Resin-matrix Ceramics Research Articles

Bonding effectiveness of multi-step adhesive resin cements to CAD/CAM blocks: impact of thermal cycling and surface treatment methods

BackgroundTo investigate the effects of thermal cycling and surface treatment methods on the bonding effectiveness of multi-step resin cements to CAD/CAM blocks.MethodsA total of 198 slices, 66 each from CAD/CAM blocks (feldspathic ceramic: Vitablocs TriLuxe Forte, V; resin matrix ceramics (RMCs): Cerasmart, C; and Shofu Block HC, S), were obtained and randomly divided into two subgroups for etching with hydrofluoric acid (HFA) and sandblasting with Al2O3 (SB). After the surface treatments, one etched and one sandblasted sample of each CAD/CAM block was observed via SEM analysis at 500× magnification. The remaining 32 etched and 32 sandblasted samples of each CAD/CAM block were divided into two subgroups to be cemented with total-etch (TE) and self-etch (SE) resin cements. Then, half of the 16 samples in all the subgroups were subjected to aging (TC) for 5000 cycles (n = 8). The shear bond strength (SBS) of each sample was measured. Four-way analysis of variance (ANOVA) and Tukey tests were used to analyze the data (p < 0.05).ResultsWith or without TC, the highest SBS values for V were obtained with the HFA-TE and HFA-SE interactions, respectively. C presented the highest SBS values with HFA-SE and SB-TE interactions, whereas S presented the highest SBS values with SB-TE and HFA-TE interactions. Except the SB-SE interaction, C presented lower SBS values after TC than other materials. HFA created less porosity on the C and S surfaces than V. SB visibly roughened the surfaces of all the materials but caused fractures, cracks, and damage to the surfaces.ConclusionSimilar SBS values can be achieved between feldspathics, RMCs, and multi-step adhesive resins with both HFA and SB treatments. However, the SBS values obtained from the SB-SE interaction may be below the recommended threshold values for all materials after TC. SB can cause distinctive cavities, fissures, and damage, especially on the surfaces of RMCs.

Masking ability of CAD-CAM resin-matrix ceramics with different translucencies and thicknesses combined with four cement shades against varying background colors when facing veneer restorations

BackgroundTo evaluate the comprehensive effect of translucency, thickness, cement shades, and background color on the masking ability of resin-matrix ceramic veneer restorations.MethodsResin-matrix ceramic specimens with 2 translucencies (LT, HT) and 3 thicknesses (0.5, 1.0, and 1.5 mm) were made of Upcera Hyramic (A2 shade). Cement specimens were made of Variolink N in 4 shades (yellow, white, transparent, and bleach XL). Five background specimens were made of IPS Natural Die Material in 5 shades (ND1, ND2, ND3, ND4, and ND5). Color coordinates of 120 subgroups (n = 5) of combined specimens composed of different ceramic, cement, and background specimens were obtained using a spectroradiometer. Color difference (ΔE00) compared with a 4-mm thick specimen of LT and HT ceramics was calculated and four-way ANOVA was used for statistical analysis (α = 0.05).ResultsTranslucency, thickness, cement shade, background color, and their interaction had significant effects on ΔE00 (p < 0.001). ΔE00 values of HT groups were always higher than that of LT groups and were greater than 1.8 against all background colors. ΔE00 values of LT groups could be achieved to be less than 1.8 with appropriate thickness and cement shade. ΔE00 value decreased with increasing ceramic thickness. The effect of cement shade on ΔE00 had no obvious regularity, but ΔE00 values of bleach XL cement shade group were always lower than other cement shade groups under ND3 and ND5 background color.ConclusionsThe masking ability of CAD-CAM resin-matrix ceramics can be simultaneously affected by translucency, thickness, cement shade, and background color. Resin-matrix ceramics with low translucency has a better masking ability than that with high translucency. The masking ability of CAD-CAM resin-matrix ceramics increase with increasing thickness. Cement shade has less impact on the final color of resin-matrix ceramic restorations.

