Polymer-infiltrated Ceramic Network Research Articles

Survival and Complication Rates of Polymer-Infiltrated Ceramic-Network Single- Tooth Restorations with an Observation Period of up to Three Years.

This study evaluated the clinical performance of a polymer-infiltrated ceramic-network (PICN) material for up to 3 years. Patients (N=286) received 581 indirect restorations as crowns (417), overlays (131), and inlays/veneers (33) fabricated using the PICN (VITA Enamic) by CAD/CAM procedures using intraoral scanning (Cerec Omnicam) and milling systems (Cerec MC XL). The restorations were evaluated annually and in case of complications. Data were analyzed using Kaplan-Meier estimate. Complications were classified as biological or technical failures. Until final recall (mean observation period: 18.3 months) with a dropout rate of 4.8%, 3 biological and 10 technical complications were observed. The overall success rate of the placed restorations was 97.7%. Biological complications included pulpitis and pulp necrosis. Technical complications were debonding (n=7) and fracture (n=3). PICN materials can be used as an alternative to lithium-disilicate or zirconium dioxide for single tooth reconstructions, providing that early failures included debonding and fractures.

A Comprehensive Review of Techniques for Enhancing Zirconia Bond Strength: Current Approaches and Emerging Innovations.

The increasing use of zirconia in dental restorations necessitates a comprehensive understanding of effective bonding techniques to ensure long-term clinical success. Zirconia's unique chemical composition presents challenges in achieving a durable bondas it lacks the glass phase necessary for traditional etching and silanization processes. This review evaluates current methods and emerging innovations for enhancing zirconia bond strength to resin cements. Our findings emphasize the importance of mechanical surface treatments such as air-particle abrasion and tribochemical silica-coating, which significantly improve micromechanical retention. Laser irradiation, while less commonly used, also shows promise in enhancing bond strength without compromising zirconia's structural integrity; 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) primers emerged as critical agents in forming stable P-O-Zr bonds, particularly when used with resin cements containing 10-MDP. However, variations in formulation and application methods impact their overall efficacy. Resin cement demonstrated superior bond strength compared to conventional cement, but clinical outcomes varied, highlighting the importance of cement-primer compatibility and strict procedural adherence. Emerging technologies such as polymer-infiltrated ceramic networks (PICNs) and additive manufacturing (AM) of zirconia offer potential for future advancements, although they require further research to address mechanical and aesthetic challenges. In conclusion, while established methods such as sandblasting and the use of MDP primers remain reliable, ongoing research into novel materials and techniques continues to offer opportunities for enhancing zirconia bonding. Clinicians must balance effectiveness, procedural complexity, and clinical practicality when selecting the most appropriate bonding protocols for zirconia restorations.

The Effect of Erosive Media on the Mechanical Properties of CAD/CAM Composite Materials.

This study aimed to investigate the effect of acidic media storage (gastric acid and Coca-Cola) on the mechanical properties of CAD/CAM materials. Three types of materials were tested: a polymer-infiltrated ceramic network (PICN) (Vita Enamic (En), VITA Zahnfabrik, Germany), a resin composite block (RCB) (Cerasmart (Cs), GC Corp, Japan), and a conventional resin-based composite (Gradia direct (Gr), GC Corp, Japan), which was used as a control. Beam-shaped specimens of each material, with dimensions of 16 mm × 4 mm × 1.5 mm, were prepared (90 in total). The specimens were divided into subgroups (10 each) and stored for 96 h in either gastric acid, Coca-Cola, or distilled water. Flexural strength and elastic modulus were evaluated using a three-point flexural strength test with acoustic emission (AE) monitoring. Vickers microhardness was measured before and after storage in gastric acid and Coca-Cola. Data were statistically analysed using two-way and one-way ANOVA, the Tukey's post hoc, and independent t-test at a significance level of 0.05. The results showed that Cs and En maintained their flexural strength and elastic modulus after acidic media exposure, while Gr experienced a significant decrease in flexural strength following gastric acid storage (p < 0.01). Initial crack detection was not possible using the AE system, impacting the determination of flexural strength. Exposure to acidic media decreased all materials' microhardness, with Gr showing the most notable reduction (p < 0.0001). Gastric acid had a greater impact on the microhardness of all tested materials compared to Coca-Cola (p < 0.0001). In conclusion, storage in erosive media did not notably affect the flexural strength or elastic modulus of CAD/CAM composites but it did affect hardness. CAD/CAM composite blocks demonstrated superior mechanical properties compared to the conventional composite.

