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Dhamande MM, Beri A, Sathe S, Jaiswal T, Dubey SA. Transforming Smiles: A Case Study on Monolithic Zirconia Prosthetic Solutions. Cureus 2024; 16:e57889. [PMID: 38725786 PMCID: PMC11079848 DOI: 10.7759/cureus.57889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
In order to effectively address challenges related to anterior teeth restoration and achieve natural-looking results, considerations such as shape, size, gingival contour, and color are crucial. Due to an increasing desire for visually appealing alternatives that are free of metal, materials such as dental zirconia have become popular because of their superior aesthetics and mechanical characteristics. This case report presents clinical insights into anterior teeth rehabilitation with the use of layered zirconia fixed dental prostheses. It delves into the experiences associated with zirconia dental restorations on both endodontically treated and vital abutments, aiming to discern how various factors influence treatment outcomes. Beginning with the design of the restoration, its intricacies significantly impact its fit, strength, and overall durability. Moreover, the composition of zirconia used plays a pivotal role, as different formulations offer varying degrees of mechanical properties, influencing factors such as resilience and wear resistance. The shade selection is also scrutinized, as it directly affects the restoration's aesthetic integration with surrounding natural teeth, contributing to a more harmonious smile. Furthermore, the layering technique employed, particularly when additional porcelain or ceramic layers are applied, is essential for both cosmetic enhancement and structural integrity. Lastly, considerations of occlusion are paramount, ensuring proper alignment and contact between teeth to prevent premature wear and discomfort. By exploring these facets in zirconia restorations across different abutment types, this inquiry seeks to illuminate best practices for achieving favorable treatment outcomes in dental restoration procedures. The choice of zirconia composition, framework design, and shade must be carefully tailored to suit the characteristics of each individual abutment. This emphasizes the significance of adopting a tailored approach to tackle the distinct challenges posed by every clinical scenario. The manuscript provides detailed observations from a clinical case involving the restoration of anterior teeth utilizing monolithic zirconia-fixed dental prostheses. Through a combination of root canal treatment and composite buildup, successful restoration was achieved, with meticulous attention paid to aesthetic considerations. The utilization of computer-aided designing/computer-aided manufacturing (CAD/CAM) technology in crafting zirconia restorations ensured precise fit and superior biocompatibility, contributing to the overall success of the treatment. The study underscores the importance of personalized treatment strategies in achieving optimal outcomes in anterior teeth restoration, emphasizing the need for careful consideration of various factors such as design, composition, and shade selection. Overall, the findings shed light on the potential of zirconia-based restorations in addressing the unique challenges associated with anterior teeth rehabilitation, offering valuable insights for dental practitioners striving to deliver aesthetically pleasing and functionally sound outcomes for their patients.
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Affiliation(s)
| | - Arushi Beri
- Prosthodontics, Sharad Pawar Dental College and Hospital, Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, IND
| | - Seema Sathe
- Prosthodontics, Sharad Pawar Dental College, Wardha, IND
| | - Tanvi Jaiswal
- Prosthodontics, Sharad Pawar Dental College, Wardha, IND
| | - Surekha A Dubey
- Prosthodontics and Crown & Bridge, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University) (DMIMSU), Wardha, IND
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Mao Z, Beuer F, Hey J, Schmidt F, Sorensen JA, Prause E. Antagonist enamel tooth wear produced by different dental ceramic systems: A systematic review and network meta-analysis of controlled clinical trials. J Dent 2024; 142:104832. [PMID: 38211687 DOI: 10.1016/j.jdent.2024.104832] [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: 10/30/2023] [Revised: 12/14/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the amount of enamel tooth wear induced by different antagonistic ceramic crown materials in the posterior area within a follow-up period up to 24 months in function. A network meta-analysis was performed to assess the effect of the materials on the mean vertical loss (MVL) of the antagonist enamel tooth surface. DATA Main search terms used in combination: ceramic, dental materials, metal ceramic, tooth wear and dental enamel. SOURCES An electronic search was conducted in PubMed/Medline, Embase, and Cochrane CENTRAL plus hand-searching. STUDY SELECTION Eligibility criteria included clinical studies reporting on MVL on antagonist's tooth up to 24 months following the permanent crown placement. From a total of 5697 articles, 7 studies reporting on 261 crowns for 177 subjects with 3 ceramic materials (Lithium disilicate, metal-ceramic, monolithic zirconia) were included. Among all, metal-ceramic and zirconia caused significantly higher enamel tooth wear on antagonist teeth, representing 82.5 µm [54.4; 110.6]) and 40.1 µm [22.2; 58.0]) more MVL than natural teeth group. In contrast, lithium disilicate showed only 5.0 µm [-48.2; 58.1]) more MVL than occurs on opposing natural teeth. CONCLUSIONS This systematic review demonstrated that prosthodontic ceramic materials produced significantly more antagonist enamel tooth wear than opposing natural enamel tooth wear, and ceramic material type was correlated to the degree of enamel tooth wear. Additional well-conducted, randomized controlled trials with homogeneous specimens are required due to inadequate sample size and number of the clinical studies included in the analyses. CLINICAL SIGNIFICANCE The amount of wear caused by different restorative materials has a high influence on the antagonistic natural teeth and should therefore be evaluated intensively by the dentist.
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Affiliation(s)
- Zhen Mao
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6 14197, Berlin, Germany.
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6 14197, Berlin, Germany
| | - Jeremias Hey
- Department of Prosthodontics, School of Dental Medicine, Martin-Luther-University, Halle, Germany
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6 14197, Berlin, Germany
| | - John A Sorensen
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, USA
| | - Elisabeth Prause
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6 14197, Berlin, Germany
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Woraganjanaboon P, Anunmana C. 3D quantitative analysis and SEM qualitative analysis of natural antagonist enamel opposing CAD-CAM monolithic zirconia or lithium disilicate tooth-supported crowns versus enamel opposing natural enamel. J Adv Prosthodont 2024; 16:12-24. [PMID: 38455676 PMCID: PMC10917629 DOI: 10.4047/jap.2024.16.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 01/16/2024] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
PURPOSE This study aimed to evaluate the maximum vertical wear, volume wear, and surface characteristic of antagonist enamel, opposing monolithic zirconia or lithium disilicate crowns. MATERIALS AND METHODS The study comprised 24 participants (n = 12), who were randomly allocated to receive either a 5 mol% Y-TZP or a lithium disilicate crown in positions which would oppose the natural first molar tooth. The contralateral first molar along with its antagonist was considered as the enamel opposing natural enamel control. Data collection was performed using an intraoral scanner and polyvinylsiloxane impression. The means of the maximum vertical loss and the volume loss at the occlusal contact areas of the crowns and the various natural antagonists were measured by 3D comparison software. A scanning electron microscope was subsequently used to assess the wear characteristics. Results The one-year results from 22 participants (n = 11) indicated no significant differences when comparing the zirconia crown's antagonist enamel (40.28 ± 9.11 µm, 0.04 ± 0.02 mm3) and the natural enamel wear (38.91 ± 7.09 µm, 0.04 ± 0.02 mm3) (P > .05). Also, there is no significant differences between lithium disilicate crown's antagonist enamel (47.81 ± 9.41 µm, 0.04 ± 0.02 mm3) and the natural enamel wear (39.11 ± 7.90 µm, 0.04 ± 0.02 mm3) (P > .05). Conclusion While some studies suggested that monolithic zirconia caused less wear on opposing enamel than lithium disilicate, this study found similar wear levels to enamel for both materials compared to natural teeth.
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Affiliation(s)
- Piyarat Woraganjanaboon
- Doctor of Philosophy Program in Dental Biomaterials Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Chuchai Anunmana
- Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Dimitriadis K, Moschovas D, Tulyaganov DU, Agathopoulos S. Microstructure, physical and mechanical properties of dental polychromic multilayer zirconia of uniform composition. Eur J Oral Sci 2024; 132:e12959. [PMID: 37864371 DOI: 10.1111/eos.12959] [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: 08/03/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023]
Abstract
The present study aimed to compare the microstructure, physical, and mechanical properties of three commercially available dental polychromatic multilayer zirconia materials of uniform composition: Dima Mill Zirconia ML, VITA YZ/ST Multicolor, and VITA YZ/XT Multicolor (with 3, 4, and 5 mol% Y2 O3 , respectively); thus, the influence of Y2 O3 content on the above properties of the produced materials was experimentally studied. Homogeneous zirconia ceramics with a dense micro- and nanostructure, without pores or defects, were produced after milling the blocks and sintering, which resulted in yttrium-stabilized tetragonal and cubic zirconia. Statistical analysis of the results of measurable magnitudes was performed by the one-way ANOVA test. The increase of Y2 O3 content (from 3 to 5 mol%) favored larger grain and crystallite sizes and a decrease of the values of the mechanical properties; yet, the differences were statistically insignificant. Clinically, these differences are expected to have no impact on their function in the oral cavity, both in terms of their fracture propensity and the damage that can be caused to the opposing teeth. Accordingly, the experimental results qualify the polychromic multilayer zirconia ceramics of uniform composition fabricated by milling technology for use in dental restorations.
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Affiliation(s)
- Konstantinos Dimitriadis
- Division of Dental Technology, Department of Biomedical Sciences, University of West Attica, Athens, Greece
- Department of Materials Science and Engineering, School of Engineering, University of Ioannina, Ioannina, Greece
| | - Dimitrios Moschovas
- Department of Materials Science and Engineering, School of Engineering, University of Ioannina, Ioannina, Greece
| | - Dilshat U Tulyaganov
- Department of Natural-Mathematical Sciences, Turin Polytechnic University in Tashkent, Tashkent, Uzbekistan
| | - Simeon Agathopoulos
- Department of Materials Science and Engineering, School of Engineering, University of Ioannina, Ioannina, Greece
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Moura MLV, de Menezes AAPM, de Oliveira Filho JWG, do Nascimento MLLB, dos Reis AC, Ribeiro AB, da Silva FCC, Nunes AMV, Rolim HML, de Carvalho Melo Cavalcante AA, Sousa JMDCE. Advances in Antitumor Effects Using Liposomal Citrinin in Induced Breast Cancer Model. Pharmaceutics 2024; 16:174. [PMID: 38399235 PMCID: PMC10892831 DOI: 10.3390/pharmaceutics16020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 02/25/2024] Open
Abstract
The study aimed to evaluate the antitumor and toxicogenetic effects of liposomal nanoformulations containing citrinin in animal breast carcinoma induced by 7,12-dimethylbenzanthracene (DMBA). Mus musculus virgin females were divided into six groups treated with (1) olive oil (10 mL/kg); (2) 7,12-DMBA (6 mg/kg); (3) citrinin, CIT (2 mg/kg), (4) cyclophosphamide, CPA (25 mg/kg), (5) liposomal citrinin, LP-CIT (2 μg/kg), and (6) LP-CIT (6 µg/kg). Metabolic, behavioral, hematological, biochemical, histopathological, and toxicogenetic tests were performed. DMBA and cyclophosphamide induced behavioral changes, not observed for free and liposomal citrinin. No hematological or biochemical changes were observed for LP-CIT. However, free citrinin reduced monocytes and caused hepatotoxicity. During treatment, significant differences were observed regarding the weight of the right and left breasts treated with DMBA compared to negative controls. Treatment with CPA, CIT, and LP-CIT reduced the weight of both breasts, with better results for liposomal citrinin. Furthermore, CPA, CIT, and LP-CIT presented genotoxic effects for tumor, blood, bone marrow, and liver cells, although less DNA damage was observed for LP-CIT compared to CIT and CPA. Healthy cell damage induced by LP-CIT was repaired during treatment, unlike CPA, which caused clastogenic effects. Thus, LP-CIT showed advantages for its use as a model of nanosystems for antitumor studies.