The Effect of Micromechanical Surface Preparation and Adhesive Surface Modification Strategies on Resin-Matrix Ceramic Repair Bond Strength Using Universal Adhesive Containing Silane Agent

Abstract Objectives This research assesses the effect of the different micromechanical surface preparations and chemically adhesive surface modification strategies applied to resin-matrix ceramics (Shofu Block HC) repaired using resin composites. Materials and Methods Eighty resin-matrix ceramics were conducted and designed into eight groups of 10 specimens and surface treated with (1) micromechanical preparation with sandblast (SB) or hydrofluoric acid (HF), and (2) chemically adhesive techniques with HC primer (HC) and/or silane (Si) and/or conventional adhesive (AD) or universal adhesive (UA) designing are as follows: group 1, SB + HC; group 2, SB + HC + AD; group 3, SB + HC + Si + AD; group 4, SB + HC + UA; group 5, HF + HC; group 6, HF + HC + AD; group 7, HF + HC + Si + AD; and group 8, HF + HC + UA. An ultradent model was put on the specimen center, then filled resin composite. Mechanical testing instrument was used to determine the samples' microshear bond strength (MSBS). To inspect failure modes, a stereomicroscope was used for observing the debonded surfaces. Statistical Analysis To assess the data, a one-way analysis of variance was employed, and the significant level (p &lt; 0.05) was established with Tukey's test. Results Group 3 (29.29 ± 2.58 MPa) and group 4 (28.34 ± 1.26 MPa) demonstrated the two maximum MSBS values. The minimum MSBS (10.02 ± 3.31 MPa) was discovered by group 5. Nevertheless, group 2's MSBS values (22.78 ± 2.44 MPa) differed significantly from the values for groups 3 and 4. All the fractured samples in groups 1, 5, 6, 7, and 8 had an adhesive failure pattern. Furthermore, group 3 presented the greatest mixed failures (40%). Conclusion The SB is the most effective protocol for producing micromechanical retention. The application of HC primer and Si agent prior to the adhesive agent is the best chemical adhesive strategy for sandblasted resin-matrix ceramic surfaces. Additionally, the application of HC primer before the use of UA containing acid-resistant Si is the best alternative chemical adhesive strategy for improving the MSBS.

Effect of different occlusal materials on peri-implant stress distribution with different osseointegration condition: A finite element analysis.

Studies have not been done to evaluate the peri-implant stress exerted by materials(like PEEK and resin matrix ceramics) in different osseointegration conditions. To investigate the effect of different occlusal materials on peri-implant stress distribution with different osseointegration condition using finite element analysis. Eighteen different 3D FEA models of implant fixed with abutment were created involving 6 different occlusal materials (Heat cured temporary acrylic resin (PMMA), Bis-GMA, PEEK, Lithium disilicate, Resin matrix ceramics and translucent Zirconia) and different osseointegrated conditions (50%, 75%, 100%). Models were subjected to loading vertically and obliquely followed by evaluation of stress distribution. The results of the simulation obtained were analysed in terms of Von mises, maximum principal and minimal principal stresses using descriptive stastistics. PMMA (40.14 MPa on vertical loading and 66 MPa on oblique loading) resulted in the highest stresses and lithium disilicate (24 MPa on vertical loading and 52.40 MPa on oblique loading) resulted in least stresses among all the crown materials. Upon oblique loading, von Mises stress increases except for translucent zirconia and lithium disilicate (52.444 MPa on 50%, 47.733 MPa on 75%, and 43.973 MPa on 100% osseointegration). Minimal principal stress values decreased with increase in osseointegration upon oblique loading for PMMA, BisGMA, and PEEK. Translucent zirconia and lithium disilicate offer a better stress transmission. Minimal principal stress values of PEEK and BisGMA decreased with increasing osseointegration.

The Effect of Different Chemical Surface Treatments on the Bond Strength of Resin-Matrix Ceramic Repaired with Resin Composite.

