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Gseibat M, Sevilla P, Lopez-Suarez C, Rodriguez V, Pelaez J, Suarez MJ. Performance of posterior third-generation monolithic zirconia crowns in a complete digital workflow: A three-year prospective clinical study. J Dent Sci 2024; 19:871-877. [PMID: 38618120 PMCID: PMC11010711 DOI: 10.1016/j.jds.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/20/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Translucent monolithic zirconia restorations have recently introduced. The purpose of this study was to evaluate the clinical behavior and the survival rate of the posterior third-generation monolithic zirconia crowns (MZCs) during three years of clinical service. Materials and methods Twenty-four patients who needed thirty crowns were enrolled in this study. Digital impressions were made, and the crowns were milled and cemented with a resin cement. The crowns outcomes were assessed using the California Dental Association's (CDA) criteria. Gingival index (GI), plaque index (PI), and periodontal probing depth (PPD) for MZCs and contralateral natural teeth (control) were assessed. Margin index (MI) for MZCs was also assessed. Data analysis was conducted using the Wilcoxon signed-rank and the Friedman tests. Results The 3-year survival rate was 100%. All MZCs were rated as satisfactory throughout the follow-up period, and no biological or mechanical complications were observed. No differences were recorded when GI, PI and PPD at 3-year of follow-up were compared to baseline. No differences were recorded between crowned and control teeth. The MI remained stable throughout the study period. Conclusion The third-generation monolithic zirconia appears to be a good treatment option for the rehabilitation of posterior single teeth.
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Affiliation(s)
- Mustafa Gseibat
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Pablo Sevilla
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Carlos Lopez-Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Veronica Rodriguez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Jesus Pelaez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Maria J. Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Shihabi S, Chrcanovic BR. Clinical outcomes of tooth-supported monolithic zirconia vs. porcelain-veneered zirconia fixed dental prosthesis, with an additional focus on the cement type: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:5755-5769. [PMID: 37626273 PMCID: PMC10560185 DOI: 10.1007/s00784-023-05219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE To compare the failure rates and the prevalence of technical complications between full-coverage tooth-supported monolithic zirconia (MZ) and porcelain-veneered zirconia (PVZ) fixed dental prosthesis, based on a systematic literature review. METHODS An electronic search was performed in three databases, supplemented by hand searching. Several statistical methods were used. RESULTS Seventy-four publications reported 6370 restorations (4264 PVZ; 2106 MZ; 8200 abutment teeth; 3549 patients), followed up until 152 months. A total of 216 prostheses failed, and survival was statistically significant different between groups. PVZ had higher occurrence of complications than MZ; the difference was especially greater for either minor or major chipping. The difference in prevalence of either minor or major chipping was statistically significant for PVZ prostheses between cementation with glass ionomer and adhesive resin cement (higher), adhesive resin and resin-modified glass ionomer cement (RMGIC, higher), and between RMGIC (higher) and glass ionomer cement. For MZ the difference was significant only for minor chipping between RMGIC (higher) and adhesive resin cement. Abutment teeth to PVZ prostheses more often lost vitality. Decementation was not observed with RMGIC. Air abrasion did not seem to clinically decrease the decementation risk. The 5-year difference in the occurrence of minor or major chipping between MZ and PVZ prostheses was statistically significant, but nor for catastrophic fracture. CONCLUSION Tooth-supported PVZ prostheses present higher failure and complication rates than MZ prosthesis. The difference in complications is striking when it comes to chipping. CLINICAL RELEVANCE Awareness of the outcome differences between different types of zirconia prostheses is important for clinical practice.
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Affiliation(s)
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Carl Gustafs Väg 34, 214 21 Malmö, Sweden
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Dewan H. Clinical Effectiveness of 3D-Milled and 3D-Printed Zirconia Prosthesis-A Systematic Review and Meta-Analysis. Biomimetics (Basel) 2023; 8:394. [PMID: 37754145 PMCID: PMC10526775 DOI: 10.3390/biomimetics8050394] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/05/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Additive manufacturing (three-dimensional (3D) printing) has become a leading manufacturing technique in dentistry due to its various advantages. However, its potential applications for dental ceramics are still being explored. Zirconia, among ceramics, has increasing popularity and applications in dentistry mostly due to its excellent properties. Although subtractive manufacturing (3D milling) is considered the most advanced technology for the fabrication of zirconia restorations, certain disadvantages are associated with it. METHODS A systematic review was piloted to compare the clinical performance of zirconium crowns that were fabricated using three-dimensional (3D) milling and 3D printing. A meta-analysis was performed, and studies published up to November 2022 were identified. The terms searched were "Zirconium crowns", "3D printing", "CAD/CAM" (Computer-Aided Design and Computer-Aided Manufacturing), "Milling", "dental crowns", and "3D milling". The characteristics that were compared were the year in which the study was published, study design, age of the patient, country, the number of crowns, the type of crown fabrication, marginal integrity, caries status, and outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to structure this systematic review. Out of eleven hundred and fifty titles identified after a primary search, nine articles were included in the quantitative analysis. The research question based on PICO/PECO (Participant, Intervention/exposure, Comparison, and Outcome) was "Do 3D-printed and milled (P) zirconia crowns and FDPs (I) have a better survival rate (O) when conventional prosthesis is also an option (C)"? The data collected were tabulated and compared, and the risk of bias and meta-analysis were later performed. Only nine articles (clinical research) were selected for the study. Since there were no clinical studies on the 3D printing of zirconium crowns, six in vitro studies were considered for the comparison. Zirconium crowns in the milling group had an average minimum follow-up of 6 months. RESULTS A moderate risk of bias was found, and survival was significant. A high heterogeneity level was noted among the studies. Marginal integrity, periodontal status, and survival rate were high. Linear regression depicted no statistical correlation between the type of cement used and the survival rate. CONCLUSIONS It can be concluded that the milled crowns had a higher performance and satisfactory clinical survival.
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Affiliation(s)
- Harisha Dewan
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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Lampl S, Gurunathan D, Krithikadatta J, Mehta D, Moodley D. Reasons for Failure of CAD/CAM Restorations in Clinical Studies: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2023; 24:129-136. [PMID: 37272145 DOI: 10.5005/jp-journals-10024-3472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM The systematic review presented herein was performed to descriptively analyze the causes for the failure of computer-aided design/computer-aided manufacture (CAD/CAM) restorations. The meta-analysis reported herein was performed to estimate long-term survival and success rates of CAD-CAM fabrications. MATERIALS AND METHODS Using the PICOS paradigm, a systematic search was carried out in the PubMed and Cochrane databases to identify randomized controlled trials (RCTs) and prospective observational studies reporting survival data for CAD/CAM restorations. After selecting studies with a predefined set of selection criteria, data from included prospective clinical studies and RCTs were used for a systematic review aimed at a descriptive analysis of factors associated with failure of CAD-CAM restorations. Data from the included prospective clinical studies were used for meta-analysis, wherein 5-year and 10-year survival and success rates were estimated using Poisson regression models. RESULTS The systematic review included data from 9 RCTs and 6 observational studies, which had a median follow-up of 36 months and 60 months, respectively. About 58 failures and 118 technical/ biological complications were noted in the included RCTs and 9 failures along with 58 technical/biological complications were noted in the prospective clinical studies. Poisson regression indicated an estimated 5-year and 10-year survival rates of 85.55-100 and 71-100, respectively. The estimated 5-year and 10-year success rates were 74.2-92.75 and 33.3-85.5, respectively. CONCLUSION Several technical and biological complications contribute to failure of CAD/CAM restorations. However, CAD/CAM restorations with routine chairside materials might have clinically meaningful success rates in the long term. CLINICAL SIGNIFICANCE The results presented herein indicate that optimal strategies for mitigation of biological and technical complications may augment the success of CAD/CAM fabrications in restorative dentistry. Studies aimed at identification of such strategies are needed to further enhance the long-term success rates of CAD/CAM restorations.
