Zirconia-reinforced Lithium Silicate Research Articles

Flexural Strength of Different Monolithic Computer-Assisted Design and Computer-Assisted Manufacturing Ceramic Materials Upon Accelerated Aging.

The durability of ceramic is crucial, which is probably influenced by aging. This study evaluated the effect of aging on flexural strength of different ceramics. One-hundred twenty ceramic discs (Ø 12 mm, 1.5 mm thickness) were prepared from zirconia-reinforced lithium silicate (ZLS, C), lithium disilicate (LS2, E), precolored yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP, Ip), and customized color Y-TZP (Ic). Samples were randomly divided into two groups for accelerated aging (A) between 5 and 55°C water baths, 30-second immersing time each, for 10,000 cycles, and nonaged group (N), serving as control. Biaxial flexural strength (σ) was evaluated utilizing the piston-on-three-balls at 0.5 mm/min speed. Analysis of variance and Tukey comparisons were determined for significant differences (α = 0.05). Weibull analysis was applied for survival probability, Weibull modulus (m), and characteristic strength (σo). Microstructures were evaluated with scanning electron microscopy and X-ray diffraction (XRD). The highest σ and σo were seen for IcN, followed by IcA, IpN, IpA, EN, CA, CN, and EA, respectively. CN showed the highest m, while EA showed the lowest m. Significant differences of σ for each ceramic were indicated (p < 0.05). Aging caused a significant difference in σ (p < 0.05). XRD showed t→m phase transformation of Ip and Ic after aging. Aging affected strength of ceramics. Comparable strength between LS2 and ZLS was evidenced, but both were less strength than Y-TZP either aging or non-aging. Comparable strength between precolored Y-TZP and customized color Y-TZP was indicated. Better resisting aging deterioration of Y-TZP than LS2 and ZLS is suggested for fabrication restorative reconstruction.

Assessment of color stability and translucency of various CAD/CAM ceramics of different compositions and Thicknesses: An in vitro study

BackgroundTranslucency and optical characteristics significantly affect the aesthetics of ceramic restorations. The introduction of new virgilite crystals to novel ceramic advanced lithium disilicate through a matrix firing process enhances the material’s strength and aesthetic quality according to the manufacturer. Materials and MethodsFour types of CAD/CAM ceramics; lithium disilicate (LD), leucite reinforced (LR), advanced lithium disilicate (ALD), and zirconia-reinforced lithium silicate (ZLS) exposed to different staining solutions (tea, cola, coffee, and distilled water). Each ceramic type had 120 specimens, divided into subgroups based on thickness (0.5 mm, 1 mm, and 1.5 mm). Color changes (ΔE00) and translucency parameters (TP00) were measured after thermocycling, and spectrophotometry was employed to evaluate ΔE00 and TP00 after 1, 7, and 30 days of exposure to the staining solutions. ResultsZLS exhibited the lowest color stability, while lithium LD and ALD displayed the highest. Thickness significantly affected color stability, with 0.5 mm thickness showing the least change. The duration of exposure also impacted color changes, with 30 days causing the most significant shift. LD demonstrated the highest translucency. Coffee and tea induced more pronounced reductions in translucency and color stability compared to the control group. ConclusionsMaterial structure, thickness, staining solution, and exposure duration significantly influenced the color stability and translucency of CAD/CAM ceramics, with LD and ALD demonstrating superior color stability and LD exhibiting the highest translucency.

Effect of Post-Processing Heat Treatment on Micro-Contact Damage of Zirconia-Reinforced Lithium Silicate Dental Materials.

Zirconia-reinforced lithium silicate (ZLS) is utilized as a material for prosthetic tooth crowns, offering enhanced strength compared to other dental glass-ceramics. In this study, we investigate a commercial ZLS material, provided in a fully crystallized form. We examine the effects of an optional post-processing heat treatment on micro-contact damage using controlled indentation tests simulating the primary modes of contact during chewing: axial and sliding. Our findings indicate that the heat treatment does not affect mechanical properties such as the elastic modulus, hardness and indentation fracture toughness. However, it does enhance the resistance to contact damage by fracture and chipping in both axial and sliding modes, as well as the resistance to crack initiation measured from sliding tests. This improvement is attributed to the refinement of the flaw population achieved through the heat treatment. The results are analysed using principles of contact and fracture mechanics theory, discussing their significance in prosthetic dentistry.

