Lithium Disilicate Glass-ceramics Research Articles

Intervertebral osteointegration and biomechanical performance of bioactive lithium disilicate glass-ceramic scaffold fabricated by digital light processing

The high strength of lithium disilicate (LD) glass-ceramic makes it difficult to form complex orthopaedic scaffolds using traditional methods. In addition, the osteointegration behavior of LD has also not been well studied in vivo. This study aimed to investigate the procedure of digital light processing (DLP) for fabricating porous LD glass-ceramic scaffolds and to assess the intervertebral osteointegration and biomechanical performance of the scaffolds. The phase formation, fracture morphology, flexural strength and density of LD glass-ceramics fabricated by DLP were evaluated to optimize the manufacturing process. Cell proliferation, cell differentiation and mineralization on the optimized glass-ceramics were recorded for comparison with traditional cast glass-ceramics (CG). The porous LD glass-ceramics scaffold was implanted into rabbits for 7 w and 14 w and then assessed using micro-CT and histological staining. Compression testing was also used to understand the scaffold’s mechanical properties. Furthermore, the scaffold was inserted into a validated finite element model of a human lumbar spine to study the stress distribution during physiological motions. The results indicated that LD glass-ceramics with step-by-step crystallization formed principal phases of Li2Si2O5 and Li3PO4, which had the highest flexural strength. Cell proliferation, cell differentiation and mineralization on the glass-ceramics formed by DLP were similar to the results of glass-ceramics formed by casting. The porous LD glass-ceramic scaffold promoted osseointegration in rabbits and was capable of withstanding physiological loads that would be experienced in a human lumbar spine. In conclusion, the bioactive LD glass-ceramic developed in this study showed good osteogenesis with sufficient mechanical performance, potentially making it suitable for applications in intervertebral fusion.

Impact of repeated heat-pressing on the microstructure and flexural strength of lithium disilicate glass-ceramics

BackgroundThe leftover material from the heat-pressing of IPS e.max Press ceramic is often discarded, despite some laboratories exploring its potential for reuse. However, there is a lack of data on the performance of IPS e.max Press ceramic when combined with the button portions. This study investigated the impact of repeated heat-pressing on the crystal structure and flexural strength of lithium disilicate glass-ceramic (LDGC).MethodsSpecimens (N = 30, n = 10 per group) were categorized based on the number of heat-pressing cycles: G0 (control group, no heat-pressing), G1 (one cycle of heat-pressing), and G2 (two cycles of heat-pressing). The crystal structure of LDGC bars was characterized using X-ray diffraction (XRD). Flexural strength was tested, and microstructures were analyzed via scanning electron microscopy (SEM) and the ImageJ processing program. Data were analyzed using one-way analysis of variance (ANOVA), and multiple pairwise comparisons of means were performed with Tukey’s post-hoc test.ResultsG2 exhibited significantly lower flexural strength and crystallinity, as well as larger crystal size, compared to G1 and G0 (p < 0.05). Flexural strength values decreased significantly with an increased number of heat-pressing cycles.ConclusionsThe mechanical properties of LDGC significantly degraded after repeated heat pressing. Therefore, it is not clinically advisable to repeatedly press the lithium disilicate ingot together with the leftover material.

Optical properties of advanced lithium disilicate.