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Affiliation(s)
- Michely Laiany Vieira Moura
- Laboratory of Toxicological Genetics—LAPGENIC, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil; (M.L.V.M.); (A.-A.P.M.d.M.); (J.W.G.d.O.F.); (M.L.L.B.d.N.); (A.C.d.R.); (F.C.C.d.S.); (A.A.d.C.M.C.); (J.M.d.C.e.S.)
| | - Ag-Anne Pereira Melo de Menezes
- Laboratory of Toxicological Genetics—LAPGENIC, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil; (M.L.V.M.); (A.-A.P.M.d.M.); (J.W.G.d.O.F.); (M.L.L.B.d.N.); (A.C.d.R.); (F.C.C.d.S.); (A.A.d.C.M.C.); (J.M.d.C.e.S.)
| | - José Williams Gomes de Oliveira Filho
- Laboratory of Toxicological Genetics—LAPGENIC, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil; (M.L.V.M.); (A.-A.P.M.d.M.); (J.W.G.d.O.F.); (M.L.L.B.d.N.); (A.C.d.R.); (F.C.C.d.S.); (A.A.d.C.M.C.); (J.M.d.C.e.S.)
| | - Maria Luiza Lima Barreto do Nascimento
- Laboratory of Toxicological Genetics—LAPGENIC, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil; (M.L.V.M.); (A.-A.P.M.d.M.); (J.W.G.d.O.F.); (M.L.L.B.d.N.); (A.C.d.R.); (F.C.C.d.S.); (A.A.d.C.M.C.); (J.M.d.C.e.S.)
| | - Antonielly Campinho dos Reis
- Laboratory of Toxicological Genetics—LAPGENIC, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil; (M.L.V.M.); (A.-A.P.M.d.M.); (J.W.G.d.O.F.); (M.L.L.B.d.N.); (A.C.d.R.); (F.C.C.d.S.); (A.A.d.C.M.C.); (J.M.d.C.e.S.)
| | - Alessandra Braga Ribeiro
- CBQF—Centro de Biotecnologia e Química Fina—Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal;
| | - Felipe Cavalcanti Carneiro da Silva
- Laboratory of Toxicological Genetics—LAPGENIC, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil; (M.L.V.M.); (A.-A.P.M.d.M.); (J.W.G.d.O.F.); (M.L.L.B.d.N.); (A.C.d.R.); (F.C.C.d.S.); (A.A.d.C.M.C.); (J.M.d.C.e.S.)
| | | | - Hercília Maria Lins Rolim
- Laboratory of Pharmaceutical Nanosystems—NANOSFAR, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil
| | - Ana Amélia de Carvalho Melo Cavalcante
- Laboratory of Toxicological Genetics—LAPGENIC, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil; (M.L.V.M.); (A.-A.P.M.d.M.); (J.W.G.d.O.F.); (M.L.L.B.d.N.); (A.C.d.R.); (F.C.C.d.S.); (A.A.d.C.M.C.); (J.M.d.C.e.S.)
| | - João Marcelo de Castro e Sousa
- Laboratory of Toxicological Genetics—LAPGENIC, Graduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina 64049-550, Brazil; (M.L.V.M.); (A.-A.P.M.d.M.); (J.W.G.d.O.F.); (M.L.L.B.d.N.); (A.C.d.R.); (F.C.C.d.S.); (A.A.d.C.M.C.); (J.M.d.C.e.S.)
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Pontevedra P, Lopez-Suarez C, Rodriguez V, Tobar C, Pelaez J, Suarez MJ. Digital workflow for monolithic and veneered zirconia and metal-ceramic posterior fixed partial dentures: A five-year prospective randomized clinical trial. J Prosthodont Res 2024; 68:78-84. [PMID: 36990752 DOI: 10.2186/jpr.jpr_d_22_00237] [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: 03/29/2023]
Abstract
Purpose To evaluate and compare the survival, success rates, and biological and technical complications of three-unit posterior monolithic and veneered zirconia and metal-ceramic (MC) posterior fixed partial dentures (FPDs) fabricated using a digital workflow and computer-aided design and computer-aided manufacturing (CAD/CAM) over a 5-year follow-up.Methods Ninety patients in need of three-unit posterior FPDs were randomized to receive monolithic zirconia (MZ), veneered zirconia (VZ), and MC restorations (n = 30 each). Teeth preparations were scanned using an intraoral scanner, and restorations were milled and cemented with resin cement. Clinical performance and periodontal parameters were assessed at baseline and yearly up to 5 years after insertion. Data analysis was performed using the Kaplan-Meier method, Friedman test, and Wilcoxon signed-rank test with Bonferroni correction and Mann-Whitney U test.Results The 5-year survival rates of the MZ, VZ, and MC FPDs were 87%, 97%, and 100%, respectively (P = 0.04). Most complications were biological in nature. Only one MZ FPD fractured 58 months after placement. All the restorations were assessed as satisfactory at each recall. Differences were found in the gingival index score over time in the VZ and MC groups. The margin index remained stable throughout the follow-up period in both zirconia groups.Conclusions The results of this study suggest that using a digital workflow to fabricate posterior FPDs is an adequate treatment option and that monolithic zirconia could be a viable alternative to metal-ceramic or veneered zirconia. However, further long-term studies are necessary to provide stronger evidence in patients with bruxism.
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Affiliation(s)
- Paula Pontevedra
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Carlos Lopez-Suarez
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Veronica Rodriguez
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Celia Tobar
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Jesus Pelaez
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Maria J Suarez
- Department of Conservative Dentistry and Buccofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Frasnelli GD, Leoni GB, Cassani R, Faria ACL, Gomes EA, Moris ICM. Effect of different ceramic systems on antagonist dental structure by microtomographic analysis. Dent Mater 2024; 40:118-123. [PMID: 37940499 DOI: 10.1016/j.dental.2023.10.021] [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: 01/12/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES This study aims to identify the two-dimensional and three-dimensional analyses and evaluate the loss of tooth structure in the tooth's different constituent elements and the ceramic antagonist's surface. METHODS In this study, three groups (n = 10) represented by different ceramic systems (lithium disilicate [GDis], lithium silicate reinforced with zirconia [GSil], and monolithic zirconia [GZir]) were evaluated. Each group obtained ten ceramic blocks and submitted them to the sintering/crystallization process. To carry out the wear test, healthy mandibular premolars were used as the specimens and the ceramic blocks as antagonists. The premolars were submitted to two-dimensional and three-dimensional analyses using a computerized microtomography (µTC) before and after the wear test. The wear test was performed with 30 N and 300,000 cycles load, with occlusion, laterality, and disocclusion movements. RESULTS The statistical analysis comparing the loss of two-dimensional tooth structure showed a statistically significant difference among all groups (p < 0.05). Statistical analysis comparing the percentage of loss of three-dimensional tooth structure showed a statistically significant difference between groups GDis and GSil and between groups GDis and GZir. However, when comparing GSil with GZir, no statistically significant difference was found. The qualitative analysis of the teeth showed that GDis showed considerable enamel loss and dentin exposure, GSil showed enamel wear with flattening the cusp without dentin exposure, and GZir showed minimal enamel wear without dentin exposure. In the qualitative analysis of ceramic antagonists, more significant wear of the ceramic material for GDis was observed, followed by the GSil and GZir groups, respectively. SIGNIFICANCE The use of the lithium disilicate should be cautious, restricting it to areas with lower masticatory forces. Areas of higher masticatory forces showed a large amount of antagonist wear, with dentin involvement. This can lead to dentinal hypersensitivity, risk of compromising patients' occlusion, by harming group disocclusion guides, causing pain and temporomandibular disorders.
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Affiliation(s)
| | | | - Raquel Cassani
- School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil
| | | | - Erica Alves Gomes
- School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil
| | - Izabela C M Moris
- School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil.
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Hammoudeh H, Carracho L, Beard C, Razzoog M. Effect of different surface and heat treatments on the surface roughness, crystallography, and phase composition of high translucency zirconia for monolithic restorations. J Prosthet Dent 2024; 131:164.e1-164.e11. [PMID: 37945513 DOI: 10.1016/j.prosdent.2023.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 11/12/2023]
Abstract
STATEMENT OF PROBLEM High translucency zirconia (HTZ) has gained popularity as an esthetic computer-aided design and computer-aided manufacturing (CAD-CAM) material for monolithic restorations. A detailed comparison between different common surface and heat treatments with a non-treated HTZ control to explain the behavior of the material under stress is lacking. PURPOSE The purpose of this in vitro study was to evaluate the effect of different surface and heat treatments on the surface roughness parameters (SRPs), topography, crystallography, and phase composition of HTZ used for monolithic restorations. MATERIAL AND METHODS Ninety Ø11.9×1.18-mm HTZ disks (Prettau Anterior) were milled, sintered, and distributed into 9 groups (n=10); 8 experimental (coarse diamond grinding GC, fine diamond grinding GF, fine diamond grinding and 3-step polishing kit GF+P1, fine diamond grinding and 3-step polishing kit and diamond paste GF+P1+DP, fine diamond grinding and 2-step polishing kit GF+P2, fine diamond grinding and GF+Gl, fine diamond grinding and 3-step polishing and glazing GF+P1+Gl, airborne-particle abrasion with 50-µm alumina), and a control group (C, as-sintered). SRPs (AveSa, AveSv, AveSz) and 3-dimensional (3D) images were obtained using a noncontact 3D-optic-profilometer. The crystal structure was determined with scanning electron microscopy. Phase composition was analyzed by X-ray diffraction (XRD). Surface roughness parameters data were statistically analyzed by 1-way ANOVA and the Tukey HSD test (α=.05). RESULTS The applied surface and heat treatment resulted in significantly different SRP mean values (P<.001) with different topographies. GC had the highest AveSa, AveSv, and AveSz mean values (0.95, 8.8, 17.4 µm, respectively) with significant microcracks. GF had significantly lower SRP with finer microcracks. GF+P1 had a significantly smoother surface, but GF+P2 resulted in SRP comparable with the GF group. GF+P1+DP had the smoothest homogenous surface (mean Sa: 0.08 µm). GF+P1 and GF+GL were equally effective, while GF+P1+GL was not superior. Airborne-particle abrasion produced a low Sa mean value (0.11 µm) with relatively high Sv and Sz mean values (5.9, 9.2 µm, respectively) and microcracks. A monoclinic phase was detected in all groups. All experimental groups had broadened XRD-peaks with lower intensity, suggesting the presence of the rhombohedral phase. CONCLUSIONS The different surface and heat treatments altered the HTZ crystals and their surface roughness with distinct topographies. Cubic crystal changes take place under stress as shown by the scanning electron microscope and the XRD diffraction pattern and may transform to the rhombohedral phase.
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Affiliation(s)
- Hanin Hammoudeh
- Assistant Professor, Restorative and Prosthodontics Department, The Ohio State University College of Dentistry, Columbus, Ohio; and Scholar, University of Jordan School of Dentistry, Amman, Jordan.
| | - Luis Carracho
- Assistant Professor, Department of Fixed Prosthodontics, University of Lisbon, Portugal; and Private Practice, Lisbon, Portugal
| | - Charles Beard
- Assistant Professor and Senior Clinical Lecturer, Biologic and Materials Sciences and Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Michael Razzoog
- Professor Emeritus, Biologic and Materials Sciences and Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, Mich
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Dhamande MM, Beri A, Bhoyar A, Dubey SA, Sathe S. Esthetic Solutions With Layered Zirconia Prostheses: A Case Report. Cureus 2023; 15:e49822. [PMID: 38164308 PMCID: PMC10758237 DOI: 10.7759/cureus.49822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 01/03/2024] Open
Abstract
To meet the challenges of rehabilitating anterior teeth and achieving natural-looking restorations, it is essential to address issues such as improper shape, size, irregular gingival contour, and unaesthetic shades. The increasing demand for aesthetically pleasing and metal-free solutions has popularized materials like dental zirconia, offering optimal aesthetics and desirable mechanical properties. Within this context, a case report highlights clinical experiences with layered zirconia fixed dental prostheses designed specifically for anterior teeth. The report focuses on the prosthetic rehabilitation of both endodontically treated and vital abutments, exploring the influence of zirconia composition, design, layering technique, shade selection, occlusion, and the unique clinical challenges associated with each condition. The selection of zirconia composition, framework design, and shade in layered zirconia prostheses is intricately tied to the characteristics of the abutments. This interconnectedness underscores the importance of a thoughtful and customized approach to address the specific requirements of each clinical scenario.
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Affiliation(s)
- Mithilesh M Dhamande
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Arushi Beri
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anjali Bhoyar
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Surekha A Dubey
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Seema Sathe
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Diken Türksayar AA, Demirel M, Donmez MB, Olcay EO, Eyüboğlu TF, Özcan M. Comparison of wear and fracture resistance of additively and subtractively manufactured screw-retained, implant-supported crowns. J Prosthet Dent 2023:S0022-3913(23)00418-3. [PMID: 37479623 DOI: 10.1016/j.prosdent.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/23/2023]
Abstract
STATEMENT OF PROBLEM Additively manufactured resins indicated for fixed definitive prostheses have been recently marketed. However, knowledge on their wear and fracture resistance when fabricated as screw-retained, implant-supported crowns and subjected to artificial aging is limited. PURPOSE The purpose of this in vitro study was to evaluate the volume loss, maximum wear depth, and fracture resistance of screw-retained implant-supported crowns after thermomechanical aging when fabricated using additively and subtractively manufactured materials. MATERIAL AND METHODS Two additively manufactured composite resins (Crowntec [CT] and VarseoSmile Crown Plus [VS]) and 2 subtractively manufactured materials (1 reinforced composite resin, Brilliant Crios [BC] and 1 polymer-infiltrated ceramic network, Vita Enamic [EN]) were used to fabricate standardized screw-retained, implant-supported crowns. After fabrication, the crowns were cemented on titanium base abutments and then tightened to implants embedded in acrylic resin. A laser scanner with a triangular displacement sensor (LAS-20) was used to digitize the preaging state of the crowns. Then, all crowns were subjected to thermomechanical aging (1.2 million cycles under 50 N) and rescanned. A metrology-grade analysis software program (Geomagic Control X 2020.1) was used to superimpose postaging scans over preaging scans to calculate the volume loss (mm3) and maximum wear depth (mm). Finally, all crowns were subjected to a fracture resistance test. Fracture resistance and volume loss were evaluated by using 1-way analysis of variance and Tukey Honestly significant difference (HSD) tests, whereas the Kruskal-Wallis and Dunn tests were used to analyze maximum wear depth. Chi-square tests were used to evaluate the Weibull modulus and characteristic strength data (α=.05). RESULTS Material type affected the tested parameters (P<.001). CT and VS had higher volume loss and maximum wear depth than BC and EN (P<.001). EN had the highest fracture resistance among tested materials (P<.001), whereas BC had higher fracture resistance than CT (P=.011). The differences among tested materials were not significant when the Weibull modulus was considered (P=.199); however, VE had the highest characteristic strength (P<.001). CONCLUSIONS Additively manufactured screw-retained, implant-supported crowns had higher volume loss and maximum wear depth. All materials had fracture resistance values higher than the previously reported masticatory forces of the premolar region; however, the higher characteristic strength of the subtractively manufactured polymer-infiltrated ceramic network may indicate its resistance to mechanical complications.
