Lithium Disilicate Ceramics Research Articles

Effect of Listerine and Chlorhexidine mouthwashes with antidiscoloration system on the colour change of CAD/CAM conventional and novel lithium disilicate ceramics

Background It has been reported that using mouthwashes can discolour the surface of teeth. Their effect on the stainability of newly introduced lithium disilicate ceramics is, however, unknown. Objective: The purpose of this in vitro study was to investigate how mouth washes affected the color change of new and conventional lithium disilicate (LS2) ceramics that were finished using various techniques. Materials and Methods A total of 56 ceramic slices were produced from conventional LS2 (E Max CAD, Ivoclar) and a novel virgilite based LS2 (Cerec Tessera, Dentsply Sirona). According to the finishing method, the specimens were divided into glazed and polished subgroups. Each subgroup was further subdivided into two based on immersion in chlorhexidine (CHXD) or Listerine (LIST) mouth washes. A handheld spectrophotometer was used to measure the color attributes, and color differences (ΔE00) were then counted using specific equation. Data were analyzed using ANOVA and Tukey’s post-hoc tests. Results Significant differences in color change (ΔE00) values were observed between conventional and novel LS2 ceramics, as well as between different finishing methods and mouth-rinse solutions. Chlorhexidine induced higher color differences than Listerine, with average ΔE00 values of 0.959 and 0.885, respectively (p < 0.001). The polished specimens generally exhibited higher ΔE00 values than the glazed specimens, with average values of 1.071 and 0.792 for conventional LS2, and 0.836 and 0.786 for novel LS2 (p < 0.001). However, most color changes did not exceed the perceptibility and acceptability thresholds. Conclusion Using CHXD and LIST mouth washes affected the color change of polished or glazed conventional and novel lithium disilicate ceramics. In general, the stainability of polished specimens was higher than that of glazed ones. There was more discoloration on specimens immersed in CHXD than those immersed in LIST. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1178-1184

Effect of Polishing Paste on Roughness of Lithium-Disilicate Ceramics

Effect of Polishing Paste on Roughness of Lithium-Disilicate Ceramics

Cutting efficiency of different dental diamond rotary instruments for sectioning monolithic zirconia and lithium disilicate crowns

BackgroundThe aim of this study was to determine the cutting efficiency of different diamond rotary instrument types for sectioning monolithic zirconia and lithium disilicate anatomical crowns.Materials and methodsThe study used 30 diamond rotary instruments divided into three groups: Zirconia cutting diamond bur (White Z), super coarse grit diamond bur (KBlack), and medium coarse grit diamond bur (KBlue); Two subgroups were assigned based on the crown materials including monolithic zirconia (5YSZ) and lithium disilicate (e.max) ceramics. The cutting efficiency was assessed by measuring the time required to fully section the crowns, followed by scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) of the dental burs before use and after every sectioned crown. A three-way ANOVA examined the effects of bur type, material type, and sectioning stage. If interaction exists, one-way ANOVA was used to compare the different subgroups, followed by the Tukey post hoc test. The significance level was assigned at α ≤ 0.05.ResultsThe results exhibited various cutting efficiencies among diamond rotary instruments and ceramic crown materials. White Z demonstrated superior cutting efficiency of zirconia crown compared with KBlack and KBlue for the first cutting cycles (p ≤ 0.05); the results tend to be more comparable at the third cutting cycle. However, the super coarse diamond bur exhibited higher efficiency in cutting lithium disilicate crowns than white Z and KBlue burs through all three cutting cycles(p ≤ 0.05). The diamond bur-cutting efficiency diminished after each use, irrespective of the bur type or the crown material (p ≤ 0.05); this was represented by the reduction of carbon and increased nickel matrix ratio after each bur usage.ConclusionWhite Z diamond bur showed higher cutting efficiency of zirconia in the first two cutting cycles; super coarse diamond bur is more efficient for cutting lithium disilicate crown in all of the cutting cycles. The amount of diamond on the burs reduced after each use, with no great impact on the material type when sectioning lithium disilicate and 5YSZ crowns.Clinical significanceThis study provides valuable insights for dental practitioners in selecting the appropriate diamond rotary instrument for crown sectioning. Practitioners can minimize the risk of damage and reduce the time required for crown removal, improving patient outcomes.