A variety of firing protocols are available for the IPS e.max lithium disilicate (LD) and can be used for new, 'advanced' LD (ALD). However, the impact of firing protocols on the optical properties of ALD is still unknown. The aim of the present study was to evaluate the color difference (ΔE00), the translucency parameter (TP00) and the whiteness index for dentistry (WID) for both LD glass ceramics after the processes of firing/glazing. Fifty disk-shaped specimens, with a diameter of 10 mm and a thickness of 1.2 mm, were fabricated from IPS e.max CAD (LD; Ivoclar) and another 50 from CEREC Tessera™ (ALD; Dentsply Sirona). The specimens from each group were further divided into 5 subgroups (n = 10) according to the firing/glazing protocol applied: crystallization (c); one-step crystallization and glazing (cg); crystallization and refiring (c-r); two-step crystallization and glazing (c-g); or long-firing crystallization (lfc). The ΔE00, TP00 and WID were assessed. The statistical analysis of ΔE00 was performed using the one-way analysis of variance (ANOVA) and Tukey's post hoc test, while TP00 and WID were analyzed with the two-way ANOVA and Tukey's post hoc test at a statistical significance level of 0.05. The cg groups were designated as the reference. The ANOVA showed that the firing procedures had no effect on ΔE00, TP00 and WID in the case of LD. In addition, LD exhibited greater translucency and brightness as compared to ALD. For ALD, all color changes observed in relation to the reference firing protocol were clinically unacceptable. The ALD specimens which underwent 1 standard firing cycle showed higher TP00 and WID values than other ALD groups. The choice of the firing protocol has no impact on the color, TP00 or WID of LD. Additionally, LD presents higher WID values than ALD, irrespective of the firing protocol used. Alternative firing protocols result in clinically unacceptable color variations when compared to the manufacturer-recommended protocol for ALD. Advanced LD is more sensitive to different firing protocols with regard to its optical properties, which makes the workflow less predictable in comparison with LD.

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.

Vertical marginal gap and internal fit of virgilite-based lithium disilicate glass ceramic veneers with different preparation designs.

To evaluate and compare internal fit and marginal adaptation of conventional lithium disilicate (LDS) glass ceramics and LDS containing virgilite computer-aided design and manufacturing (CAD-CAM) blocks before and after aging. Seventy-two epoxy replicated dies from two prepared maxillary right central incisors acrylic typodont were divided into two groups of different preparation designs (n = 36): Group I, incisal butt-joint, and Group P, incisal overlap. Each group was further subdivided into two equal groups according to ceramic material (n = 18): Group E, IPS e.max CAD, and Group T, Tessera advanced lithium disilicate (ALD) CAD-CAM blocks. The replica technique was used to assess the internal fit using a stereomicroscope at 45× magnification. Laminate veneers were cemented to their corresponding epoxy dies, then the vertical marginal gap was evaluated before and after thermal cycling. Repeated measures analysis of variance (ANOVA) were used for marginal fit data and 2-way ANOVA for internal fit measurements (α = 0.05). For internal fit, there were no significant differences between tested groups. For vertical marginal gap results, two-way ANOVA showed that only aging had a significant effect on the vertical marginal gap (p<0.001), while different CAD-CAM materials and preparation designs did not affect the vertical marginal gap. The vertical marginal gap and internal fits of IPS e.max CAD and CEREC Tessera CAD for both preparation designs were comparable. Aging significantly affected the vertical marginal gap of the laminate veneers of both materials and both preparation designs; however, all were within clinically acceptable ranges before and after aging.

Mechanical behavior and biological activity performance of Li+/Ca2+@Li+/K+ ion-exchanged lithium disilicate glass-ceramics

Lithium disilicate (LD) glass-ceramics used for bone repair need to have good mechanical properties and biological activity. Ion-exchange can lead a significant surficial strengthening and bioactivity of LD glass-ceramics. In this work, LD glass-ceramics were Li+/Ca2+@Li+/K+ exchanged in a mixed salt bath of 30 % Ca(NO3)2 + 70 % KNO3 (in mol %) at 400 °C for 16 h, 32 h and 64 h respectively. LD glass-ceramics were significantly strengthened after Li+/Ca2+@Li+/K+ exchange. However, due to the shallow depth of the ion-exchange layer and stress relaxation, the strengthening effect deteriorated with the prolongation of the ion-exchange time. The Li+/Ca2+@Li+/K+ exchanged LD glass-ceramics could be conducive to the formation of the hydroxyapatite (HA) after soaking in the simulated body fluid (SBF). Moreover, the protein adsorption, cytotoxicity, cell adhesion, osteoblast proliferation and alkaline phosphatase (ALP) activity expression of Li+/Ca2+@Li+/K+ exchanged LD glass-ceramics were investigated. Ca2+ release might promote the bioactivity of ion-exchanged LD glass-ceramics. Therefore, Li+/Ca2+@Li+/K+ exchange can improve the mechanical properties and bioactivity of LD glass-ceramics, which has important significance for its application in orthopedic reconstruction.