Effect of Thermal Cycling or Simulated Gastric Acid on the Surface Characteristics of Dental Ceramic Materials

(1) Background: The presence of various dental ceramic materials with different chemical compositions complicates clinicians’ decision making, especially in cases with a highly acidic environment appearing in patients suffering from gastroesophageal reflux disease or other eating disorders. Thermal alterations in the oral cavity can also affect surface structure and roughness, resulting in variations in both degradation mechanisms and/or bacteria adhesion. The aim of the present in vitro study was to evaluate the effect of thermal cycling and exposure to simulated gastric acid on the surface roughness of different ceramics; (2) Methods: Five groups of different ceramics were utilized, and twenty specimens were fabricated for each group. Specimens were either thermocycled for 10,000 cycles in distilled water or immersed in simulated gastric acid for 91 h. The evaluation of surface roughness was performed with optical profilometry, while scanning electron microscopy, X-ray diffraction analysis and inductively coupled plasma atomic emission spectroscopy were also performed; (4) Conclusions: Based on the combination of the surface roughness profile and structural integrity, zirconia specimens presented the smallest changes after immersion in simulated gastric acid followed by lithium disilicate materials. Zirconia-reinforced lithium silicate ceramic presented the most notable changes in microstructure and roughness after both treatments.

Effect of Two Different Intraoral Polishing Systems on Surface Roughness, Color Stability, and Bacterial Accumulation of Zirconia-Reinforced Lithium Silicate Ceramic.

The aim of this study was to investigate the effects of two intraoral polishing methods on zirconia-reinforced lithium silicate ceramic after ultrasonic scaling. Thirty disc-shaped samples of zirconia-reinforced lithium silicate were constructed. Freshly extracted bovine teeth were collected and cleaned then the discs were cemented into a cavity prepared onto their labial surface. The samples were divided into three groups (10 samples per group); S: Scaling only, SE: Scaling followed by polishing using Eve Diapro lithium disilicate polishers, SD: Scaling followed by polishing using Diatech ShapeGuard ceramic polishing plus kit. The surface roughness was evaluated after scaling and polishing the samples. For color stability, the samples were stored for 12 days at 37°C in an incubator to simulate 1-year consumption of coffee. L*a*b* color parameters were assessed using VITA Easyshade Advance 4.0 before and after the staining procedure and the color difference was measured. Finally, bacterial accumulation was evaluated by incubating the samples with a suspension of Streptococcus mutans ( S. mutans), after that the S. mutans colonies were counted to obtain the values of colony-forming units (CFU). The final overall roughness, change in color and bacterial count were compared between all groups using one-way ANOVA and Tukey's post-hoc analysis. The Pearson correlation coefficient was used to determine the correlation between continuous variables. The cutoff for significance was chosen at p ≤ 0.05. Scaling induced surface roughness of the zirconia-reinforced lithium silicate ceramic was significantly decreased after using both intraoral polishing systems and this was accompanied by a significant decrease in color change and bacterial count. Intraoral polishing techniques can reduce the roughness of the surface of zirconia reinforced lithium silicate restorations induced due to scaling and subsequently reduce the stainability and bacterial accumulation.