Influence of Dentin Sealing Technique on the Shear Bond Strength between Lithium Disilicate Ceramics and Try-In-Paste-Contaminated Dentin

This study aimed to evaluate the effect of try-in paste contamination on the bond strength of lithium disilicate glass–ceramic to dentin treated with immediate (IDS) or delayed (DDS) dentin sealing techniques. Occlusal halves of 33 molars were decapitated and divided into three groups (n = 10). Lithium disilicate discs (3 × 5 mm) were prepared. For Group A, the provisional crown was applied over dentin and was soaked in distilled water. Lithium disilicate discs were cemented following dentin conditioning with a three-step etch and rinse adhesive. In Group B (IDS), the three-step adhesive was applied to dentin. The dentin surfaces were conditioned only in the final cementation for Group C (DDS). The intaglio surfaces of test groups were contaminated with try-in paste. All specimens were thermally cycled 3000 times at 5–55 °C and were subjected to shear tests. An additional three specimens for each group were contaminated with try-in paste and subjected to the same surface cleaning as the test specimens were examined with SEM/EDS. The adhesive surfaces were also examined with SEM/EDS for try-in paste remnants. Group C showed a significant decrease in bond strength values compared to Group B and Group A (5.84 ±1.4 MPa, 11.45 ±2.4 MPa, and 10.29 ±2.5 MPa, respectively). No statistically significant difference was detected between Group B and Group A (p ≥ 0.05). The SEM-EDS analyses revealed obstructions of the dentinal tubules in the try-in-paste-contaminated specimens. Immediate dentin sealing application enhanced the bonding strength of lithium disilicate to the try-in-paste-contaminated dentin. Try-in paste contamination over dentin negatively influenced the bonding process.

Enhancing the Opacity of Glass Ceramics by Applying Opaque Stains to the Intaglio Surface.

The aim of this study was to assess the effect of opaque stain application to the intaglio surface of lithium disilicate glass ceramics on the masking ability of discolored substrates and bond strength to a resin-based luting agent (depending on etching time); the stain film-thickness was also assessed. Ceramic specimens were produced with CAD-CAM blocks of lithium disilicate (IPS e.max CAD). Two opaque stains were tested at ceramic intaglio surface: opaque glassy stain for titanium frameworks (OP-ti) and low-fusion glassy stain for ceramic characterization (LFG-iv). Non-stained ceramic specimens served as controls. For optical and colorimetric analyses, A2-shaded ceramics of medium and low-translucencies were tested, in thicknesses of 1.0- and 1.5-mm (n = 10), with two coupling agents (non-shaded-glycerin and A2-shaded try-in paste). CIEDE2000 formula was used for calculation of translucency parameter (TP00) and color differences (ΔE00). Whiteness index for dentistry (WID) was also reported. ΔE00 were assessed over discolored substrates (tooth-shaded A2-reference, A4, C3, and C4; coppery metal, silvery metal, white zirconia, and PEEK). Microshear bond strength of stained and non-stained ceramic specimens to a resin-based luting agent was evaluated. Film-thickness of stains was assessed by scanning electron microscopy. The application of opaque stains to the intaglio surface of lithium disilicate ceramics resulted in significant reduction of TP00 (p < 0.001) and WID (p < 0.001) and differences in L*, C*, and ho color coordinates (especially with OP-ti) (p < 0.001). ΔE00 was significantly reduced in stained ceramic groups in comparison with the control, for all discolored substrates (p < 0.001). Acceptable color matching was obtained with stained ceramic specimens for all discolored substrates, depending on the type of stain, ceramic thickness, ceramic translucency, and coupling agent. The application of stains to the ceramic intaglio surface was not detrimental to bond strength to a resin-based luting agent, but depended on the time of hydrofluoric acid-etching (20 s for OP-ti and 60 s for LFG-iv) (p < 0.001). Film-thickness of stains presented mean values <70 μm. The application of opaque stains to the intaglio surface of lithium disilicate glass ceramics was effective to mask severely discolored substrates, presenting adequate bond strength to the luting agent and thin film-thicknesses. For indirect restorations over severely discolored substrates, the application of opaque stain to the intaglio surface of lithium disilicate glass ceramic ensures acceptable color matching, with adequate bond strength to resin-based luting agents and clinically acceptable stain film-thickness.