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Affiliation(s)
- Stephan Lampl
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Deepa Gurunathan
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India, Phone: +91 9994619386, e-mail:
| | - Jogikalmat Krithikadatta
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Deepak Mehta
- Department of Conservative Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India; Department of Operative Dentistry, Tohoku University Graduate School of Dentistry, Tohoku University, Sendai, Japan
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Ozden YE, Guncu MB, Aktas G, Canay S. Effect of sintering time on the marginal and internal fit of monolithic zirconia crowns containing 3–4 mol% Y2O3. BMC Oral Health 2022; 22:493. [PMID: 36380324 PMCID: PMC9664799 DOI: 10.1186/s12903-022-02563-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background Short-term sintering may offer advantages including saving time and energy but there is limited evidence on the effect that altering sintering time has on the accuracy of monolithic zirconia crowns. The purpose of this in vitro study was to investigate the effect of shortened sintering time on the marginal and internal fit of 3Y-TZP and 4Y-TZP monolithic crowns. Methods Sixty monolithic zirconia crowns were fabricated for the maxillary first molar tooth on the prefabricated implant abutment. Groups were created according to the material composition: 3Y-TZP Generation 1, 3Y-TZP Generation 2 and 4Y-TZP. Two different sintering protocols were performed: same final sintering temperature (1500 °C) and various rates of heating (10 °C/min and 40 °C/min), cooling down speed (− 10 °C/min and − 40 °C/min), holding time (45 and 120 minutes), and total sintering time (approximately 2 and 7 hours, respectively). The marginal and internal fit of the crowns were determined using the silicone replica technique. Comparisons between groups were analyzed using two-way ANOVA. Pairwise multiple comparisons were performed using t-test (p < 0.05). Results The mean marginal gap values of 4Y-TZP zirconia revealed statistically significant increase for the short-term sintering protocol (p < 0.0001), while no difference was observed between the sintering protocols for the mean marginal gap values of 3Y-TZP groups. Although all groups showed clinically acceptable gap values, altering the sintering time had an effect on marginal fit of the crowns manufactured from 4Y-TZP zirconia. Conclusions Shortening the sintering time may lead to differences within clinically acceptable limits. The manufacturer’s recommendations according to material composition should be implemented with care.
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El-Ashkar A, Nabil O, Taymour M, El-Tannir A. Evaluation of zirconia crowns restoring endodontically treated posterior teeth with 2 finish line designs and 2 occlusal reduction schemes: A randomized clinical trial. J Prosthet Dent 2022:S0022-3913(22)00634-5. [PMID: 36396490 DOI: 10.1016/j.prosdent.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Preparation design has been linked to restoration survival, and the finish line geometry, such as a deep chamfer or shoulder, has been linked to marginal integrity. However, limited data are available for restoration success with the feather-edge finish line when used with monolithic zirconia crowns with different occlusal reduction schemes. PURPOSE The purpose of this randomized clinical trial was to evaluate the clinical performance of 2 finish line designs (feather-edge and rounded shoulder) in relation to 2 occlusal designs (flat and planar) in endodontically treated teeth restored with monolithic zirconia crowns. MATERIAL AND METHODS Sixty-six complete-coverage monolithic zirconia crowns were provided for posterior endodontically treated teeth. The participants were divided into 3 groups based on the preparation design: the control group (PS) had a planar occlusal scheme with a rounded shoulder finish line; the first intervention group (FF) had a flat occlusal scheme with a feather-edge finish line; and the second intervention group (FS) had a flat occlusal scheme with a rounded shoulder finish line. The crowns were designed with the exocad software program and milled with a 5-axis machine. After cementation, clinical performance in terms of marginal adaptation, marginal discoloration, fracture, and secondary caries was evaluated by using the modified United States Public Health Service (USPHS) criteria. The gingival index score system was used to evaluate the gingival response. The scores were recorded immediately after cementation and at 3 subsequent follow-up visits every 3 months for 1 year. The chi-square test was used in all comparisons of outcomes and follow-up durations (α=.05). RESULTS In terms of marginal adaptations, the control group (PS) demonstrated the best marginal adaptation scores during follow-up visits, followed by intervention 2 (FS), and lastly, intervention 1 (FF), which was scored mostly with Bravo. At the third follow-up visit, the intervention 1 (FF) group reported the most gingival responses of all groups. No significant difference among the groups was found in terms of marginal discoloration, fracture, or secondary caries at any of the follow-up visits. Each group received a perfect Alfa score of 100% on all 3 follow-up assessments. CONCLUSIONS In this 1-year randomized clinical trial, all evaluated preparation schemes and corresponding crowns were clinically successful. The clinical performance of monolithic zirconia crowns of the novel preparation design (FF) was successful in terms of marginal adaption, fracture, secondary caries, and marginal discoloration.
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Affiliation(s)
- Alaa El-Ashkar
- Lecturer, Fixed Prosthodontics Department, Faculty of Dentistry, Galala University, Suez, Egypt.
| | - Omnia Nabil
- Lecturer, Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Maha Taymour
- Professor, Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt; Professor, Fixed Prosthodontics Department, School of Dentistry, New Giza University, Giza, Egypt
| | - Adel El-Tannir
- Professor, Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Kao CT, Liu SH, Kao CY, Huang TH. Clinical evaluation of 3D-printed zirconia crowns fabricated by selective laser melting (SLM) for posterior teeth restorations: Short-term pilot study. J Dent Sci 2022; 18:715-721. [PMID: 37021225 PMCID: PMC10068370 DOI: 10.1016/j.jds.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/14/2022] [Indexed: 11/28/2022] Open
Abstract
Background/purpose Zirconia crowns (ZrC) without veneering porcelain have become an effective alternative in clinical practice. Monolithic zirconia restorations fabricated by the dry milling method do not have acceptable clinical properties. This study evaluated the periodontal qualities of three-dimensional printed ZrC using the modified United States Public Health Service (USPHS) criteria. Materials and methods A total of 15 patients who required dental crowns were recruited, and all 15 teeth were restored with digital 3D-printed ZrC. All crowns were assessed at the time of crown placement and 2, 6, and 24 weeks post-placement. Clinical parameters, including plaque index, gingival index, probing depth, crown marginal integrity, and attrition of the antagonist's teeth, were evaluated and recorded. Results According to the Modified California Dental Association quality evaluation system, 100% of the crowns received satisfactory grades. Despite the significant increase in plaque index and gingival index at two weeks post-ZrC placement, there was no deterioration in probing depth. Moreover, there was discard usage of ZrC on the antagonist's teeth at 24 weeks posttreatment. Of the 15 crowns, one tooth had to be extracted due to a vertical root fracture. Overall, the digital 3D-printed crowns showed no adverse effects on periodontal tissues after 24 weeks of follow-up. Conclusion The 3D-printed ZrC showed no periodontal problems. It can serve as an alternative for patients, particularly those with high esthetic expectations.