Biomechanical behaviour of tilted abutment after fixed partial denture restoration of CAD/CAM materials

BackgroundFailure to restore missing teeth in time can easily lead to the mesial tilting of the distal abutment teeth. However, a fixed partial denture (FPD) can improve stress conduction and distribution and prevent periodontal injuries. In these more complex cases, it is necessary to consider various factors comprehensively to improve conventional treatment planning and achieve better results.MethodsWe selected a patient with a missing first molar and a mesial inclination of the second molar, leaving inadequate space or bone mass for implant denture restoration, necessitating an FPD for restoration. Three-dimensional finite element analysis (3D-FEA) combined with photoelastic analysis were used to explore how the inclination angle (0 ‒ 30°) and different dental restoration materials (zirconia, lithium disilicate, polymer-infiltrated ceramic network, and resin composite) affect the biomechanical behaviour of FPD‒abutments‒periodontal tissue complex.ResultsThe stress was easily concentrated in the FPD connectors, enamel shoulder collar, periapical area, and root bifurcation. The stress on FPD and the periodontal ligament (PDL) of the second premolar increased with an increase in the elastic modulus of FPD, with an opposite trend in the abutments, the alveolar bone, and the PDL of the second molar. The stress on the FPD and alveolar bone increased with increased inclination angle of the distal abutment. The stress on two abutments and their PDL were positively correlated with the inclination angle in two stages; however, when the inclination angle > 12°, the second premolar and its PDL showed a negative correlation.ConclusionsFPDs can be used for restoration within 24° of distal abutment inclination, but protecting the abutments (< 12° especially) and the periodontal tissue (> 12° especially) must be taken seriously. For this purpose, an FPD material with higher strength is recommended.

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.

Effect of resin cement viscosities and surface roughness on shear bond strength of conditioned polymer infiltrated ceramic network

BackgroundHybrid ceramics bonding with the dentinal substrate is crucial for clinical success and longevity. To enhance adhesion, the surface of ceramic restorations is modified through various conditioning techniques AimEffect of Different Surface Conditioners Erbium-doped yttrium aluminum garnet (ER: YAG) laser and Low-level laser therapy (LLLT) activated Methylene blue (MB) on the surface roughness (Ra) and shear bond strength (SBS) of Polymer infiltrating ceramic network (PICN) discs bonded using different viscosity resin cement before and after thermal aging. Material and MethodsOne hundred and fifty human central incisors and one hundred and fifty-three PICN discs were prepared. PICN discs were randomly allocated into three groups based on the surface conditioning(n = 51) Group 1:10 % HF acid-S, Group 2: LLLT (MB), and Group 3: Er: YAG laser. Following conditioning Ra scores of ten samples were performed. Surface topography of samples was performed using a scanning electron microscope (SEM). Bonding of forty PICN discs from each conditioning group was performed with high (A) or low viscosity (B) dual-curing resin cement (n = 20 each). Each subgroup was divided into two cohorts and subjected to varying storage conditions. The SBS test and failure mode analysis were performed using a universal testing machine and stereomicroscope. Descriptive statistics of SBS and Ra for each group were analyzed using ANOVA and Tukey post hoc tests. HF acid-S attained the highest Ra scores. ResultsGroup 1A (HF-S+HIGH) samples achieved the highest SBS values at baseline. Group 3A, on the other hand, displayed the lowest bond score (Er: YAG laser+HIGH) after thermal aging. Intergroup comparison analysis at baseline unveiled that Group 1A and Group 1B (HF(S) + LOW) displayed no significant difference in their bond strength scores (p>0.05). Following artificial aging, it was observed that Group 2A (LLLT (MB) + HIGH) and Group 3A (Er:YAG laser + HIGH) ) presented comparable SBS(p > 0.05). Thermal aging decreased SBS significantly in all groups. PICN conditioned with HF-S results in high surface roughness. ConclusionPICN conditioned with HF acid with silane and bonded with low-viscosity resin cement to the dentinal substrate is preferable. Aging influences SBS.