Long-Term Bonding Efficacy of CAD/CAM Hybrid Restorative Materials and Universal Adhesives.

In-office and lab milled prostheses are the staple for indirect restorations. It is therefore critical to determine their long-term bonding durability. CAD/ CAM blocks of two classes of restorative materials: 1) a nano-ceramic reinforced polymer matrix (NCPM) and, 2) a polymer-infiltrated ceramic network (PICN) were bonded using four different universal adhesives (UA) and silane systems. A lithium disilicate glassceramic (LDS) was used as a reference. The blocks were bisected and bonded with different UA/resin-cement pairs. Bonded blocks were then cut into 1.0x1.0x12.0 mm bar specimens for microtensile bond testing. Half the bars were subjected to bond strength testing immediately and the other half after aging by 50,000 thermal cycles between 5°C and 55°C. ANOVA and post-hoc tests were used to compare mean bond strength among groups. NCPM presented consistently high bond strength regardless of bonding techniques, while the bond strength of PICN and LDS were lower when bonded with UA relative to traditional silanes. The more hydrophilic UA produced higher bond strengths. Glass-ceramics exhibited lower bond strength with UA than the conventional etch-rinse-silane techniques. However, UAs preserved bonding interface in the long-term. NCPM displayed superior bond strength relative to PICN and LDS regardless of the type of adhesives and bonding techniques.

Optimal Hydrofluoric Acid Etching Duration and Impact of Silane/Adhesive on Profilometric Properties and Bonding to Lithium Disilicate Glass Ceramics.

This study aimed to assess the surface roughness, surface free energy (SFE), and shear bond strength (SBS) on a lithium disilicate glass-ceramic surface following varying etching protocols (time variation) and application of silane either with or without adhesive material. Lithium disilicate glassceramic (LDGC) computer-aided design and computer-aided manufacture (CAD/CAM) blocks were cut using a slow-speed cutting mechanism. CAD/CAM blocks were then evaluated for surface roughness, 6 groups (n=20); SFE,12 groups (n=5); and SBS, 10 groups (n=10). The cut CAD/CAM blocks were randomly allocated to 28 groups. Groups were based on the following: 30 or 90 seconds of etching with 9% hydrofluoric acid (HF); application or absence of silane coupling agent (Sil); and application or absence of adhesive (Adh).The control group (Cont) had untreated surfaces. Unetched surfaces were surveyed with only silane (Sil), only adhesive (Adh), or silane+adhesive (SilAdh). Further etched groups were HF30 with HF for 30 seconds, HF30-Sil, HF30-Adh, and HF30-SilAdh. Alternative 90-second etching times produced similar groups: HF90, HF90-Sil, HF90-Adh, and HF90-SilAdh. A digital profilometer was used to assess the surface roughness of specimens, and two readings were recorded. Sessile drop analysis was used to examine SFE specimens, and the OWRK model was modified to measure liquid surface tension. A universal testing machine (UltraTester, Ultradent Products, Inc, South Jordan, UT, USA) was utilized for the SBS test, with the crosshead speed set at 0.5 mm/min until failure. Representative treated specimens from each group were submitted to surface morphological evaluation and chemical analysis using scanning electron microscopy/energy dispersive x-ray spectroscopy (SEM/EDXS) (n=3). After data collection, evaluation using one- or two-way analysis of variance and the post-hoc Tukey test (α=5%) was conducted. A longer etching time of 90 seconds produced a rougher surface. After the 90-second etching process, SFE displayed the greatest values; nevertheless, the use of silane did not affect SFE. For every group examined, the application of silane followed by adhesive resulted in an increase in SBS and more stable bonding over time. SEM/EDXS showed that etching times did affect the amount of cerium on the surface and altered surface morphology. Higher and more consistent bond strengths have been observed with longer etching periods. Silane and adhesive application on the ceramic surface showed stronger and enhanced bond strength, specifically when longer etching times were employed.