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Cadore-Rodrigues AC, Machry RV, Dapieve KS, Werner A, Pereira GKR, Valandro LF, Kleverlaan CJ. In-lab simulation of CAD/CAM grinding and intaglio surface treatments of 4YSZ monolithic restorations: Effect on its load-bearing capacity under fatigue. J Mech Behav Biomed Mater 2022; 134:105417. [PMID: 36049370 DOI: 10.1016/j.jmbbm.2022.105417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To evaluate the effect of in-lab simulation of CAD/CAM grinding and intaglio surface treatments on the surface characteristics (topography and roughness) and fatigue behavior of adhesively luted 4YSZ simplified restorations. METHODS Ceramic discs (Ø = 10 mm, thickness = 1 mm) were randomly allocated into 6 groups considering: "In-lab simulation of CAD/CAM grinding" (ground or polished) and "intaglio surface treatments": Ctrl (without surface treatment), AlOx (aluminum oxide air abrasion) or GLZ (glaze spray application). The surface roughness of all samples was measured, the treated discs received a ceramic primer, were luted with resin cement onto a dentin analogue material (woven glass-reinforced epoxy resin) and tested under a cyclic fatigue test (step-stress approach, n = 15; 1.4 Hz, 10,000 cycles/step, step-size of 100N starting at 200N until failure). A complementary analysis was performed to corroborate the findings in the fatigue test that the glaze fill defects increase the mechanical properties of the ceramic. To do so, bars (n= 10; 1.0 × 1.0 × 12 mm; considering the groups: N-ID: non-indented; ID: indented; ID-GLZ: indented plus glaze spray application) were indented in a vickers hardness tester to produce a crack pattern, treated with glaze or not, and then submitted to flexural strength tests (FS). Fractographic and topographic analysis were performed. RESULTS In-lab simulation of CAD/CAM grinding decreased the fatigue failure load of the 4YSZ ceramic when comparing polished and ground groups, regardless of surface treatment. GLZ induced better fatigue performance compared to the air abrasion, regardless of the grinding condition (ground or polished surface). The results of the flexural strength test corroborated the findings in the fatigue test, as the ID-GLZ group presented superior FS than the ID group, however both had inferior FS than N-ID. There is an inverse association between roughness and fatigue failure load, as the higher the surface roughness, the lower the fatigue failure load. Failures in the fatigue and flexural strength tests started from the face subjected to tensile stresses. CONCLUSION In-lab simulation of CAD/CAM grinding had a detrimental effect on the fatigue behavior of 4YSZ and glaze spray induced better 4YSZ performance compared to the air abrasion. The intaglio surface treatments differently influenced the 4YSZ fatigue performance, however, only glaze spray can reverse the damage caused by the grinding.
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Souza LFB, Pilecco RO, Menna Barreto VS, Chiapinotto GF, Daudt NDF, Valandro LF, Pereira GKR. Pre-sintering pigmentation techniques do not affect the fatigue behavior of adhesively luted 4YSZ restorations. J Mech Behav Biomed Mater 2022; 132:105270. [PMID: 35617820 DOI: 10.1016/j.jmbbm.2022.105270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 11/20/2022]
Abstract
This study aims to characterize the effect of shading techniques on the fatigue behavior of a 4YSZ ceramic (4 mol% yttrium stabilized zirconia) adhesively bonded to a dentin analogue (fiber-reinforced epoxy resin). 4YSZ ceramic discs (IPS e.max ZirCAD, Ø = 10 mm and 1 mm of thickness) were allocated according to the factor 'shading technique' into 4 groups: Brush- unshaded ceramic disc (IPS e.max ZirCAD BL) pigmented at the pre-sintered stage with pigment solution applied manually using a round liner brush; Immersion- unshaded ceramic disc pigmented through immersion in the solution for 1 s on only one side of the ceramic disc; Manufacturer- specimens already shaded by the manufacturer (IPS e.max ZirCAD MT A2 - Manufacturer group); Control- a control condition with absence of pigment (i.e. non-pigmented specimens). The specimens were sintered and a spectrophotometer (SP60, EX- Rite) was used to ensure that the same perceived color (i.e. pigment saturation) was achieved in the different shading strategies (Manufacturer, Brush or Immersion groups). To do so, the color differences (ΔE00) were calculated using the CIEDE 2000 equation; and an ΔE00 of up to 1.77 was considered as an acceptability threshold. Dentin analogue discs were obtained (Ø = 10 mm and 2.5 mm of thickness) and randomly allocated into pairs with the 4YSZ ceramic discs. Next, the pairs were adhesively bonded using a resin cement (Multilink N). The bonded assemblies (n = 15) were tested for fatigue using the step-stress test method (frequency of 20 Hz; 10,000 cycles per step, initial load 200 N; step-size of 100 N, up to 700 N; and after, step-size of 50 N, until specimen failure/fracture or radial cracks). Fatigue failure load (FFL) and number of cycles for failure (CFF) were recorded for statistical analysis. Fractographic features were accessed, and complementary roughness, topography, grain size and phase content analyses were performed. No statistical differences were observed in the fatigue behavior among the non-shaded condition (Control group - 880 N) and the shaded specimens (Manufacturer - 887 N, Brush - 820 N, and Immersion - 850 N groups; p > 0.05). However, the use of a brush shading technique induced slightly inferior fatigue mechanical behavior of the restorative set compared to the specimens already shaded by the manufacturer (p = 0.027). No differences in Weibull modulus were observed among the tested groups. The specimens pigmented by the brush technique demonstrated a rougher surface, with statistically higher Rz values, in addition to a larger grain size in comparison to all other conditions (p< 0.05). No m-phase content was identified (only t and c phases were detected). Thus, the shading techniques used to provide a Vita classic A2 shade does not negatively affect the mechanical fatigue properties of a bonded 4YSZ ceramic. However, the brush technique has detrimental effect on the fatigue behavior compared to when the ceramic was already provided in a shaded format by its manufacturer.
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Affiliation(s)
- Luiza Freitas Brum Souza
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Rafaela Oliveira Pilecco
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | | | | | - Natália de Freitas Daudt
- MSciEng and PhD Post-Graduate Program in Mechanical Engineering, Faculty of Mechanical Engineering, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
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Kim M, Kim RH, Lee SC, Lee TK, Hayashi M, Yu B, Jo DW. Evaluation of Tensile Bond Strength between Self-Adhesive Resin Cement and Surface-Pretreated Zirconia. Materials (Basel) 2022; 15:ma15093089. [PMID: 35591424 PMCID: PMC9101034 DOI: 10.3390/ma15093089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 02/01/2023]
Abstract
The tensile bond strength between zirconia subjected to different surface-pretreatment methods and methacryloyloxydecyl-dihydrogen-phosphate (MDP)-containing self-adhesive resin cement was evaluated herein. Eighty-eight cylindrical zirconia specimens were randomly divided into the following four groups based on the pretreatment method: (1) no treatment, (2) air abrasion, (3) HNO3/HF etching, and (4) zirconia-nanoparticle coating. The tensile bond strength of the zirconia−resin-cement complexes was investigated. One-way ANOVA and post hoc tests were performed at a 95% significance level, and the Weibull modulus was calculated. Fracture patterns were visualized by SEM. The surface roughness of the specimens without resin bonding was evaluated by AFM. The tensile bond strength of the specimens decreased as follows: Groups 3 > 4 > 2 > 1 (28.2 ± 6.6, 26.1 ± 5.7, 16.6 ± 3.3, and 13.9 ± 3.0 MPa, respectively). Groups 3 and 4 had significantly higher tensile bond strengths (p < 0.05) and lower fracture probabilities than those of Groups 1 and 2. They also showed both mixed failure and resin-cement cohesive failure, whereas Groups 1 and 2 showed mixed failure exclusively. The zirconia−resin tensile bond was stronger after HNO3/HF etching or ZrO2-nanoparticle coating than after air abrasion or no treatment. The estimated surface roughness decreased as follows: Groups 3 > 4 > 2 > 1. The combination of zirconia pretreated with HNO3/HF etching or ZrO2-nanoparticle coating and an MDP-containing self-adhesive resin cement can increase the clinical longevity of zirconia restorations by preventing their decementation.