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.

Nanoindentation creep: The impact of water and artificial saliva storage on milled and 3D-printed resin composites.

This study evaluated the effects of artificial saliva and distilled water on the nanoindentation creep of different 3D-printed and milled CAD-CAM resin composites. Disk-shaped specimens were subtractively fabricated from polymer-infiltrated ceramic network (EN) and reinforced resin composite (B) and additively from resin composite (C) and hybrid resin composite (VS) using digital light processing (DLP). Specimens from each material were divided into two groups according to their storage conditions (artificial saliva or distilled water for 3 months). Creep was analyzed by nanoindentation testing. Statistical analysis was done using two-way ANOVA, one-way ANOVA, Bonferroni post hoc tests, and independent t-test (α = 0.05). The main effects of material and storage conditions, and their interaction were statistically significant on nanoindentation (p<0.001). Storage condition had the greatest influence (partial eta squared ηP 2 =0.370), followed by the material (ηP 2 = 0.359), and the interaction (ηP 2 = 0.329). The nanoindentation creep depths after artificial saliva storage ranged from 0.34 to 0.51µm and from 0.50 to 0.87µm after distilled water storage. One of the additively manufactured groups had higher nanoindentation creep depths in both storage conditions. All specimens showed comparable performance after artificial saliva storage, but increased nanoindentation creep after distilled water storage for 3 months. The subtractive CAD-CAM blocks showed superior dimensional stability in terms of nanoindentation creep depths in both storage conditions. Additively manufactured composite resins had lower dimensional stability than one of the subtractively manufactured composites, which was demonstrated as having higher creep deformation and maximum recovery. However, after artificial saliva storage, one of the additively manufactured resins had dimensional stability similar to that of subtractively manufactured.

Do all ceramic and composite CAD-CAM materials exhibit equal bonding properties to implant Ti-base materials? An Interfacial Fracture Toughness Study

ObjectivesTo compare the interfacial fracture toughness (IFT) with or without aging, of four different classes of CAD-CAM ceramic and composite materials bonded with self-adhesive resin cement to titanium alloy characteristic of implant abutments. MethodsHigh translucent zirconia (Katana; KAT), lithium disilicate-based glass-ceramic (IPS. emax.CAD; EMX), polymer-infiltrated ceramic network material (PICN) (Vita Enamic; ENA), and dispersed filler composite (Cerasmart 270; CER) were cut into equilateral triangular prisms and bonded to titanium prisms with identical dimensions using Panavia SA Cement Universal. The surfaces were pretreated following the manufacturers’ recommendations and developed interfacial area ratio (Sdr) of the pretreated surfaces was measured. IFT was determined using the Notchless Triangular Prism test in a water bath at 36 °C before and after thermocycling (10,000 cycles) (n = 40 samples/material). ResultsIFT of the materials ranged from 0.80 ± 0.25 to 1.10 ± 0.21 MPa.m1/2 before thermocycling and from 0.71 ± 0.24 to 1.02 ± 0.25 MPa.m1/2 after thermocycling. There was a statistical difference between IFT of CER and the two top performers in each scenario: KAT and EMX before aging, and KAT and ENA after aging. Thermocycling significantly decreased IFT of EMX. The Weibull modulus of IFT was similar for all materials and remained so after thermocycling. Sdr measurements revealed that ENA (7.60)>Ti (4.97)>CER (2.85)>KAT (1.09)=EMX (0.96). SignificanceDispersed filler CAD-CAM composite showed lower performance than the other materials. Aging only affected IFT of Li-Si glass-ceramic, whereas zirconia and PICN performed equally well, probably due to their chemical bonding potential and surface roughness respectively.

