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Zandinejad A, Floriani F, Madhu N, Cunha SR, Barmak AB, Diegel DA, Cho SH. Shear bond strength of resin cement to additively manufactured zirconia with customized surface texture and porosity: Part 1. J Prosthet Dent 2025:S0022-3913(25)00248-3. [PMID: 40169342 DOI: 10.1016/j.prosdent.2025.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 03/08/2025] [Accepted: 03/10/2025] [Indexed: 04/03/2025]
Abstract
STATEMENT OF PROBLEM The additive manufacturing of zirconia has been reported to present promising mechanical properties. However, studies on bonding to additively manufactured (AM) zirconia are lacking. PURPOSE The purpose of this in vitro study was to investigate the effect of customized porosity and surface texture on the shear bond strength (SBS) of resin cement to 3-dimensionally (3D) printed zirconia. MATERIAL AND METHODS A total of 60 zirconia disks (Ø12×5 mm) were designed with different surface porosity using a computer-aided design (CAD) software program and manufactured via stereolithography (SLA) 3D printing. The disks were divided into 4 groups (n=15) based on surface texture and porosity: Control (no designed porosities), G1:50 (50×50-µm pores 200 µm apart), G2:100 (100×100-µm pores 400 µm apart), and G3:200 (200×200-µm pores 800 µm apart). The specimens were cleaned, and the binder removed before sintering. The microstructural analysis of the specimen's surface before SBS was performed using a profilometer to determine surface texture (n=5). SBS was measured using a universal testing machine, and thermal cycling was performed to simulate aging (n=10). Data for SBS were analyzed using 2-way ANOVA (α=.05). RESULTS Surface texture and porosities were confirmed by profilometry. In all comparisons, the G3:200 group demonstrated the highest mean SBS with 8.78 MPa (P<.001); however, it was similar to the Control group, which had a mean of 8.41 MPa (P=.631). The G1:50 showed significantly lower SBS values at 3.90 MPa (P<.001), followed by the G2:100 group with 5.14 MPa (P<.001). Thermal cycling generally decreased SBS in all groups (P<.001). CONCLUSIONS Customized surface textures can improve bond strengths, with larger pores (200×200 µm) providing values comparable with those of traditional mechanical pretreatments surfaces, while smaller pores resulted in lower bond strengths. This approach avoids surface damage and phase transitions caused by traditional treatments. These findings provide a foundation for future research aimed at developing more durable and reliable zirconia restorations, ultimately enhancing clinical outcomes.
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Affiliation(s)
- Amirali Zandinejad
- Private practice, Arlington, Texas.; and Adjunct Associate Professor, Department of Prosthodontics, School of Medicine and Dentistry, University of Rochester, Rochester, NY.
| | - Franciele Floriani
- Clinical Assistant Professor, Department of Prosthodontics, University of Iowa, Iowa City, IA
| | - Nikkita Madhu
- Clinical Assistant Professor, Department of Prosthodontics, University of Iowa, Iowa City, IA
| | - Sandra Ribeiro Cunha
- Clinical Assistant Professor Department of Operative Dentistry, University of Iowa, Iowa City, IA
| | - Abdul Basir Barmak
- Associate Professor, Clinical Research and Biostatistics, School of Medicine and Dentistry, University of Rochester, Rochester, NY
| | - David Allan Diegel
- Sales and Business Development Associate, 3DCeram Sinto Company, Grand Ledge, Mich
| | - Seok-Hwan Cho
- Clinical Associate Professor and Chair, Department of Prosthodontics, University of Iowa, Iowa City, IA
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Andrei AD, Constantin CA, Tabitha AL, Anca J. Zirconia single retainer fixed dental prostheses for the posterior region-A novel preparation technique and literature review. Clin Case Rep 2024; 12:e9460. [PMID: 39421529 PMCID: PMC11483597 DOI: 10.1002/ccr3.9460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 08/21/2024] [Accepted: 09/01/2024] [Indexed: 10/19/2024] Open
Abstract
The principles of tissue preservation, minimally invasiveness and approaching different clinical situations biologically rather than surgically govern today's dentistry. Thus, different clinical scenarios require procedures that offer the dentist and the patient the possibility to choose the more invasive treatment options later in life. Subsequently, the case reported refers to a minimally invasive technique that treats single tooth edentulism using single partial retainer FDPs fabricated from monolithic zirconia. This approach is conservative, biocompatible, aesthetic, strong, rapidly obtained through CAD/CAM techniques and cost-effective.