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Affiliation(s)
- Almira Ada Diken Türksayar
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey; and Guest Researcher, ADMiRE Research Center-Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Villach, Austria
| | - Münir Demirel
- Assistant Professor, Oral and Dental Health, Vocational School, Biruni University, Istanbul, Turkey
| | - Mustafa Borga Donmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; and Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Emin Orkun Olcay
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey
| | - Tan Fırat Eyüboğlu
- Associate Professor, Department of Endodontics, Istanbul Medipol University, Faculty of Dentistry, Istanbul, Turkey
| | - Mutlu Özcan
- Professor and Head, Clinic of Masticatory Disorders and Dental Biomaterials, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
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Zhang R, Hao X, Zhang K. Evaluation of two different occlusal patterns on single posterior implant-supported crowns: A 12-month prospective study of occlusal analysis. J Prosthet Dent 2023:S0022-3913(22)00759-4. [PMID: 36610845 DOI: 10.1016/j.prosdent.2022.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 01/07/2023]
Abstract
STATEMENT OF PROBLEM According to the concept of implant-protected occlusion, light occlusion and late contact could prevent implants from occlusal overload. However, clinical data demonstrating how light occlusion differs from normal occlusion are lacking. PURPOSE The purpose of this prospective clinical study was to characterize the occlusal variation of single posterior implant-supported crowns with or without light occlusion. MATERIAL AND METHODS Participants with a single missing posterior maxillary or mandibular molar who were to receive implant-supported zirconia ceramic crowns were enrolled. The participants were divided into a light occlusion group, in which a 12-μm articulating film could be removed from the implant-supported crown and opposing natural teeth under the intercuspal position, and a normal occlusion group, in which the articulating film could not be removed. All participants underwent occlusal examinations using the T-scan III system, answered a satisfaction questionnaire using a visual analog scale (VAS), and received regular follow-ups. The participants were evaluated at 0.5, 3, 6, and 12 months after implant-supported crown delivery. The relative occlusal force of the implant-supported crowns, mesial teeth, control teeth (corresponding natural tooth on the dentition contralateral to each implant), and the occlusal contact time of implant-supported crowns were recorded. Moreover, the asymmetry index of the occlusal force and the VAS score were calculated. Two independent-sample tests were used to compare the 2 groups. The Wilcoxon rank sum and Mann‒Whitney tests were used to compare nonnormally distributed data (α=.001). RESULTS Fifty study participants with a mean ±standard deviation age of 36.97 ±7.34 years (23 men and 27 women aged 20 to 50 years) were followed for 0.5 to 12 months. No obvious complications of overloading were observed in either group. The mean ±standard deviation of the relative occlusal force of implant-supported crowns in the light occlusion group (from 4.91 ±3.52% to 10.34 ±4.35%) was always lower than that in the normal occlusion group (from 10.45 ±4.32% to 18.15 ±4.80%), while the mean ±standard deviation of the occlusal contact time in the light occlusion group (from 0.38 ±0.26 seconds to 0.10 ±0.07 seconds) was significantly later than that in the normal occlusion group (from 0.12 ±0.08 seconds to 0.04 ±0.02 seconds) (P<.001). The value of the asymmetry index of occlusal force remained within the normal range (10%). The VAS score in the normal occlusion group was significantly higher than that in the light occlusion group (P<.001). CONCLUSIONS Providing light occlusion to reduce occlusal force and delay the contact time was not stable over time. The relative occlusal force and occlusal contact time showed a similar development trend in both groups, and no obvious signs of occlusal overloading were observed in this study. Long-term follow-up is necessary for implant-supported prostheses because of the continuous increase in occlusal force.
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Affiliation(s)
- Ru Zhang
- Attending, Department of Prosthodontics, Capital Medical University School of Stomatology, Beijing Stomatological Hospital, Beijing, PR China
| | - Xiaoyu Hao
- Graduate Student, Department of Prosthodontics, Capital Medical University School of Stomatology, Beijing Stomatological Hospital, Beijing, PR China
| | - Kaiyu Zhang
- Associate Chief, Department of Oral and Maxillofacial Surgery, Capital Medical University School of Stomatology, Beijing Stomatological Hospital, Beijing, PR China.
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12
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Zhou T, Mirchandani B, Li XX, Mekcha P, Buranawat B. Quantitative parameters of digital occlusal analysis in dental implant supported restorative reconstruction recent 5 years: a systematic review. Acta Odontol Scand 2023; 81:1-17. [PMID: 35617455 DOI: 10.1080/00016357.2022.2077980] [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: 02/08/2023]
Abstract
OBJECTIVE The aims of this systematic review were to evaluate the clinical masticatory performance of implant-supported restorations, observe the occlusal force changes in the distribution of the implant restoration and reveal the positive and negative contributing factors of implant design and components based on the outcomes of digital occlusal measurement. MATERIAL AND METHODS An extensive search was conducted through PubMed and CENTRAL to identify clinical trials on implant-retained restorations using digital occlusal analysis methods. Two researchers assessed the identified studies and data extraction independently, and the data synthesis strategies without meta-analysis that summarizes the effect estimates were adopted. RESULTS The search screened 3821 titles and abstracts, then full-text analysis for 26 articles was performed, and 14 studies were included in the quantitative synthesis. Four of six studies for implant-retained overdenture showed statistically significant improved bite force when immediate loading (p = .00045, .00005, .00055, and .00005, respectively), and no statistically significant results in the other two studies (p = .225, .371, respectively.) However, the results of the favoured intervention were not statistically significant (p = .104, .166, respectively) in two studies of single posterior implant restorations. In all three studies, the bite force distributed on the implant prostheses of partially fixed implant-retained restoration increased statistically significantly (p = .013, .001, .05, respectively). CONCLUSIONS The edentulous restoration supported by implants seems to significantly improves bite force and chewing efficiency compared with conventional dentures. Regular quantitative occlusal measurement is recommended to avoid the possible risk of overload. Smaller implants size and relatively small and flexible attachment designs may be more conducive to the stability and retention of the restoration of atrophy of alveolar bone.
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Affiliation(s)
- Ting Zhou
- Department of Orthodontics, School of Stomatology, Kunming Medical University, Yunnan, PR China.,Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Bharat Mirchandani
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Xing-Xing Li
- Department of Prosthodontics, School of Stomatology, Kunming Medical University, Yunnan, PR China
| | - Pichaya Mekcha
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Borvornwut Buranawat
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
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León Velastegui M, Montiel-Company JM, Agustín-Panadero R, Fons-Badal C, Solá-Ruíz MF. Enamel Wear of Antagonist Tooth Caused by Dental Ceramics: Systematic Review and Meta-Analysis. J Clin Med 2022; 11:6547. [PMID: 36362777 PMCID: PMC9657667 DOI: 10.3390/jcm11216547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis aimed to evaluate the wear of the antagonist tooth in ceramic restorations. MATERIAL AND METHODS This study was carried out based on Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) recommendations; it was also registered in PROSPERO (register number: CRD42022316252). Three databases were consulted in the literature search, Embase, Scopus, and Web of Science. The citation searching was conducted by two researchers independently. The clinical studies that evaluated wear in antagonist teeth concerning ceramic restoration were included. Twelve articles were selected after eliminating duplicates ones and applying the inclusion criteria, and two were chosen through citation. Fourteen articles were considered for the qualitative and quantitative analysis (meta-regression and meta-analysis). RESULTS The mean linear wear of the antagonist tooth in relation to feldspathic was 8.914 μm, for lithium disilicate it was 0.018 μm, and for zirconia it was 0.257 μm. The mean volumetric wear of the antagonist tooth in relation to feldspathic was 0.273 mm3, for hybrid ceramic it was 0.030 mm3, for lithium disilicate it was 0.018 mm3, and for zirconia it was 0.014 mm3. The mean natural tooth wear was 0.7974 μm per month. Tooth wear caused by zirconia at six months was 31.755 μm, at 12 months it was 24.648 μm, and at 24 months it was 20.662 μm. CONCLUSIONS Feldspathic produces greater wear of the antagonist tooth from ceramic restorations linearly and volumetrically. In addition, zirconia generates the least wear that will decrease over time, and it will be equal to or less than the natural wear in the tooth.
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Affiliation(s)
- Manuel León Velastegui
- School of Dentistry, Faculty of Health Sciences, Universidad Nacional de Chimborazo, Riobamba 060103, Ecuador
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Rubén Agustín-Panadero
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Carla Fons-Badal
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - María Fernanda Solá-Ruíz
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
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14
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De Angelis F, Buonvivere M, Sorrentino E, Rondoni GD, D’Arcangelo C. Wear Properties of Conventional and High-Translucent Zirconia-Based Materials. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7324. [PMID: 36295389 PMCID: PMC9606984 DOI: 10.3390/ma15207324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the two-body wear resistance of a first generation 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP), a second generation 3Y-TZP, a third generation 4 mol% yttria partially stabilized zirconia (4Y-PSZ), a 5 mol% yttria partially stabilized zirconia (5Y-PSZ), and a type III gold alloy (Aurocast 8), performed using opposing antagonistic cusps made out of the same material. Eight cylindrical specimens were prepared for each material (n = 8) for a total of forty specimens (N = 40). Conical cusps were fabricated for each material. Each cylinder−cusp pair was arranged inside a two-axis chewing simulator over up to 360,000 loading cycles. The wear resistance was analyzed by measuring the vertical substance loss (mm) and the volume loss (mm3). The antagonist wear (mm) was recorded before and after the wear test to evaluate the linear difference. Statistical analysis was performed using one-way analysis of variance (ANOVA); multiple comparisons were performed according to Tukey’s method. No statistically significant differences (p > 0.05) among the first generation 3Y-TZP, second generation 3Y-TZP, and 4Y-PSZ wear were found. 5Y-PSZ showed statistically significant higher wear compared to other the zirconias. Aurocast 8 displayed the highest values in terms of vertical wear, antagonist cusp wear, and volumetric loss. Although still not statistically comparable, the wear behavior of the latest 5Y-PSZ was the closest to the widely recognized gold standard represented by the type III gold alloy.
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Affiliation(s)
- Francesco De Angelis
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy
| | - Matteo Buonvivere
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy
| | - Edoardo Sorrentino
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy
| | | | - Camillo D’Arcangelo
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy
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15
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Shaik K, Reddy KM, Shastry YM, Aditya SV, Babu PJK. Comparative evaluation of enamel wear against monolithic zirconia and layered zirconia after polishing and glazing: An in vitro study. J Indian Prosthodont Soc 2022; 22:354-360. [PMID: 36511069 PMCID: PMC9709870 DOI: 10.4103/jips.jips_503_21] [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: 10/28/2021] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/06/2022] Open
Abstract
Aim The aim of this study was to compare the wear behavior of human tooth enamel opposing monolithic zirconia and layered zirconia after glazing and polishing by a two-body wear mechanism using a wear simulator. Settings and Design This In-vitro study was done in Department of Prosthodontics, Sri Sai College of Dental Research, Vikarabad. Materials and Methods Zirconia specimens were divided into four groups (n = 15), Group monolithic glazed zirconia (MG), Group monolithic polished zirconia (MP), Group zirconia layered with E. max ceram and glazed (LG), Group zirconia layered with E. max ceram and polished without glaze (LP). Sixty human premolar teeth were subjected to wear test against the zirconia specimens using a Pin on Disc wear tester under a constant load of 5 kg (49 N) at 30 rpm for 10,000 cycles. The loss of enamel was recorded before and after the wear test and mean loss of height of tooth enamel after 10,000 cycles of wear was measured with a profile projector. The surface characteristics of all the four group zirconia specimens were evaluated qualitatively with scanning electron microscope. Statistical Analysis Used One way ANOVA, Tukey Post hoc. Results One-way analysis of variance test revealed that the mean loss of enamel of four groups was statistically different with P < 0.001. A further Tukey post hoc test revealed that the MP group had lesser mean scores than group LP, MG, and LG. Conclusion It was concluded that MP caused less wear to opposing natural teeth, and polished surfaces of both monolithic and layered zirconia showed less tooth wear compared to glazed surfaces of monolithic and layered zirconia.