Chemical etching of CAD-CAM glass-ceramic-based materials using fluoride solutions for bonding pretreatment.

The surface treatment of glass-ceramic-based materials, namely, lithium disilicate glass (IPS e.max CAD), feldspar porcelain (VITABLOCS Mark II), and a polymer-infiltrated ceramic network (VITA ENAMIC), using aqueous fluoride solutions and their influence on luting agent bonding were investigated. Six experimental aqueous fluoride solutions were applied to these materials, and their effects were assessed by surface topological analysis. The obtained results were compared using non-parametric statistical analyses. Ammonium hydrogen fluoride (AHF) etchant demonstrated the greatest etching effect. Subsequent experiments focused on evaluating different concentrations of the AHF etchant for the bonding pretreatment of glass-ceramic-based materials with a luting agent (PANAVIA V5). AHF, particularly at concentrations above 5 wt%, effectively roughened the surfaces of the materials and improved the bonding performance. Notably, AHF at a concentration of 30 wt% exhibited a more pronounced effect on both etching and bonding capabilities compared to hydrofluoric acid.

Comparison of fatigue lifetime of new generation CAD/CAM crown materials on zirconia and titanium abutments in implant-supported crowns: a 3D finite element analysis.

Due to the dynamic character of the stomatognathic system, fatigue life experiments simulating the cyclic loading experienced by implant-supported restorations are critical consideration. The aim of this study was to examine the effect of different crown and abutment materials on fatigue failure of single implant-supported crowns. Models were created for 10 different designs of implant-supported single crowns including two zirconia-reinforced lithium silicates (crystallized and precrystallized), monolithic lithium disilicate, polymer-infiltrated ceramic networks, and polyetheretherketone supported by zirconia and titanium abutments. A cyclic load of 179 N with a frequency of 1 Hz was applied on palatal cusp of a maxillary first premolar at a 30° angle in a buccolingual direction. In the models with titanium abutments, the polymer-infiltrated ceramic network model had a lower number of cycles to fatigue failure values in the implant (5.07), abutment (2.30), and screw (1.07) compared to others. In the models with zirconia abutments, the crystallized zirconia-reinforced lithium silicate model had a higher number of cycles to fatigue failure values in the abutment (8.52) compared to others. Depending on the fatigue criteria, polyetheretherketone implant crown could fail in less than five year while the other implant crowns exhibits an infinite life on all models. The type of abutment material had an effect on the number of cycles to fatigue failure values for implants, abutments, and screws, but had no effect on crown materials. The zirconia abutment proved longer fatigue lifetime, and should thus be considered for implant-supported single crowns.

An In Vitro Study of Retention and Marginal Adaptation of Endocrowns With Different Intracoronal Depths.