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Affiliation(s)
- Adam Dragoș Andrei
- Department of Prosthodontics, Faculty of Dental MedicineUniversity of Medicine and Pharmacy “Victor Babeș” TimișoaraTimișoaraRomania
| | - Cândea Adrian Constantin
- Department of Prosthodontics, Faculty of Dental MedicineUniversity of Medicine and Pharmacy “Victor Babeș” TimișoaraTimișoaraRomania
| | - Avram Liane Tabitha
- Department of Prosthodontics, Faculty of Dental MedicineUniversity of Medicine and Pharmacy “Victor Babeș” TimișoaraTimișoaraRomania
| | - Jivănescu Anca
- Department of Prosthodontics, Faculty of Dental MedicineUniversity of Medicine and Pharmacy “Victor Babeș” TimișoaraTimișoaraRomania
- Digital and Advanced Technique for EndodonticRestorative and Prosthetic Treatment TADERPTimișoaraRomania
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Kasem AT, Abo-Madina M, Al-Zordk W. Influence of retainer design and number of inlay boxes on the biomechanical behavior of zirconia cantilever resin bonded fixed dental prosthesis. J ESTHET RESTOR DENT 2024; 36:652-662. [PMID: 37737460 DOI: 10.1111/jerd.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES The development of dental adhesives with enhanced bond strength has assisted minimally invasive dentistry. The aim of this study was to evaluate the fracture load and stress distribution pattern of two retainer designs for posterior cantilever resin bonded fixed dental protheses (RBFDPs). MATERIALS AND METHODS Forty human mandibular molars were divided into two groups according to the retainer design; lingual coverage (LC) and occlusal coverage (OC) retainers. Each main group was then divided according to the number of inlay boxes (n = 10); one inlay and two inlay boxes. High translucency (3Y) zirconia was used to manufacture all restorations, and a dual-polymerizing adhesive resin cement was used for bonding. All specimens underwent 10,000 cycles of thermocycling (5-55°C), 240,000 cycles of dynamic loading (50 N, descending speed v = 30 mm/second, frequency = 1.6 Hz), and failure load test. Both one-way and two-way ANOVA tests were used to analyze the data. The four models included in the in-vitro study are part of the finite element analysis (FEA). When the restorations failed, maximal principal stress values on restorations, enamel, dentin, and luting resin were investigated. RESULTS A statistically significant (p = 0.018) higher failure load was recorded for OC1 (627.00 ± 153.4 N) than the other groups; (548.0 ± 75.6 N, 521.20 ± 11.3 N, and 509.20 ± 14.9 N for LC1, LC2, and OC2, respectively). With regard to failure mode, one inlay box designs showed more favorable failure pattern than those of two inlay boxes. FEA showed higher stress magnitude transmitted to the tooth structure in models LC2 and OC2. CONCLUSIONS Lingual coverage and occlusal coverage retainers are promising designs capable to withstand the normal occlusal force for cantilever RBFDP in premolar area. The use of two inlay boxes decreased the fracture load of the two retainer designs and increased the stress transmitted to the tooth and resulted in high incidence of catastrophic failure. CLINICAL SIGNIFICANCE Monolithic high translucent zirconia RBFDP could be considered as a viable treatment option to substitute missing posterior tooth, with improved esthetics and biocompatibility.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Chaar MS, Passia N, Becker M, Kern M. Long-term clinical outcome of three-unit fixed-fixed posterior zirconia ceramic inlay-retained FDPs with a modified design. J Dent 2024; 140:104781. [PMID: 37981045 DOI: 10.1016/j.jdent.2023.104781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/11/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVES To assess the long-term clinical outcome of posterior inlay-retained fixed dental prostheses (IRFDPs) with a modified design made from zirconia ceramic. METHODS In 30 patients thirty 3-unit IRFDPs were placed to replace 7 premolars (4 in the maxilla, 3 in the mandible), and 23 first molars (15 in the maxilla, 8 in the mandible). Preparations were accomplished in agreement with the general principles for ceramic inlay restorations and modified with a short retainer-wing bevel preparation within the enamel at the buccal and oral sides. The frameworks were milled from 3Y-TZP ceramic, and the pontics were veneered with feldspathic ceramic. All IRFDPs were bonded with a phosphate monomer containing luting resin after air-abrasion of the intaglio surfaces. The patients were recalled 6-12 months after placement, and then annually. Kaplan-Meier analysis was used to calculate the survival and complication rates of the IRFDPs. RESULTS The mean observation time was 10.6 ± 1.5 years. The 10-year cumulative survival rate was 89% with 4 failures, two of them were due to deep secondary caries with loss of retention, one due to repeated debonding with enamel fractures, and one due to generalized progressive periodontitis. The most common complication was chipping of the veneering ceramic (20.1%). Eighteen IRFDPs were free of any type of complication up to 15.4 years, which corresponds to a 10-year cumulative success rate of 70.4%. CONCLUSION The long-term clinical performance of modified IRFDPs made of veneered zirconia ceramics was favorable after 10 years, therefore, they represent a treatment alternative to replace posterior single missing teeth. CLINICAL SIGNIFICANCE Zirconia-based IRFDPs fabricated in the modified design may represent a substance-preserving alternative to conventional posterior FDPs to replace posterior single missing teeth, particularly in cases where implants cannot be placed, and when the adjacent teeth already have small restorations or defects.