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Affiliation(s)
- Kamila Shaik
- Department of Prosthodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - K. Mahendranadh Reddy
- Department of Prosthodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - Y. Mahadev Shastry
- Department of Prosthodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - S. Venkat Aditya
- Department of Prosthodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - P. Jaya Krishna Babu
- Department of Prosthodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
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Hatanaka A, Sawada T, Sen K, Saito T, Sasaki K, Someya T, Hattori M, Takemoto S. Wear Behavior between Aesthetic Restorative Materials and Bovine Tooth Enamel. MATERIALS 2022; 15:ma15155234. [PMID: 35955169 PMCID: PMC9369959 DOI: 10.3390/ma15155234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/14/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023]
Abstract
Tooth enamel wear occurs because of daily mastication and occlusion. This study investigated the wear behavior of bovine teeth against aesthetic restorative materials in vitro. Abrader specimens were fabricated using four tooth-colored restorative materials (zirconia, lithium disilicate glass ceramic, dental porcelain, and resin composite), with bovine tooth enamel as a control. Flattened bovine tooth enamel was used as the substrate specimen. These materials were characterized by Vickers hardness tests and surface roughness measurements. Two-body wear tests between the abrader and substrate specimens were performed, and the worn topographies were evaluated using a contour-measuring instrument and 3D laser microscope. The restorative materials and bovine tooth enamel had similar surface roughness but different hardness and wear behaviors. Bovine teeth showed the largest wear in tooth–tooth contact as the abrader and substrate specimens. Compared to bovine teeth, zirconia, lithium disilicate glass ceramic, and dental porcelain showed greater hardness and less wear on their surfaces, and less substrate wear of the opposite tooth enamel. The lowest hardness resin composite showed intermediate wear on its surface, resulting in the lowest substrate wear. Accordingly, dentists should pay attention to the selection of restorative materials to reconstruct their morphologies owing to different wear behaviors.
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Affiliation(s)
- Akihiko Hatanaka
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3694, Iwate, Japan; (A.H.); (K.S.); (S.T.)
| | - Tomofumi Sawada
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3694, Iwate, Japan; (A.H.); (K.S.); (S.T.)
- Correspondence: ; Tel.: +81-19-651-5110
| | - Kazuyo Sen
- School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka-shi 020-8505, Iwate, Japan; (K.S.); (T.S.)
| | - Takahiro Saito
- School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka-shi 020-8505, Iwate, Japan; (K.S.); (T.S.)
| | - Kaori Sasaki
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3694, Iwate, Japan; (A.H.); (K.S.); (S.T.)
| | - Tomoko Someya
- Department of Dental Materials Science, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan; (T.S.); (M.H.)
| | - Masayuki Hattori
- Department of Dental Materials Science, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan; (T.S.); (M.H.)
| | - Shinji Takemoto
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3694, Iwate, Japan; (A.H.); (K.S.); (S.T.)
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Stück AVD, Raith S, Reich S. Twenty-four months in vivo wear of enamel antagonists to lithium disilicate implant crowns - a pilot study. J Dent 2022; 124:104215. [PMID: 35810925 DOI: 10.1016/j.jdent.2022.104215] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/26/2022] [Accepted: 07/04/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate whether there is a significant difference between the ratio of wear of lithium disilicate implant crowns and their enamel antagonists and adjacent enamel/enamel antagonist contacts. Additionally, the movement of the adjacent teeth was determined. MATERIALS AND METHODS Intraoral scans of the occlusal surfaces of 41 patients were performed after insertion of the implant restoration (baseline), after 12 and 24 months. From the initial study cohort, eleven implant crown/enamel antagonist pairs with adjacent enamel antagonist pairs could be analyzed in nine patients after 12 months. After 24 months, ten implant crowns of eight patients were available due to one decementation of an implant crown. A semiautomatic specifically developed iterative closest point algorithm was used to superimpose the surfaces of the baseline scan with the follow-up scans to measure the maximum height loss of each identified wear side. The mean maximum tooth wear and the standard deviation (SD) were calculated per unit. The ratio of wear of enamel/enamel antagonist teeth and the wear ratio of adjacent lithium disilicate implant crowns and their enamel antagonist surfaces were evaluated. Tooth movements were described by translations and rotations using a separate measurement procedure. The surfaces of the scans were superimposed setting the implant as a reference structure for registration. RESULTS After 12 months the wear ratio between the enamel antagonist pairs was 0.95 ± 0.27 µm and the ratio between lithium disilicate/enamel was 0.73 ± 0.49 µm. After 24 months the ratio of enamel antagonist pairs was 1.04 ± 0.28 µm and the ratio of lithium disilicate/enamel was 0.73 ± 0.51 µm. The ratios did not differ significantly. CONCLUSIONS Intraoral scanning and computer analysis showed that the two-years wear ratios between enamel/enamel and enamel/lithium disilicate implant crowns did not differ significantly. STATEMENT OF CLINICAL RELEVANCE The methodology described in this study could measure tooth wear and detect long-term wear performance. In the future, digital monitoring of prosthetic restorations should be integrated into clinical workflow to identify potential factors affecting longevity.
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Affiliation(s)
- Annabelle von der Stück
- Department of Prosthodontics and Biomaterials, Uniklinik RWTH Aachen, Pauwelsstraße 30, Aachen 52074, Germany.
| | - Stefan Raith
- Department of Oral and Maxillofacial Surgery, Uniklinik RWTH Aachen, Aachen, Germany
| | - Sven Reich
- Department of Prosthodontics and Biomaterials, Uniklinik RWTH Aachen, Pauwelsstraße 30, Aachen 52074, Germany
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18
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Dimitriadis K, Sfikas AK, Kamnis S, Tsolka P, Agathopoulos S. Influence of heat treatment on the microstructure and the physical and mechanical properties of dental highly translucent zirconia. J Adv Prosthodont 2022; 14:96-107. [PMID: 35601351 PMCID: PMC9095450 DOI: 10.4047/jap.2022.14.2.96] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Microstructural and physico-mechanical characterization of highly translucent zirconia, prepared by milling technology (CAD-CAM) and repeated firing cycles, was the main aim of this in vitro study. MATERIALS AND METHODS Two groups of samples of two commercial highly-translucent yttria-stabilized dental zirconia, VITA YZ-HTWhite (Group A) and Zolid HT + White (Group B), with dimensions according to the ISO 6872 "Dentistry - Ceramic materials", were prepared. The specimens of each group were divided into two subgroups. The specimens of the first subgroups (Group A1 and Group B1) were merely the sintered specimens. The specimens of the second subgroups (Group A2 and Group B2) were subjected to 4 heat treatment cycles. The microstructural features (microstructure, density, grain size, crystalline phases, and crystallite size) and four mechanical properties (flexural strength, modulus of elasticity, Vickers hardness, and fracture toughness) of the subgroups (i.e. before and after heat treatment) were compared. The statistical significance between the subgroups (A1/A2, and B1/B2) was evaluated by the t-test. In all tests, P values smaller than 5% were considered statistically significant. RESULTS A homogenous microstructure, with no residual porosity and grains sized between 500 and 450 nm for group A and B, respectively, was observed. Crystalline yttria-stabilized tetragonal zirconia was exclusively registered in the X-ray diffractograms. The mechanical properties decreased after the heat treatment procedure, but the differences were not statistically significant. CONCLUSION The produced zirconia ceramic materials can be safely (i.e., according to the ISO 6872) used in extensive fixed prosthetic restorations, such as substructure ceramics for three-unit prostheses involving the molar restoration and substructure ceramics for prostheses involving four or more units. Consequently, milling technology is an effective manufacturing technology for producing zirconia substructures for dental fixed all-ceramic prosthetic restorations.
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Affiliation(s)
- Konstantinos Dimitriadis
- Division of Dental Technology, Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | | | - Spyros Kamnis
- Castolin Eutectic-Monitor Coatings Ltd, Newcastle, United Kingdom
| | - Pepie Tsolka
- Division of Dental Technology, Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | - Simeon Agathopoulos
- Department of Materials Science and Engineering, School of Engineering, University of Ioannina, Ioannina, Greece
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Wear Behavior of Different Generations of Zirconia: Present Literature. Int J Dent 2022; 2022:9341616. [PMID: 35295406 PMCID: PMC8920625 DOI: 10.1155/2022/9341616] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/16/2022] [Accepted: 02/10/2022] [Indexed: 12/22/2022] Open
Abstract
Objective. The wear behavior of the novel zirconia generation is less well understood and may be affected by compositional modifications compared to the conventional zirconia. Materials and Methods. Combinations of keywords such as “zirconia,” “high translucent,” and “wear” were searched in PubMed and Google Scholar databases up to May 2021. The total of 23 relevant articles was selected according to inclusion criteria. Results. Reports show comparable wear resistance of translucent zirconia to the conventional zirconia despite an increased cubic phase content and lower mean flexural strength. A meticulously polished surface creates the lowest surface roughness, producing favorable zirconia wear resistance and antagonist wear compared to a glazed surface. In comparison to other ceramic materials, zirconia produces the least wear on an enamel antagonist and almost undetectable wear when opposed by zirconia. Wear when paired against resin materials yields a favorable outcome, whereas wear behavior against a metal antagonist varies with the surface hardness of the metal. Conclusions. All zirconia generations are considered wear-friendly to all types of antagonists. Nonetheless, comparative studies on antagonist wear opposing zirconia of different compositions are still limited and further investigation is required.
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20
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Occlusal change in posterior implant-supported single crowns and its association with peri-implant bone level: a 5-year prospective study. Clin Oral Investig 2022; 26:4217-4227. [PMID: 35129663 DOI: 10.1007/s00784-022-04394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/17/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study aims to analyze the 5-year occlusal change in posterior implant-supported single crowns and the association between the relative occlusal force (ROF) and peri-implant bone level. MATERIALS AND METHODS Partially edentulous patients who had received implant-supported single crowns in the posterior region were included. Occlusal examinations with a computerized occlusion analysis system were conducted at 0.5, 3, 6, 12, 24, 36, 48, and 60 months after delivery of the implant-supported single crown. The ROFs of implant-supported single crowns, mesial adjacent teeth, and control natural teeth were recorded. Intraoral periapical radiographs were taken at each follow-up time to evaluate marginal bone level (MBL). Ordinary least square regression was used to analyze the association between ROF and MBL. RESULTS Thirty-seven posterior implant-supported single crowns in 33 participants (23.9 to 70.0 years) were followed up for 0.5 to 60 months [(42.4 ± 26.0) months]. The ROF of implant-supported single crowns increased from 2 weeks to 3 months (P < 0.01) and increased continuously between all two sequential time points from 6 to 36 months, with significant differences (P < 0.05). Then ROFs of implant-supported single crowns were significantly higher than those of control teeth at 48 and 60 months (P < 0.05). Regression analysis showed that ROF was significantly associated with MBL with a coefficient of 0.008 (P < 0.05). CONCLUSION The ROFs of posterior implant-supported single crown have significant change during 5 years' follow-up. The association between ROF and MBL has limited clinical significance. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR-ROC-17012240. CLINICAL RELEVANCE The occlusion of implant-supported single crowns should be carefully monitored during follow-up examinations, and occlusal adjustment should be considered to prevent overloading.
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21
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Jin M, Zhao J, Zheng Y. Effects of Grinding and Polishing on Surface Characteristics of Monolithic Zirconia Fabricated by Different Manufacturing Processes: Wet Deposition and Dry Milling. J Prosthodont 2022; 31:714-721. [PMID: 35076140 DOI: 10.1111/jopr.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the effects of grinding and polishing on surface characteristics of monolithic zirconia fabricated by two different manufacturing processes. MATERIALS AND METHODS Two types of monolithic zirconia specimens, self-glazed zirconia (SZ) and conventional zirconia (CZ), were fabricated by wet deposition and dry milling, respectively. The specimens were randomly assigned into 4 groups (n = 10): as-sintered, ground, polished with a special zirconia polishing kit, and polished with a general-purpose ceramic polishing kit. Surface morphology and roughness (Ra ) were characterized, followed by one-way ANOVA analysis (α = 0.05). RESULTS The as-sintered SZ exhibited a smooth surface with obvious different morphologies compared with the as-sintered CZ (Ra : 0.26 ±0.05 μm versus 0.33 ±0.10 μm). Ra of the ground SZ was significantly higher than that of the as-sintered SZ (P<0.001) and the ground CZ (P = 0.011). For both SZ and CZ, Ra decreased significantly after polishing (P<0.001), and there was no significant difference between the two groups with different polishing kits (SZ- P = 0.144; CZ- P = 0.322). Surface morphologies of SZ and CZ became similar after grinding and polishing. CONCLUSIONS Monolithic zirconia SZ fabricated by wet deposition exhibited a smooth surface with specific patterns compared to the dry milled CZ. Grinding significantly changed the surface morphology of SZ and increased surface roughness of both zirconia specimens, which can be improved by polishing without being influenced by polishing kit selection. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Manjia Jin
- Postgraduate student, Major of Prosthodontics, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jing Zhao
- Attending physician, Department of general dentistry, Stomatological Hospital affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanna Zheng
- Associate Professor, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
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22
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Ghaffari T, Rad F, Goftari A, Pashazadeh F, Ataei K. Natural teeth wear opposite to glazed and polished ceramic crowns: A systematic review. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.363567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Fischer P, Barbu HM, Fischer CAI, Pantea M, Baciu F, Vranceanu DM, Cotrut CM, Spinu TC. Bending Fracture of Different Zirconia-Based Bioceramics for Dental Applications: A Comparative Study. MATERIALS 2021; 14:ma14226887. [PMID: 34832293 PMCID: PMC8621405 DOI: 10.3390/ma14226887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 01/09/2023]
Abstract
The fabrication of fixed dental prostheses using aesthetic materials has become routine in today’s dentistry. In the present study, three-unit full zirconia fixed prosthetic restorations obtained by computer-aided design/computer-aided manufacturing (CAD/CAM) technology were tested by bending trials. The prostheses were intended to replace the first mandibular left molar and were manufactured from four different types of zirconia bioceramics (KatanaTM Zirconia HTML and KatanaTM Zirconia STML/Kuraray Noritake Dental Inc.; NOVAZir® Fusion float® ml/NOVADENT/Dentaltechnik; and 3D PRO Zirconia/Bloomden Bioceramics). In total, sixteen samples were manufactured—four samples per zirconia material. Additionally, the morphology, grain size area distribution, and elemental composition were analyzed in parallelepiped samples made from the selected types of zirconia in three different areas, noted as the upper, middle, and lower areas. The scanning electron microscope (SEM) analysis highlighted that the grain size area varies with respect to the researched area and the type of material. Defects such as microcracks and pores were also noted to a smaller extent. In terms of grain size area, it was observed that most of the particles in all samples were under 0.5 μm2, while the chemical composition of the investigated materials did not vary significantly. The results obtained after performing the bending tests showed that a zirconia material with fewer structural defects and an increased percentage of grain size area under 0.5 µm2, ranging from ~44% in the upper area to ~74% in the lower area, exhibited enhanced mechanical behavior. Overall, the resulting values of all investigated parameters confirm that the tested materials are suitable for clinical use.