Marginal adaptation and retention of endocrowns are crucial for the success and survival of endocrowns. This study aimed to investigate the effect of different materials and intracoronal depth on the retention and marginal adaptation of CAD/CAM fabricated all-ceramic endocrowns. Thirty-six mandibular premolar teeth with an average surface area of 64.49 mm2 were prepared to receive CAM/CAM fabricated endocrowns. Samples were divided randomly and equally into groups of lithium disilicate with 2 mm intracoronal depth (LD2), lithium disilicate with 4 mm intracoronal depth (LD4), polymer infiltrated ceramic network with 2 mm intracoronal depth (PICN2) and polymer infiltrated ceramic network with 4 mm intracoronal depth (PICN4). All endocrowns were cemented using ParaCore resin cement with 14N pressure and cured for 20 seconds. Fifty measurements of absolute marginal discrepancy (AMD) were done using a stereomicroscope after cementation. After 24 hours, all samples were subjected to thermocycling before the retention test. This involved using a universal testing machine with a crosshead speed of 0.5 mm/min and applying a load of 500N. The maximum force to detach the crown was recorded in newtons and the mode of failure was identified. Two-way ANOVA revealed that the AMD for PICN was statistically significantly better than lithium disilicate (p=0.01). No statistically significant difference was detected in the AMD between the two intracoronal depths (p=0.72). PICN and endocrowns with 4 mm intracoronal depth had statistically significant better retention (p<0.05). 72.22% of the sample suffered from cohesive failures and 10 LD endocrowns suffered adhesive failures. Within the limitations of this study, we found that different materials and intracoronal depths can indeed influence the retention of CAD/CAM fabricated endocrowns. Based on the controlled setting findings, PICN was found to have better retention and better marginal adaptation than similar lithium disilicate premolar endocrowns.

Fracture resistance of additively or subtractively manufactured resin-based definitive crowns: Effect of restorative material, resin cement, and cyclic loading

ObjectiveTo evaluate how restorative material, resin cement, and cyclic loading affect the fracture resistance of resin-based crowns fabricated by using additive or subtractive manufacturing. MethodsA right first molar crown standard tessellation language (STL) file was used to fabricate 120 crowns from one subtractively manufactured polymer-infiltrated ceramic network (SM) and two additively manufactured resin composites (AM-B and AM-S) (N = 40). These crowns were randomly divided into 4 groups within each material according to the dual-polymerizing resin cement to be used (RX and PN) and the aging condition (n = 10). After cementation, the crowns without cyclic loading were subjected to fracture testing, while the others were first cyclically loaded (1.7 Hz, 1.2 million cycles, and 49-N load) and then subjected to fracture testing. Data were analyzed with generalized linear model analysis (α = .05). ResultsFracture resistance of the crowns was affected by material, resin cement, and cyclic loading (P ≤ .030). However, none of the interactions significantly affected fracture resistance of tested crowns (P ≥ .140). Among tested materials, SM had the highest fracture resistance, whereas AM-B had the lowest (P ≤ .025). RX led to higher fracture resistance, and cyclic loading decreased the fracture resistance (P ≤ .026). SignificanceTested materials can be considered reliable in terms of fracture resistance in short- or mid-term (5 years of intraoral simulation) when used for single molar crowns with 2 mm occlusal thickness. In the long term, polymer-infiltrated ceramic network crowns cemented with RelyX Universal may provide promising results and be less prone to complications considering higher fracture resistance values obtained.

Intraoral wear of PICN CAD-CAM composite restorations used in severe tooth wear treatment: 5-year results of a prospective clinical study using 3D profilometry

ObjectivesTo evaluate, in a prospective clinical study over 5 years with ex vivo 3D profilometry analyses, the intraoral wear of Polymer-Infiltrated Ceramic Network (PICN) CAD-CAM composite restorations used in severe tooth wear treatment with the One-Step No-Prep technique. Methods192 PICN (Vita Enamic) restorations on molars and premolars were included in a prospective clinical study involving patients treated according to the One-step No-prep protocol (n = 7). All patients showed clinical signs of bruxism. Replicas of restorations on molars and premolars were realized at each evaluation time (baseline and then every year up to 5 years) and scanned to perform 3D profilometry. Baseline and recall scans were superimposed with Geomagic Control software. The mean material wear was calculated for the full occlusal area (FOA) and for the occlusal contact area (OCA), respectively. Clinical evaluation of restorations was performed at recall. ResultsAt 5 years, the estimated mean material wear for FOA was inferior to the accuracy threshold of the profilometry measurement chain. For OCA, the estimated mean wear of the material was – 27.97 µm. This material wear was shown to be significantly influenced by time (p < 0.0001) and patient (p = 0.026), while the type of tooth (molar or premolar) had no influence. At 5 years, the survival and the success rates of restorations were 99.48% and 90.62%, respectively. SignificanceThe PICN material exhibits a low wear process in the treatment of severe tooth wear despite the presence of clinical signs of bruxism, and it constitutes a suitable material for the One-step No-prep technique.