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Affiliation(s)
- Mijoo Kim
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Reuben H. Kim
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Samuel C. Lee
- California Smile Dental Studio, Gardena, CA 90247, USA;
| | - Thomas K. Lee
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Marc Hayashi
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Bo Yu
- Restorative Materials and Applied Dental Research Laboratory, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (M.K.); (R.H.K.); (T.K.L.); (M.H.); (B.Y.)
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Deuk-Won Jo
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam 13620, Korea
- Correspondence: ; Tel.: +82-31-787-7548
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Pontevedra P, Lopez-Suarez C, Rodriguez V, Pelaez J, Suarez MJ. Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up. Clin Oral Investig 2022. [PMID: 35142924 DOI: 10.1007/s00784-022-04396-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022]
Abstract
Objectives To evaluate and to compare the clinical performance and survival rate of posterior monolithic and veneered zirconia fixed partial dentures (FPDs). Material and methods Sixty 3-unit posterior FPDs were included in the study. The patients were randomly distributed into two groups (n = 30 each) to receive either a monolithic (Zenostar T, Wieland Dental) or veneered zirconia (IPS e.max ZirCAD, Ivoclar Vivadent) FPD. Each patient received only 1 FPD. Tooth preparations were scanned (Trios 3, 3Shape), designed (Dental System 2016, 3 Shape), milled (Zenotec CAM 3.2, Wieland Dental), and cemented with a resin cement. Technical and biological outcomes and periodontal parameters were assessed. Data analysis was made using the Friedman and the Wilcoxon signed-rank tests with the Bonferroni correction and the Mann–Whitney U test. Results The survival rate at 3 years was 100% for veneered and 90% for monolithic zirconia restorations. Three monolithic zirconia FPDs were lost because of biologic complications. The main complication in the veneered zirconia FPDs was the fracture of the veneering ceramic in 4 of the veneered zirconia FPDs. No fracture of the frameworks was observed in any of the groups. All restorations were assessed as satisfactory after 3 years. No differences in periodontal parameters were observed between the groups. Conclusions The results of this study suggest that monolithic zirconia and complete digital flow could be a viable alternative to veneered zirconia in the posterior regions. Clinical relevance The monolithic zirconia restorations with a digital workflow can be a viable alternative in posterior fixed partial dentures, with good periodontal outcomes. Clinical trial registration number ClinicalTrials.gov (Identifier NCT 04,879,498).
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Gseibat M, Sevilla P, Lopez-Suarez C, Rodríguez V, Peláez J, Suárez MJ. Prospective Clinical Evaluation of Posterior Third-Generation Monolithic Zirconia Crowns Fabricated with Complete Digital Workflow: Two-Year Follow-Up. Materials (Basel) 2022; 15:672. [PMID: 35057389 DOI: 10.3390/ma15020672] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
Clinical studies on the behavior of posterior translucent monolithic zirconia restorations are lacking. We assessed the clinical outcome and survival rate of posterior third-generation monolithic zirconia crowns over a 2-year period. A total of 24 patients, requiring 30 posterior full-contour restorations were selected. All abutments were scanned, and crowns were milled and cemented with a self-adhesive dual cure cement. Crowns were assessed using the California Dental Association’s criteria. Gingival status was assessed by evaluating the gingival index, plaque index, periodontal probing depth of the abutments and control teeth, and the margin index of the abutment teeth. Statistical analyses were performed using the Friedman and the Wilcoxon signed-rank tests. During the 2-year follow-up, no biological or mechanical complications were observed, and the survival and success rate was 100%. All restorations ranked as satisfactory throughout the follow-up period. The gingival index and plaque index were worse at the end of the 2-year follow-up. The margin index was stable during the 2 years of clinical service. No significant differences were recorded in periodontal parameters between crowns and control teeth. Third-generation monolithic zirconia could be a reliable alternative to posterior metal–ceramic and second-generation monolithic zirconia posterior crowns.
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Isola G, Giudice A, Palazzo G, Campagna P, Fichera G. Analysis of Therapy by Means of Gallium Aluminum Arsenide Laser During Orthodontic Tooth Movement: A Randomized, Split Mouth Controlled Clinical Trial. Dent Hypotheses 2022. [DOI: 10.4103/denthyp.denthyp_48_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cadore-Rodrigues AC, Machry RV, Zucuni CP, Pereira GKR, Valandro LF. Grinding and polishing of the inner surface of monolithic simplified restorations made of zirconia polycrystals and lithium disilicate glass-ceramic: Effects on the load-bearing capacity under fatigue of the bonded restorations. J Mech Behav Biomed Mater 2021; 124:104833. [PMID: 34562764 DOI: 10.1016/j.jmbbm.2021.104833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
This study evaluated the effect of grinding and polishing the inner surface of monolithic discs made of zirconia polycrystals (ZR) and lithium disilicate glass-ceramic (LD) on the load-bearing capacity under fatigue of the restorations bonded onto a dentin analogue material (epoxy resin). ZR and LD ceramic discs (10 mm in diameter, 1 mm in thickness) were produced and randomly allocated into 10 groups considering the internal adjustment approach: Ctrl - No adjustment; F - Grinding with fine diamond bur (46 μm); F + Pol - Grinding with fine diamond bur followed by polishing with 2 tips (finisher and polisher); FF - Grinding with extrafine diamond bur (30 μm); FF + Pol - Grinding with extrafine diamond bur followed by polishing. In addition, discs (10 mm in diameter, 2.5 mm in thickness) of fiber reinforced epoxy resin were produced. Afterwards, the intaglio surface of the ZR discs were air-abraded with 45 μm alumina particles for 10 s, the LD and resin epoxy discs were etched with hydrofluoric acid (5%/20 s and 10%/60 s, respectively), and the treated discs were primed as recommended. Each ceramic disc was luted onto the epoxy resin disc with resin cement. Then, the samples were tested under a step-stress fatigue test (20 Hz, 10,000 cycles/step, step-size of 100 N starting at 200 N, and proceeding until failure detection). Fractographic, topographic and surface roughness analysis were also performed. The adjustments (grinding with or without polishing) (ZR: 733-880 N; LD: 1040-1106 N) triggered a detrimental effect on the fatigue behavior in both ceramics compared with the absence of treatment (control group; ZR: 973 N; LD: 1406 N). The polishing step had no effect on fatigue findings. Thus, grinding the inner surface of the tested ceramics should be avoided wherever possible to prevent introducing damage and its detrimental effects on the fatigue behavior.