This study investigates the effect of different chemical surface treatment protocols with different functional monomers of universal adhesives on the shear bond strength between resin-matrix ceramic and resin composite. Eighty resin-matrix ceramics (Shofu block HC) were built and designed into eight groups of ten specimens and surface treated with HC primer (HC) and/or three universal adhesives (single bond universal [SBU], Scotchbond universal plus [SBP], and Tetric N-bond universal [TNU]) assigning follows; group 1, nonsurface treated; group 2, HC; group 3, SBU; group 4, HC + SBU; group 5, SBP; group 6, HC + SBP; group 7, TNU; group 8, HC + TNU. A template was put on the specimen center, and then pushed packable resin composite. Mechanical testing machinery was used to examine the samples' shear bond strength (SBS) values. To examine failure patterns, the debonded specimen surfaces were examined by a stereomicroscope. The one-way analysis of variance method was used to evaluate the data, and the Tukey's test was used to determine the significant level (p < 0.05). The highest SBS was obtained in group 6 (39.25 ± 1.65 MPa). Group 1 (4.15 ± 0.54 MPa) had the lowest SBS. Group 6 exhibited the highest percentage of cohesive failure patterns (70%). High SBS values were frequently correlated with the surface treatment groups and the cohesive failure patterns. The application of HC primer prior to the universal adhesive is an alternative protocol for enhancing the repair bond strength between resin-matrix ceramic and resin composite interfaces. Moreover, the application of HC primer prior to the SBP is the best strategy for resin-matrix ceramic and resin composite repairs.

The effect of repair protocols and chewing simulation on the microtensile bond strength of two resin matrix ceramics to composite resin

BackgroundTo assess the micro tensile bond strength (µTBS) of two resin matrix ceramic (RMC) blocks bonded to composite resin by using different repair protocols with and without chewing simulation (CS).Materials and methodsTwo resin matrix ceramic blocks (Vita Enamic and Lava Ultimate) were divided into 4 groups according to the surface treatments: Bur grinding (control), Bur grinding + silane, 9.5% HF acid etching, and 9.5% HF acid etching + silane. The single bond universal adhesive was applied on all specimens after the surface treatments according to the manufacturer’s instructions, it was administered actively on the treated surface for 20 s and then light cured for 10 s, followed by incremental packing of composite resin to the treated surface. Each group was further divided into 2 subgroups (with/without chewing simulation for 500,000 cycles). A micro tensile bond strength test was performed for each group (n = 15). The effect of surface treatments on the materials was examined by using a scanning electron microscope (SEM). The micro tensile bond strength (MPa) data were analyzed with a three-way ANOVA, the independent t-test, and one-way ANOVA followed by the Tukey post-hoc test.ResultsµTBS results were significantly higher for Lava Ultimate than Vita Enamic for all the surface treatment protocols with (p < 0.01). The chewing simulation significantly negatively affected the micro-tensile bond strength (p < 0.001). Bur grinding + saline exhibited the highest bond strength values for Lava Ultimate, both with and without chewing simulation. For Vita Enamic, bur grinding + saline and HF acid + saline showed significantly higher bond strength values compared to other surface treatments, both with and without chewing simulation (p ≤ 0.05).ConclusionBur grinding + silane could be recommended as a durable repair protocol for indirect resin matrix ceramics blocks with composite resin material.

Effects of erosion and abrasion on resin-matrix ceramic CAD/CAM materials: An in vitro investigation.

The aim of the study was to evaluate the effects of erosion and abrasion on resin-matrix ceramic CAD/CAM materials [CERASMART (GC); VITA ENAMIC (VITA Zahnfabrik); Lava Ultimate (3M)] in comparison to feldspar ceramic (VITABLOCS Mark II, VITA Zahnfabrik) and resin composite materials (ceram.x universal, Dentsply Sirona). Daily brushing and acid exposure were simulated using a brushing apparatus and a solution of 0.5vol% citric acid. Microhardness, surface roughness, and substance loss were measured at baseline and after simulation of 1 and 3 years of function. All materials showed a decrease in microhardness after 3 years and an increase in surface roughness (Ra) after 1 and 3 years. The Ra increase was statistically significantly lower for the resin-matrix ceramics than for feldspar ceramic and similar to composite material. After 3 years, only feldspar ceramic showed no significant substance loss. In conclusion, resin-matrix ceramics demonstrate reduced roughening compared to feldspar ceramics, potentially improving restoration longevity by preventing plaque buildup, but differences in abrasion resistance suggest the need for further material-specific research. Future research should aim to replicate clinical conditions closely and to transition to in vivo trials.