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Affiliation(s)
- Peter Fischer
- Oral Implantology Department, Titu Maiorescu University, 67A Gh. Petrascu Street, 040441 Bucharest, Romania; (P.F.); (H.M.B.)
| | - Horia Mihail Barbu
- Oral Implantology Department, Titu Maiorescu University, 67A Gh. Petrascu Street, 040441 Bucharest, Romania; (P.F.); (H.M.B.)
| | - Caroline Adela Ingrid Fischer
- Doctoral School, Faculty of Dental Medicine, Titu Maiorescu University, 67A Gh. Petrascu Street, 040441 Bucharest, Romania;
| | - Mihaela Pantea
- Department of Fixed Prosthodontics and Occlusology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 17-23 Plevnei Street, 010221 Bucharest, Romania; (M.P.); (T.C.S.)
| | - Florin Baciu
- Department of Strength of Materials, Faculty of Industrial Engineering and Robotics, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania;
| | - Diana Maria Vranceanu
- Department of Metallic Materials Science, Physical Metallurgy, Faculty of Materials Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
- Correspondence: (D.M.V.); (C.M.C.); Tel.: +40-(0)21-316-9563 (D.M.V. & C.M.C.)
| | - Cosmin Mihai Cotrut
- Department of Metallic Materials Science, Physical Metallurgy, Faculty of Materials Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
- Correspondence: (D.M.V.); (C.M.C.); Tel.: +40-(0)21-316-9563 (D.M.V. & C.M.C.)
| | - Tudor Claudiu Spinu
- Department of Fixed Prosthodontics and Occlusology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 17-23 Plevnei Street, 010221 Bucharest, Romania; (M.P.); (T.C.S.)
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Azmy E, Al-kholy MRZ, Gad MM, Al-Thobity AM, Emam ANM, Helal MA. Influence of Different Beverages on the Color Stability of Nanocomposite Denture Base Materials. Int J Dent 2021; 2021:5861848. [PMID: 34804165 PMCID: PMC8601796 DOI: 10.1155/2021/5861848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/24/2021] [Accepted: 10/28/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The effect of beverages on nanocomposite denture base materials is neglected. Therefore, this study aimed to investigate the influence of different beverages (coffee, tea, cola, and mineral water) on the color stability of nanoparticles-modified denture base materials (DBMs). MATERIALS AND METHODS A total of 280 specimens (n = 10/group) were prepared from heat-polymerized acrylic resin modified with different concentrations (3% and 7%) of zirconium dioxide (nano-ZrO2), titanium dioxide (nano-TiO2), and silicon dioxide (nano-SiO2) nanoparticles, while 0% was taken as a control. Color change (∆E) of the specimens was evaluated after simulating 6-month immersion time in four commonly used beverages, coffee, tea, cola, and mineral water, as experimental groups. Color stability was measured using a spectrophotometer, and then values were converted to National Bureau of Standards units (NBS units). The one-way ANOVA test was applied to compare color change (ΔE) results followed by Bonferroni's post hoc test (α = 0.05). RESULTS The results showed that the heat-polymerized acrylic resin modified with different types of nanoparticles showed lower color changes after being immersed in beverage solutions compared to the unmodified group (P < 0.001), so the color stability of heat-polymerized acrylic resin was significantly enhanced by the addition of several nanoparticles; nano-ZrO2 showed the lowest ΔE followed by nano-TiO2 and then nano-SiO2. Regardless of the filler type, 3% concentration showed lower mean ΔE than 7% concentration. Regarding the beverage solutions, the greatest color change was found in the coffee group followed by tea and cola, while water showed the least changes. CONCLUSION Modification of heat-polymerized acrylic resin with certain amounts of nano-ZrO2, nano-TiO2, and nano-SiO2 may be useful in improving color stability.
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Affiliation(s)
- Emad Azmy
- Elmarg Students' Clinic, General Authority of Health Insurance, Western Elmarg Area, Cairo, Egypt
| | - Mohamed Reda Zaki Al-kholy
- Department of Removable Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, AlmokhyamAldaem St., Nasr Road, 11884 Nasr City, Cairo, Egypt
| | - Mohammed M. Gad
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Ahmad M. Al-Thobity
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Abdel-Naser M. Emam
- Department of Removable Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, AlmokhyamAldaem St., Nasr Road, 11884 Nasr City, Cairo, Egypt
| | - Mohamed Ahmed Helal
- Department of Removable Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, AlmokhyamAldaem St., Nasr Road, 11884 Nasr City, Cairo, Egypt
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25
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Leitão CIMB, Fernandes GVDO, Azevedo LPP, Araújo FM, Donato H, Correia ARM. Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis. J Prosthodont Res 2021; 66:374-384. [PMID: 34615842 DOI: 10.2186/jpr.jpr_d_21_00081] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology. STUDY SELECTION An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search. RESULTS From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672). CONCLUSIONS Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.
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Affiliation(s)
| | | | | | - Filipe Miguel Araújo
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health, Viseu, Portugal
| | - Helena Donato
- Coimbra Hospital and University Centre, Documentation Department, Coimbra, Portugal
| | - André Ricardo Maia Correia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health, Viseu, Portugal
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Laboratory Characterization of In-Service Full-Mouth Rehabilitation with Monolithic Translucent Zirconia Restorations. Symmetry (Basel) 2021. [DOI: 10.3390/sym13091755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The chance to critically and microscopically inspect the quality of bonded restorations once they are delivered to the patient after several pre-cementation steps is rare or nonexistent. Replicas of in-service restorations can provide a wealth of information on the integrity of the restorations and moreover make it possible to bring this information to the laboratory for further detailed analysis. This study aimed to characterize the epoxy replicas of 27 cemented monolithic yttria-stabilized zirconia crowns of the maxillary and mandibular arch to assess surface roughness, topography, and symmetry. The topography of the facial, lingual, and occlusal/incisal surfaces of each crown was observed under the optical microscope and further characterized using the scanning electron microscope. Surface roughness measurements were performed using the atomic force microscope. The optical microscope was used to measure the golden proportion and visible width of the anterior maxillary crowns. Surface damage consistent with unpolished adjustment was identified mostly in the occlusal surface of the posterior teeth. Other irregularities, such as scratch marks, small pits, and coarse pits were also found. The surface roughness had great variability. Not all of the anterior maxillary and mandibular teeth followed the golden proportion concept. This study design allows in vitro characterization of in-service restorations. It provides a framework for using replicas for early identification of patterns or features that can trigger fracture and for analysis of morphology and symmetry.
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Luo F, Hong G, Wan Q. Artificial Intelligence in Biomedical Applications of Zirconia. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.689288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Artificial intelligence (AI) is rapidly developed based on computer technology, which can perform tasks that customarily require human intelligence by building intelligent software or machines. As a subfield of AI, machine learning (ML) can learn from the intrinsic statistical patterns and structures in data through algorithms to predict invisible data. With the increasing interest in aesthetics in dentistry, zirconia has drawn lots of attention due to its superior biocompatibility, aesthetically pleasing, high corrosion resistance, good mechanical properties, and absence of reported allergic reactions. The evolution of AI and ML led to the development of novel approaches for the biomedical applications of zirconia in dental devices. AI techniques in zirconia-related research and clinical applications have attracted much attention due to their ability to analyze data and reveal correlations between complex phenomena. The AI applications in the field of zirconia science change according to the application direction of zirconia. Therefore, in this article, we focused on AI in biomedical applications of zirconia in dental devices and AI in zirconia-related applications in dentistry.
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Çömlekoğlu ME, Tekeroğlu F, Dündar Çömlekoğlu M, Özcan M, Türkün LŞ, Paken G. Clinical wear and quality assessment of monolithic and lithium disilicate layered zirconia restorations. Aust Dent J 2021; 66:413-422. [PMID: 34319585 DOI: 10.1111/adj.12869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Wear and quality assessments of translucent monolithic zirconia and CAD-on® restorations were performed. METHODS Forty 3-unit posterior fixed partial denture (FPD) in 18 patients (age:18-50 years) were made from translucent monolithic zirconia (tm) (Zenostar T) and zirconia-frameworked, lithium disilicate layered (c) (CAD-on), materials in a split-mouth design. Restorations were digitally fabricated and their internal and marginal adaptations were measured before cementation followed by luting (Multilink Speed). Clinical evaluations were made by modified United States Public Health Service criteria at baseline, 6, 12, and 24-months. Wear of the restorations and the antagonists were digitally evaluated after optical scanning of stone casts at 1st week and 24 m through a software (Cerec 4.4). Statistical analysis was made (analysis of variance, Shapiro-Wilk, Friedman and Wilcoxon tests (SPSS 20)) at α = 0.05 significance level. RESULTS At 24 m, all restorations were clinically acceptable. Insignificant differences were found between tm and c restorations (P > 0.05). Mean internal and marginal adaptation of c restorations were significantly better (145 µm (premolar)-174 µm (molar)) than tm (190 µm (premolar)-207 µm (molar)) (P < 0.05). C restorations significantly caused more wear (0.3 ± 0.1 mm) than tm (0.1 ± 0.07 mm) on the antagonistic dentition (P < 0.05). CONCLUSIONS Translucent monolithic zirconia restorations caused less wear and antagonist wear than CAD-on restorations. CAD-on restorations exhibited higher internal and marginal adaptation.
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Affiliation(s)
- M E Çömlekoğlu
- Department of Prosthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - F Tekeroğlu
- Private Dental Practice, Kuşadası, Aydın, Turkey
| | - M Dündar Çömlekoğlu
- Department of Prosthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - M Özcan
- Division of Dental Biomaterials, Center of Dental Medicine, Clinic for Reconstructive Dentistry, University of Zürich, Zürich, Switzerland
| | - L Ş Türkün
- Department of Restorative Dentistry, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - G Paken
- Department of Prosthodontics, Faculty of Dentistry, Uşak University, Uşak, Turkey
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Zhou T, Wongpairojpanich J, Sareethammanuwat M, Lilakhunakon C, Buranawat B. Digital occlusal analysis of pre and post single posterior implant restoration delivery: A pilot study. PLoS One 2021; 16:e0252191. [PMID: 34214089 PMCID: PMC8253389 DOI: 10.1371/journal.pone.0252191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/09/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives The purposes of this study were to analyze the effects of single posterior implant restorations delivery on the redistribution of bite force and to evaluate the changes in occlusal force distribution of prostheses and potential influencing factors on occlusion variation at different stages. Materials and methods Thirty-two single posterior restorations in 30 participants (18 women and 12 men aged 27 to 75 years) were placed into either a unilateral single-tooth defect (n = 17) or on either side of a bilateral teeth defects (n = 15). The bite force (%) of the prostheses, teeth and segments at the maximum intercuspation position (MIP) was evaluated using a T-scan at 5 stages (pre-placement, immediately following placement, and 2 weeks, 3 months, and 6 months post-placement). Results The occlusal force of implant-supported prostheses was significantly (P = .000) lower than those of the control natural teeth at the baseline, then no significant difference was found with that of the mesial teeth at 3 months, and finally it was significantly (P = .000) lower than that of the distal teeth at 6 months; meanwhile, it significantly (P = .008) increased by a mean of 2.04 times from 2 weeks (3.39 ± 2.61%) to 3 months (6.90 ± 4.77%), whereas no significant difference (P = .900) was found from 3 months (6.90 ± 4.77%) to 6 months (7.31 ± 4.60%). In addition, the bite force of the posterior segment on the restored side of both unilateral and bilateral gaps was significantly (P = .013,.001) improved by 3.31% and 6.83%, respectively, although the discrepancy in bite force significantly (P = .039) increased from an initial 3.52% to 5.02% for subjects with bilateral defects, accompanying increases in the proportion (15.38%) of the level III bilateral bite force deviation (P >.05). Conclusions Bite force and masticatory ability can be improved with the immediate delivery of a single posterior implant restoration. The bite force distributed on the implant prosthesis inevitably increases after placement of implant prostheses, a routine follow-up and occlusal evaluation are strongly needed.