Static and dynamic stress analysis of different crown materials on a titanium base abutment in an implant-supported single crown: a 3D finite element analysis

BackgroundThis Finite Element Analysis was conducted to analyze the biomechanical behaviors of titanium base abutments and several crown materials with respect to fatigue lifetime and stress distribution in implants and prosthetic components.MethodsFive distinct designs of implant-supported single crowns were modeled, including a polyetheretherketone (PEEK), polymer-infiltrated ceramic network, monolithic lithium disilicate, and precrystallized and crystallized zirconia-reinforced lithium silicates supported by a titanium base abutment. For the static load, a 100 N oblique load was applied to the buccal incline of the palatal cusp of the maxillary right first premolar. The dynamic load was applied in the same way as in static loading with a frequency of 1 Hz. The principal stresses in the peripheral bone as well as the von Mises stresses and fatigue strength of the implants, abutments, prosthetic screws, and crowns were assessed.ResultsAll of the models had comparable von Mises stress values from the implants and abutments, as well as comparable maximum and minimum principal stress values from the cortical and trabecular bones. The PEEK crown showed the lowest stress (46.89 MPa) in the cervical region. The prosthetic screws and implants exhibited the highest von Mises stress among the models. The lithium disilicate crown model had approximately 9.5 times more cycles to fatique values for implants and 1.7 times more cycles to fatique values for abutments than for the lowest ones.ConclusionsWith the promise of at least ten years of clinical success and favorable stress distributions in implants and prosthetic components, clinicians can suggest using an implant-supported lithium disilicate crown with a titanium base abutment.

Fracture resistance and failure mode of three esthetic CAD-CAM post and core restorations

BackgroundThe rising demand for improved aesthetics has driven the utilization of recently introduced aesthetic materials for creating custom post and core restorations. However, information regarding the fracture resistance of these materials remains unclear, which limits their practical use as custom post and core restorations in clinical applications.Aim of the studyThis study aimed to evaluate the fracture resistance of three non-metallic esthetic post and core restorations and their modes of failure.Materials and methodsThirty-nine single-rooted human maxillary central incisors were endodontically treated. A standardized post space preparation of 9mm length was performed to all teeth to receive custom-made post and core restorations. The prepared teeth were randomly allocated to receive a post and core restoration made of one of the following materials (n=13): glass fiber-reinforced composite (FRC), polyetheretherketone (PEEK) and polymer-infiltrated ceramic-network (PICN). An intraoral scanner was used to scan all teeth including the post spaces. Computer-aided design and computer-aided manufacturing (CAD-CAM) was used to fabricate post and core restorations. Post and core restorations were cemented using self-adhesive resin cement. All specimens were subjected to fracture resistance testing using a universal testing machine. Failure mode analysis was assessed using a stereomicroscope and SEM. The data was statistically analyzed using One-Way ANOVA test followed by multiple pairwise comparisons using Bonferroni adjusted significance level.ResultsCustom PEEK post and core restorations displayed the least fracture load values at 286.16 ± 67.09 N. In contrast, FRC exhibited the highest average fracture load at 452.60 ± 105.90 N, closely followed by PICN at 426.76 ± 77.99 N. In terms of failure modes, 46.2% of specimens with PICN were deemed non-restorable, while for PEEK and FRC, these percentages were 58.8% and 61.5%, respectively.ConclusionsWithin the limitation of this study, both FRC and PICN demonstrated good performance regarding fracture resistance, surpassing that of PEEK.

Investigation of Mechanical Properties of Polymer-Infiltrated Tetrapodal Zinc Oxide in Different Variants.