Color stability of two different resin matrix ceramics: randomized clinical trial

BackgroundOne of the most common causes of aesthetic failure and restoration replacement is the tooth restorations color mismatch specifically after aging.MethodsOne hundred and two participants with endodontically treated first molar were selected clinically. The patients were randomly splited into two groups and restored either with Cerasmart hybrid ceramic or Vita Enamic polymer infiltrated ceramic network (PICN) crowns and cemented using dual cure adhesive cement. The color difference (ΔE) values after cementation at 0 (Baseline), 6, and 12 months of use were obtained by quantification of L*, a*, and b* values with a digital spectrophotometer. Mann–Whitney test used to compare between tested groups at each time point and between (α = 0.05).ResultsAt 6 months follow-up intervals, Vita Enamic group showed the highest significant ∆L* (p = 0.035) and ∆a* (p < 0.001) compared to Cerasmart group. ∆b* and ∆E showed no significant difference between both groups (p > 0.05). Furthermore, all color parameters of both groups showed statistically significant difference at 12 months follow-up intervals. After 12 months, Vita Enamic restorations presented higher color change compared to Cerasmart restorations with a (p-value of 0.0120). When comparing the total color difference ∆Et through-out the follow-up intervals of Vita Enamic & Cerasmart groups, there were insignificant difference (p = 0.263).ConclusionBoth hybrid materials demonstrated comparable color stability after 1 year of clinical service within clinical acceptance range. However, Cerasmart demonstrated a better colour stability after 1 year.Trial registrationClinicalTrials.gov (ID: NCT05501808) 15/8/ 2022- ‘retrospectively registered’.

Bond Strength and Surface Roughness of Two Ceramics After Metal Bracket Debonding.

The aims of this study were to compare the bond strength between metallic brackets and two different glass ceramics and to evaluate the ceramic surface roughness after different finishing protocols. The surface roughness of lithium disilicate and resin matrix ceramic samples was measured (initial). All samples were treated with hydrofluoric acid and silane and bonded to metallic brackets with orthodontic cement adhesive. Shear bond strength tests were performed using a universal testing machine (n=12). The surface roughness was measured again (intermediate, n=6) after removing the remaining cement adhesive from the ceramic surfaces with a diamond or 24-blade bur after polishing the ceramic surfaces (final, n=6). The resin matrix ceramic had the highest bond strength. The rotatory instrument used for the removal of cement adhesive did not affect the surface roughness of the resin matrix ceramic or lithium disilicate (p=0.985 and p=0.504, respectively), but did affect the evaluation time (p<0.001) for both restorative materials. The intermediate roughness was the highest. For the resin matrix ceramic, polishing promoted a final surface roughness similar to the initial condition; however, changes in the surface shape of this ceramic could be visibly observed when using a 24-blade bur. The bond strength of metallic brackets bonded on resin-matrix ceramics is higher than bonding on lithium disilicate. The use of diamond burs for the removal of the remaining adhesive from the resin matrix ceramics is highly recommended.

Wear characteristics of esthetic resin matrix and zirconia reinforced lithium disilicate CAD/CAM materials: two-body wear and surface topography analysis.