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Affiliation(s)
- Ana Carolina Cadore-Rodrigues
- MSciD and PhD Post-Graduate Program in Oral Sciences (Prosthodontic Units), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Renan Vaz Machry
- MSciD and PhD Post-Graduate Program in Oral Sciences (Prosthodontic Units), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Camila Pauleski Zucuni
- MSciD and PhD Post-Graduate Program in Oral Sciences (Prosthodontic Units), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Post-Graduate Program in Oral Sciences (Prosthodontic Units), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Oral Sciences (Prosthodontic Units), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
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Pjetursson BE, Sailer I, Latyshev A, Rabel K, Kohal RJ, Karasan D. A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns. Clin Oral Implants Res 2021; 32 Suppl 21:254-288. [PMID: 34642991 PMCID: PMC9293296 DOI: 10.1111/clr.13863] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 12/28/2022]
Abstract
Objective To assess the survival, failure, and complication rates of veneered and monolithic all‐ceramic implant‐supported single crowns (SCs). Methods Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow‐up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all‐ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models. Results Forty‐nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta‐analysis of the included studies indicated an estimated 3‐year survival rate of veneered‐reinforced glass‐ceramic implant‐supported SCs of 97.6% (95% CI: 87.0%–99.6%). The estimated 3‐year survival rates were 97.0% (95% CI: 94.0%–98.5%) for monolithic‐reinforced glass‐ceramic implant SCs, 96.9% (95% CI: 93.4%–98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%–97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%–97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%–87.7%) for resin‐matrix‐ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates. Conclusions With the exception of RMC SCs, veneered and monolithic implant‐supported ceramic SCs showed favorable short‐term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
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Affiliation(s)
- Bjarni Elvar Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.,Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrey Latyshev
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Maxillofacial, Oral and Plastic Surgery, Faculty of Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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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: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Waldecker M, Behnisch R, Rammelsberg P, Bömicke W. Five-year clinical performance of monolithic and partially veneered zirconia single crowns-a prospective observational study. J Prosthodont Res 2021; 66:339-345. [PMID: 34556602 DOI: 10.2186/jpr.jpr_d_21_00024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to prospectively evaluate the medium-term clinical performance and esthetics of monolithic and partially (i.e., facially) veneered zirconia single crowns (MZ-SC and PZ-SC, respectively). METHODS Between September 2011 and June 2013, 68 participants received 90 MZ-SC and 72 PZ-SC. Clinical study documentation was performed at crown cementation (baseline), at 6-month follow-up, and then yearly thereafter using standardized report forms. Three participants with four MZ-SC dropped out during clinical follow-up. Thus, 65 participants (n = 31, 47.7% men) fitted with 158 restorations (86 MZ-SC, 72 PZ-SC) were evaluated. The mean observation period of the restorations was 5.8 ±2.5 years; 6.3 ±2.2 for MZ-SC and 5.2 ±2.6 for PZ-SC. RESULTS The 5-year rate of complication-free survival (success) was 87.0% for MZ-SC and 95.8% for PZ-SC (log-rank test, p = 0.026). The 5-year failure-free survival rate was 93.1% for MZ-SC and 96.2% for PZ-SC (log-rank test, p = 0.111), and the 5-year ceramic fracture-free survival rate was 100% for MZ-SC and 98.6% for PZ-SC (log-rank test, p = 0.274). Crowns of both designs were awarded excellent scores for esthetics by participants and dentists. CONCLUSIONS Monolithic and partially veneered zirconia crowns can be used clinically with high medium-term survival and success and uncompromised esthetic results.
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Affiliation(s)
- Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
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Salazar Marocho SM, Vanlandingham MB, Mourad F, Pappa A, Koka S. Laboratory Characterization of In-Service Full-Mouth Rehabilitation with Monolithic Translucent Zirconia Restorations. Symmetry (Basel) 2021; 13:1755. [DOI: 10.3390/sym13091755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [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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Banh W, Hughes J, Sia A, Chien DCH, Tadakamadla SK, Figueredo CM, Ahmed KE. Longevity of Polymer-Infiltrated Ceramic Network and Zirconia-Reinforced Lithium Silicate Restorations: A Systematic Review and Meta-Analysis. Materials (Basel) 2021; 14:5058. [PMID: 34501148 DOI: 10.3390/ma14175058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/22/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to systematically review the existing literature to assess the clinical survival and success of PICN and ZLS indirect restorations as the clinical evidence for them remains lacking. PubMed, SCOPUS, Embase, Cochrane Library, Web of Science, LILACs, and SciElo databases were searched from 1 January 2000 to 1 February 2021. Clinical trials and cohort studies published in English were included while case studies, case series, and in vitro studies were excluded. Results were analyzed qualitatively and a meta-analysis using a random effects model was performed. A strength of recommendation taxonomy (SORT) analysis was conducted and risk of bias (RoB) was assessed using the Newcastle-Ottawa scale and Cochrane RoB tools. An electronic search through the databases yielded 2454 articles, of which 825 remained after duplicate removal. Five studies investigating PICN and four investigating ZLS indirect restorations remained after assessing for eligibility. The overall survival rate of PICN over 1 year was 99.6% and 99.2% over 2 years. The overall survival rate of ZLS over 1 year was 99%. The main mode of failure for both materials was catastrophic fracture. One study had a high RoB, four had a moderate RoB, and four had a low RoB. Both materials demonstrated moderate strength of recommendation at a level 2 evidence for all studies based on SORT analysis. PICN and ZLS show promising short-term clinical performance as full and partial coverage indirect restorations, but longer follow-up studies are required to confirm their long-term performance.
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Cadore-Rodrigues AC, Machado PS, Oliveira JSD, Jahn SL, Dorneles LS, Rippe MP, Pereira GKR, Valandro LF. Surface treatments and its effects on the fatigue behavior of a 5% mol yttria partially stabilized zirconia material. J Mech Behav Biomed Mater 2021; 120:104543. [PMID: 33957570 DOI: 10.1016/j.jmbbm.2021.104543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
This study evaluated the effect of distinct surface treatments on the fatigue behavior (biaxial flexural fatigue testing) and surface characteristics (topography and roughness) of a 5% mol yttria partially stabilized zirconia ceramic (5Y-PSZ). Disc-shaped specimens of 5Y-PSZ (IPS e.max ZirCAD MT Multi) were manufactured (ISO 6872-2015) and allocated into six groups (n = 15) considering the following surface treatments: Ctrl - no-treatment; GLZ - low-fusing porcelain glaze application; SNF - 5 nm SiO2 nanofilm; AlOx - aluminum oxide particle air-abrasion; SiC - silica-coated aluminum oxide particles (silica-coating); and 7%Si - 7% silica-coated aluminum oxide particles (silica-coating). The biaxial flexural fatigue tests were performed by the step-stress method (20Hz for 10,000 cycles) with a step increment of 50N starting at 100N and proceeding until failure detection. The samples were tested with the treated surface facing down (tensile stress side). Topography, fractography, roughness, and phase content assessments of treated specimens were performed. GLZ group presented the highest fatigue behavior, while AlOx presented the lowest performance, and was only similar to SiC and 7%Si. Ctrl and SNF presented intermediary fatigue behavior, and were also similar to SiC and 7%Si. GLZ promoted a rougher surface, Ctrl and SNF had the lowest roughness, while the air-abrasion groups presented intermediary roughness. No m-phase content was detected (only t and c phases were detected). In conclusion, the application of a thin-layer of low-fusing porcelain glaze, the deposition of silica nanofilms and the air-abrasion with silica-coated alumina particles had no detrimental effect on the fatigue behavior of the 5Y-PSZ, while the air-abrasion with alumina particles damaged the fatigue outcomes.