A novel simplified method for assessing crystal length and crystalline content in dental ceramics.

The purpose of this study was to introduce a novel and simple method of evaluating the crystal length and crystalline content of lithium disilicate dental ceramics using images obtained from scanning electron microscopy (SEM) and analyzed with ImageJ (NIH) processing software. Three evaluators with varying experience levels assessed the average crystal length and percentage of crystalline content in four commercial lithium disilicate reinforced glass ceramic materials: IPS e.max (Ivoclar Vivadent), Rosetta SM (Hass), T-Lithium (Talmax), and IRIS CAD (Tianjin). The specimens, prepared from partially crystallized CAD/CAM blocks (3.0 mm3), were fully crystallized and treated with 5% hydrofluoric acid for 20 s prior to SEM analysis. After acquiring the SEM images, ImageJ software was used to evaluate the average crystal length and crystalline content on the surface of the different ceramics. An inter-operator agreement was observed (ICC/p = 0.724), indicating that assessments by the various operators were similar across all ceramic materials tested (p < 0.001). When crystal length and crystalline content were compared, IRIS CAD exhibited significant differences compared to the other materials (p < 0.001), showing a less dense crystalline matrix based on the average length of crystals and the percentage of crystals per unit area. The use of this software facilitated the evaluation of crystalline content and average crystal lengths in dental ceramics using SEM images, and demonstrated very low variability among different operators. RESEARCH HIGHLIGHTS: The described method, using ImageJ open-source software, provides precise and reliable measurements of crystal length and crystalline content in lithium disilicate ceramics, with high inter-operator agreement. The proposed method identifiedhigher crystalline content in IPS e.max CAD compared to Rosetta SM CAD and T-lithium CAD ceramics, while IRIS CAD exhibited significantly lower crystalline content and larger average crystal length. The novel, simplified method for assessing crystal length and crystalline content presented in this study may also be useful for evaluating other dental ceramics.

Effect of hydrothermal aging on color stability and translucency of two zirconia generations compared to lithium disilicate ceramics.

An esthetically acceptable ceramic restoration should have optical properties like the teeth and reflect, transmit, and absorb light. The present investigation compared how hydrothermal aging affected the properties of two types of zirconia and lithium disilicate. Thirty rectangular samples (12×14×1 mm) were prepared and sectioned from three different ceramic blocks/blanks (n=10), then assigned into three groups according to the ceramic type: group Z: IPS e.max ZirCAD prime, gradient zirconia (3Y/5Y-TZP); group K: Katana UTML (5Y-TZP); and group E: IPS e.max CAD (lithium disilicate). Color analysis of samples was performed before and after hydrothermal aging (1, 3, and 5 hours) using a spectrophotometer. Color difference (∆E00), translucency parameter (TP00), and contrast ratio (CR) were evaluated. The microstructural analysis was performed using x-ray diffraction (XRD). Data were statistically analyzed at a significance level of P<0.05. A statistically significant variation was observed across means of ∆E00, TP00, and CR at different times. Group Z displayed the highest statistically significant mean ∆E00. Group E demonstrated the greatest statistically significant mean TP00. Group K exhibited the most statistically significant mean CR. Hydrothermal aging significantly affected the optical characteristics of lithium disilicate and zirconia ceramics. The translucency of samples increased with aging.

The impact of Streptococcus mutans biofilms on the color stability and topographical features of three lithium disilicate ceramics.

Secondary caries around ceramic restorations is the most common reason for the replacement of fixed dental prostheses (FDPs). Therefore, it is important to examine the susceptibility of different ceramic materials to biofilm formation. This study aimed to evaluate biofilm development and associated roughness and color alterations in three lithium disilicate ceramics: Emax CAD (EC), Emax Press (EP), and LiSi Press (LP). Streptococcus mutans biofilms were grown on the three ceramics (n = 10 per group) for 7 days. Surface roughness values and color alteration were assessed before and after the biofilm using a non-contact profilometer and spectrophotometer, respectively. Biofilm growth was evaluated using colony-forming units (CFUs) and scanning electron microscope (SEM) images. The data were analyzed using one-way ANOVA and Tukey tests. There was a significant (p≤0.001) growth of S. mutans colonies on EC (6.75 ± 0.56) and EP (6.72 ± 0.54) specimens compared to LP, which showed no biofilm growth. The change in average surface roughness (∆Ra, nm) was significantly lower (p < 0.001) in the EC specimens (0.029 ± 0.003) compared to the EP (0.055 ± 0.012) and LP (0.041 ± 0.010). When the changes in the Rv and Rt values were investigated, no significant difference was observed among the groups. Following the biofilm challenge, the change in color (∆E00) was significantly lower (p = 0.005) in the LP group (1.68 ± 1.45) compared to the EC group (3.89 ± 1.50) and no significant difference was observed between the EP group (2.74±1.01) and the other two ceramics (p ≥ 0.05). LP ceramics exhibited superior resistance to S. mutans biofilm formation and associated changes in surface roughness and color compared to the Emax CAD and Emax Press ceramics. These findings suggest that the LiSi Press material may be more favorable to mitigate the risk of secondary caries.