Comparison of Mechanical Properties Between Zirconia-reinforced Lithium Silicate Glass-ceramic and Lithium Disilicate Glass-ceramic: A Literature Review

Lithium disilicate glass-ceramic (LDS) is increasingly being adopted for use in therapeutic restorative procedures. Concurrently, zirconia-reinforced silicate glassceramics (ZRS) are becoming broadly utilized in dental applications. The purpose of this study was to evaluate and compare the mechanical properties of zirconia-reinforced lithium silicate glass-ceramics and lithium disilicate-based glass-ceramics, with a focus on their application in CAD/CAM technologies. In this review, the researchers conducted a search of the PubMed (MEDLINE) database to identify studies related to LDS and ZRS. This search was limited to articles published in English over a seven-year period, from January 1, 2015, to December 31, 2022. Additional studies were sourced from Google Scholar and through manual exploration. Key published works were identified and included in the literature review. The findings concluded that ZRS exhibits superior mechanical properties, including higher flexural strength, fracture toughness, and hardness, compared to LDS. Furthermore, ZRS combines desirable esthetic qualities with robust mechanical strength, rendering it an excellent material for single tooth aesthetic restorations such as inlays, onlays, crowns, and veneers, applicable to both tooth and implant supports. Currently, there is a notable scarcity of data concerning the mechanical properties and clinical efficacy of ZRS. Therefore, it is imperative to conduct long-term clinical studies to verify the optical and mechanical properties, clinical applications, limitations, and long-term effectiveness of ZRS.

Performance of Bonded Lithium Disilicate Partial-coverage Crowns in the Restoration of Endodontically Treated Posterior Teeth: An Up to Seven-Year Retrospective Study.

To evaluate the clinical performance of adhesively bonded lithium disilicate glass-ceramic (LDG) partial-coverage crowns in restoring posterior endodontically treated teeth (ETT). A total of 121 morphologically compromised posterior ETT were restored with LDG partial-coverage crowns between October 2015 and January 2018. The restorations were fabricated in the laboratory or at the chairside. Two adhesive systems and resin cements were used to cement the restorations. Tooth and restoration survival rates were calculated. The restorations were evaluated clinically using the modified United States Public Health Service (USPHS) criteria for an observation period of 5-7 years. The Cox proportional hazards model was used to estimate relative failure risks such as tooth type, resin cements, gender, and sleep bruxism. The standard chi-squared test was used to compare the survival of different tooth types for significant differences (α=0.05). In addition, survival probability was calculated using the Kaplan-Meier algorithm. Among seven failed cases, one was a tooth fracture, and six were restoration fractures. According to the Kaplan-Meier analysis, the estimated survival rate of the teeth was 99% for seven years, while the estimated survival rate of the restorations was 94.8% for 5 years and 92.8% for 7 years. Tooth type and resin cements did not influence restoration survival rates (p>0.05), while sleep bruxism and male patients might increase the risk of failure (p<0.05). The indirect adhesively bonded LDG partial-coverage crowns of posterior ETT exhibited favorable clinical outcomes. Ceramic fracture was the most common failure pattern.

Impact of common social habits on optical properties of lithium disilicate glass ceramic crowns: An in vitro study

Statement of the problemPatient stratifications considered the stability of color and treatment longevity are key success of restoration. Daily consumption of colored beverages, such as coffee, tea, and soft drinks, as well as the use of globally consumed materials, such as smokeless tobacco (ST), snuff, Khat, and Yerba mate, can change the color of restorative materials, such as lithium disilicate glass ceramics (LDGC). These changes can ultimately lead to treatment failure. PurposeThis in vitro study aimed to evaluate color changes, translucency, and opalescence of full anatomical LDGC crowns exposed to commonly used and potentially colorant solutions. Materials and methodsNinety LDGC specimens/crowns were prepared and divided into nine groups according to immersion solution (control, Saudi Coffee, Cola, Khat, Yerba mate, Nescafe, ST Snuff, and Mixed Fruit Juice). The specimens were immersed in colorant solutions for 15 days with alternating twice daily at 37 °C. Color parameters were measured with a spectrophotometer and calculated using two backgrounds (black and white). Data were subjected to ANOVA followed by the Student t-test and Bonferroni test at a significant difference level (α = 0.05). ResultsThe greatest color change (ΔE*) among groups after immersion was observed in Yerba mate (7.6 ± 1.6). The mean difference of before and after staining within Yerba mate group was 3.14 ± 1.6 (p = 0.001). Translucency mean values of groups after immersion into staining media were ranging between 7.6 ± 1.2 and 9.1 ± 2, showing a slight decrease compared with pre-staining values but was not significantly different. Immersion in Mixed Fruit Juice significantly reduced opalescence (7.4 ± 1.9) compared to (8.8 ± 1.7) before staining. ConclusionThe findings confirm that appropriate user guidance helps to preserve both translucency and opalescence as well as prevent color changes. This can improve patient compliance and promote treatment longevity.