Comparison of Two Body Wear Resistance of Novel Strength- Gradient Monolithic Zirconia with Two Different CAD/CAM Materials

Objective: Novel strength-gradient monolithic zirconia is a developed material recently introduced to the market and its mechanical properties should be investigated in vitro. The aim of the study is to compare the wear rates of three different CAD/CAM materials with a chewing simulator after one year of dynamic loading.&#x0D; Methods: 7x7x3 mm discs were prepared from lithium disilicate, strength-gradient monolithic zirconia, and zirconia-reinforced lithium silicate glass ceramic. Both groups were divided into two subgroups (n=12) as glazed and mechanically polished. &#x0D; The samples were scanned with a laser scanner device (SD Mechatronic Laser Scanner LAS-20, Westerham, Germany) to determine the amount of wear. The samples were placed in a chewing simulator (SD Mechatronic Chewing Simulator CS-4.2, Westerham, Germany) for 240 000 cycles which is equivalent to 1 year of clinical use. After the dynamic loading in the chewing simulator, the samples were scanned again in the laser scanner, and the data was obtained. Kruskal Wallis test was used to analyze the data.&#x0D; Results: The amount of wear of each material was found to be statistically significant (p&lt; .05). No significant differences between the polished and glazed groups of Zir and LD were found but glazed CD was significantly more wear-resistant than polished CD (p&lt; .05). &#x0D; Conclusions: Wear is a phenomenon that can be affected by different factors such as microstructure and surface finishing of the materials. Wear resistance should be taken into consideration when choosing a material.

Surface Roughness Evaluation of Pre- Versus Post-Crystallization Polish of Two High-Strength Silicate Ceramics for Chairside CAD/CAM Technology

This in vitro study evaluated the surface roughness (Sa) of two high-strength silicate ceramics, lithium disilicate IPS e.max CAD, Ivoclar Vivadent (LDS group), and zirconia-reinforced lithium silicate Vita Suprinity, VITA Zahnfabrik (ZLS group). The surface roughness was investigated before and after milling using different polishing systems and timings relative to the final crystallization of the ceramics. Forty-eight samples per group were polished by a single calibrated operator using two polishing systems: Dialite LD (Brasseler) and Lithium Silicate Polishers (Meisinger) for the LDS group and Dialite LD (Brasseler) and Vita Suprinity Polishing Set Technical (VITA Zahnfabrik) for the ZLS group, both pre- and post-crystallization. Surface roughness was measured using a confocal laser microscope (OLS4000 LEXT/Olympus), with scanning electron microscopy (SEM) used to evaluate surface morphological changes. Significant differences in Sa values were found between baseline groups, with ZLS exhibiting lower values. All polishing methods significantly reduced surface roughness compared to baseline (p ≤ 0.05). No significant differences were found in LDS samples when polishing pre- or post-crystallization (p = 0.129), while for ZLS samples, post-crystallization polishing achieved significantly smoother surfaces (p &lt; 0.001). The study concluded that the choice of polishing system and timing did not significantly affect surface roughness for LDS. However, it is recommended that post-crystallization polishing be performed for the optimal smoothness of ZLS. This study aimed to evaluate the post-milling polishing procedures of CAD/CAM high-strength restorations, emphasizing the importance of an optimal surface roughness to prevent issues such as increased risk of abrasion on opposing teeth, enhanced plaque adhesion, and mechanical failures. Investigating these polishing techniques enables clinicians to optimize clinical performance, thereby improving the quality and longevity of high-strength silicate ceramics.

The Influence of Ferrule Design and Pulpal Extensions on the Accuracy of Fit and the Fracture Resistance of Zirconia-Reinforced Lithium Silicate Endocrowns.