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Affiliation(s)
- M Sad Chaar
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 16, Kiel 24105, Germany.
| | - Nicole Passia
- Department of Prosthodontics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Merlind Becker
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 16, Kiel 24105, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 16, Kiel 24105, Germany
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Al-Bermani ASA, Quigley NP, Ha WN. Do zirconia single-retainer resin-bonded fixed dental prostheses present a viable treatment option for the replacement of missing anterior teeth? A systematic review and meta-analysis. J Prosthet Dent 2023; 130:533-542. [PMID: 34893319 DOI: 10.1016/j.prosdent.2021.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Zirconia has been widely used in restorative dentistry because of its favorable strength and esthetics. However, its polycrystalline structure presents a challenge for resin bonding. Significant research into surface treatments of zirconia to improve bonding has been reported, yet a universally accepted protocol remains elusive. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the performance of anterior single-retainer zirconia resin-bonded fixed dental prostheses (RBFDPs) and review the bonding protocols used in the published data. MATERIAL AND METHODS An electronic search of English language literature was conducted in the PubMed and Ovid (MEDLINE) databases. Following the application of inclusion and exclusion criteria, the research was evaluated to assess the quantitative data. RESULTS Of the included studies, 1 randomized controlled trial, 3 prospective cohort studies, and 2 retrospective cohort studies reporting on anterior single-retainer zirconia RBFDPs were evaluated. Over a 3- to 10-year period, the success rate of anterior single-retainer zirconia RBFDPs was over 80%. Although there were reports of debonds, this is a minor complication as rebonding is usually possible. Furthermore, catastrophic fractures of the entire prosthesis were rare. CONCLUSIONS Evidence for the use of single-retainer zirconia RBFDPs as a suitable treatment option for the replacement of anterior missing teeth is considerable. Based on the findings of this systematic review and meta-analysis, a 2-step process comprising micromechanical retention using airborne-particle abrasion and subsequent resin-zirconia adhesion by the application of 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) can be recommended.
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Affiliation(s)
| | | | - William N Ha
- Lecturer, The University of Queensland, School of Dentistry, Brisbane, QLD, Australia
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Güngör MB, Nemli SK, Inal CB, Aydin C. Effects of ceramic type, connector dimension, and thermomechanical-aging on the fracture resistance and fit of CAD-CAM produced inlay-retained fixed partial dentures. Dent Mater J 2023:2022-230. [PMID: 37271542 DOI: 10.4012/dmj.2022-230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of the present study is to evaluate the fracture resistance and the fit of CAD-CAM produced inlay-retained fixed partial dentures. Eighteen experimental groups were generated according to different CAD-CAM ceramic materials (zirconia, lithium disilicate, and zirconia-reinforced lithium silicate), different connector dimensions (12, 14, and 16 mm2), and application of thermomechanical-aging (1,200,000 cycles of cyclic loading with simultaneous thermal cycling). Gap values of thermomechanically-aged groups were measured by using periapical radiographs. Then, the specimens were tested for fracture resistance and failure types were examined. The results were statistically analyzed (α=0.05). Higher gap values were observed after aging. Zirconia showed the highest fracture resistance values among the most of the experimental groups. In non-aged groups, the most frequent failure type was decementation in zirconia group. In the aged groups, the most frequent failure type was molar connector fracture. Thermomechanical-aging increased the gap values and decreased the fracture resistance values.
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Affiliation(s)
| | | | | | - Cemal Aydin
- Gazi University, Faculty of Dentistry, Department of Prosthodontics
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Kasem AT, Elsherbiny AA, Abo-Madina M, Tribst JPM, Al-Zordk W. Biomechanical behavior of posterior metal-free cantilever fixed dental prostheses: effect of material and retainer design. Clin Oral Investig 2023; 27:2109-2123. [PMID: 36456895 PMCID: PMC10160170 DOI: 10.1007/s00784-022-04813-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To study the fracture resistance and stress distribution pattern of translucent zirconia and fiber-reinforced composite cantilever resin-bonded fixed dental prostheses (RPFDPs) with two retainer designs. MATERIALS AND METHODS Forty human mandibular molars were divided into two groups according to the retainer design. The restorations included a premolar pontic and 2 retainer designs: (D1) inlay ring retainer and (D2) lingual coverage retainer. Each main group was then divided according to the material used (n = 10): zirconia (Z) or fiber-reinforced composite (FRC) (F). Restorations were cemented using dual polymerizing adhesive luting resin. All specimens were thermo-cycled (5-55 °C for 10,000 cycles), then subjected to dynamic loading (50 N, 240,000, and 1.6 Hz) and fracture resistance test. The finite element analysis includes the two models of retainer designs used in the in vitro test. Modified von Mises stress values on enamel, dentin, luting resin, and restorations were examined when the restorations failed. RESULTS A significantly higher failure load was recorded for zirconia groups (505.00 ± 61.50 and 548.00 ± 75.63 N for D1Z and D2Z, respectively) than for FRC groups (345.00 ± 42.33 and 375.10 ± 53.62 N for D1F and D2F, respectively) (P = 0.001). With regard to failure mode, D2 showed a more favorable failure pattern than D1. Model D2 resulted in lower stresses in tooth structure than model D1, and zirconia transmitted more stresses to the tooth structure than FRC. CONCLUSIONS The lingual coverage retainer (D2) enhanced the biomechanical performance of the restoration/tooth complex. Considering the failure mode and tooth stress, FRC is a promising treatment option when constructing a cantilever RPFDP. CLINICAL RELEVANCE Dentists should be aware of the biomechanical behavior during the selection of the material and for the replacement of a single missing mandibular premolar tooth with minimally invasive RBFDP.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Abdallah Ahmed Elsherbiny