Effect of multiple firings on optical and mechanical properties of Virgilite-containing lithium disilicate glass-ceramic of varying thickness

ObjectivesTo investigate the effect of multiple firings on color, translucency, and biaxial flexure strength of Virgilite-containing (Li0.5Al0.5Si2.5O6) lithium disilicate glass ceramics of varying thickness.Materials and methodsSixty discs were prepared from Virgilite-containing lithium disilicate blocks. Discs were divided according to thickness (n = 30) into T0.5 (0.5 mm) and T1.0 (1.0 mm). Each thickness was divided according to the number of firing cycles (n = 10); F1 (Control group): 1 firing cycle; F3: 3 firing cycles, and F5: 5 firing cycles. The discs were tested for color change (ΔE00) and translucency (TP00) using a spectrophotometer. Then, all samples were subjected to biaxial flexure strength testing using a universal testing machine. Data were collected and statistically analyzed (α = 0.5). For chemical analysis, six additional T0.5 discs (2 for each firing cycle) were prepared; for each firing cycle one disc was subjected to X-ray diffraction analysis (XRD) and another disc was subjected to Energy dispersive X-ray spectroscopy (EDX) and Scanning electron microscope (SEM).ResultsRepeated firing significantly reduced the translucency of F3 and F5 compared to F1 in T0.5 (p < 0.001), while for T1.0 only F5 showed a significant decrease in TP00 (p < 0.001). For ΔE00, a significant increase was recorded with repeated firings (p < 0.05) while a significant decrease resulted in the biaxial flexure strength regardless of thickness.ConclusionsRepeated firings had a negative effect on both the optical and mechanical properties of the Virgilite-containing lithium disilicate glass ceramics.Clinical relevanceRepeated firings should be avoided with Virgilite-containing lithium disilicate ceramics to decrease fracture liability and preserve restoration esthetics.

Quantitative examination of factors influencing the colour reproduction ability of lithium disilicate glass-ceramics

BackgroundEffects of ceramic translucency, layer thickness, and substrate colour on the shade of lithium disilicate glass-ceramic restorations proved to be significant in several studies, however, quantitative, numerical results on the relationship between the colour difference and these parameters are still lacking. The purpose of this in vitro study was to quantitatively determine how the colour reproduction ability of a lithium disilicate glass-ceramic is affected by its translucency, layer thickness, and substrate colour.MethodsCeramic samples were prepared from A2 shade IPS e.max CAD blocks with high and low translucencies (HT and LT) in a thickness range of 0.5–2.5 mm (+/- 0.05 mm). Layered samples were acquired utilizing composite substrates in 9 shades; transparent try-in paste was used. The spectral reflectance of the specimens was assessed under D65 standard illumination with a Konica Minolta CM-3720d spectrophotometer. The CIEDE2000 colour difference (ΔE00) between two samples was analysed using perceptibility and acceptability thresholds set at 50:50%. Statistical analysis involved linear regression analysis and the Kruskal–Wallis test.ResultsAn increase in the thickness of 0.5 mm reduced the ΔE00 of the HT samples to 72.8%, and that of the T samples to 71.1% (p < 0.0001). 7 substrates with HT and LT specimens had significantly different results from the mean (p < 0.05). A thickness of 0.5 mm is not sufficient to achieve an acceptable result at any level of translucency, while the low translucency ceramic at a thickness of 1.5 mm gave acceptable results, except for severely discoloured substrates (ND8 and ND9).ConclusionsThe colour reproduction ability of lithium disilicate glass-ceramics is significantly affected by their translucency, layer thickness, and 7 substrates out of 9 substrates examined.

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.