The study aimed to assess the marginal, axial, and internal adaptation, as well as the fracture resistance of zirconia-reinforced lithium silicate (ZLS) endocrowns with varying pulpal inlay extensions and marginal geometry. Sixty extracted maxillary first molar teeth were divided into six groups (n = 10) according to pulpal inlay extension and marginal configuration. The first three groups (J2, J3, and J4) utilized prepared teeth for endocrowns without ferrule design and 2 mm, 3 mm, and 4 mm pulpal extensions, respectively. The second three groups (F2, F3, and F4) utilized prepared teeth with 1 mm shoulder margins and 2 mm, 3 mm, and 4 mm pulpal extensions. The endocrowns were fabricated from ZLS blocks using CAD/CAM milling technology. After cementation, the specimens underwent thermal aging for 5000 cycles and were evaluated for marginal adaptation. Using a universal testing machine, the fracture resistance was tested under quasistatic loading (1 mm/min). Two-way ANOVA and the Tukey's post hoc test were employed for data analysis (p ≤ 0.05). The results of this study revealed that endocrowns without ferrule exhibited superior fracture strength than a 1 mm ferrule design p < 0.05, irrespective of the inlay depth. All designs with and without ferrule and all inlay depths showed clinically acceptable marginal and internal fit. The conventional endocrown design without ferrule and 2 mm inlay depth showed the lowest surface gap. The pulpal surface showed the highest discrepancy among all groups compared to the other surfaces. Endocrowns without ferrule are more conservative and have higher fracture strength than 1 mm ferrule designs; extending the inlay depth showed a significant increase in fracture resistance of the 1 mm ferrule design, but not for the conventional design without ferrule and 2 mm inlay depth. All groups exhibited a high auspicious fracture strength value for molar endocrown restorations.

SEM Evaluation of the Marginal Gap of Zirconia-Reinforced Lithium Silicate Full Crowns and the Effect of Post Crystallization: An In Vitro Study.

This study compared the influence of crystallization on marginal gap adaptation by using computer-aided design and manufacturing (CAD-CAM) for producing monolithic zirconia-reinforced lithium silicate (ZLS) ceramic crowns. A total of 25 plastic teeth were scanned using a Primescan intra-oral scanner (IOS), and ZLS crowns were ground. For each unit (abutment and crown), the marginal gap was evaluated pre crystallization and post crystallization at four regions of interest through the use of a scanning electron microscope (SEM). To compare the marginal gap between the two groups, a Kolmogorov-Smirnov test performed on the study variables indicated a normal distribution (p > 0.05) followed by paired samples T-tests (α = 0.0005). After crystallization, there were significantly higher circumferential marginal gaps (CMGs) for all four surfaces (distal (p = 0.0005), mesial (p = 0.0005), palatal (p = 0.0005), and buccal (p = 0.0005)). The total mean marginal gap (MMG) revealed a significantly higher result for the post-crystallization group (79.82 ± 7.86 μm) compared to the pre-crystallization group (24.25 ± 5.49 μm). The post-crystallization group showed a significantly higher marginal gap compared to the pre-crystallization group in all parameters, but both groups were in the clinically accepted threshold (<120 microns). In terms of the marginal gap, it is arguable whether to carry out post-crystallization for CELTRA® DUO crowns and achieve better mechanical properties but significantly increase the marginal gap.

Effects of Various Laser Treatments on Surface Characterization and Repair Bond Strength of Zirconia-Reinforced Lithium Silicate Ceramics.

To evaluate the effects of two different lasers and their use in combination with hydrofluoric acid (HF) etching on the surface roughness of zirconia-reinforced lithium silicate (ZLS) ceramics and their shear bond strength (SBS) to composite resin. The five study groups were as follows: (1) Group H = HF etching; (2) Group N = Nd:YAG (neodymium: yttrium-aluminum-garnet) laser; (3) Group NH = Nd:YAG laser + HF gel; (4) Group E = Er:YAG (erbium: yttrium-aluminum-garnet) laser; and (5) Group EH = Er:YAG laser + HF gel. Surface roughness was assessed using a noncontact profilometer, and SBS tests were conducted with a universal testing machine. The mean SBS values were 16.23 ± 1.77 MPa for Group H, 17.1 ± 1.65 MPa for Group N, 16.65 ± 1.11 MPa for Group NH, 8.08 ± 1.12 MPa for Group E, and 11.58 ± 0.82 MPa for Group EH. There were significant differences between groups E and EH (P < .001) but no significant differences (P > .05) among the other groups. Clinicians may prefer Nd:YAG laser or the combination of Nd:YAG and HF to intraorally repair fractured areas.

