Fatigue resistance of anterior monolithic crowns produced from CAD-CAM materials: An in vitro study

Edge Chipping Resistance and Flexural Strength of CAD-CAM Ceramics Before and After Thermomechanical Aging

OBJECTIVES

To evaluate the complementary mechanical properties of dental ceramics using edge chipping resistance (Rea) and flexural strength before and after thermomechanical aging.

MATERIAL AND METHODS

Computer-aided design and computer-aided manufacturing of ceramic materials, including zirconia (ZR), lithium disilicate (LS2), and resin nanoceramics (RNC), were evaluated. Specimens for flexural strength testing were fabricated with dimensions of 3 × 4 × 25 mm, with 30 specimens per group. For the edge chipping test (ECT), specimens were fabricated with dimensions of 3 × 4 × 12 mm, with 48 specimens per group. Half of the specimens for both tests were subjected to thermomechanical aging for 200,000 cycles at 50 N. A Weibull analysis was performed to determine flexural strength. Fractographic analysis was performed before and after thermomechanical aging during the ECT. X-ray diffractometry (XRD) was performed on the ZR specimens before and after thermomechanical aging. Flexural strength was analyzed using a two-way repeated analysis of variance (ANOVA) with a t-test, and Rea was analyzed using Pearson correlation and a two-way repeated ANOVA.

RESULTS

The flexural strength and Rea differed according to the material (p = 0.001), whereas they were similar before and after thermomechanical aging (p > 0.05). The Weibull modulus of the flexural strength decreased after thermomechanical aging. In the fractographic analysis of the ECT, more than two fracture origins were identified after thermomechanical aging. The XRD analysis of ZR showed an increased monoclinic phase after thermomechanical aging.

CONCLUSION

All the materials met the ISO 6872 standards for bending test. However, LS2 and RNC show low edge chipping resistance within the range of the occlusal force. The thermomechanical aging did not significantly alter the mechanical properties of the materials. However, the Weibull coefficients of the flexural strength decreased, and an additional origin of fracture appeared after thermomechanical aging.

SIGNIFICANCE

Flexural strength and Rea differed depending on the material used. The probability of the material fracture increased after thermomechanical aging. To understand ceramic fractures, two mechanical tests and thermomechanical aging must be performed together.

Effect of cement type, luting protocol, and ceramic abutment material on the shade of cemented titanium-based lithium disilicate crowns and surrounding peri-implant soft tissue: a spectrophotometric analysis

PURPOSE

The objective of the study was to analyze the impact of cement, bonding pretreatment, and ceramic abutment material on the overall color results of CAD-CAM ceramic crowns bonded to titanium-based hybrid abutments.

MATERIALS AND METHODS

For single implant restoration of a maxillary lateral incisor a total of 51 CAD-CAM-fabricated monolithic lithium disilicate crowns were fabricated and subsequently bonded onto 24 lithium disilicate Ti-base abutments, 24 zirconia Ti-base abutments and 3 resin abutment replicas as a control group. The 48 copings were cemented with three definitive and one provisional cement on both grit-blasted and non-blasted Ti-bases. The color of each restoration and surrounding artificial gingiva was measured spectrophotometrically at predefined measuring points and the CIELAB (ΔEab) color scale values were recorded.

RESULTS

The color outcome of ceramic crowns bonded to hybrid abutments and soft tissues was affected differently by cements of different brands. Grit-blasting of Ti-bases prior to cementing CAD-CAM copings affected the color results of all-ceramic crowns. There was a significant difference (P = .038) for the median ΔE value between blasted and non-blasted reconstructions at the cervical aspect of the crown. Full-ceramic crowns on zirconia Ti-base abutments exhibited significantly lower ΔE values below the threshold of visibility (ΔE 1.8). In all subcategories tested, the use of a highly opaque temporary cement demonstrated the lowest median ΔE for both the crown and the artificial gingiva.

CONCLUSION

Various cements, core ceramic materials and airborne particle abrasion prior to bonding can adversely affect the color of Ti-base supported ceramic crowns and peri-implant soft tissue. However, zirconia CAD-CAM copings and an opaque cement can effectively mask this darkening.

