Marginal adaptation and fracture resistance of adhesively luted glass fibre-composite reinforced molar crowns with different inner crown surfaces

Fracture resistance of computer-aided design/computer-aided manufacturing-generated composite resin-based molar crowns

The aim of this study was to investigate whether different fabrication processes, such as the computer-aided design/computer-aided manufacturing (CAD/CAM) system or the manual build-up technique, affect the fracture resistance of composite resin-based crowns. Lava Ultimate (LU), Estenia C&B (EC&B), and lithium disilicate glass-ceramic IPS e.max press (EMP) were used. Four types of molar crowns were fabricated: CAD/CAM-generated composite resin-based crowns (LU crowns); manually built-up monolayer composite resin-based crowns (EC&B-monolayer crowns); manually built-up layered composite resin-based crowns (EC&B-layered crowns); and EMP crowns. Each type of crown was cemented to dies and the fracture resistance was tested. EC&B-layered crowns showed significantly lower fracture resistance compared with LU and EMP crowns, although there was no significant difference in flexural strength or fracture toughness between LU and EC&B materials. Micro-computed tomography and fractographic analysis showed that decreased strength probably resulted from internal voids in the EC&B-layered crowns introduced by the layering process. There was no significant difference in fracture resistance among LU, EC&B-monolayer, and EMP crowns. Both types of composite resin-based crowns showed fracture loads of >2000 N, which is higher than the molar bite force. Therefore, CAD/CAM-generated crowns, without internal defects, may be applied to molar regions with sufficient fracture resistance.

The effects of scaling and root planing on the marginal gap and microleakage of indirect composite crowns prepared with different finish lines: an in vitro study

The present in vitro study aimed to assess the effects of root surface mechanical instrumentation on the marginal integrity and adaptation of resin composite crowns. The following null hypotheses were tested: no differences exist between finish line and 1) marginal gap or 2) marginal microleakage before and after manual mechanical periodontal maintenance. A total of 56 intact human mandibular molars were randomly distributed into four groups and subjected to standardized tooth preparations for indirect composite crowns with different marginal finish lines (90° shoulder, beveled 90° shoulder, feather edge, chamfer). One-half of the specimens was used as a control and remained untreated, and the remaining half was subjected to root surface procedures simulating five years of semestral mechanical supportive periodontal treatment. The marginal gap and microleakage were evaluated and statistically analyzed. The specimens used as controls showed lower mean marginal gaps than those subjected to the simulated periodontal treatment, whereas the latter showed lower microleakage than the control crowns. Statistically significant differences were recorded for both the experimental variables. The root surface procedures resulted in altered surfaces of the composite crowns. The marginal gap increased after the treatment, whereas the marginal microleakage was reduced. The 90° shoulder and the chamfer preparation could be considered a viable option to fabricate composite crowns, but the beveled 90° shoulder and the feather edge should not be recommended.

Surface Treatment Protocols in the Cementation Process of Ceramic and Laboratory-Processed Composite Restorations: A Literature Review

The clinical longevity of indirect restorations made of ceramics or indirect composite resins depends on their successful treatment and cementation. The cementation technique is determined by the type of restorative material-ceramics or indirect composite resins; thus, their intaglio surface treatment should be performed according to their particular compositions. The aim of this literature review was to define surface treatment protocols of different esthetic indirect restorative materials. A PubMed database search was conducted for in vitro studies pertaining to the most common treatment protocols of tooth-colored materials. Articles that described at least the surface treatment procedure, its effects on adhesion, its relationship with the material's composition, clinical aspects, and expected longevity were selected. The search was limited to peer-reviewed articles published in English between 1965 and 2004 in dental journals. Sandblasting, etching techniques, and silane coupling agents are the most common procedures with improved results.

CLINICAL SIGNIFICANCE

Tooth-colored restorative materials vary considerably in composition and require different protocols for adhesive cementation.