Impact of Er,Cr:YSGG Laser Debonding on the Mechanical Properties of Aged and Non-aged Lithium Disilicate Ceramics

Aim: The aim of this study is to evaluate the effects of Er,Cr:YSGG laser debonding on the mechanical properties of aged and non-aged lithium disilicate ceramics. Material and Methods: A total of 36 lithium disilicate samples with dimensions of 14x4x1 mm were prepared. Half of the samples underwent 5000 thermal cycles to simulate artificial aging. The aged and non-aged samples were divided into two subgroups: one subgroup was designated as the control group and did not receive laser treatment, while the other subgroup was treated with Er,Cr:YSGG laser for debonding (n=9). The flexural strength and modulus of the lithium disilicate samples were assessed using three-point bending tests before and after artificial aging. The surface roughness of a sample that did not undergo the three-point bending test was measured with AFM, its microhardness was assessed using Vickers hardness tests, and surface morphology was examined with FESEM. Two-way ANOVA and Bonferroni correction to determine the significance of the results were used for statistical analysis. Results: The results indicated that aging significantly reduced the flexural strength (p=0.031), however, laser debonding did not have a significant effect on the flexural strength or modulus of either aged or non-aged samples. Conclusion: Laser debonding effectively removes lithium disilicate restorations without compromising their mechanical properties, supporting their reuse in clinical practice. It is important to note that aging reduces the flexural strength of lithium disilicate ceramics.

Long-Term Bonding Performance of One-Bottle vs. Two-Bottle Bonding Agents to Lithium Disilicate Ceramics.

The aim of this study was to compare the long-term bonding performance to lithium disilicate (LDS) ceramic between one-bottle and two-bottle bonding agents. Bonding performance was investigated under these LDS pretreatment conditions: with hydrofluoric acid (HF) only, without HF, with a two-bottle bonding agent (Tokuyama Universal Bond II) only. Shear bond strengths between LDS and nine resin cements (both self-adhesive and conventional adhesive types) were measured at three time periods: after one-day water storage (Base), and after 5000 and 20,000 thermocycles (TC 5k and TC 20k respectively). Difference in degradation between one- and two-bottle bonding agents containing the silane coupling agent was compared by high-performance liquid chromatography. With HF pretreatment, bond strengths were not significantly different among the three time periods for each resin cement. Without HF, ESTECEM II and Super-Bond Universal showed significantly higher values than others at TC 5k and TC 20k when treated with the recommended bonding agents, especially at TC 20k. Difference in degradation between one- and two-bottle bonding agents containing the silane coupling agent was compared by high-performance liquid chromatography (HPLC). For both cements, these values at TC 20k were also not significantly different from pretreatment with only Tokuyama Universal Bond II. For LDS, long-term bond durability could be maintained by pretreatment with Tokuyama Universal Bond II instead of the hazardous HF.

Comparative Invitro Testing of the Tensile Bond Strength Under Artificial Aging Between Different Lithium Disilicate Ceramics to Composite Substrate: A Novel Methodology.