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Affiliation(s)
- Ting Zhou
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
- Department of Orthodontics, School of Stomatology, Kunming Medical University, Yunnan, China
| | - Jirapa Wongpairojpanich
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Maytha Sareethammanuwat
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Charukrit Lilakhunakon
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Borvornwut Buranawat
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
- * E-mail:
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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: 24] [Impact Index Per Article: 8.0] [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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Risk Indicators Affecting the Survival of the Mandibular First Molar Adjacent to an Implant at the Mandibular Second Molar Site: A Retrospective Study. J Clin Med 2021; 10:jcm10122543. [PMID: 34201316 PMCID: PMC8227410 DOI: 10.3390/jcm10122543] [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: 05/04/2021] [Revised: 05/29/2021] [Accepted: 06/04/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to compare the survival of mandibular first molars (MnM1s) adjacent to implants placed in mandibular second molar sites (ImM2s) with MnM1s adjacent to mandibular second molars (MnM2s) and to investigate risk indicators affecting the survival of MnM1s adjacent to ImM2s. A total of 144 patients who had MnM1s adjacent to ImM2s and MnM1s adjacent to MnM2s on the contralateral side were included in this study. Clinical variables and radiographic bone levels were evaluated. The survival of MnM1s adjacent to ImM2s or MnM2s was evaluated using a Kaplan–Meier analysis and Cox proportional hazards model. The 5-year cumulative survival rates of MnM1s adjacent to ImM2s and MnM2s were 85% and 95%, respectively. MnM1s adjacent to ImM2s of the internal implant-abutment connection type had higher multivariate hazard ratios (HR) for loss. MnM1s that had antagonists with implant-supported prostheses also had higher HR for loss. The multivariate HR for the loss of MnM1s adjacent to ImM2s with peri-implant mucositis was 3.74 times higher than MnM1s adjacent to healthy ImM2s. This study demonstrated several risk indicators affecting the survival of MnM1s adjacent to ImM2s. It is suggested that supportive periodontal and peri-implant therapy combined with meticulous occlusal adjustment can prolong the survival of MnM1s and ImM2s.
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Ozkir SE, Bicer M, Deste G, Karakus E, Yilmaz B. Wear of monolithic zirconia against different CAD-CAM and indirect restorative materials. J Prosthet Dent 2021; 128:505-511. [PMID: 34059295 DOI: 10.1016/j.prosdent.2021.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM The wear of monolithic zirconia against enamel has been widely studied, but how zirconia affects different opposing restorative materials is not clear. PURPOSE The purpose of this in vitro study was to investigate the depth of wear and volumetric loss of different restorative materials opposed by monolithic zirconia. MATERIAL AND METHODS Sixty-six Ø10×3-mm specimens (n=11) were fabricated from monolithic zirconia, zirconia reinforced ceramic, lithium disilicate ceramic, feldspathic ceramic, ORMOCER, and ceramic optimized polymer. A 2-body pin-on-disk wear test was performed by using monolithic zirconia pins. The specimens were scanned with a noncontact profilometer after the tests. The scan parameters were a frame size area of 1.5×1.5 mm, frequency of 400 Hz, and scan sensitivity of 2 μm. After the evaluation of depth and volume loss, the specimens were analyzed with a scanning electron microscope. The Kruskal-Wallis test was used to analyze the differences in wear values across the specimen groups, and pairwise comparison tests were performed with a post hoc test (α=.05). RESULTS Maximum depth of wear was 257.55 ±18.88 μm for lithium disilicate ceramic, 295.36 ±14.46 μm for zirconia reinforced ceramic, 421.82 ±214.49 μm for ORMOCER, 333.73 ±79.09 μm for ceramic optimized polymer, 146.27 ±22.86 μm for feldspathic ceramic, and 41.55 ±5.04 μm for monolithic zirconia. The depth of wear was not significantly different among lithium disilicate, zirconia-reinforced ceramic, ORMOCER, and ceramic optimized polymer (P<.05). However, the depth of wear of monolithic zirconia and feldspathic ceramic was less than that of other materials (P<.001). Volume loss of lithium disilicate was 1.68 ±0.25 mm3, 1.08 ±0.35 mm3 for zirconia reinforced ceramic, 4.29 ±2.91 mm3 for ORMOCER, 2.46 ±0.63 mm3 for resin ceramic, 1.07 ±0.09 mm3 for feldspathic ceramic, and 0.19 ±0.02 mm3 for monolithic zirconia. Feldspathic ceramic and monolithic zirconia had significantly less volume loss than the other groups (P<.001), and the difference between them for volume loss was statistically insignificant (P>.05). CONCLUSIONS The tested ceramic-based materials had favorable wear resistance compared with the tested composite resin-based ones. However, the ceramics tended to crack formation than the composite resins.
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Affiliation(s)
- Serhat Emre Ozkir
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Osmangazi University, Eskişehir, Turkey.
| | - Mehmet Bicer
- Research Assistant, Department of Prosthodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Gonca Deste
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Uludag University, Bursa, Turkey
| | - Elif Karakus
- Research Assistant, Department of Prosthodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
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Park CJ, Son JJ, Lin R, Phark JH, Wilson ML, Chee WW, Cho G. Evaluation of fracture resistance of zirconia modification/polishing around implant abutments. J ORAL IMPLANTOL 2021; 48:202-209. [PMID: 33945621 DOI: 10.1563/aaid-joi-d-20-00144] [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: 11/22/2022]
Abstract
Subcrestal placement of implants may have interproximal bone proximity issues that interfere with submucosal contour of the implant-supported Zirconia restorations during delivery of these restorations. Modification of the mesial distal submucosal areas may be necessary to fully seat the restoration without impingement of the interproximal bone. Our aim was to determine if modification of submucosal cervical contour of implant supported zirconia titanium base (Zi-Ti base) restorations result in a significant change in fracture strength compared to Zi-Ti base restorations without any modification near the cervical submucosal area. Implant Zi-Ti base restorations, designed in the form of a maxillary premolar was made for the Straumann implant lab analog. Zirconia samples were cemented onto the Ti-base and the test group (N=20) underwent recontouring and polishing at the junction of the Zi-Ti-base cervical areas. The control group (N=20) did not undergo any modifications. All 40 samples underwent fracture testing with an Instron machine. We assessed differences between modified and unmodified implant restorations using a two-tailed t-test for independent samples. Fracture strength values (N) ranged from 4,354.68 to 6,412.49 in the test group (N=20) and from 5,400.31 to 6,953.22 in the control group (N=20). The average fracture strength in the control group (6,154.84 ± 320.50) was higher than in the modified group (5,593.13 ± 486.51; p<.001)). Modification of submucosal contour significantly decreased the fracture strength. However, the average fracture strength exceeded the masticatory forces of humans.
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Affiliation(s)
- Cheryl Jonghee Park
- Herman Ostrow School of Dentistry of University of Southern California Dentistry 925 W. 34th Street Rm4374 UNITED STATES Los Angeles CA 90089 12139991716 Assistant Professor of Clinical Dentistry, Carl Rieder Professor of Restorative Dentistry, Division of Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Jenny Jin Son
- Assistant Professor of Clinical Dentistry, Division of Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Richard Lin
- Assistant Professor of Clinical Dentistry, Director of CAD/CAM Dentistry, Division of Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Jin-Ho Phark
- Associate Professor of Clinical Dentistry, Director of Biomaterials Research Laboratory, Co-Director of Advanced Program in Operative and Adhesive Dentistry, Division of Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern Califo
| | - Melissa Lee Wilson
- Associate Professor of Clinical Preventive Medicine, University of Southern California KECK School of Medicine, Los Angeles, California, USA
| | - Winston W Chee
- Associate Professor, Ralph & Jean Bleak Professor of Restorative Dentistry, Director of Advanced Education in Prosthodontics, Director of Implant Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, US
| | - George Cho
- Associate Professor, Phillip Maurer Tennis Professor of Clinical Dentistry, Assistant Director of Advanced Prosthodontics, Director of Predoctoral Implant Dentistry, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Califor
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Mikeli A, Walter MH, Rau SA, Raedel M, Raedel M. Three-year clinical performance of posterior monolithic zirconia single crowns. J Prosthet Dent 2021; 128:1252-1257. [PMID: 33865558 DOI: 10.1016/j.prosdent.2021.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM Monolithic zirconia has become widely used for single crowns, with the advantages of minimal tooth reduction and good esthetics. However, clinical studies evaluating the performance of and patient satisfaction with posterior monolithic zirconia crowns are sparse. PURPOSE The purpose of this clinical study was to evaluate the clinical performance of and patient satisfaction with posterior monolithic zirconia crowns. MATERIAL AND METHODS Within a prospective cohort study design, participants were recruited from a university dental clinic if they required 1 posterior monolithic zirconia crown. The clinical performance was evaluated at follow-up appointments 1, 2, and 3 years after insertion. Bleeding on probing and pocket probing depths for the crowned teeth were recorded. Overall patient satisfaction was measured by using a visual analog scale (VAS), and quality of life was measured by using the validated German version of the Oral Health Impact Profile 14 (OHIP-G14). Descriptive statistical methods were applied. Mean values were calculated and compared by using the paired t test (α=.05). RESULTS Thirty participants received a monolithic zirconia crown (14 premolars, 16 molars). One biologic complication (vertical root fracture) was identified at the 1-year follow-up. Three years after insertion, 22 participants could be examined, and the crowns were still in function. The gingival and the periodontal status of the crowned teeth had not changed significantly over the 3 years. After insertion, a significant improvement in patient satisfaction was measured up to 3 years CONCLUSIONS: Posterior monolithic zirconia crowns led to enhanced patient satisfaction up to 3 years after insertion. They provided good middle-term success and offered a promising alternative to conventional metal-ceramic crowns.
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Affiliation(s)
- Aikaterini Mikeli
- Research fellow, Prosthodontics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Michael H Walter
- Professor and Chair, Prosthodontics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Stefanie Anke Rau
- Research fellow, Prosthodontics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Martina Raedel
- Research fellow, Prosthodontics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Michael Raedel
- Senior Lecturer and Research Group Leader, Prosthodontics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany.
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Tang Z, Zhao X, Wang H. Quantitative analysis on the wear of monolithic zirconia crowns on antagonist teeth. BMC Oral Health 2021; 21:94. [PMID: 33663477 PMCID: PMC7934252 DOI: 10.1186/s12903-021-01452-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 02/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study aimed to quantitate the wear of the highly transparent Yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) ceramic monolithic zirconia crown on the enamel in vivo and discuss the prone position of the wear and the underlying mechanism. METHODS A total of 43 patients with 43 posterior teeth were selected for full zirconia crown restoration and examined immediately, at 6 months, and at 1 year after restoration. During the follow-up visit, the fine impression of the patients' monolithic zirconia crowns, the antagonist teeth, the corresponding contralateral natural teeth, the super plaster cast, and epoxy resin model was ontained. The model of epoxy resin was observed under a stereo microscope, and the microstructure parts were observed under a scanning electron microscope. RESULTS After 1 year, the mean depth and volume of wearing of the monolithic zirconia crown were the smallest (all P < 0.01), while those of the antagonist teeth were significantly larger than those of the natural teeth (P < 0.0001), and no significant difference was found among the natural teeth (P = 0.3473, P = 0.6996). The amount of wear after one year was remarkably higher than that at 6 months (P < 0.0001). The microscopic observation revealed the tendency of wearing of the monolithic zirconia crown on the antagonist teeth at the protruding early contact points. Electron micrographs of tooth scars showed that the wearing mechanism of the monolithic zirconia crown on natural teeth was mainly abrasive and fatigue wear. CONCLUSIONS Although the self-wearing is insignificant, the monolithic zirconia crown can cause wear of the antagonist teeth via occlusal or early contact significantly; the amount of wearing is higher than that of natural teeth and increases over time. The wearing mechanism is mainly abrasive and fatigue wear.
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Affiliation(s)
- Zhenyu Tang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Dental Materials, School of Stomatology, The Fourth Military Medical University, Xi'an, China.,Department of Stomatology, Liuzhou People's Hospital, Liuzhou, China
| | - Xinyi Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Dental Materials, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
| | - Hui Wang
- Guilin Medical University, Guilin, China
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Tachibana K, Atsuta I, Tsukiyama Y, Kuwatsuru R, Morita T, Yoshimatsu H, Matsushita Y, Narimatsu I, Ayukawa Y, Sawae Y, Koyano K. The need for polishing and occlusal adjustment of zirconia prostheses for wear on antagonist teeth. Dent Mater J 2021; 40:650-656. [PMID: 33456027 DOI: 10.4012/dmj.2020-190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The attrition of enamel when opposed by ceramics is of great concern. The purpose of this study was to evaluate enamel wear against high translucent zirconia (Zr), lithium disilicate (LD), gold (Au), and enamel (E) with different surface and contact conditions. The materials were divided into two groups: polished and ground (n=8 each). Two-body wear tests were performed against human enamel with vertical and horizontal, horizontal, and vertical repetitive movements as experiments 1 to 3 respectively. The surface roughness of all materials except Zr changed throughout the experiments. In experiment 1, Zr and Au showed less antagonist wear when polished than when ground. In experiment 2, polished groups showed less antagonist wear than ground groups in all materials. In experiment 3, Zr and LD exerted greater antagonist wear than E, regardless of Ra. These findings confirm the importance of polishing and occlusal adjustment of zirconia.