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - João Paulo M Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit Van Amsterdam and Vrije Universiteit, Amsterdam, Noord-Holland, the Netherlands
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Al-Dwairi ZN, Al-Aghbari L, Al-Haj Husain N, Özcan M. Durability of cantilever inlay-retained fixed dental prosthesis fabricated from multilayered zirconia ceramics with different designs. J Mech Behav Biomed Mater 2023; 137:105547. [PMID: 36370641 DOI: 10.1016/j.jmbbm.2022.105547] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this in-vitro study was to investigate the effect of framework design on fracture resistance and failure modes of cantilever inlay-retained fixed partial dentures (IRFDPs) fabricated from two multilayered monolithic zirconia materials. MATERIALS AND METHODS Seventy-two natural premolar teeth were prepared as abutments for cantilever IRFDPs using three designs: mesial-occlusal (MO) inlay with short buccal and palatal wings (D1), MO inlay with long palatal wing (D2), MO inlay with long palatal wing and occlusal extension (D3). Full-contoured IRFDPs were fabricated from two monolithic zirconia materials; IPS e.max ZirCAD Prime and Zolid Gen-X. Adhesive surfaces were air-abraded and bonded with MDP-containing resin cement. Specimens were subjected to thermocycling (5-55 °C, 5000 cycles); then, mechanical loading (1.2 × 10⁶ cycles, 49 N). Surviving specimens were loaded until failure in the universal testing machine. All specimens were examined under stereomicroscope, and two samples from each group were evaluated using Scanning Electron Microscope. RESULTS Mean failure loads were not significantly different between different framework designs or between two materials. However, IPS e.max ZirCAD Prime showed significantly higher failure rate than Zolid Gen-X during dynamic fatigue (p = 0.009). Samples with D1 design showed higher debonding rate, D2 failed mainly by fracture of the palatal wing and debonding, and D3 failed mainly by fracture of the abutment tooth. Debonded restorations showed mainly mixed failures. CONCLUSION Cantilever IRFDPs with framework designs that maximize adhesion to enamel exhibited promising results. IPS e.max ZirCAD Prime was more susceptible to fractures with the long palatal wing design.
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Affiliation(s)
- Ziad N Al-Dwairi
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology (JUST), Irbid, Jordan.
| | - Latifah Al-Aghbari
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Khaled M, Sabet A, Ebeid K, Salah T. Effect of Different Preparation Depths for an Inlay-Retained Fixed Partial Denture on the Accuracy of Different Intraoral Scanners: An In Vitro Study. J Prosthodont 2021; 31:601-605. [PMID: 34837276 DOI: 10.1111/jopr.13457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim was to evaluate the effect of different preparation depths for inlay-retained fixed partial dentures on the accuracy of intraoral scanners. MATERIALS AND METHODS Tooth preparations for two inlay-retained fixed partial dentures were done and divided according to depth of the preparation. Group A: 2mm pulpal floor depth, 3mm gingival floor depth and Group B: 3mm pulpal floor depth, 4mm gingival floor depth. The CEREC Omnicam4.4.4, Omnicam4.6.2. Trios3 and Medit i500 intraoral scanners were used in this study. Tooth preparations were scanned by each scanner 10 times. The STL files obtained from the intraoral scanners were compared to the reference models (trueness) and within each test group (precision) using a 3D comparison software. Data were then statistically analyzed. RESULTS Regarding trueness, two-way ANOVA revealed significant differences between the different types of scanners (p<0.001) (Omnicam4.4.4: 65.09 ±2.87 Omnicam4.6.1: 52.73 ±3.31 Medit i500: 58.45 ±2.63 Trios 3: 41.79 ±4.42). Preparation depth had no significant influence on the trueness (p = 0.083). For precision two-way ANOVA revealed significant differences between the different types of scanners (p<0.001). Preparation depth had no significant influence on the precision (p = 0.111). Statistically significant interactions were found between the different variables. CONCLUSIONS The depth of preparation did not have an influence on the accuracy of different scanners. However, the type of scanner influenced the accuracy of digital impressions with Trios3 showing the highest accuracy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mohamed Khaled
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ahmed Sabet
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.,Department of Fixed Prosthodontics, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - Kamal Ebeid
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Tarek Salah
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Influence of Resin Cement Thickness and Elastic Modulus on the Stress Distribution of Zirconium Dioxide Inlay-Bridge: 3D Finite Element Analysis. Polymers (Basel) 2021; 13:polym13223863. [PMID: 34833162 PMCID: PMC8625147 DOI: 10.3390/polym13223863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022] Open