Objective The purpose of this study is to compare the tensile bond strength values to composite substrate pre- and post-aging between IPS E.max CAD and Initial LiSi. Methods The study utilized four blocks of IPS E.max CAD LT/B1 C14 (Ivoclar Vivadent, Liechtenstein, Germany) (referred to as E) and four blocks of Initial LiSi LT/B1 (GC, Tokyo, Japan) (referred to as L). These blocks were milled to produce 76 ceramic bars measuring 2 mm × 2 mm × 10 mm (E = 38, L = 38/n = 19). After acid etching with hydrofluoric acid (BISCO, Schaumburg, IL, USA) and silane application (BIS-SILANE, BISCO), the specimens were embedded in putty (Express STD, 3M, Decatur, AL, USA) to create a mold for the resin cement (RelyX U200, 3M). Subsequently, one group of each brand underwent mechanical tensile testing (E0 and L0), while the other groups were subject to tensile testing after artificial aging involving 500 thermal cycles between 5 and 55°C (E5 and L5). The mean tensile strength for each group (E0, E5, L0, and L5) was determined using the Brown-Forsythe one-way ANOVA and Tamhane's post hoc tests. Results Initial LiSi showed a superior pre-aging mean (11.7 MPa). However, both materials had identical post-aging means (7.6 MPa). There were no statistically significant differences, except between the dependent Initial LiSi groups (L0-L5).Most failure modes were mixed (cohesive cement and adhesive). There were no cohesive failures on the cement side except in three specimens of Initial LiSi post-aging. Conclusion The tested conditions have shown that Initial Lisi exhibited the highest pre-aging mean; however, it exhibited inferior bond stability under aging conditions compared to IPS E.max CAD. Analyzing the microstructure before and after aging may provide insights into the greater decrease in bond strength observed in the Initial LiSi specimens.

ERRATUM (An erratum has been prepared for the following articles in the 33rd volume and 2nd issue of Current Research in Dental Sciences in 2023.)

Erratum An erratum has been prepared for the following articles in the 33rd volume and 2nd issue of Current Research in Dental Sciences in 2023. - In the article titled "Özyurt E, Kurt A. Effect of Different Teas on Surface Roughness of Conventional and Bulk-Fill Composite Resins Beverage Effect on Composite Resins. Curr Res Dent Sci. 2023; 33(2): 84-89", a patient consent draft was added inadvertently, even though there was no participant. - In the article titled "Keleş ZH, Ozan G. Effect of preheating on the microhard- ness and depth of cure of two composite resins with and without BIS-GMA. Curr Res Dent Sci. 2023; 33(2): 79-83", a patient consent draft was added inadvertently, even though there was no participant. - In the article titled “Yamalı AY, Turhan Bal B. Properties and clinical applications of lithium disilicate ceramics. Curr Res Dent Sci. 2023; 33(2): 122-130” although the article titled is a compilation, a patient consent draft was mistakenly included. - In the article titled "Eriş Derkuş F, Yılmaz UN. Demographic Analysis, Diagnosis, and Treatment Methods of Maxillofacial Trauma Cases in the Southeastern Anatolia Region of Turkey: Retrospective and Comparative Analysis. Curr Res Dent Sci. 2023; 33(2): 103-107", it was forgotten to write Dicle University in the sections left as XXX in the Methods section for the sake of article blindness. - Since the study titled “Yıldızer Keriş E. Comparison of Articular Eminence Steepness in Patients With Temporomandibular Joint Disc Disorders. Curr Res Dent Sci. 2023; 33(2): 117-121” was retrospective, patient consent could not be obtained and this information was forgotten to be added. - In the article titled “Şener E, Baksı Şen G. 3D Modelling and virtual planning technologies in dentistry. Curr Res Dent Sci. 2023; 33(2): 131-134” although the article titled is a compilation, a patient consent draft was mistakenly included.

A Surface Topographical Analysis of Lithium Disilicate Ceramics Pretreated With Rose Bengal, Er:YAG Laser, and Ceramic Primer on Bond Integrity, Surface Roughness, and Bond Failure to Composite Resin

To evaluate adhesive bond integrity and surface roughness (Ra) of LDS ceramics following various surface modification treatments. Forty LDS ceramic disks were manufactured and allocated into distinct groups according to the pretreatment procedure. Group 1 samples were treated with HF (hydrofluoric acid) and S (silane). Group 2 uses RBe (Rose Bengal photosensitizer) S. Group 3 utilizes SECP (self-etch ceramic primer), while Group 4 employs Er:YAG laser. The Ra, shear bond strength (SBS), and surface topography of the conditioned LDS ceramic were evaluated. The bonding of all LDS ceramics was assessed with a universal testing machine. Debonded samples were analyzed using a stereomicroscope. The Ra and bond integrity values were assessed through the utilization of a two-way ANOVA, followed by Tukey post hoc testing. The samples prepared with HF+S displayed the highest Ra and bond values. However, group 2 (RBe+S) exhibited the least bond strength. There were no notable disparities in the results regarding the strength of the bonds among group 1, group 3 (SECP), and group 4 (Er:YAG laser+S). Er:YAG and SECP show promise as potential substitutes for hydrofluoric acid (HFA) in conditioning LDS ceramics, yielding satisfactory bond scores by positively altering the surface morphology.