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Affiliation(s)
- Ana Carolina Cadore-Rodrigues
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Pablo Soares Machado
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Jivago Schumacher de Oliveira
- Post-Graduate Program in Chemical Engineering, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Sérgio Luiz Jahn
- Post-Graduate Program in Chemical Engineering, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Lucio Strazzabosco Dorneles
- Post-Graduate Program in Physics, Physics Department, Federal University of Santa Maria, Santa Maria, Brazil.
| | - Marília Pivetta Rippe
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil.
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22
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Mazza LC, Lemos CAA, Pesqueira AA, Pellizzer EP. Survival and complications of monolithic ceramic for tooth-supported fixed dental prostheses: A systematic review and meta-analysis. J Prosthet Dent 2021; 128:566-574. [PMID: 33745685 DOI: 10.1016/j.prosdent.2021.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 01/11/2023]
Abstract
STATEMENT OF PROBLEM Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the survival and biological and technical complication rates of monolithic single crowns and fixed partial dentures (FPDs). MATERIAL AND METHODS An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE, Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk of bias tool were used to assess the quality and risk of bias of the included studies. Meta-analysis was performed by using the R software program. RESULTS The search identified 763 articles, 18 of which met the eligibility criteria. A total of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate, 461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36 lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed a direct comparison between monolithic and veneered ceramic restorations, and no significant difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91; P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29). CONCLUSIONS The use of monolithic ceramic can be considered a favorable treatment for tooth-supported single crowns and FPDs, with high survival and low complication rates. However, further randomized controlled trials are needed to reassess these clinical performances, mainly by comparing them with the performance of veneered restorations.
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Affiliation(s)
- Letícia Cerri Mazza
- MSc student, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Division of Prosthodontics, Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Aldiéris Alves Pesqueira
- Assistant Professor, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil.
| | - Eduardo Piza Pellizzer
- Titular Professor, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil
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Habib SR, Bajunaid S, Almansour A, AbuHaimed A, Almuqrin MN, Alhadlaq A, Zafar MS. Shear Bond Strength of Veneered Zirconia Repaired Using Various Methods and Adhesive Systems: A Comparative Study. Polymers (Basel) 2021; 13:polym13060910. [PMID: 33809539 PMCID: PMC7998840 DOI: 10.3390/polym13060910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to investigate the shear bond strength of five different repair methods and adhesive systems for zirconia (Zr) cores layered with feldspathic porcelain. Seventy-five Zr specimens (10 × 10 × 4 mm3) were prepared, sintered, layered with 2 × 10 × 10 mm3 of feldspathic porcelain, and fired. The ceramic was fractured, and the load recorded using a shear-bond test. Specimens were thermocycled and randomly divided into 5 groups (n = 15/group) based on the repair methods. Composite repair blocks with similar dimensions to the layered ceramic (2 × 10 × 10 mm3) were built according to each repair method. Shear bond strength testing of the specimens with composite built up was carried out using a universal testing machine (Instron®5960, Massachusetts, USA). The shear bond strengths of the adhesive interface between repaired composite and the Zr were recorded for all the test groups. The fractured specimens’ surfaces were examined under a scanning electron microscope (Jeol, Musashino, Akishima, Tokyo, Japan) for evaluation of the type of failure and surface characteristics. Shear bond strength of the veneered ceramic bonded to the Zr for all the test groups was non-significant (ANOVA, p = 0.062). Shear bond strength after the repair revealed significant differences (ANOVA, p = 0.002). Group-C (13.79 ± 1.32) and Group-D (9.77 ± 4.77) showed the highest and lowest shear bond strength values, respectively. Paired Sample T-tests showed significantly lower values (p = 0.000) for the repaired (composite) Zr compared to the layered (ceramic) Zr. Multiple comparisons revealed differences (significant) between the shear bond strength of Group-D with Groups A (p = 0.010) and C (p = 0.003, Post Hoc Tukey test). The repair methods tested showed variations in their respective shear bond strengths. Complete ceramic/zirconia repair systems showed better bonding between the repaired composite and Zr core. The mean shear bond strength for the repaired fractured layered Zr showed acceptable outcomes in terms of clinical perspective, but was, however, unpredictable.
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Affiliation(s)
- Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.B.); (A.A.); (A.A.); (M.N.A.); (A.A.)
- Correspondence: ; Tel.: +966-534-750-834
| | - Salwa Bajunaid
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.B.); (A.A.); (A.A.); (M.N.A.); (A.A.)
| | - Abdulrahman Almansour
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.B.); (A.A.); (A.A.); (M.N.A.); (A.A.)
| | - Abdulkarim AbuHaimed
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.B.); (A.A.); (A.A.); (M.N.A.); (A.A.)
| | - Muqrin Nasser Almuqrin
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.B.); (A.A.); (A.A.); (M.N.A.); (A.A.)
| | - Abdullah Alhadlaq
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.B.); (A.A.); (A.A.); (M.N.A.); (A.A.)
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia;
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
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Wu L, Sun Z, Zhao J, Zheng Y. Retrospective clinical study of monolithic zirconia crowns fabricated with a straightforward completely digital workflow. J Prosthet Dent 2021:S0022-3913(21)00061-5. [PMID: 33678440 DOI: 10.1016/j.prosdent.2021.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Current computer-aided design and computer-aided manufacturing (CAD-CAM) technology has digitalized some traditional prosthodontic processes, but manual interventions are still needed for both clinical and dental laboratory procedures, and improved digital workflows are required. PURPOSE The purpose of this retrospective clinical study was to develop a straightforward completely digital workflow to fabricate monolithic zirconia crowns and evaluate clinical efficiency and prosthetic outcomes. MATERIAL AND METHODS Self-glazed zirconia crowns (N=229) were placed in 177 participants between 2016 and 2019 with a completely digital workflow. The extent of clinical adjustment needed for each crown was recorded and then divided into 3 categories: zero adjustment, minimal adjustment, and unacceptable. Color match and marginal adaption were evaluated according to the modified US Public Health Service (USPHS) criteria. RESULTS A total of 213 (93.0%) crowns required zero adjustment during clinical evaluation, 11 (4.8%) needed minimal adjustment, and 5 (2.2%) were deemed unacceptable since they could not meet the clinical requirements through adjustment. Except for the unacceptable crowns, the marginal adaption of the remaining 224 crowns was rated as Alfa and the color match as Alfa (91.5%), Bravo (6.3%), and Charlie (2.2%). CONCLUSIONS The self-glazed monolithic zirconia crowns fabricated with the completely digital workflow provided efficient and satisfactory clinical performance.