Abstract
The mechanical properties and the thickness of the resin cement agents used for bonding inlay bridges can modify the clinical performance of the restoration such as debonding or prosthetic materials fracture. Thus, the aim of this study was to evaluate the stress distribution and the maximum strain generated by resin cements with different elastic moduli and thicknesses used to cement resin-bonded fixed partial denture (RBFPD). A three-dimensional (3D) finite element analysis (FEA) was used, and a 3D model was created based on a Cone-Beam Computed Tomography system (CBCT). The model was analyzed by the Ansys software. The model fixation occurred at the root of the abutment teeth and an axial load of 300 N was applied on the occlusal surface of the pontic. The highest stress value was observed for the Variolink 0.4 group (1.76 × 106 Pa), while the lowest was noted for the Panavia 0.2 group (1.07 × 106 Pa). Furthermore, the highest total deformation value was found for the Variolink 0.2 group (3.36 × 10-4 m), while the lowest was observed for the Panavia 0.4 group (2.33 × 10-4 m). By means of this FEA, 0.2 mm layer Panavia F2.0 seemed to exhibit a more favorable stress distribution when used for cementation of posterior zirconium-dioxide-based RBFPD. However, both studied materials possessed clinically acceptable properties.
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Laumbacher H, Strasser T, Knüttel H, Rosentritt M. Long-term clinical performance and complications of zirconia-based tooth- and implant-supported fixed prosthodontic restorations: A summary of systematic reviews. J Dent 2021; 111:103723. [PMID: 34119611 DOI: 10.1016/j.jdent.2021.103723] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To present an overview on systematic reviews on prosthodontic zirconia restorations and to discuss long-term complications as well as information on anatomical and functional changes to the masticatory system. DATA/SOURCES MEDLINE, EMBASE, Trip medical, and Cochrane Library databases were searched for systematic reviews up to February 2021. Bias was assessed and clinical survival and complications were analyzed. STUDY SELECTION 38 eligible articles published between 2006 and 2021 were included. The reviews were based on 128 in vivo studies on approximately 10,000 zirconia restorations. 5-year cumulative survival rates varied between 91.2% and 95.9% for tooth-supported (TS) single crowns (SC), 89.4% and 100% for TS multi-unit fixed dental prostheses (FDP), 97.1% and 97.6% for implant-supported (IS) SCs and 93.0% and 100% for IS FDPs. Chipping was the most often technical complication, followed by framework fracture, loss of retention, marginal discrepancies/discoloration, occlusal roughness and abutment/screw loosening. Color mismatch was the only esthetic complication. Biological complications were caries, endodontic complications, tooth fracture, periodontal disease, abrasion/attrition, persisting pain, high sensitivity, peri‑implantitis and soft tissue issues. Patients with bruxism were only examined sporadically. CONCLUSIONS 5-year results for zirconia restorations were satisfactory. The predominant technical problem of veneering fractures could be overcome with adapted design or fabrication and application of monolithic restorations, but reviews of clinical studies on this subject are rare. The impact of zirconia restorations on the masticatory system remains unclear. CLINICAL SIGNIFICANCE Zirconia restorations are experiencing a rapidly increasing use in dental practice. Being highly wear-resistant, hard and durable, it can be assumed that they do not follow natural abrasion and changes in the masticatory system. Possible long-term effects on the stomatognathic system as a whole should therefore be considered.
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Affiliation(s)
- Harald Laumbacher
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Thomas Strasser
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, 93042 Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany.
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Quigley NP, Loo DS, Choy C, Ha WN. Clinical efficacy of methods for bonding to zirconia: A systematic review. J Prosthet Dent 2021; 125:231-240. [DOI: 10.1016/j.prosdent.2019.12.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 01/20/2023]
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The Influence of Cement Layer Thickness on the Stress State of Metal Inlay Restorations-Photoelastic Analysis. MATERIALS 2021; 14:ma14030599. [PMID: 33525369 PMCID: PMC7866133 DOI: 10.3390/ma14030599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 12/16/2022]
Abstract
The successful restoration of teeth requires a good connection between the inlay and natural tissue. A strong bond may improve retention and reinforce tooth structure. The purpose of this study was to evaluate the influence of cement layer thickness on contraction stress generated during photopolymerization, and to determine the changes in stress state of the cement occurring during aging in water (over 84 days). Two cements were used: resin composite cement (NX3) and self-adhesive resin cement (Maxcem Elite Chroma). A cylindrical sample made of CuZn alloy was used to imitate the inlay. The stress state was measured by photoelastic analysis. The contraction stress of the inlay restoration was calculated for cement layer thicknesses of 25 µm, 100 µm, 200 µm, and 400 µm. For both tested materials, the lowest contraction stress was observed for the thinnest layer (25 µm), and this increased with thickness. Following water immersion, a significant reduction in contraction stress was observed due to hygroscopic expansion. Applying a thin layer (approximately 25 µm) of composite and self-adhesive resin cements resulted in high levels of expansion stresses (over −6 MPa) after water aging.