The effect of photoinitiator type and filler load on physicochemical and mechanical properties of experimental light-cured resin cements through lithium disilicate ceramics of different shades and thicknesses

ObjectiveThis study investigated the influence of photoinitiator types on degree of conversion (DC), rate of polymerization (RP), flexural strength (FS), flexural modulus (FM), and light transmittance (LT) of filled and unfilled light-curable resin cements through different thicknesses and shades of lithium disilicate ceramics. MethodsLithium disilicate ceramic discs (IPS Emax Press, background [0.0], 0.5, 1.0, 2.0, 3.0, and 4.0 mm, shades A1 and BL3) were prepared. Experimental resin-based cements [TEGDMA/BisGMA (50/50 mass%)] were prepared using either camphorquinone (CQ)/amine (0.44/1.85 mol%) or TPO (0.44 mol%)], and a micro and nanofiller loads of nil (unfilled); 40/10 mass%; and 50/10 mass%). Resin cements (0.2 mm thick) were placed on the lower surface of the ceramic specimens and light-activated for 30 s from the upper surface using a Bluephase Style curing light (exitance at tip: 1236 mW/cm2 ± 1.20). LT and distribution of irradiance through the ceramics were measured using a UV–vis spectrometer and a beam profile camera, respectively (n = 3). The DC and RP were measured in real-time using mid infrared spectroscopy in attenuated total reflectance (ATR) mode (n = 3). FS and FM were measured using a universal testing machine (n = 5). Statistical analyses were performed on LT, DC, RP, FS, and FM data using a general linear model, and supplementary ANOVA and post hoc Tukey multiple comparison test were also performed (α = .05). ResultsThicknesses, shades, photoinitiator type, and fillers load significantly influenced the optical and mechanical characteristics of the resin-based materials (p < 0.05). The BL3 shade ceramic provided higher values of DC, RP, FS, FM, and LT compared with the A1 shade (p < 0.05). Increasing ceramic thickness decreased the properties of the resin-based materials (p < 0.05). Generally, TPO improved mechanical properties of the resin cement compared with CQ (p < 0.05). SignificanceThe luting process of indirect restorations may be improved by using high molar absorptivity, more reactive, and more efficient photoinitiators such as TPO, as opposed to conventional CQ. The use of such initiator may allow the placement of thicker and more opaque indirect restorations.

Evaluation of Shear Bond Strength of CAD/CAM Ultra-translucent Zirconia and Lithium Disilicate Ceramics Bonded to Enamel: An In Vitro Study

Evaluation of Shear Bond Strength of CAD/CAM Ultra-translucent Zirconia and Lithium Disilicate Ceramics Bonded to Enamel: An In Vitro Study

Effect of Er:YAG laser on debonding zirconia and lithium disilicate crowns bonded with 2- and 1-bottle adhesive resin cements.