This in vitro study assessed the wear behavior of different CAD-CAM blocks and the abrasion of the enamel antagonist against these materials. 64 disk-shaped specimens were prepared from 8 different CAD/CAM blocks as follow: one lithium disilicate glass ceramics block "IPS Emax CAD" as control group, two zirconia reinforced lithium silicate "Vita Suprinity & Celtra DUO," one interpenetrating network ceramic block "Vita Enamic," Three resin-based block composites "Lava Ultimate, Cerasmart & Brilliant-crios" as well as one hybrid nanoceramic "Shofu block HC". All specimens were mounted against canine and tested for two body wear analysis using a chewing simulating loading machine (100,000 cycles, 50 N, 5/55 °C). The amount of wear loss was measured for each specimen using a digital precise scale. Wear area before and after the chewing simulation were evaluated using an optical profilometer. Data analysed using one-way ANOVA test followed by Tukey's post hoc. The results showed a significantly higher wear loss in resin matrix ceramics in comparison to glass ceramics. However, for tooth wear glass ceramics had significantly higher value than hybrid ceramics. Resin based CAD/CAM Blocks gives a superior result when evaluating the wear behavior and its effect on the opposing tooth surface.

Coffee Solution Effect on Color Differences of Resin Matrix Ceramics

Amaç: Bu çalışmanın amacı; güncel olarak kullanılan üç farklı rezin matriks içerikli CAD/CAM seramiğe iki farklı polisaj işlemi uygulandıktan sonra kahve solüsyonda bekletmenin renk değişimine olan etkisini incelemektir.&#x0D; Gereç ve Yöntemler: Üç farklı rezin matriks CAD/CAM bloktan [Polimer-infiltre ağ yapılı seramik (VE, VITA Enamic), Rezin nanoseramik (LU, Lava Ultimate), Nanopartikülle doldurulmuş nanoseramik (CE, Cerasmart)] toplam 60 örnek (1.5 mm ±0.01 kalınlıkta) hazırlandı (n=20). Hazırlanan örnekler polisaj işlemine göre iki alt gruba ayrıldı (n=10). Birinci gruba polisaj lastiği uygulanırken (D, Diapol Twist) diğer gruba polisaj diskleri uygulandı (S, Sof-Lex Disc). Örneklerin kahve solüsyonunda bekletmeden önceki (L0, a0, b0) ve beklettikten sonraki renk değerleri (L1, a1, b1) spektrofotometre cihazı (Vita EasyShade) ile CIE Lab renk sisteminde kaydedildi. Renk farklılıkları CIEDE2000 (ΔE00) formülü ile hesaplandı. Elde edilen değerler iki yönlü varyans (ANOVA) ve Tukey’s çoklu karşılaştırma testleri ile analiz edildi.&#x0D; Bulgular: İki yönlü varyans analizi sonucu sadece seramik tipinin renk değişikliği üzerine anlamlı farklılıklar oluşturduğu görüldü (p0.05). Bütün gruplarda klinik olarak kabul edilebilir değerin üzerinde renk değişikliği oluştuğu görüldü (ΔE00&gt;1.8). İstatistiksel olarak en az renk değişikliği VE gruplarında görüldü (p

The effect of sandblasting versus acid etching on the surface roughness and biaxial flexural strength of CAD/CAM resin-matrix ceramics (In vitro study)

BackgroundCAD/CAM resin matrix ceramics are one of the materials used in dental offices. The long-term success of the restoration depends on the bond strength of the restoration to the tooth and other materials; thus, surface treatment of the restoration is necessary to achieve this. But such treatment may affect the restoration strength. The purpose of this study is to assess the impact of various surface treatments on the surface roughness (Ra) and the biaxial flexural strength of two CAD-CAM resin-matrix ceramics.MethodsThirty-six-disc-shaped specimens, each measuring 1.2 mm in thickness and 12 mm in diameter, were machined from two resin-matrix ceramic blocks (Lava Ultimate and Cerasmart) (n = 18). Based on the surface treatments, each material was divided into 3 groups: control (no treatment), 50-μm Al2O3 sandblasting, or 9% hydrofluoric acid etching (n = 6). The surface roughness (Ra) was evaluated by the 3D laser scanning microscope. Then, specimens were aged by thermal cycling (5000 cycles) and tested for biaxial flexural strength using a universal testing machine at a crosshead speed of 1.0 mm/min.ResultsNo significant differences in flexural strength or Ra were found for Lava Ultimate among the surface treatment groups. For Cerasmart, only the sandblasting group showed significantly higher Ra values than the control group. Also, the Ra values for the sandblasting group were significantly higher than those for the acid etching group. The flexural strengths of the sandblasting and acid etching groups for Cerasmart were statistically similar, and both were significantly lower than the control group.ConclusionsAlthough all of the applied surface conditioning techniques improved Ra, they had a negative impact on the flexural strength of resin-matrix ceramics. Thus, clinicians should utilize the appropriate surface treatment techniques, taking into account their effects on the surface roughness and mechanical properties of resin-matrix ceramics.