Effect of 4-META on microtensile bond strength of cements to ceramics

Background: This study assessed the effect of different concentrations of 4-methacryloyloxyethy trimellitate anhydride (4-META) added to silane on microtensile bond strength (µTBS) of light-cure and dual-cure resin cement to hybrid and zirconia-reinforced lithium silicate ceramics. Materials and Methods: This in vitro, experimental study was conducted on 32 Celtra Duo and 32 VITA Enamic ceramics bonded to Allcem Veneer light-cure and Allcem dual-cure resin cements using silane impregnated with 4-META in 0%, 2.5%, 5%, and 10 wt% concentrations in 16 groups (n = 4). The µTBS of specimens was measured by a universal testing machine and analyzed by the Kruskal–Wallis and Mann–Whitney tests, and the mode of failure was determined under a stereomicroscope and analyzed by the Chi-square test (alpha = 0.05). Results: The lowest mean µTBS was recorded in the Enamic ceramic group with 4-META (0%) bonded to dual-cure cement (14.26 MPa), and the highest mean µTBS was recorded in Enamic ceramic with 4-META (10%) bonded to light-cure cement (18.59 MPa) (P &lt; 0.001). The µTBS of Celtra Duo was significantly higher than that of Enamic in bonding to light-cure cement using 4-META (2.5%) (P = 0.003). All failures (100%) were adhesive in most groups. The frequency of adhesive failure was the lowest (90%) in Celtra Duo bonded to dual-cure cement with 4-META (5%). Conclusion: According to the results of this pilot study, the addition of 4-META (10%) to silane caused a significant improvement in µTBS to light-cure cement. The addition of 4-META in all concentrations significantly improved the µTBS to Enamic ceramic in the use of dual-cure cement; however, it had no significant effect on µTBS of Celtra Duo. Nonetheless, the results should be interpreted with caution due to the relatively small sample size.

Fracture strength of endocrowns after thermomechanical aging.

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

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

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

Fracture resistance evaluation of CAD/CAM zirconia and composite primary molar crowns with different occlusal thicknesses.

To evaluate the effect of different CAD/CAM materials and occlusal thicknesses on the fracture resistance of primary molar crowns. Sixty extracted primary molar teeth were prepared and randomly divided into six experimental groups according to the material and thickness. Primary molar crowns with a central groove thickness of 0.3 and 0.5 mm were fabricated from CAD/CAM zirconia (group Z), zirconia-reinforced lithium silicate (group ZLS), and pre-polymerized composite resin blocks (group C). Each crown was cemented with self-adhesive resin cement on the prepared tooth. All specimens were subjected to fracture tests until fracture. Fracture load values were recorded in Newtons (N). Data were statistically analyzed using a two-way analysis of variance (ANOVA) followed by Tukey multiple comparison test. The highest fracture load values were obtained in group Z at 0.5 mm occlusal thickness and were significantly higher compared with the other experimental groups (p < 0.05). Although the lowest fracture load values were obtained in group ZLS at 0.3 mm occlusal thickness, all the tested CAD/CAM primary molar crowns at both thicknesses demonstrated fracture load values exceeding reported chewing force in pediatric patients. CAD/CAM primary molar crowns with reduced occlusal thickness may be used for the full-coverage restoration of primary molar teeth.

Surface treatments of the zirconia-reinforced lithium disilicate ceramic in the adhesion to the resin cement.