Erbium-doped yttrium-aluminum-garnet (Er:YAG) laser debonding of zirconia and lithium disilicate restorations is increasingly used for a range of clinical applications. Using rotary instruments to remove such restorations for any purpose has proven to be challenging. Erbium laser has been reported to be a conservative method for removing ceramic restorations. There is little data in the literature about the effect of adhesive resin cement type on the debonding time of the ceramic restoration using the Er:YAG laser. To evaluate and compare the time required for the Er:YAG laser to debond zirconia and lithium disilicate crowns bonded with a 2- and 1-bottle adhesive resin cement systems. Forty extracted premolar teeth were prepared and scanned for milled 40 CAD/CAM crowns. Teeth were randomly assigned into groups (n = 10 per group): 3 mol% yttria-partially stabilized zirconia crowns 3Y-PSZ (G1a) bonded with Panavia™ V5 (2-bottle adhesive resin cement), Zirconia 3Y-PSZ crowns (G1b) bonded with RelyX™ Ultimate (1-bottle adhesive resin cement), and for the lithium disilicate crowns bonded with the two types of cements (G2a, G2b). Each specimen was irradiated with an Er:YAG laser at 335 mJ, 15 Hz, 5.0 W, and 50-ms pulse duration (super short pulse mode). The irradiation time required for crowns to be successfully debonded was recorded for each specimen. Data were statistically analyzed using ANOVA and Tukey HSD post-hoc test (p < 0.05), at the 95 percent level of confidence. The intaglio surface of the debonded crown was analyzed using scanning electron microscopy (SEM). The mean ± standard deviation times needed for crown debonding were 5.75 ± 2.00 min for the G1a group, 4.79 ± 1.20 min for group G1b, 1.69 ± 0.49 min for group G2a, and 1.12 ± 0.17 for group G2b. There was no statistically significant difference in debonding time between the 2- and 1- bottle adhesive resin cement within the groups G1a and b (p = 0.2914), or between groups G2a b (p = 0.7116). A statistically significant difference (p < 0.05) was found between groups G1a and G2a and b and between groups G1b and G2a and b were SEM analysis showed no changes in the microstructure of the ceramic surface after Er:YAG laser irradiation. Zirconia and lithium disilicate restorations can be debonded using Er:YAG lasers in a safe and efficient manner. There is no significant difference in the debonding time between the 2- and 1- bottle adhesive resin cement systems used in this study. Retrieving zirconia and lithium disilicate ceramics can be a challenging process when using diamond rotary instruments. ER:YAG lasers may efficiently debond these ceramics from the tooth structure, independent of the bonding process used for bonding them.

Effect of Artificial Aging on Translucency of Zirconia Reinforced Lithium Silicate and Lithium Disilicate Ceramics: A Systematic Review.

Digital dentistry and advanced ceramic materials have been widely used but which material has a better esthetically durable outcome needs to be evaluated. The purpose of this systematic review and meta-analysis was to evaluate the difference in the translucency of CAD zirconia-reinforced lithium silicate and CAD lithium disilicate glass ceramics after being subjected to artificial aging. Two independent reviewers searched the MEDLINE/ PubMed, Embase, and EBSCO databases and the Google Scholar search engine for in-vitro studies published from January 2010 to May 2023 to identify relevant studies measuring the translucency of CAD ZLS and CAD lithium disilicate glass ceramics after being subjected to different artificial aging conditions using the coffee solution, 4% acetic acid, distilled water and UV aging. For qualitative synthesis, 10 studies were included. A statistically significant difference was observed between CAD zirconia-reinforced lithium silicate and CAD lithium disilicate glass ceramics (P⟨0.05, mean difference=-0.25 [-0.38,-0.11]). Translucency of CAD ZLS was less than CAD lithium disilicate glass ceramics. Artificial aging has decreased the translucency of glass ceramics. For fixed prosthetic rehabilitation clinicians can opt for CAD lithium disilicate glass-ceramic as a more esthetically pleasing and durable material in oral environment.

Fracture load of chairside CAD-CAM veneers fabricated with pre-and fully crystalized lithium disilicate ceramics.

To evaluate the fracture load of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) veneers fabricated with two conventional pre-crystallized and two fully crystallized lithium disilicate ceramic materials. Seventy-five chairside CAD-CAM veneers (15 specimens/group) for maxillary right central incisors were fabricated with different lithium disilicate brands: (1) IPS e.max CAD; (2) Amber Mill; (3) Cerec Tessera; (4) n!ce Straumann; and (5) GC Initial LiSi Block. Restorations were cemented with resin luting cement (Variolink Esthetic, Ivoclar) to 3D-printed resin dies. Bonded restorations received 5000 thermal cycles and then were loaded until fracture. Statistical analysis included One-Way ANOVA. Conventional pre-crystallized e.max CAD displayed the highest fracture load value (640 N), followed by fully-crystallized n!ce Straumann (547 N), pre-crystallized Cerec Tessera (503 N), pre-crystallized Amber Mill (476 N), respectively; fully-crystallized GC Initial LiSi Block (431 N) displayed the lowest values. When comparing the fracture load of recent lithium disilicate ceramic material to the e.max group, which acted as the control, significant differences were noted. The LiSi Block GC group, in particular, had considerably higher mean difference values (208.867, p < 0.001, 95% CI [89.63, 328.10]), as did the Amber Mill group (164.200, p = 0.002, 95% CI [44.96, 283.44]) and CEREC Tessera group (137.533, p = 0.016, 95% CI [18.30, 256.77]). The e.max and n!ce Straumann groups had no statistically significant differences in mean scores (92.933, p = 0.198, 95% CI [-26.30, 212.17]). These findings imply that the clinical performance of recent lithium disilicate veneers varies when compared to the e.max CAD group. The fracture load of chairside CAD-CAM lithium disilicate veneers for maxillary central incisors varies according to the type of ceramic brands. Conventional pre-crystallized e.max CAD displayed higher fracture load than the recent pre- and fully-crystallized lithium disilicate materials, emphasizing the significance of choosing the right product based on the desired clinical outcome.