Effect of Anti-COVID-19 Mouthwashes on Shear Bond Strength of Resin-Matrix Ceramics Repaired with Resin Composite Using Universal Adhesive: An In Vitro Study

Using anti-COVID-19 mouthwashes has become necessary to reduce acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmissions. Resin-matrix ceramic (RMCs) materials that are exposed to mouthwashes may affect the bonding of repaired materials. This research was performed to assess the effects of anti-COVID-19 mouthwashes on the shear bond strengths (SBS) of RMCs repaired with resin composites. A total of 189 rectangular specimens of two different RMCs (Vita Enamic (VE) and Shofu Block HC (ShB)) were thermocycled and randomly divided into nine subgroups according to different mouthwashes (distilled water (DW), 0.2% povidone-iodine (PVP-I), and 1.5% hydrogen peroxide (HP)) and surface treatment protocols (no surface treatment, hydrofluoric acid etching (HF), and sandblasting (SB)). A repair protocol for RMCs was performed (using universal adhesives and resin composites), and the specimens were assessed using an SBS test. The failure mode was examined using a stereomicroscope. The SBS data were evaluated using a three-way ANOVA and a Tukey post hoc test. The SBS were significantly affected by the RMCs, mouthwashes, and surface treatment protocols. Both surface treatment protocols (HF and SB) for both RMCs, whether immersed in anti-COVID-19 mouthwash or not, improved the SBS. For the VE immersed in HP and PVP-I, the HF surface treatment had the highest SBS. For the ShB immersed in HP and PVP-I, the SB surface treatment had the highest SBS.

In-Vitro Investigation of Marginal Adaptation and Fracture Resistance of Resin Matrix Ceramic Endo-Crown Restorations

The aim of this study was to evaluate the fracture resistance and marginal adaptation of endo-crown restorations produced from different resin-matrix ceramics (RMS) and the effects of these materials on marginal adaptation and fracture resistance. Three frasaco models were used by preparing (first) premolar teeth in three different margin preparations: butt-joint, heavy chamfer and shoulder. Each group was further divided into four subgroups according to the type of restorative material used: Ambarino High Class (AHC), Voco Grandio (VG), Brilliant Crios (BC) and Shofu (S) (n = 30). Master models were obtained using an extraoral scanner and fabricated with a milling machine. Marginal gap evaluation was performed with a silicon replica technique using a stereomicroscope. Replicas of the models (n = 120) were produced with epoxy resin. The fracture resistance of the restorations was recorded using a universal testing machine. The data were statistically analyzed using two-way ANOVA, and a t-test was applied for each group. Tukey's post-hoc test was performed to compare significant differences (p ≤ 0.05). The highest marginal gap was observed in VG, and the best marginal adaptation and the highest fracture resistance were found in BC. The lowest fracture resistance in Butt-joint preparation design was found in S. In addition, the lowest fracture resistance value in the heavy chamfer preparation design was found in AHC. The heavy shoulder preparation design displayed the highest fracture resistance values for all materials.

Mechanical Properties, Wear Resistance, and Reliability of Two CAD-CAM Resin Matrix Ceramics.

