while resin composite and hybrid ceramic groups had the lowest strength regardless of the erosive medium. Cyclic fatigue significantly reduced initial flexural strengths for all materials except for hybrid ceramic and resin composite. Weibull moduli were the highest for zirconia, lithium disilicate and resin composite and lowest for hybrid ceramic. Erosive media significantly changed surface roughness of CAD-CAM materials except for zirconia and resin composite without jeopardizing the flexural strength of the CAD-CAM materials. Despite the higher flexural strengths for zirconia and lithium disilicate, resin composite and hybrid ceramic were more resistant to cyclic fatigue.

Effect of virtual cement space and restorative materials on the adaptation of CAD-CAM endocrowns.

This study aimed to evaluate the effect of virtual cement space and restorative materials on the fit of computer-aided design and computer-aided manufacturing (CAD-CAM) endocrowns. A mandibular first molar tooth model received a butt joint margin endocrown preparation with a 2-mm occlusal thickness. Then, using a 3D-printing system, 120 copies of this prepared die were printed and assigned equally to three groups with different cement space settings (30, 60, and 120μm) during the chairside CAD design. In the milling process, CAD-based models with a particular space setting were subdivided into four groups (n = 10) and fabricated from different CAD-CAM materials: Vita Suprinity (VS), Celtra Duo (CD), Lava Ultimate (LU), and Grandio blocs (GR). Finally, the endocrowns were stabilized over their corresponding models with siloxane and subjected to micro-computed tomography to measure the fit. The cement space that was predesigned at 30μm generated the largest marginal discrepancy (from 144.68 ± 22.43μm to 174.36 ± 22.78μm), which was significantly different from those at 60μm and 120μm (p < 0.001). The combination of VS or CD with a pre-setting cement space of 60μm and the combination of LU or GR with a cement space of 120μm showed better agreement between the predesigned and actual measured marginal gap widths. For internal adaptation, only the cement space set to 30μm exceeded the clinically acceptable threshold (200μm). The setting of the cement space and restorative material significantly affected the marginal adaptation of CAD-CAM endocrown restorations. Considering the discrepancy between design and reality, different virtual cement spaces should be applied to ceramic and resin composite materials.

Effect of CAD/CAM aesthetic material thickness and translucency on the polymerisation of light- and dual-cured resin cements.

This study investigated potential variations in polymerisation of light- and dual-cured (LC and DC) resin cements photoactivated through four CAD/CAM restorative materials as a function of substrate thickness. Four CAD/CAM materials [two resin composites CeraSmart (CS) and Grandio Blocs (GB); a polymer infiltrated ceramic Vita Enamic (VE) and a feldspathic ceramic Vita Mark II (VM)], with five thicknesses (0.5, 1, 1.5, 2, and 2.5mm) were prepared and their optical characteristics measured. 1mm discs of LC and DC resin cement (Variolink® Esthetic, Ivoclar AG) were photoactivated through each specimen thickness. After 1h post-cure, polymerisation efficiency was determined by degree of conversion (DC%) and Martens hardness (HM). Interactions between materials, thicknesses and properties were analysed by linear regressions, two-way ANOVA and one-way ANOVA followed by post hoc multiple comparisons (α=0.05). All substrates of 0.5- and 1.0-mm thickness transmitted sufficiently high peak irradiances at around 455nm: (It = 588-819mW/cm2) with translucency parameter TP =21.14 - 10.7; ranked: CS>GB =VM>VE. However, increasing the substrate thickness (1.5-2.5mm) reduced energy delivery to the luting cements (4 - 2.8J/cm2). Consequently, as their thicknesses increased beyond 1.5mm, HM of the cement discs differed significantly between the substrates. But there were only slight reduction of DC% in LC cements and DC cement discs were not affected. Photoactivating light-cured Ivocerin™ containing cement through feldspathic ceramics and polymer-infiltrated ceramics achieved greater early hardness results than dual-cured type, irrespective of substrate thickness (0.5 - 2.5mm). However, only 0.5 and 1mm-thick resin composites showed similar outcome (LC>DC). Therefore, for cases requiring early hardness development, appropriate cement selection for each substrate material is recommended.

Influence of surface treatments on the bond strength of metal brackets to CAD/CAM materials and discoloration after various refinishing procedures : Scanning electron microscopy and atomic force microscopy study.

This study evaluated the shear bond strength (SBS) of ametal bracket bonded to three different computer-aided design/computer-aided manufacturing (CAD/CAM) restoration materials pretreated with different surface treatments. In addition, the surface topography and color change of the restorations after debonding with two different tungsten carbide burs were examined. A total of 216plates were cut from three different CAD/CAM blocks, each of which was divided into three subgroups with different pretreatment methods: (1)acid etching, (2)sandblasting, and (3)laser irradiation. Incisor metal brackets were bonded. The SBS test was performed, and the failure types were classified. Then, samples were randomly divided into two subgroups according to the adhesive removal procedure to be used: atungsten carbide bur with 12blades or 24blades (n = 12). Color change was calculated based on the ∆E00, and surface morphology was evaluated via SEM and AFM analysis. The SBS data revealed that the type of CAD/CAM material and the applied surface treatment significantly affected bond strength. The highest SBS values were detected for the Grandio Blocs (VOCO GmbH, Cuxhaven, Germany; 14.3 ± 4.4 MPa), and the lowest was observed for Cerasmart (GC Europe, Leuven, Belgium; 12.0 ± 4.0 MPa). The ∆E00 results demonstrated significant differences only as aresult of the applied surface treatment. The ∆E00 value in all groups was above the 1.77 threshold. CAD/CAM material types and surface treatments affected the bond strength, but the interactions of these factors did not. The chosen surface treatment also significantly affected the ∆E00 after the polishing was done.