Effect of surface treatment and resin cement type on the bond strength of polyetheretherketone to lithium disilicate ceramic

BackgroundThis study aims to evaluate the effect of surface treatment and resin cement on the shear bond strength (SBS) and mode of failure of polyetheretherketone (PEEK) to lithium disilicate ceramic (LDC). This is suggested to study alternative veneering of PEEK frameworks with a ceramic material.Methodseighty discs were prepared from PEEK blank and from lithium disilicate ceramic. Samples were divided into four groups according to surface treatment: Group (A) air abraded with 110 μm Al2O3, Group (AP) air abrasion and primer application, Group (S) 98% sulfuric acid etching for 60 s, Group (SP) Sulfuric acid and primer. Each group was subdivided into two subgroups based on resin cement type used for bonding LDC:1) subgroup (L) self- adhesive resin cement and 2) subgroup (B) conventional resin cement (n = 10). Thermocycling was done for all samples. The bond strength was assessed using the shear bond strength test (SBS). Failure mode analysis was done at 50X magnification with a stereomicroscope. Samples were chosen from each group for scanning electron microscope (SEM). The three-way nested ANOVA followed by Tukey’s post hoc test were used for statistical analysis of results. Comparisons of effects were done utilizing one way ANOVA and (p < 0.05).ResultsThe highest mean of shear bond strength values was demonstrated in Group of air abrasion with primer application using conventional resin cement (APB) (12.21 ± 2.14 MPa). Sulfuric acid groups showed lower shear bond strength values and the majority failed in thermocycling especially when no primer was applied. The failure mode analysis showed that the predominant failure type was adhesive failure between cement and PEEK, while the remaining was mixed failure between cement and PEEK.ConclusionThe air abrasion followed by primer application and conventional resin cement used for bonding Lithium Disilicate to PEEK achieved the best bond strength. Primer application did not have an effect when self-adhesive resin cement was used in air-abraded groups. Priming step is mandatory whenever sulfuric acid etching surface treatment is utilized for PEEK.

Lithium Silicate-Based Glass Ceramics in Dentistry: A Narrative Review

Considering the rapid evolution of lithium silicate-based glass ceramics (LSCs) in dentistry, this review paper aims to present an updated overview of the recently introduced commercial novel LSCs. The clinical and in vitro English-language literature relating to the microstructure, manufacturing, strengthening, properties, surface treatments and clinical performance of LSC materials was obtained through an electronic search. Findings from relevant articles were extracted and summarised for this manuscript. There is considerable evidence supporting the mechanical and aesthetic competency of LSC variants, namely zirconia-reinforced lithium silicates and lithium–aluminium disilicates. Nonetheless, the literature assessing the biocompatibility and cytotoxicity of novel LSCs is scarce. An exploration of the chemical, mechanical and chemo-mechanical intaglio surface treatments—alternative to hydrofluoric acid etching—revealed promising adhesion performance for acid neutralisation and plasma treatment. The subtractive manufacturing methods of partially crystallised and fully crystallised LSC blocks and the additive manufacturing modalities pertaining to the fabrication of LSC dental restorations are addressed, wherein that challenges that could be encountered upon implementing novel additive manufacturing approaches using LSC print materials are highlighted. Furthermore, the short-term clinical performance of zirconia-reinforced lithium silicates and lithium–aluminium disilicates is demonstrated to be comparable to that of lithium disilicate ceramics and reveals promising potential for their long-term clinical performance.