Effects of dental tissue substructure and size on fracture strengths of lithium disilicate and zirconia ceramics

We aimed to assess the effects of standard resin preparation models with five different thicknesses of occlusal surface on the fracture strengths of zirconia (ZrO2) and lithium disilicate glass ceramics. The specimens of 10 first maxillary molars collected between January 2019 and January 2020 were selected. Standard mathematical models were formed after scanning the resin matrices using software. The full crowns with five different thicknesses of occlusal surface were established, among which the molar specimens prepared by ZrO2 glass ceramic composites alone were assigned into ZrO2 group (n=5, 40 specimens) while those prepared using ZrO2-lithium disilicate glass ceramic composites were allocated into ZTCLDC group (n=5, 40 specimens). When the thickness of glass-ceramic full crowns was 0.5, 0.8, 1.0, 1.2 and 1.5 mm, the fracture load of the specimens in ZTCLDC group was not significantly different from that in ZrO2 group, and there was no significant difference in the three-point flexural strength between ZTCLDC group and ZrO2 group (P&gt;0.05). The fracture toughness was not significantly different between the two groups in the case of the thickness of glass-ceramic full crown at 0.5, 0.8, 1.0, 1.2 and 1.5 mm (P&gt;0.05). The thickness was positively correlated with fracture load, three-point flexural strength and fracture toughness (P&lt;0.05). The fracture strength of lithium disilicate and ZrO2 ceramics is directly proportional to the thickness of ZrO2 and ZTCLDC crowns.

Engineering antibacterial tannic acid/polyethyleneimine coatings on lithium disilicate glass-ceramics for dental applications

This study introduces an innovative approach to enhance the antibacterial properties of lithium disilicate glass ceramics, widely used in dental restorations. We explored the efficacy of tannic acid (TA) and polyethyleneimine (PEI) as coating agents, capitalizing on a robust defense against microbial colonization and biofilm formation. We employed various analytical techniques, including differential thermal analysis (DTA), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM), to characterize the physical, chemical, and antibacterial properties of the TA/PEI coated glass-ceramics. Results indicated a notable improvement in the mechanical properties, such as Weibull modulus, elastic modulus, and fracture toughness of the coated samples. Moreover, the TA/PEI coatings displayed superior thermal stability and effective leaching behavior in different pH, pertinent to dental applications. Significantly, the TA/PEI coatings exhibited high antibacterial activity against Gram-negative (E. coli) and Gram-positive (S. aureus) bacteria, making them promising candidates for enhancing the bioactivity of dental restorative materials. This study lays the foundation for developing advanced antibacterial coatings for dental applications, aiming to improve patient outcomes in dental care.

Fracture resistance of CAD/CAM endocrowns made from different materials in maxillary premolar interproximal defects.

This in vitro study aims to compare the fracture resistance of three CAD/CAM materials used in endocrown restoration of interproximal defects in maxillary premolars. 45 maxillary premolars extracted as part of orthodontic treatment were included. Following standardized root canal treatment, all teeth were prepared into Mesial-Occlusal (MO) cavity types. The samples were then randomly divided into three groups: LD [repaired with lithium disilicate glass ceramics (IPS e.max CAD)], VE [treated with polymer-infiltrated ceramics (Vita Enamic)], and LU [repaired with resin-based nanoceramics (Lava Ultimate)]. Axial static loading was applied using a universal testing machine at 1mm/min until fracture, and fracture resistance and failure modes were recorded. Regarding Fracture Resistance Values (FRVs), the LD group exhibited significantly higher values than the other two groups, VE (P = 0.028) and LU (P = 0.005), which showed no significant difference (P = 0.778). On the other hand, regarding failure modes, the LD group had a higher prevalence of irreparable fractures compared to the other two groups, VE (P < 0.001) and LU (P < 0.001), which showed no significant difference. Although lithium disilicate glass ceramics exhibited higher FRVs, they had a lower repair probability. In contrast, polymer-infiltrated ceramics and resin-based nanoceramics contributed to tooth structure preservation. For maxillary premolars with interproximal defects following root canal treatment, resin ceramic composites are recommended for restoration to enhance abutment teeth protection.