The aim of this study was to evaluate the influence of weight ratio, the shape of the precursor particles, and the application of a phosphate-monomer-containing primer on the mechanical properties of polymer infiltrated ceramic networks (PICNs) using zinc oxide. Two different types of zinc oxide particles were used as precursors to produce zinc oxide networks by sintering, each with two different densities resulting in two different weight ratios of the PICNs. For each of these different networks, two subgroups were built: one involving the application of a phosphate-monomer-containing primer prior to the infiltration of Bis-GMA/TEGDMA and one without. Elastic modulus and flexural strength were determined by using the three-point bending test. Vertical substance loss determined by the chewing simulation was evaluated with a laser scanning microscope. There was a statistically significant influence of the type of precursor particles on the flexural strength and in some cases on the elastic modulus. The application of a primer lead to a significant increase in the flexural strength and in most cases also in the elastic modulus. A higher weight ratio of zinc oxide led to a significantly higher elastic modulus. Few statistically significant differences were found for the vertical substance loss. By varying the shape of the particles and the weight fraction of zinc oxide, the mechanical properties of the investigated PICN can be controlled. The use of a phosphate-monomer-containing primer strengthens the bond between the infiltrated polymer and the zinc oxide, thus increasing the strength of the composite.

Comparison of Treatment Time for Single-Implant Crowns Between Digital and Conventional Workflows for Posterior Implant Restorations: A Randomized Controlled Trial.

To compare the treatment time of digital and conventional workflows for single-implant crowns, as well as prostheses made of polymer-infiltrated ceramic-network (PICN; Vita Enamic, Vita Zahnfabrik) and lithium disilicate (LS2; n!ce, Straumann). A total of 40 patients who needed a single-implant crown in posterior regions were considered and randomly divided into digital workflows (n = 20) that used an intraoral scanner (IOS; iTero Element 5D, Align Technologies) and conventional workflows (n = 20) that used polyether impressions (3M ESPE Impregum Penta). Then, each group was again distributed into two subgroups based on the crown material used: PICN (n = 10) and LS2 (n = 10). Treatment time was calculated for both digital and conventional workflows. Analysis was done at a 5% confidence interval (P < .05). An independent two-sample t test was used to compare treatment time between the groups. The Kruskal-Wallis test was used to compare clinical try-in time among subgroups. Any of the implant crowns that had to be remade in each subgroup were evaluated using the Fisher exact test. The entire process of digital and conventional workflows required 104.31 ± 20.83 and 153.48 ± 16.35 minutes, respectively. Digital workflows saved 39.2% more time than the conventional protocol for the single-implant crown treatment (P < .0001). Both digital and conventional workflow protocols can achieve a successful outcome for single-implant monolithic crowns in posterior areas. The digital protocol yielded greater timesaving over the conventional procedure in data acquisition and laboratory steps, while the time for clinical try-in and delivery were similar.

Polymer-Infiltrated Ceramic Network Produced by Direct Ink Writing: The Effects of Manufacturing Design on Mechanical Properties

Polymer-infiltrated ceramic network (PICN) materials have gained considerable attention as tooth-restorative materials due to their mechanical compatibility with human teeth, especially with computer-aided design and computer-aided manufacturing (CAD/CAM) technologies. However, the designed geometry affects the mechanical properties of PICN materials. This study aims to study the relationship between manufacturing geometry and mechanical properties. In doing so, zirconia-based PICN materials with different geometries were fabricated using a direct ink-writing process, followed by copolymer infiltration. Comprehensive analyses of the microstructure and structural properties of zirconia scaffolds, as well as PICN materials, were performed. The mechanical properties were assessed through compression testing and digital image correlation analysis. The results revealed that the compression strength of PICN pieces was significantly higher than the respective zirconia scaffolds without polymer infiltration. In addition, two geometries (C-grid 0 and C-grid 45) have the highest mechanical performance.

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

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