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Affiliation(s)
- Keishu Tachibana
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Ikiru Atsuta
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University
| | - Yoshihiro Tsukiyama
- Section of Dental Education, Division of Oral Biological Sciences, Faculty of Dental Science, Kyushu University
| | - Rika Kuwatsuru
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Takehiro Morita
- Machine Elements and Design Laboratory, Department of Mechanical Engineering, Kyushu University
| | | | - Yasuyuki Matsushita
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Ikue Narimatsu
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Yasunori Ayukawa
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Yoshinori Sawae
- Machine Elements and Design Laboratory, Department of Mechanical Engineering, Kyushu University
| | - Kiyoshi Koyano
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
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Mešić K, Majnarić I, Obhođaš J, Baršić G, Mehulić K. The Effect of Aging on Composition and Surface of Translucent Zirconia Ceramic. Acta Stomatol Croat 2020; 54:339-352. [PMID: 33642598 PMCID: PMC7871433 DOI: 10.15644/asc54/4/1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives To examine the effect of two aging protocols on the chemical and phase composition as well as the surface state of monolithic translucent zirconia ceramics. Material and Methods Translucent zirconia ceramics KATANA-Zirconia STML with different surface treatments (no treatment, K1, K2; glazed, G1-G8; polished, P1-P8) underwent testing in order to examine how the two aging protocols (three-hour hydrothermal degradation in an autoclave at 134 °C and 2 bars: G1-G4, P1-P4, and sixteen-hour chemical degradation in four-percent acetic acid at 80 °C (ISO 6872): G5-G8, P5-P8) affect chemical composition, particularly the share of stabilizing yttrium oxide (Energy Dispersive X-Ray Fluorescence – EDXRF), phase composition (X-ray diffraction – XRD) and surface state in terms of roughness and gloss. Results Aging protocols did not affect the tested chemical composition stability of specimens and a high share of stabilizing yttrium-oxide (≥10% of total content), which correlates with the absence of monoclinic phase. A decrease in gloss on all specimens is statistically significant. Chemical degradation substantially increased the surface roughness of tested specimens. Conclusions Translucent monolithic zirconia demonstrated a stable chemical composition and resistance to tetragonal-to-monoclinic transformation. Surface gloss was significantly reduced, especially in polished specimens. Contrary to glazed specimens, the tested polished specimens manifested an increase in surface roughness. Glazing the surface of translucent monolithic zirconia produces better esthetic, tribological and hygienic effects than polishing.
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Affiliation(s)
- Korina Mešić
- Polyvalent Dental Office, 10 000 Zagreb, Croatia
| | | | | | - Gorana Baršić
- Faculty of Mechanical Engineering and Naval Architecture, 10 000 Zagreb, Croatia
| | - Ketij Mehulić
- School of Dental Medicine University of Zagreb & Dental Clinic, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia
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Tanaka K, Someya T, Kawada E, Ohyama T, Yoshinari M, Takemoto S, Hattori M. In vitro wear behavior of restorative resin composites against bovine enamel. Dent Mater J 2020; 39:915-923. [PMID: 31694995 DOI: 10.4012/dmj.2018-297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to clarify the effects of fabrication method of restorative resin-based composites on its wear using enamel as antagonist teeth. Wear evaluation was performed via two-body wear test using hemispherical samples of restorative resin-based composite (abrader specimen) fabricated through direct restoration method, indirect restoration method, and CAD/CAM, and bovine enamel (substrate specimen). As a result, there was a difference in wear volume between resin-based composite and bovine enamel depending on the fabrication method. Resin composite used for indirect restoration method showed more wear in both the abrader and substrate specimens. Resin composite used for CAD/CAM crowns showed greater wear volume in the abrader specimen. In conclusion, results clarified that fabrication method of restorative resin-based composite has an influence on the wear of the resin composite itself and enamel as antagonist teeth.
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Affiliation(s)
- Kensuke Tanaka
- Department of Dental Materials Science, Tokyo Dental College
| | - Tomoko Someya
- Department of Dental Materials Science, Tokyo Dental College
| | - Eiji Kawada
- Department of Dental Materials Science, Tokyo Dental College
| | - Takashi Ohyama
- Department of Dental Materials Science, Tokyo Dental College
| | | | - Shinji Takemoto
- Department of Biomedical Engineering, Iwate Medical University
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Matta RE, Motel C, Kirchner E, Stelzer SP, Adler W, Wichmann M, Berger L. Wear of feldspathic-ceramic-veneered zirconia posterior FPDs after 10 years. BMC Oral Health 2020; 20:345. [PMID: 33256686 PMCID: PMC7708209 DOI: 10.1186/s12903-020-01336-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/18/2020] [Indexed: 11/18/2022] Open
Abstract
Background The abrasion behavior of various ceramics is rarely investigated, though it is relevant for the clinical success of such restorations. The aim of this in vivo study was to evaluate the wear of feldspathic-ceramic-veneered zirconium oxide frameworks over a period of at least 10 years. Methods The abrasion behavior of 15 bridge constructions from 15 different participants was examined after a period of 3, 5, and 10 years using plaster models, which were then subjected to a scanning process on the Atos II industrial scanner and digitized for three-dimensional evaluation of the abrasion by the corresponding software (ATOS Professional 7.6). The individual post-examination models were compared to the baseline model and deviations calculated in the sense of the largest, punctual loss of material in millimeters (“minimal distance”), the average abrasion in millimeters (“mean distance”), and the volume decrease in cubic millimeters (“integrated distance”). Statistical analyses were performed using the Wilcoxon sign rank test or mixed regression models. Multiple testing was considered by Benjamini-Hochberg correction. The significance level was set at 0.05. Results We found steadily increasing wear of the ceramic. The average volume decrease was significant (P < 0.001) at 3 years and 10 years (− 3.25 mm3 and − 8.11 mm3, respectively). Conclusions The results of this study indicate that the rate of volume loss in feldspathic-ceramic-veneered zirconia frameworks in the posterior region increases significantly over time. An increasing frequency of parameters was observed, particularly in the second half of the study period. However, the use of this class of materials can be considered clinically acceptable. Trial registration This study is registered in DRKS - German Clinical Trials Register with the register number DRKS00021743. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021743
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Affiliation(s)
- Ragai-Edward Matta
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, 91054, Erlangen, Germany.
| | - Constantin Motel
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, 91054, Erlangen, Germany
| | - Elena Kirchner
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, 91054, Erlangen, Germany
| | - Simon Paul Stelzer
- Zahnarztpraxis Haidhausen Dr. Hans-Rudolf Kurpiers und Christian Pollok, Weißenburger Platz 8, 81667, Munich, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University of Erlangen Nuremberg, Waldstr. 6, 91054, Erlangen, Germany
| | - Manfred Wichmann
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, 91054, Erlangen, Germany
| | - Lara Berger
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, 91054, Erlangen, Germany
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Michailova M, Elsayed A, Fabel G, Edelhoff D, Zylla IM, Stawarczyk B. Comparison between novel strength-gradient and color-gradient multilayered zirconia using conventional and high-speed sintering. J Mech Behav Biomed Mater 2020; 111:103977. [DOI: 10.1016/j.jmbbm.2020.103977] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 11/29/2022]
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Solá-Ruiz MF, Baixauli-López M, Roig-Vanaclocha A, Amengual-Lorenzo J, Agustín-Panadero R. Prospective study of monolithic zirconia crowns: clinical behavior and survival rate at a 5-year follow-up. J Prosthodont Res 2020; 65:284-290. [PMID: 33041280 DOI: 10.2186/jpr.jpr_d_20_00034] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose To evaluate the clinical behavior and survival of full coverage monolithic zirconia crowns on posterior teeth over a 5-year follow-up.Methods Fifty patients were recruited and underwent restoration with a Lava Plus monolithic zirconia crown (Lava™ Frame Zirconia, 3M Espe, Germany) on premolars or molars. Patients were monitored over a 5-year follow-up (2014-19), recording any biological and/or mechanical complications; these data were used to estimate the crowns' success rate. Periodontal clinical parameters were recorded (pocket probing depth (PPD), plaque index (PLI), bleeding on probing (BOP), and gingival recession (GR)). Wear to the zirconia crowns and antagonist teeth were also evaluated with Geomagic software (3D Systems, U.S.A.). Patients' satisfaction with treatment was evaluated in a questionnaire.Results For the 50 monolithic zirconia crowns analyzed, the survival rate was 98% after 5 years. Only 6% of the crowns presented some type of complication (two debonding and one root fracture). No fracture or fissures were detected. GR and BOP were the only clinical parameters found to be significantly greater around teeth restored with crowns. The monolithic zirconia crowns suffered less wear than the enamel of antagonist teeth. Patient's general satisfaction with treatment was high.Conclusions Monolithic zirconia crowns on posterior teeth are a highly predictable treatment option, with a high survival rate. The single treatment failure was due to a biological complication arising from root fracture. This treatment may be recommended as a treatment that conserves dental structure, and requires minimal dental preparation.
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Affiliation(s)
- Mª Fernanda Solá-Ruiz
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Mar Baixauli-López
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Ana Roig-Vanaclocha
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Jose Amengual-Lorenzo
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Rubén Agustín-Panadero
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Branco AC, Silva R, Jorge H, Santos T, Lorenz K, Polido M, Colaço R, Serro AP, Figueiredo-Pina CG. Tribological performance of the pair human teeth vs 3D printed zirconia: An in vitro chewing simulation study. J Mech Behav Biomed Mater 2020; 110:103900. [PMID: 32957205 DOI: 10.1016/j.jmbbm.2020.103900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/04/2020] [Accepted: 05/30/2020] [Indexed: 11/17/2022]
Abstract
This study aims to evaluate the tribological performance of the pair human teeth/robocasted zirconia, with a special focus on the enamel wear mechanisms. Zirconia pieces produced by robocasting (RC) and unidirectional compression (UC) were compared in terms of crystalline structure, density, porosity, hardness and toughness. Chewing simulation tests were performed against human dental cusps. The cusps wear was quantified and the wear mechanisms identified. Although most of the properties of UC and RC samples are similar, differences were observed for surface roughness and porosity. Although the samples did not suffer wear, the antagonist cusps worn in a similar way. In conclusion, robocasting seems a promising technique to produce customized zirconia dental pieces, namely in what concerns the overall tribological behaviour.
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Affiliation(s)
- A C Branco
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - R Silva
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - H Jorge
- Centro Tecnológico da Cerâmica e Do Vidro (CTCV), Coimbra, Portugal
| | | | - K Lorenz
- INESC-MN, IPFN, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - M Polido
- CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal
| | - R Colaço
- IDMEC e Departamento de Engenharia Mecânica, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - A P Serro
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal.
| | - C G Figueiredo-Pina
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal; CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal; CeFEMA, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
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F Esquivel-Upshaw J, Hsu SM, Bohórquez AC, Abdulhameed N, Scheiffele GW, Kim M, Neal D, Chai J, Ren F. Novel methodology for measuring intraoral wear in enamel and dental restorative materials. Clin Exp Dent Res 2020; 6:677-685. [PMID: 32955159 PMCID: PMC7745065 DOI: 10.1002/cre2.322] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/02/2022] Open
Abstract
Objectives To test the hypotheses that (a) the chairside/handheld dental scanner combined with a metrology software will measure clinical wear in vivo in agreement with measurements from X‐ray computed microtomography and; (b) polished monolithic zirconia does not cause accelerated wear of opposing enamel. Materials and methods Thirty single crowns were randomized to receive a monolithic zirconia or metal‐ceramic crown. Two non‐restored opposing teeth in the same quadrants were identified to serve as enamel controls. After cementation, quadrants were scanned using an intraoral dental scanner. Patients were recalled at 6‐months and 1‐year for re‐scanning. Scanned images were compared using a metrology software to determine maximum vertical wear of teeth. The accuracy of the scanning measurements from this new method was compared with X‐ray computed microtomography (micro‐CT) measurements. Statistical analysis was performed using Mann–Whitney U test to determine significant differences between wear of enamel against zirconia, metal‐ceramic or enamel. Linear regression analysis determined agreement between measurements obtained using intraoral scanning and micro‐CT. Results Regression analysis demonstrated that there is a quantitative agreement between depth and volume measurements produced using intraoral scanning and the micro‐CT methodologies. There was no significant difference between the wear of enamel against polished monolithic zirconia crowns and enamel against enamel. Conclusions Intraoral scanning combined with a matching software can accurately quantify clinical wear to verify that monolithic zirconia exhibited comparable wear of enamel compared with metal‐ceramic crowns and control enamel. Agreement between the intraoral scanner and the micro‐CT was 99.8%. Clinical Trials.gov NCT02289781.