Background and Objectives: There are limited data regarding the behavior of resin matrix ceramics for current CAD-CAM materials. Further studies may be beneficial and can help clinicians planning to use these materials during prosthodontic rehabilitation. The aim of this study was to evaluate and compare the flexural strength and strain distributions, filler content, wear, and reliability of two resin matrix ceramic CAD-CAM materials. Materials and Methods: Two resin matrix ceramics, Ambarino High-Class (AH) and Vita Enamic (VE), were tested for flexural strength (n = 24), wear (n = 10), and reliability (n = 18). Thermogravimetric analysis was used to determine the percentage of filler by weight, and digital image correlation (DIC) was used for strain analysis in flexural strength test. Reliability of each resin matrix ceramic was compared after accelerated lifetime testing of crowns using a two-parameter Weibull distribution. Data of flexural strength, wear, and thermogravimetry were analyzed by independent t-tests with significance level at 5%. Results: The results of DIC analysis were analyzed by a qualitative comparison between the images obtained. The materials tested showed different flexural strength (p &lt; 0.05) and strain distributions. The filler content was the same as informed by manufacturers. No difference was observed in the wear or reliability analysis (p &gt; 0.05). The flexural strength of material AH was superior to VE, and the strain distribution was compatible with this finding. Conclusions: The two resin matrix ceramics tested showed similar behavior in wear and reliability analysis. Both can provide safe use for dental crowns.

Effects of Streptococcus mutans and its fluoride resistant strains on the adhesion of CAD/CAM ceramics to teeth and resin.

The similar elastic modulus of resin-matrix ceramics to dentin has resulted in their recent widespread application clinically. Nevertheless, the bacterial environment of oral cavity can degrade the resin composite. The objective was to analyse the effect of S. mutans and its fluoride-resistant strains on the adhesion of three CAD/CAM ceramics. S. mutans UA159 (UA) was identified, and its fluoride-resistant strain (FR) was induced. For crack observation, three kinds of CAD/CAM ceramics (IPS Empress, Lava Ultimate and Vita Enamic) were bonded with tooth complex (enamel, dentin and flowable resin) through adhesive. For micro-tensile test, ceramics were bonded with flowable resin, and cut into strip test pieces. Then specimens were immersed into the UA, FR and the control solution (BHI) separately for 14 d. Ceramic-adhesive interface and adhesive-tooth complex interface were observed and analyzed through electron microscope and stereomicroscope. Micro-tensile test was conducted. Specimens in bacterial solutions had more cracks and comparatively weaker micro-tensile strength than those in BHI. In ceramic-adhesive interface, Lava Ultimate produced the most cracks. In adhesive-tooth complex interface, adhesive-dentin produced the most cracks. Meanwhile, IPS Empress had the strongest micro-tensile strength when bonded with resin. S. mutans and its fluoride resistant strain can cause cracks in the bonding of ceramics and dental tissue, especially resin-matrix ceramic and dentin, and weaken the bonding strength between ceramics and resin.

Indirect restorative systems-A narrative review.

The background and clinical understanding of the properties of currently available indirect restorative systems and fabrication methods is, along with manufacturer and evidence-based literature, an important starting point to guide the clinical selection of materials for tooth and/or implant supported reconstructions. Therefore, this review explores most indirect restorative systems available in the market, especially all-ceramic, along with aspects of manufacturing process, clinical survival rates, and esthetic outcomes. Progressive incorporation of new technologies in the dental field and advancements in materials science have enabled the development/improvement of indirect restorative systems and treatment concepts in oral rehabilitation, resulting in reliable and predictable workflows and successful esthetic and functional outcomes. Indirect restorative systems have evolved from metal ceramics and polymers to glass ceramics, polycrystalline ceramics, and resin-matrix ceramics, aiming to improve not only biological and mechanical properties, but especially the optical properties and esthetic quality of the reconstructions, in attempt to mimic natural teeth. Based on several clinical research, materials, and patient-related parameters, a decision tree for the selection of indirect restorative materials was suggested to guide clinicians in the rehabilitation process. The pace of materials development is faster than that of clinical research aimed to support their use. Since no single material provides an ideal solution to every case, professionals must continuously seek information from well designed, long-term clinical trials in order to incorporate or not new materials and technological advancements.

Removal of broken screws on implant abutment by digital guide plate: A case report and literature review.