This study verified the effect of surface treatments of the zirconia-reinforced lithium disilicate ceramic bonded to resin cement. Ceramic blocks were divided according to treatments (n=10): FA+SRX (Fluoric acid + silane RX), FA+MDP (Fluoric acid + MDP), FA+SCF+MDP (Fluoric acid + silane CF + MDP), FA+MEP (Fluoric acid + MEP), and MEP (Self-etch primer). Resin cement cylinders were made in the ceramic blocks, photoactivated with 1,200 mW/cm² for 40s, stored in water at 37°C for 24h, and evaluated by the microshear strength test, optical failure descriptive analysis (%), surface characterization (SEM) and contact angle (Goniometer). Other samples were submitted to 10,000 thermocycles between 5°C and 55°C. Bond strength data were submitted to two-way ANOVA and Tukey's test. Contact angle to one-way ANOVA and Games-Howell's test (5%). At 24h, MEP showed higher bond strength, and FA+SRX the lower. FA+MDP and FA+SCF+MDP showed similar values and FA+MEP was intermediate. After thermocycling, FA+SCF+MDP, FA+MEP, and MEP showed higher values, and FA+SRX the lower while FA+MDP was intermediate. When the periods were compared, FA+MDP, FA+SCF+MDP, FA+MEP, and MEP showed higher values for 24h while FA+SRX was similar. SEM showed retentive surface and crystal exposure when treated with FA+SCF+MDP. The less retentive surface was obtained with MEP, and the other treatments promoted intermediate irregularities. In conclusion, surface treatment and thermocycling promoted different values of adhesive strength and contact angle in a zirconia-reinforced lithium silicate ceramic. Failures were predominantly adhesive, and the ceramic surface was characterized by different levels of roughness and selective exposure of crystals.

Monolithic hybrid abutment crowns: Influence of crown height, crown morphology and material on the implant-abutment complex.

This in vitro study investigated the influence of material selection, crown morphology, and vertical crown height on the biomechanical behavior of monolithic hybrid abutment crowns (HACs). Ninety implants were embedded in accordance with ISO standard 14801; ninety HACs were mounted (N=90). Monolithic crowns with varying group-specific designs were luted using titanium bases. HACs were fabricated from monolithic lithium disilicate ceramic (LD) or zirconia-reinforced lithium silicate ceramic (ZLS). The crown morphology was either maxillary premolar (LD_PM, ZLS_PM) or molar (LD_MO). The three groups were further divided into three subgroups of ten specimens, each designed with a small (7.5 mm), middle (10.5 mm), and high (13.5 mm) configuration of crown heights (N=10). A load-to-failure test at 30° off-axis was conducted using a universal testing machine until failure. For statistical analysis, Kolmogorov-Smirnov and Mann-Whitney U tests were conducted (P < 0.05). All LD_MO groups presented the highest failure values (808.7 to 947.9 N), followed by the LD_PM (525.8 to 722.8 N) and ZLS_PM groups (312.6 to 478.8N). A comparison between LD and ZLS materials (P < 0.001) as well as the crown morphology (P < 0.001) showed significant differences in failure values. The values in the subgroups of ZLS_PM (low, middle, high) decreased as the crown height increased. The fracture modes showed no consistent patterns across the test groups. Material selection, crown morphology, and vertical crown height appear to be important factors that may influence the clinical failure values and patterns of HACs.

Effect of Cement Translucency and Ceramic Thickness on the Resulting Colour Match of Zirconia-Reinforced Lithium Silicate Restorations Cemented over Dark-Coloured Substrate

Effect of Cement Translucency and Ceramic Thickness on the Resulting Colour Match of Zirconia-Reinforced Lithium Silicate Restorations Cemented over Dark-Coloured Substrate

Zirconia-Reinforced Lithium Silicate Ceramic in Digital Dentistry: A Comprehensive Literature Review of Our Current Understanding.

Zirconia-reinforced lithium silicate (ZLS) ceramic is a new innovative dental material with unique a chemical composition that is designed to combine harmoniously with the appropriate optical properties of lithium disilicate and the enhanced mechanical strength of zirconia. A thorough understanding of ZLS materials is essential for both clinicians and dental technicians. At present, the mechanical behavior and optical properties of the ZLS ceramic system have not been extensively researched, and there is still a lack of consensus regarding the fabrication process and clinical behavior of ZLS all-ceramic restorations. The aim of the present study was to present a selection of comprehensive information concerning zirconia-reinforced lithium silicate ceramics and their optical and mechanical properties, as well as to assess data regarding cementation procedures and clinical outcomes for ZLS all-ceramic restorations. Three electronic databases (PubMed, Web of Science, and the Cochrane Library) were used for the research by two independent reviewers. The search was limited to articles published in the English language, as well as clinical and in vitro studies of color and studies on mechanical behavior and the cementation procedures of ZLS restorations. The exclusion criteria comprised abstracts, questionnaire-based studies, case reports, literature reviews, and studies that were not available in English. Zirconia-reinforced lithium-silicate-based ceramic presents a unique and complex microstructure that increases mechanical resistance but decreases aesthetic appearance, especially its translucency, due to tetragonal zirconia content. A material's thickness, the color of the underlying tooth structure, and the resin cement shade are important factors that influence the final shade and aesthetic appearance of ZLS restorations. Mechanical properties, which are defined by the fracture toughness, flexural strength, elastic modulus, and hardness of ZLS ceramic are higher compared to feldspathic, lithium disilicate, and hybrid ceramics, as well as resin nanoceramics; however, they are lower than translucent or high-translucency zirconia. Acid etching, sandblasting, and laser etching represent the most used methods to prepare the ZLS restoration surfaces for proper bonding procedures.