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Dal Piva AMDO, Tribst JPM, Benalcázar Jalkh EB, Anami LC, Bonfante EA, Bottino MA. Minimal tooth preparation for posterior monolithic ceramic crowns: Effect on the mechanical behavior, reliability and translucency. Dent Mater 2020; 37:e140-e150. [PMID: 33246664 DOI: 10.1016/j.dental.2020.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/10/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Despite the increased use of monolithic crowns, their performance has yet to be determined when the minimal tooth preparation (MTP) principle is considered. The goal of this study was to evaluate the effect of MTP on the mechanical behavior, reliability and translucency of posterior monolithic ceramic crowns. METHODS Dentin analogues were machined using two preparation designs (0.5 or 1 mm reduction) to receive first molar crowns in order to evaluate the monolithic crown performance. Next, 126 crowns were divided (21/g) according to the material (High translucent zirconia - YZHT, Zirconia reinforced lithium silicate - ZLS and Hybrid ceramic - HC) and thickness (0.5 or 1 mm). Tensile stress concentration was calculated using the finite element method. The crowns were adhesivelly cemented and step stress fatigued to calculate reliability for missions at 600 and 1000 N. Translucency was analyzed in 10 discs of each material and thickness. RESULTS Higher stress concentration was found in thinner crowns and those with higher elastic modulus. YZHT crowns were suspended when fatigue reached 1500 N load, thus 1-parameter Weibull was used to analyze the data. Reliability was only affected by thickness at 1000 N. ZLS.5 showed lower survival than HC.5, which was similar to the groups that presented 100% survival. YZHT showed the highest strength and data scattering. ZLS1 (22.3 ± 1.4) presented higher translucency than HC1 (19.2 ± 0.6) and YZHT1 (12.0 ± 2.9), whereas ZLS.5 and HC.5 were similar to each other (26.5 ± 2.3, 26.7 ± 2.2) and superior to YZHT.5 (12.7 ± 1.2). SIGNIFICANCE HC.5 combined high reliability and translucency with low stress concentration, yielding better crown performance and tooth preservation.
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Affiliation(s)
- Amanda Maria de Oliveira Dal Piva
- PhD Graduate Program in Restorative Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, Av. Eng. Francisco José Longo, nº 777, Jardim São Dimas, 12245-000 São José dos Campos, SP, Brazil.
| | - João Paulo Mendes Tribst
- PhD Graduate Program in Restorative Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, Av. Eng. Francisco José Longo, nº 777, Jardim São Dimas, 12245-000 São José dos Campos, SP, Brazil.
| | - Ernesto Byron Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry. Alameda Dr. Octávio Pinheiro Brisolla, 9-75, 17012-901, Bauru, SP, Brazil.
| | - Lilian Costa Anami
- PhD Graduate Program in Restorative Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, Av. Eng. Francisco José Longo, nº 777, Jardim São Dimas, 12245-000 São José dos Campos, SP, Brazil.
| | - Estevam Augusto Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry. Alameda Dr. Octávio Pinheiro Brisolla, 9-75, 17012-901, Bauru, SP, Brazil.
| | - Marco Antonio Bottino
- PhD Graduate Program in Restorative Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, Av. Eng. Francisco José Longo, nº 777, Jardim São Dimas, 12245-000 São José dos Campos, SP, Brazil.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Pontevedra P, Lopez‐Suarez C, Pelaez J, Garcia‐Serdio S, Suarez MJ. Prospective Clinical Evaluation of Posterior Monolithic Zirconia Fixed Partial Dentures Using a Complete Digital Workflow: Two‐Year Follow‐Up. J Prosthodont 2020; 30:298-304. [DOI: 10.1111/jopr.13251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 02/04/2023] Open
Affiliation(s)
- Paula Pontevedra
- Department of Conservative Dentistry and Buccofacial Prostheses Faculty of Odontology, University Complutense of Madrid Madrid Spain
| | - Carlos Lopez‐Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses Faculty of Odontology, University Complutense of Madrid Madrid Spain
| | - Jesus Pelaez
- Department of Conservative Dentistry and Buccofacial Prostheses Faculty of Odontology, University Complutense of Madrid Madrid Spain
| | - Sara Garcia‐Serdio
- Department of Conservative Dentistry and Buccofacial Prostheses Faculty of Odontology, University Complutense of Madrid Madrid Spain
| | - Maria J Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses Faculty of Odontology, University Complutense of Madrid Madrid Spain
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Limones A, Molinero-Mourelle P, Azevedo L, Romeo-Rubio M, Correia A, Gómez-Polo M. Zirconia-ceramic versus metal-ceramic posterior multiunit tooth-supported fixed dental prostheses: A systematic review and meta-analysis of randomized controlled trials. J Am Dent Assoc 2020; 151:230-238.e7. [PMID: 32222175 DOI: 10.1016/j.adaj.2019.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/08/2019] [Accepted: 12/14/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The authors aimed to compare the survival and complication rates of zirconia-ceramic (ZC) versus metal-ceramic (MC) restorative material in multiunit tooth-supported posterior fixed dental prostheses (FDP). TYPES OF STUDIES REVIEWED The authors conducted a systematic search of randomized controlled trials (RCTs), with no time or language restrictions, up to May 2019 using the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases, followed by a manual search. RESULTS The authors included 7 RCTs in the review and 5 RCTs in the meta-analysis. All studies had a low risk of bias. The authors included 330 participants (177 ZC and 173 MC tooth-supported FDP) in the meta-analysis, which revealed a medium-term survival rate of 95.4% (95% confidence interval [CI], 90.5% to 99.1%) for ZC FDP compared with 96.9% (95% CI, 94.3% to 99.4%) for MC FDP, with no significant differences (P = .364). The biological or technical complications did not show statistically significant differences, except in the global ceramic veneering chipping analysis (P = .023; risk difference [RD], 22.3%; 95% CI, 3.0% to 41.6%) and their subanalysis: minor chipping or chipping that can be solved with polishing (P = .044; RD, 19.5%; 95% CI, 0.5% to 38.4%), and major chipping or chipping that needs repair in the laboratory (P = .023; RD, 6.0%; 95% CI, 0.8% to 11.3%). CONCLUSIONS AND PRACTICAL IMPLICATIONS Posterior multiunit ZC restorations are considered a predictable treatment in the medium term, although they are slightly more susceptible to chipping of the veneering ceramic than MC restorations.
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Koenig V, Wulfman C, Bekaert S, Dupont N, Le Goff S, Eldafrawy M, Vanheusden A, Mainjot A. Clinical behavior of second-generation zirconia monolithic posterior restorations: Two-year results of a prospective study with Ex vivo analyses including patients with clinical signs of bruxism. J Dent 2019; 91:103229. [PMID: 31722238 DOI: 10.1016/j.jdent.2019.103229] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This study aimed to investigate (1) clinical outcomes of second-generation zirconia restorations, including patients with bruxism clinical signs, and (2) the material wear process. METHODS A total of 95 posterior monolithic zirconia tooth-elements in 45 patients were evaluated, 85 on implants and 10 on natural teeth, and 20.3% of restorations being fixed partial dentures (FPDs). Occlusal contact point areas were determined and half of those areas were left unglazed and just polished. Restorations were clinically evaluated following criteria of the World Dental Federation and antagonistic teeth were examined at each evaluation time. Wear ex vivo analyses using SEM and 3D laser profilometry were performed at baseline and after 6 months, 1 year, and 2 years respectively, temporarily removing the prostheses. RESULTS The Kaplan-Meier survival rate of restorations was 93.3% (100% for FPDs) and the success rate was 81.8%, with 4 abutment debondings, 3 tooth-supported crown debondings (provisional cement use), 1 restoration fracture, 1 minor chipping, 1 core fracture, 1 root fracture, and 2 implant losses. 80% of catastrophic failures occurred in patients with clinical signs of bruxism (61.7% of patients). Complications were also observed on antagonistic teeth (3 catastrophic failures). Clinical evaluation of the restorations showed good results from the aesthetic, functional, and biological perspective. Zirconia wear was inferior to 15 μm, while glaze wear was observed on all occlusal contact areas after 1 year. CONCLUSIONS Monolithic zirconia FPDs are promising but the failure rate of single-unit restorations was not as high as expected in this sample including patients with bruxism clinical signs. CLINICAL SIGNIFICANCE Within study limitations, FPDs showed excellent short-term results but further research is needed for single-unit restorations considering samples, which do not exclude bruxers. The weak link is the restoration support or the antagonist tooth, one hypothesis being that zirconia stiffness and lack of resilience do not promote occlusal stress damping.