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Vidal CL, Ferreira I, Ferreira PS, Valente MLC, Teixeira ABV, Reis AC. Incorporation of Hybrid Nanomaterial in Dental Porcelains: Antimicrobial, Chemical, and Mechanical Properties. Antibiotics (Basel) 2021; 10:98. [PMID: 33498278 PMCID: PMC7909241 DOI: 10.3390/antibiotics10020098] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 11/16/2022] Open
Abstract
Biofilm formation on biomaterials is a challenge in the health area. Antimicrobial substances based on nanomaterials have been proposed to solve this problem. The aim was to incorporate nanostructured silver vanadate decorated with silver nanoparticles (β-AgVO3) into dental porcelains (IPS Inline and Ex-3 Noritake), at concentrations of 2.5% and 5%, and evaluate the surface characteristics (by SEM/EDS), antimicrobial activity (against Streptococcus mutans, Streptococcus sobrinus, Aggregatibacter actinomycetemcomitans, and Pseudomonas aeruginosa), silver (Ag+) and vanadium (V4+/V5+) ions release, and mechanical properties (microhardness, roughness, and fracture toughness). The β-AgVO3 incorporation did not alter the porcelain's components, reduced the S. mutans, S. sobrinus and A. actinomycetemcomitans viability, increased the fracture toughness of IPS Inline, the roughness for all groups, and did not affect the microhardness of the 5% group. Among all groups, IPS Inline 5% released more Ag+, and Ex-3 Noritake 2.5% released more V4+/V5+. It was concluded that the incorporation of β-AgVO3 into dental porcelains promoted antimicrobial activity against S. mutans, S. sobrinus, and A. actinomycetemcomitans (preventing biofilm formation), caused a higher release of vanadium than silver ions, and an adequate mechanical behavior was observed. However, the incorporation of β-AgVO3 did not reduce P. aeruginosa viability and increased the surface roughness of dental porcelains.
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Affiliation(s)
| | | | | | | | | | - Andréa C. Reis
- Dental Materials and Prosthesis Department, Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Café, s/n, Ribeirão Preto 14040-904, Brazil; (C.L.V.); (I.F.); (P.S.F.); (M.L.C.V.); (A.B.V.T.)
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15
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Bömicke W, Rathmann F, Pilz M, Bermejo JL, Waldecker M, Ohlmann B, Rammelsberg P, Zenthöfer A. Clinical Performance of Posterior Inlay-Retained and Wing-Retained Monolithic Zirconia Resin-Bonded Fixed Partial Dentures: Stage One Results of a Randomized Controlled Trial. J Prosthodont 2020; 30:384-393. [PMID: 32924240 DOI: 10.1111/jopr.13258] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To prospectively compare the clinical performance of posterior inlay-retained and wing-retained monolithic zirconia fixed partial dentures (FPDs). MATERIALS AND METHODS After simple randomization, 30 participants received either one inlay-retained (n = 15; mean age: 56.38 ± 12.70 years; 10 men [66.7%]) or one wing-retained (n = 15; mean age: 45.90 ±13.24 years; 7 men [46.7%]) FPD. The restorations, which predominantly replaced first molars, were fabricated from translucent, 3 mol% yttria-stabilized zirconia and attached with self-etching resin cement. Restorations and abutment teeth were clinically followed up for complications one week and 3, 6, and 12 months after cementation. Plaque and gingival scores, probing pocket depths, and attachment levels were recorded for the abutment and contralateral reference teeth both before treatment and during follow-up examinations. The restorations were also assessed in accordance with FDI World Dental Federation criteria. Statistical analyses were conducted with R (α = 0.05). An adaptive, 2-stage study design based on the incidence of failure-free survival in the groups after 12 months (stage 1) was implemented. Predefined decision rules were used to determine whether further recruitment (stage 2) would enable the detection of a statistically significant difference between the restoration designs with sufficient power. RESULTS During 12 months, only one wing retainer debonded which required removal of the FPD. Failure-free survival was thus 93.3% for wing-retained and 100% for inlay-retained FPDs (log-rank test, p = 0.317). Moderate aftercare resulted in intervention-free rates of 78.8% and 86.7% for inlay-retained and wing-retained restorations, respectively (log-rank test, p = 0.605). Based on FDI World Dental Federation criteria, all restorations were acceptable at the 12-month follow-up (Fisher-Boschloo test, p = 0.161). Plaque, gingival, and periodontal scores remained practically unchanged from before treatment to the 12-month follow-up. Recruitment was stopped after stage 1 because, based on the small difference in the incidence of failure-free survival in the groups, it was accepted that it would not be possible to recruit the necessary number of participants to show a statistically significant difference between the retainer designs. CONCLUSIONS Both inlay-retained and wing-retained monolithic zirconia resin-bonded FPDs performed well for the 12-month, short-term follow-up period.