Influence of Different Thicknesses of Monolithic Crowns Made from Different Resin-Bonded Glass Ceramic on Their Load-bearing Capacity (An in vitro Comparative Study)

Objective: To investigate the load-bearing capacity of the full-coverage crowns made from lithium disilicate glass-ceramic LDGC (IPS e.max®, Ivoclar Vivadent) and 10% zirconia reinforced lithium silicate glass ceramic ZLS (Dentsply DeTrey) with different thicknesses.&#x0D; Methods: Forty resin dies with supporting bases were duplicated from two prepared typodont teeth for all-ceramic crowns as a maxillary first molar. Forty crowns corresponding to each die were prepared and then they were divided into four groups: Group I (n 10) made from ZLS with a restoration thickness of (1.0 mm occlusally and 1.0 mm radially) and Group II (n 10) made from LDGC with a restoration thickness of (1.0 mm occlusally and 1.0 mm radially), and Group III (n 10) made from ZLS (1.5 mm occlusally and 1.5mm radially) and Group IV (n 10) made from LDGC (1.5 mm occlusally and 1.5 radially). All crowns were fabricated by chair side CEREC CAD/CAM and crystallized with Speed fire Dentsply Furness. The virolink resin cement (VariolinkII, Ivoclar Vivadent) was used to bond the crowns to the corresponding dies.  All samples were thermo-cycled (10000 cycles between 5c and 55c) and tested for fracture resistance using a Universal testing machine at 0.5 mm/minute speed until failure. ANOVA and Tukey HSD test were used to compare the fracture resistance between groups.&#x0D; Results: The result demonstrates that the fracture resistance means and SD of ZLS with different thicknesses ranged from 572 N ± 122.002 to 1171±217.432 N, and those of LDGC with different thicknesses ranged from 625 N ±151.676 N to 845 N ±388.222 N.&#x0D; Conclusions: The fracture resistance increased with increasing crown thickness using different glass-ceramic materials.

Strength of a Zirconia- Reinforced Glass-Ceramic After Diamond Bur Adjustment.

Adjustments with diamond burs on the ceramic surface can affect its roughness and decrease flexural strength. This study evaluated the effect of polishing or glazing on the surface roughness and biaxial flexural strength of a zirconia-reinforced lithium silicate glass-ceramic upon adjustment with diamond burs. Seventy disks were prepared according to ISO 6872 and divided into seven groups (n = 10) according to different adjustments and finishing processes. Surface roughness was measured prior to biaxial flexural strength testing. The topography was analyzed using an atomic force microscope , fracture markings were identified using a stereomicroscope and representative specimens were analyzed using scanning electron microscopy. The use of diamond burs significantly increased the surface roughness and decreased the strength of the evaluated ceramic (p⟨0.05). Polishing reduced the ceramic's roughness but resulted in flexural strength similar to that of the groups with wear (p⟩0.05). The glaze-treated specimens showed flexural strength statistically similar to the control group (p>0.05) but higher roughness, similar to those with wear. Polishing reduced the surface roughness but did not affect the biaxial flexural strength of the ZLS ceramic. At the same time, the application of glaze after wear increased the strength.