Pressureless sintered lithium disilicate glass-ceramics: Influence of particle size and crystallization state

The pressureless sintering process is essential to densify near net shaped parts with good shape fidelity. In this work, the impact of the particle size distribution and crystallization state on the processing and properties of final sintered multicomponent lithium disilicate (SiO2-Li2O-K2O-P2O5-Al2O3-ZnO) was evaluated. Higher densification was achieved by pressureless sintering at lower temperatures for samples prepared with fine glass-based powders (825 °C; ≈96%) rather than coarse crystallized powders (975 °C; 92.9%). However, samples based on fine powders presented a microstructure characterized by low aspect ratio crystals, while those based on coarse powders presented needle-like crystals with high aspect ratio. Best mechanical properties were found in samples prepared with coarse glass powders (relative density≈ 95.1%; Vickers Hardness≈ 5.2 GPa; indentation fracture toughness≈ 2 MPam0.5; flexural strength≈ 317 MPa) sintered at 875 °C-1 h. These results can provide valuable orientations for the post-processing of lithium disilicate glass-ceramics prepared by additive manufacturing techniques.

Occlusal veneers and load-bearing capacity of a restored tooth.

The aim of this study was to evaluate the influence of restoration bonding and type of preparation on load bearing capacity of a tooth restored with indirect glass ceramic or hybrid ceramic occlusal veneer restoration. Occlusal surfaces of extracted human molar teeth were prepared for indirect occlusal veneers with or without circumferential chamfer. The occlusal veneers were milled either from CAD/CAM hybrid ceramic (HC) Cerasmart (GC), or lithium-disilicate glass ceramic (LDGC) IPS e.max CAD (Ivoclar Vivadent) blocks. Finalized veneers were bonded to teeth following manufacturers' instructions or according to the technique for the intended deteriorated bonding using n-hexane wax solution preconditioning on restorations (n=8/group). The ultimate fracture load was recorded, and fracture types were analyzed and classified visually. Statistical analysis was performed using one-way ANOVA. The highest fracture load was recorded in teeth with bonded LDGC veneer (p≤0.0007). The bonded HC veneers had only marginally higher fracture load compared to non-bonded veneers. In all groups with deteriorated bonding, veneers loosened without tooth fracture whereas in the bonded veneer groups tooth fractures were observed, especially in teeth restored with LDGC material. Bonded LDGC occlusal veneers have high load bearing capacity which exceeds the fracture resistance of tooth structure. Circumferential chamfer preparation for an occlusal veneer has no influence on fracture load of a restored tooth.

Biosafety and chemical solubility studies of multiscale crystal-reinforced lithium disilicate glass-ceramics.

Lithium disilicate (Li2 Si2 O5 ) glass-ceramics are currently a more widely used all-ceramic restorative material due to their good mechanical properties and excellent aesthetic properties. However, they have a series of problems such as high brittleness and low fracture toughness, which has become the main bottleneck restricting its development. Therefore, in order to compensate for these shortcomings, we propose to prepare a reinforced glass-ceramics with better mechanical properties and to test the biosafety and chemical solubility of the material. Li2 Si2 O5 whiskers were synthesized by a one-step hydrothermal method, and multi-scale crystal-enhanced Li2 Si2 O5 glass-ceramics were prepared by reaction sintering. The biosafety of multi-scale crystal-reinforced Li2 Si2 O5 glass-ceramics was investigated by in vitro cytotoxicity test, rabbit pyrogen test, mice bone marrow micronucleus test, skin sensitization test, sub-chronic systemic toxicity test, and chronic systemic toxicity test. Additionally, the chemical solubility of multi-scale crystal-reinforced Li2 Si2 O5 glass-ceramics was investigated. The test results showed that the material was non-cytotoxic, non-thermogenic, non-mutagenic, non-sensitizing, and non-systemic. The chemical solubility, determined to be 377 ± 245 μg/cm2 , complied with the ISO 6872 standard for the maximum solubility of ceramic materials. Multi-scale crystal-reinforced Li2 Si2 O5 glass-ceramics' biosafety and chemical solubility met current normative criteria, and they can move on to mechanical property measurements (such as flexural strength test, fatigue life test, friction and wear property study, etc.) and bonding property optimization, which shows promise for future clinical applications.