Topographical and crystalline change on surface by sandblasting improve flexural and shear bond strength of niobia-modified yttria-stabilized tetragonal zirconia polycrystal

This study aimed to investigate the effects of sandblasting on the physical properties and bond strength of two types of translucent zirconia: niobium-oxide-containing yttria-stabilized tetragonal zirconia polycrystals ((Y, Nb)-TZP) and 5 mol% yttria-partially stabilized zirconia (5Y-PSZ). Fully sintered disc specimens were either sandblasted with 125 µm alumina particles or left as-sintered. Surface roughness, crystal phase compositions, and surface morphology were explored. Biaxial flexural strength (n=10) and shear bond strength (SBS) (n=12) were evaluated, including thermocycling conditions. Results indicated a decrease in flexural strength of 5Y-PSZ from 601 to 303 MPa upon sandblasting, while (Y, Nb)-TZP improved from 458 to 544 MPa. Both materials significantly increased SBS after sandblasting (p<0.001). After thermocycling, (Y, Nb)-TZP maintained superior SBS (14.3 MPa) compared to 5Y-PSZ (11.3 MPa) (p<0.001). The study concludes that (Y, Nb)-TZP is preferable for sandblasting applications, particularly for achieving durable bonding without compromising flexural strength.

A Comparison of Failure Loads for Polycrystalline Zirconia Ceramics with Varying Amounts of Yttria, Glass-Ceramics and Polymers in Two Different Test Conditions

It is unclear how zirconia dental crowns with different yttria compositions will perform clinically, and how they will compare with crowns made of glass-ceramics and polymers. The present objective was to determine failure loads of crowns and discs made of glass ceramics or polymers as compared to yttria-partially stabilized zirconia (Y-PSZ) crowns and discs with varying yttria concentrations. Crowns of zirconia (Cercon XT, Katana UTML, BruxZir Anterior), glass ceramic (Celtra press, IPS e.max press, Lisi press), and polymeric materials (Trilor, Juvora, Pekkton) were fabricated and cemented to epoxy abutments. The total number of specimens was 135 for crowns and 135 for discs (n = 15 specimens per material type and design). A universal testing machine was used to perform compressive loading of crowns/discs to failure with a steel piston along the longitudinal axis of the abutments. Energy dispersive spectroscopy (EDS) was used to identify the yttria concentration for each zirconia brand. The data were analyzed using generalized linear models and regression analyses. The results revealed significant differences (p < 0.05) in mean failure loads for different crown materials: Trilor (6811 ± 960 N) > Juvora (5215 ± 151 N) > Cercon (4260 ± 520 N) = BruxZir (4186 ± 269 N) = e.max (3981 ± 384 N) > Katana (3195 ± 350 N) = Lisi (3173 ± 234 N) = Pekkton (3105 ± 398 N) > Celtra (2696 ± 393 N). The general linear model revealed significant differences (p < 0.05) in mean failure loads when comparing the different materials for the discs, i.e., Trilor (5456 ± 1748 N) > Juvora (4274 ± 869 N) > Pekkton (3771 ± 294 N) > Katana (2859 ± 527 N) > Cercon (2319 ± 342 N) = BuxZir (2250 ± 515 N) = e.max (2303 ± 721 N) = Lisi (2333 ± 535 N) > Celtra (1965 ± 659 N). EDS showed that the zirconia materials contained yttria at different concentrations (BruxZir = 5Y-PSZ, Cercon = 4Y-PSZ, Katana = 3Y-PSZ). The yttria concentration had a significant effect on the failure load of the Katana (3Y-PSZ) crowns, which revealed lower failure loads than the Cercon (4Y-PSZ) and BruxZir (5Y-PSZ) crowns, whose failure loads were comparable or higher than e.max glass ceramic. The failure load of the trilayer disc specimens did not correlate with the failure load of the respective crown specimens for the zirconia, glass-ceramic and polymeric materials.