Implant restoration is currently the most mainstream method for repairing missing teeth. With the increasing number of plantings, various planting complications begin to be paid attention to. Among them, there are many reports of disability phenomena such as loose and broken abutment screws and broken top screws, which cause the implant to fail or fail to function. In recent years, with the development of computer-aided software and its application in the field of oral treatment, digital guide plates based on 3D printing of oral CBCT scanning data are widely used in oral implants. Therefore, we explore the application prospect of post-core crown restoration after removing broken screws from the implant abutment with a digital guide plate. We reported a case of upper right first molar implant abutment screws broken, which were removed by a digital guide plate and customized turning bur. The resin-matrix ceramics crown post core was prepared, and then the occlusal force was tested by the T-ScanIII system. It provides a reference for the application of digital guide plates in special cases such as broken screws of implant abutment.

Marginal and Internal Misfit of Occlusal Veneers Made in Resin-matrix Ceramics.

Considering that misfit is a significant predictor of the clinical success of indirect restorations, the objective of this study was to evaluate the marginal and internal misfit of two computer-aided design and manufacturing (CAD/CAM) RMC ceramic materials used as occlusal veneers (OVs) of different thicknesses. A CAD model of a mandibular first molar was obtained and OV preparations 0.5-, 1.0-, and 1.5-mm thick were modeled and milled in two different materials (n=10/group): resin nanoceramic (RNC) and polymer-infiltrated ceramic network (PICN). Using the same CAD model, tooth preparations were milled in fiber-reinforced epoxy resin (n=20/thickness). The marginal and internal misfit of the restorations was assessed by X-ray microtomography. The measurements of the marginal gap (MG) and absolute marginal discrepancy were performed in two locations on each slice, whereas internal gap (IG) measurements were performed at ten locations on each slice. The data obtained were analyzed using two-way analysis of variance and Tukey post-hoc tests (α=0.05). No significant effect was attributable to the material type or material-thickness interaction for the MG, absolute marginal discrepancy (AMD), or IG (p>0.05). However, the thickness significantly affected the IG of the restorations (p<0.05). CAD/CAM RNC and PICN systems presented similar MG and AMD for OVs 0.5-, 1.0-, and 1.5-mm thick. However, the IG varied between thicknesses.

Rezin Matriks Seramiklere Uygulanan Yüzey İşlemlerinin Bağlanma Dayanımına Etkisi

Günümüz diş hekimliği uygulamalarında en sık tercih edilen restorasyon materyali tam seramiklerdir. CAD/CAM uygulamalarındaki gelişmelerle birlikte materyal çeşitliliği ve kullanım alanları genişleyen tam seramik sistemler metal destekli seramikler için alternatif oluşturmaktadır. Rezin matriks seramikler direkt ve indirekt restorasyonlarda sık tercih edilen iki materyalin avantajlarını bir araya getirmeyi amaçlamaktadır. Seramik ve kompozitin olumlu özelliklerini bir araya getiren bu materyaller kolay işlenebilirlik, iyi marjinal uyum, yüksek mekanik direnç ve tamir edilebilirlik gibi avantajlara sahiptir. Tüm restorasyonlarda olduğu gibi tam seramiklerde de başarılı bir restorasyon için başarılı bir bağlanma gereklidir. Rezin matriks seramiklerde adeziv bağlanma önerilmektedir. Adeziv bağlanmanın başarısı uygulama yapan hekimin bilgi ve becerisine, izolasyon koşullarına, doğru materyal seçimine ve simantasyon öncesi gerekli yüzey hazırlıklarının yapılmış olmasına bağlıdır. Başarılı adeziv bağlantı için simantasyon öncesinde uygulanan yüzey hazırlıkları bağlanma dayanımı değerlerini oldukça arttırmaktadır. Bu yüzey işlemleri; mekanik, kimyasal veya hem mekanik hem kimyasal olabilmektedir ve materyal içeriğine uygun olarak seçilmelidir. Rezin matriks seramikler için simantasyon öncesinde yüzey işlemi ve silan uygulaması önerilmektedir.