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Affiliation(s)
- Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Friederike Rathmann
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Maximilian Pilz
- Department of Medical Biometry, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Justo Lorenzo Bermejo
- Department of Medical Biometry, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Brigitte Ohlmann
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Andreas Zenthöfer
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
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Kermanshah H, Motevasselian F, Kakhaki SA, Özcan M. Effect of ceramic material type on the fracture load of inlay-retained and full-coverage fixed dental prostheses. Biomater Investig Dent 2020; 7:62-70. [PMID: 32342046 PMCID: PMC7170296 DOI: 10.1080/26415275.2020.1744443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 03/03/2020] [Indexed: 10/28/2022] Open
Abstract
Objective: Ceramic inlay-retained fixed partial denture (IRFPD) is a conservative prosthetic option but the mechanical durability of new high strength zirconia reinforced glass ceramic FPDs is not investigated. The purpose of this study was to compare fracture load of 3-unit ceramic FPDs. Materials and methods: Extracted premolars and molars (N = 64) were used to create three test groups (IRFPDs) and one control group (full coverage FPD) (n = 8). The teeth were embedded in PMMA resin with a mesiodistal distance of 6 mm. Premolars had a distal and molars had a mesial inlay preparation (width: 3 mm; height: 4 mm) in the test groups. IRFPDs were made from a zirconia reinforced lithium silicate (VS) or a monolithic zirconia. Zirconia IRFPDs received 2 types of surface treatments: sandblasting (Zr-IRFPD) or internal coating with feldspathic porcelain (ZrC-IRFPD). Control group was made from monolithic zirconia with the same connector size and zirconia surfaces were sandblasted (Zr-FPD). All restorations were cemented using a resin luting cement. After 5000 thermo-cycles, fracture load values (N) were determined with a universal testing machine at a crosshead speed of 0.75 mm/min. Data were analyzed using 1-way ANOVA and Tukey`s post hoc test (p ˂ .05). Result: Fracture load (mean ± SD) of Zr-FPDs, Zr-IRFPDs and ZrC-IRFPDs were 672 ± 183, 672 ± 123 and 638 ± 59, respectively, being not statistically different (p > .05). VS-IRFPD exhibited statically lower values (391 ± 136). The predominant mode of failure was fracture at the connector area in all groups. Conclusion: The fracture load of 3-unit IRFPD was significantly affected by types of ceramics but the retainer design and surface treatment in Zr groups did not show a significant effect.
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Affiliation(s)
- Hamid Kermanshah
- Restorative Dentistry department, Tehran University of Medical Sciences School of Dentistry, Tehran, Iran
| | - Fariba Motevasselian
- Restorative Dentistry department, Tehran University of Medical Sciences School of Dentistry, Tehran, Iran
| | - Saeedeh Alavi Kakhaki
- Restorative Dentistry department, Tehran University of Medical Sciences School of Dentistry, Tehran, Iran
| | - Mutlu Özcan
- Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, University of Zurich, Zurich, Switzerland
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Kim SG. Classification of the journal category "oral surgery" in the Scopus and the Science Citation Index Expanded: flaws and suggestions. J Korean Assoc Oral Maxillofac Surg 2019; 45:186-191. [PMID: 31508350 PMCID: PMC6728620 DOI: 10.5125/jkaoms.2019.45.4.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 12/29/2022] Open
Abstract
Objectives The aim of this study was to evaluate the journal category “oral surgery” in Scopus and in the Science Citation Index Expanded (SCIE). Materials and Methods The Journal of Oral and Maxillofacial Surgery (JOMS), The Journal of the Korean Association of Oral and Maxillofacial Surgeons (JKAOMS), and The Journal of Prosthodontic Research (JPR) were selected from the Scopus list of journals as oral surgery journals. Maxillofacial Plastic and Reconstructive Surgery (MPRS) was selected from PubMed as a Scopus oral surgery title. From these titles, 10 recently published articles were collected and used for reference analysis. Results The percentage of citations from oral surgery journals was 26.7%, 24.5%, and 40.1% for JKAOMS, MPRS, and JOMS, respectively. In total, 1.1% of JPR's citations were from oral surgery journals and significantly fewer from other journals (P<0.001). The percentage of citations from dentistry journals excluding oral surgery journals was 11.9%, 34.4%, and 15.8% for JKAOMS, MPRS, and JOMS, respectively. For JPR, 80.6% of citations were from dentistry journals and significantly more were from other journals (P<0.001). Conclusion Selected samples revealed that JPR is incorrectly classified as an oral surgery journal in Scopus. In addition, the scientific interaction among JKAOMS, MPRS, and JOMS was different to JPR in the reference analysis.