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Affiliation(s)
- Josephine F Esquivel-Upshaw
- Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Shu-Min Hsu
- Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Ana C Bohórquez
- Herbert Wertheim College of Engineering's Research Service Centers, University of Florida College of Engineering, Gainesville, Florida, USA
| | - Nader Abdulhameed
- Restorative Dentistry, LECOM School of Dental Medicine Bradenton, Florida, USA
| | - Gary W Scheiffele
- Herbert Wertheim College of Engineering's Research Service Centers, University of Florida College of Engineering, Gainesville, Florida, USA
| | - Mijin Kim
- Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Dan Neal
- Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida, USA
| | - John Chai
- Department of Prosthodontics, Northwestern University Dental School, Chicago, Illinois, USA
| | - Fan Ren
- Department of Chemical Engineering, University of Florida Herbert Wertheim College of Engineering, Gainesville, Florida, USA
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Miura S, Yamauchi S, Kasahara S, Katsuda Y, Fujisawa M, Egusa H. Clinical evaluation of monolithic zirconia crowns: a failure analysis of clinically obtained cases from a 3.5-year study. J Prosthodont Res 2020; 65:148-154. [PMID: 32938882 DOI: 10.2186/jpr.jpor_2019_643] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The primary purpose of this study was to examine the clinical performance of monolithic zirconia single crowns in terms of short-term failure or complications. The secondary purpose was to detect the originating flaws of clinically failed monolithic zirconia crowns to find the causes of failure. METHODS A short-term prospective cohort study based on record evaluation and clinical examination of patients treated with tooth-supported monolithic zirconia crowns was performed in the Department of Fixed Prosthodontics, Tohoku University Hospital, Japan. The crowns were prepared during the follow-up period from April 2014 to July 2018. The 3.5-year cumulative success and survival rates were set as primary endpoints. Fractures of the crown or fragments were inspected under a scanning electron microscope for descriptive fractography. RESULTS During the study period, 40 monolithic zirconia crowns were placed. Four crowns experienced clinical complications, including: 1) fracture of the crown (two crowns), 2) abrasion of the crown (one crown), and 3) fracture of the antagonist tooth (one crown). The estimated Kaplan-Meier 3.5-year success and survival rates were 90.5% (95% confi dence interval [CI]: 73.1-97.1) and 92.8% (95% CI: 74.1-98.3), respectively. Fractography revealed that all fractures were initiated from the wear phase on the occlusal surface. CONCLUSIONS The results of this study suggest that the molar application of monolithic zirconia crowns requires detailed attention to interocclusal clearance and the restoration of the antagonist tooth.
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Affiliation(s)
- Shoko Miura
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado.,Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Shinobu Yamauchi
- Department of Biomaterials, Nihon University School of Dentistry at Matsudo
| | - Shin Kasahara
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Yusuke Katsuda
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
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Branco AC, Colaço R, Figueiredo-Pina CG, Serro AP. A State-of-the-Art Review on the Wear of the Occlusal Surfaces of Natural Teeth and Prosthetic Crowns. MATERIALS 2020; 13:ma13163525. [PMID: 32785120 PMCID: PMC7476047 DOI: 10.3390/ma13163525] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 11/16/2022]
Abstract
This review focuses on the wear mechanisms of natural and restorative dental materials, presenting a comprehensive description and analysis of the works published in the last two decades on the wear at the interface of occlusal surfaces. Different groups of tribological pairs were considered: tooth-tooth, tooth-restorative material (tooth-ceramic, tooth-resin-based-materials, and tooth-metal), and restorative-restorative materials. The lack of standardization of the wear tests impairs the direct comparison of the obtained results. However, it was possible to infer about the main wear mechanisms observed on the different classes of dental materials. Concerning ceramics, their toughness and surface finishing determines the wear of antagonist tooth. Abrasion revealed to be the main wear mechanisms at occlusal interface. In the case of resin-based composites, the cohesion of the organic matrix and the nature, shape, and amount of filler particles greatly influences the dental wear. The protruding and detachment of the filler particles are the main causes of abrasion of antagonist enamel. Metallic materials induce lower wear on antagonist enamel than the other classes of materials, because of their low hardness and high ductility. Most of the studies revealed plastic deformation and adhesive wear as the main wear mechanisms. Overall, more research in this area is needed for a better understanding of the mechanisms involved at the occlusal surfaces wear. This would be essential for the development of more suitable restoration materials.
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Affiliation(s)
- Ana Catarina Branco
- Centro de Química Estrutural (CQE), Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal; (A.C.B.); (A.P.S.)
- Centro de Desenvolvimento de Produto e Transferência de Tecnologia (CDP2T), Department of Mechanical Engineering, Instituto Politécnico de Setúbal, 2910-761 Setúbal, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Caparica, Portugal
| | - Rogério Colaço
- Instituto de Engenharia Mecânica (IDMEC), Department of Mechanical Engineering, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal;
| | - Célio Gabriel Figueiredo-Pina
- Centro de Desenvolvimento de Produto e Transferência de Tecnologia (CDP2T), Department of Mechanical Engineering, Instituto Politécnico de Setúbal, 2910-761 Setúbal, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Caparica, Portugal
- Centro de Física e Engenharia de Materiais Avançados (CeFEMA), Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
- Correspondence:
| | - Ana Paula Serro
- Centro de Química Estrutural (CQE), Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal; (A.C.B.); (A.P.S.)
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Caparica, Portugal
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Evaluation of the wear of glazed and polished zirconia crowns and the opposing natural teeth: A clinical pilot study. J Prosthet Dent 2020; 126:52-57. [PMID: 32665120 DOI: 10.1016/j.prosdent.2020.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM Clinical studies on the wear properties of different zirconia surfaces are lacking. Selecting a surface that causes and undergoes minimal wear will help improve clinical outcomes. PURPOSE The purpose of this clinical study was to evaluate and compare the wear over 1 year use of glazed zirconia (GZ) and polished zirconia (PZ) crowns opposing natural enamel and the wear of natural enamel opposing PZ and GZ crowns. MATERIAL AND METHODS This prospective, split mouth, randomized clinical trial included 14 participants requiring complete coverage crowns on first molars, bilaterally, in a completely dentate mandibular arch. GZ and PZ crowns were cemented according to a randomization chart. Polyvinyl siloxane impressions were made immediately and 1 year after the cementation of the crowns. The respective casts were scanned by using a 3D scanner and a software program to measure the amount of linear wear of zirconia crowns and opposing natural teeth. Wear was observed in 8 groups: PZ crowns, GZ crowns, natural enamel opposing natural enamel in the molar and premolar regions (NE-M and NE-PM), natural enamel opposing PZ crowns in the molar region (NE-PZ-M), natural enamel opposing GZ crowns in the molar region (NE-GZ-M), natural enamel opposing PZ crowns in the premolar region (NE-PZ-PM), and natural enamel opposing GZ crowns in the premolar region (NE-GZ-PM). A descriptive analysis was followed by comparison between groups by using a repeated-measure ANOVA with post hoc adjustments (α=.05). RESULTS The mean wear (μm) observed was as follows (in ascending order): PZ crowns (13 ±3), NE-PM (13 ±1), GZ crowns (27 ±9), NE-M (34 ±3), NE-PZ-PM (44 ±18), NE-PZ-M (63 ±22), NE-GZ-PM (69 ±21), NE-GZ-M (113 ±33). Wear of GZ and PZ crowns was less than wear of NE-M. The difference was statistically significant when comparing PZ with NE-M (P<.001, CI=-17 to -24). Wear of NE-GZ-M and NE-PZ-M was higher than wear of NE-M, with a statistically significant difference (P<.001, CI=-49 to -107 and P =.004, CI=-8 to -49, respectively). Wear of NE-GZ-M was more than that of NE-PZ-M, and the difference was statistically significant (P<.001, CI=-68 to -32). Wear of NE-PZ-PM and NE-GZ-PM was also more than the wear of NE-PM, and the difference was statistically significant (P<.001, CI=-17 to -43 and P<.001, CI=-39 to -70). CONCLUSIONS PZ and GZ crowns wear substantially with time, with lesser wear observed in PZ crowns. PZ and GZ crowns also cause more wear in opposing natural enamel than natural enamel antagonists, with the highest wear caused by GZ crowns.
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Cha MS, Huh YH, Cho LR, Park CJ. A comparative study of the wear of dental alloys against monolithic zirconia. J Prosthet Dent 2020; 123:866-873. [DOI: 10.1016/j.prosdent.2019.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/19/2019] [Accepted: 06/13/2019] [Indexed: 11/27/2022]
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Güth JF, Erdelt K, Keul C, Burian G, Schweiger J, Edelhoff D. In vivo wear of CAD-CAM composite versus lithium disilicate full coverage first-molar restorations: a pilot study over 2 years. Clin Oral Investig 2020; 24:4301-4311. [PMID: 32399736 PMCID: PMC7666668 DOI: 10.1007/s00784-020-03294-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 04/17/2020] [Indexed: 12/02/2022]
Abstract
Objectives To present a digital approach to measure and compare material wear behavior of antagonistic first molar restorations made of an experimental CAD/CAM composite (COMP) and lithium disilicate ceramic (LS2) in patients with reconstructed vertical dimension of occlusion (VDO) after generalized hard tissue loss. Methods A total of 12 patients underwent complete full jaw rehabilitation with full occlusal coverage restorations made either of COMP or LS2. The first molar restorations (n = 48) were chosen for wear examination. At annual recall appointments, polyether impressions were taken, and resulting plaster casts were digitalized using a laboratory scanner. Mean observation period was 371 days for first and 769 days for second year. The resulting 96 datasets were analyzed by superimposition of 3-D datasets using an iterative best-fit method. Based on the superimposition data, the wear rates of the occlusal contact areas (OCAs) were calculated. Results For antagonistic restorations made of COMP, the average wear rate was 24.8 ± 13.3 μm/month, while for LS2, it was 9.5 ± 4.3 μm/month in first year, with significant differences (p < 0.0001) between the materials. In second year, monthly wear rates decreased significantly for both materials: COMP (16.2 ± 10.7 μm/month) and LS2 (5.5 ± 3.3 μm/month). Statistical comparison between wear time showed significant differences for both materials: COMP p < 0.037 and LS2 p < 0.001. A logarithmic fit (COMP R2 = 0.081; LS2 R2 = 0.038) of the data was calculated to estimate the wear progression. Significance In patients with reconstructed VDO, restorations made of LS2 show a more stable wear behavior than ones out of experimental CAD/CAM composite. In cases of complete rehabilitation, load bearing CAD/CAM-composite restorations should be critically considered for application due to their occlusal wear behavior. However, when choosing a restorative material, not only the functional occlusal stability should be taken into account but also the prospect of minimally invasive treatment with maximum preservation of natural tooth structures.
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Affiliation(s)
- Jan-Frederik Güth
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Kurt Erdelt
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Christine Keul
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Gintare Burian
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
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Wear analysis and topographical properties of monolithic zirconia and CoCr against human enamel after polishing and glazing procedures. J Mech Behav Biomed Mater 2020; 105:103712. [DOI: 10.1016/j.jmbbm.2020.103712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 11/17/2022]
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50
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Solá-Ruíz MF, Baima-Moscardó A, Selva-Otaolaurruchi E, Montiel-Company JM, Agustín-Panadero R, Fons-Badal C, Fernández-Estevan L. Wear in Antagonist Teeth Produced by Monolithic Zirconia Crowns: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E997. [PMID: 32252404 PMCID: PMC7231268 DOI: 10.3390/jcm9040997] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The aim of this systematic review and meta-analysis was to determine the wear sustained in the natural antagonist tooth in cases of full-coverage fixed-base prosthetic restorations or monolithic zirconia tooth-supported crowns, as well as to determine the wear in the restoration itself, both in the short- and medium-term and considering the factors that may influence wear. MATERIAL AND METHODS A systematic literature review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated wear in antagonist teeth in relation to fixed-prosthesis monolithic zirconia crowns. A total of 5 databases were consulted in the literature search: Pubmed-Medline, Cochrane, Scopus, Embase and Web of Science (WOS). After eliminating duplicated articles and applying the inclusion criteria, eight articles were selected for the qualitative analysis and four for the quantitative analysis. RESULTS Mean maximum wear of the antagonist tooth in relation to monolithic zirconia crowns of magnitude 95.45 µm (CI at 95% 79.57-111.33) was observed. By using a meta-regression model (R2 = 0.92) the significant effect of time in maximum wear rate (p < 0.001) was observed, estimated at 6.13 µm per month (CI at 95% 3.99-8.27). Furthermore, monolithic zirconia crowns are subject to a mean maximum wear of 58.47 µm (CI 95% 45.44-71.50). By using a meta-regression model (R2 = 0.53) the significant effect of time in the maximum wear value was observed (p = 0.053), estimated at 3.40 µm per month (CI al 95% -0.05-6.85). CONCLUSIONS Monolithic zirconia crowns lead to a progressive maximum wear of the antagonist tooth over time which is greater than the maximum wear sustained in the crown itself. It is not possible to establish an objective and quantitative objection in relation to natural enamel wear or metal-ceramic crowns.
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Affiliation(s)
| | - Alejandra Baima-Moscardó
- Department of Dental Medicine Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag n1, 46010 Valencia, Spain; (M.F.S.-R.); (E.S.-O.); (J.M.M.-C.); (R.A.-P.); (C.F.-B.); (L.F.-E.)
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