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Affiliation(s)
- Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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Becker M, Chaar MS, Garling A, Kern M. Fifteen-year outcome of posterior all-ceramic inlay-retained fixed dental prostheses. J Dent 2019; 89:103174. [PMID: 31362035 DOI: 10.1016/j.jdent.2019.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES To evaluate the long-term clinical outcome of inlay-retained fixed dental prostheses (IRFDPs) made from lithium-disilicate glass-ceramic. MATERIAL AND METHODS Forty-five IRFDPs were placed in 42 patients (21 women, mean age 36.1 years and 21 men, mean age 42.0 years). The IRFDPs replaced 4 premolars and 19 first molars in the maxilla and 4 premolars and 18 first molars in the mandible. All teeth were prepared following a standardized protocol for ceramic inlay restorations. Five of the 45 FDPs were hybrid-retained restorations, i.e. one abutment tooth with an inlay retainer and one with a full crown retainer. All restorations were fabricated from heat-pressed lithium-disilicate ceramic (IPS e.max Press, Ivoclar Vivadent AG). The minimal size of the proximal connector was 16 mm2 (4 mm × 4 mm in height and width) with a minimum occlusal ceramic thickness of 1.5 mm. Hydrofluoric acid etching (5%) and silane application was used for conditioning the bonding surfaces. Standard adhesive luting techniques were performed using a dentin adhesive and a resin composite. Standardized follow-up reports were performed annually. The survival rates were performed using the Kaplan-Meier analysis. RESULTS The mean observation period was 100 months (minimum 4, maximum 234 months). Thirty-three FDPs (73%) failed during the observation period and had to be replaced by other restorations. The Kaplan-Meier survival rate for IRFDPs was 57% after 5 years, 38% after 8 years and 22% after 15 years, while for hybrid-retained FDPs it was 100% after 5 years, 60% after 8 years and also 60% after 15 years. CONCLUSION With the design used in the current, study lithium-disilicate ceramic IRFDP had a high clinical failure rate and cannot be recommended for regular clinical use.
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Affiliation(s)
- Merlind Becker
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Arnold-Heller Str. 16, 24105 Kiel, Germany.
| | - M Saad Chaar
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Arnold-Heller Str. 16, 24105 Kiel, Germany
| | - Anne Garling
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Arnold-Heller Str. 16, 24105 Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Arnold-Heller Str. 16, 24105 Kiel, Germany
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Influence of different preparation forms on the loading-bearing capacity of zirconia cantilever FDPs. A laboratory study. J Prosthodont Res 2019; 63:347-353. [DOI: 10.1016/j.jpor.2018.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 10/08/2018] [Accepted: 10/10/2018] [Indexed: 11/21/2022]
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Li X, Zhu ZM, Li ZY, Zhou JR, Chen WC. [All-ceramic premolar guiding plate retains resin-bonded fixed partial dentures]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:285-289. [PMID: 31218863 DOI: 10.7518/hxkq.2019.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aims to investigate the fracture resistance and short-term restorative effects of resin-bonded fixed partial dentures (RBFPDs) made from heat-pressed lithium-disilicate-based glass-ceramic (IPS e.max press) and zirconia ceramic (WIELAND) and retained by all-ceramic guiding plates when used to restore missing mandibular second premolars. METHODS A total of 64 human mandibular first premolars and first molars were prepared as abutments, then were randomly divided into 4 groups (n=8): E0, heat-pressed ceramic RBFPDs, no cyclic loading; E1, heat-pressed ceramic RBFPDs exposed to 300 000 cycles of dynamic loading; W0, zirconia ceramic RBFPDs, no cyclic loading; and W1, zirconia ceramic RBFPDs exposed to 300 000 cycles of dynamic loading. Fracture strength was tested in a universal testing machine. RESULTS The medians of fracture strength were 1 242.85 N±260.11 N (E0), 1 650.85 N±206.77 N (W0), 1 062.60 N±179.98 N (E1), and 1 167.61 N±265.50 N (W1). Statistical analysis showed that all the groups exhibited significantly higher fracture strength compared with the maximum bite force in the premolar region (360 N; P<0.001). The W0 group had significantly higher fracture strength than the E0 group (P<0.05). Meanwhile, no significant difference in fracture strength was observed between the E1 and W1 groups (P>0.05). Significant statistical differences were found between the zirconia ceramic groups (W0 and W1, P<0.05) but not between the glassceramic groups (E0 and E1, P>0.05) after dynamic loading. CONCLUSIONS The RBFPDs retained by all-ceramic guiding plates exhibited promising fracture properties and optimal short-term restorative effects when used to restore missing mandibular second premolars.
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Affiliation(s)
- Xin Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;Nanyuan Outpatient Department, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Zhi-Min Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zi-Yan Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jin-Ru Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wen-Chuan Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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