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Affiliation(s)
- V Koenig
- Dental Biomaterials Research Unit (d-BRU), University of Liège (ULiège), 45 Quai G. Kurth, Liège, 4020, Belgium; Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), 45 Quai G. Kurth, Liège, 4020, Belgium
| | - C Wulfman
- Dental Biomaterials Research Unit (d-BRU), University of Liège (ULiège), 45 Quai G. Kurth, Liège, 4020, Belgium; Unité de Recherches en Biomatériaux Innovants et Interfaces (URB2i) - EA4462, Faculté de Chirurgie Dentaire, Université Paris Descartes, Sorbonne Paris-Cité, Montrouge, 92120, France
| | - S Bekaert
- Dental Biomaterials Research Unit (d-BRU), University of Liège (ULiège), 45 Quai G. Kurth, Liège, 4020, Belgium; Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), 45 Quai G. Kurth, Liège, 4020, Belgium
| | - N Dupont
- Dental Biomaterials Research Unit (d-BRU), University of Liège (ULiège), 45 Quai G. Kurth, Liège, 4020, Belgium; Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), 45 Quai G. Kurth, Liège, 4020, Belgium
| | - S Le Goff
- Unité de Recherches en Biomatériaux Innovants et Interfaces (URB2i) - EA4462, Faculté de Chirurgie Dentaire, Université Paris Descartes, Sorbonne Paris-Cité, Montrouge, 92120, France
| | - M Eldafrawy
- Dental Biomaterials Research Unit (d-BRU), University of Liège (ULiège), 45 Quai G. Kurth, Liège, 4020, Belgium
| | - A Vanheusden
- Dental Biomaterials Research Unit (d-BRU), University of Liège (ULiège), 45 Quai G. Kurth, Liège, 4020, Belgium; Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), 45 Quai G. Kurth, Liège, 4020, Belgium
| | - A Mainjot
- Dental Biomaterials Research Unit (d-BRU), University of Liège (ULiège), 45 Quai G. Kurth, Liège, 4020, Belgium; Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), 45 Quai G. Kurth, Liège, 4020, Belgium.
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Abstract
Although all-ceramic crowns have excellent biocompatibility and esthetic appearance, chipping may occur. The mechanical properties of monolithic zirconia restorative material are superior to those of all-ceramic restorative materials, and chipping caused by chewing hard foods could be avoided. This study aimed to evaluate the clinical efficacy of monolithic zirconia crowns for posterior teeth restorations.A total of 46 patients requiring posterior teeth restorations involving 49 teeth were treated with monolithic zirconia crown procedure. The treatment results were evaluated according to the modified California Dental Association criteria immediately after the procedure, and at 2, 24, 48, and 96 weeks after the procedure. The plaque index, gingival index, probing depth, crown marginal integrity, and attrition of the abutment teeth, antagonist teeth, corresponding contralateral teeth, and antagonist of the corresponding contralateral teeth were assessed. The patients were followed for up to 96 weeks.The marginal adaptation results of all 46 patients were evaluated as excellent, resulting in an excellent rate of 100%. Regarding the crown color match, only 3 cases (6.1%) were evaluated as acceptable. Marginal adaptation, anatomic form, crown margin integrity, color match, and gross fracture did not show significant differences compared with the different time points (P = .999). Surface texture at different time did not change significantly (P = .807). During the 96-week follow-up, 1 crack in the antagonist teeth was found in 1 patient. There were no significant differences in wear of the antagonist teeth at different time points (P = .972). The rate of "excellent" evaluation for crown restorations was 93.9% to 100%.The monolithic zirconia crown had no detectable adverse effects on the periodontal tissues, and the antagonist teeth attrition was small. Therefore, it has good potential in the clinical application of posterior teeth restorations in the short term.
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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
- The Second Affiliated Hospital of Guilin Medical University, Guilin, 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
| | - Hui Wang
- The Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Bin Liu
- The Second Affiliated Hospital of Guilin Medical University, Guilin, China
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Moreira A, Freitas F, Marques D, Caramês J. Aesthetic Rehabilitation of a Patient with Bruxism Using Ceramic Veneers and Overlays Combined with Four-Point Monolithic Zirconia Crowns for Occlusal Stabilization: A 4-Year Follow-Up. Case Rep Dent 2019; 2019:1640563. [PMID: 31531247 DOI: 10.1155/2019/1640563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/20/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022] Open
Abstract
Management of severe worn dentition in patients with bruxism is challenging as a result of the loss of tooth structure and occlusal vertical dimension, temporomandibular implications, tooth hypersensitivity, and masticatory or aesthetic impairment. This case describes the 4-year follow-up clinical evaluation of a full mouth tooth-supported rehabilitation made on a 66-year-old man with bruxism and tooth wear, with aesthetic complaints and compromised masticatory function. The prosthetic treatment was planned with a digital smile design and a mock-up technique for an aesthetic and minimally invasive approach using lithium disilicate pressed and layered veneers on anterior teeth, posterior CAD/CAM lithium disilicate overlays with facial coverage, and CAD/CAM monolithic zirconia crowns with facial feldspathic ceramic on maxillary and mandibular canines and first molars in order to ensure the occlusal stability at the increased occlusal vertical dimension. After 4 years of function, no complications were registered. The choice of an appropriate material for the rehabilitation of these patients is essential to improve treatment prognosis and should be guided by mechanical and aesthetical properties. The use of four-point occlusal stabilization with CAD/CAM high strength monolithic zirconia crowns combined with ceramic veneers and overlays appears to be a reliable treatment option that enhances aesthetics and minimizes the occurrence of ceramic fractures, ensuring the treatment prognosis and predictability.
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Zucuni CP, Pereira GKR, Dapieve KS, Rippe MP, Bottino MC, Valandro LF. Low-fusing porcelain glaze application does not damage the fatigue strength of Y-TZP. J Mech Behav Biomed Mater 2019; 99:198-205. [PMID: 31374515 DOI: 10.1016/j.jmbbm.2019.07.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/10/2019] [Accepted: 07/20/2019] [Indexed: 02/04/2023]
Abstract
This study evaluated and compared the effects of two glaze application methods (brush and spray) on the fatigue strength and surface characteristics (topography and roughness) of a translucent yttrium stabilized partially tetragonal zirconia polycrystal ceramic (Y-TZP) prior to and after grinding. Disc-shaped specimens of translucent Y-TZP (Vita YZ-HT; Vita-Zahnfabrik) were processed (ISO 6872-2015) and randomly allocated into 6 groups, according to the surface treatments performed on the tensile surface: Ctrl - as-sintered (no treatment); Gr - grinding with a diamond bur (181 μm-grit; #3101G); Br - glaze obtained from a powder-liquid mix and applied by brush (Vita Akzent; Vita Zahnfabrik); Sp - glaze application via spray (Vita Akzent Plus; Vita Zahnfabrik); Gr + Br and Gr + Sp - association of grinding + respective glaze method. Analyses of surface roughness (Ra and Rz), fatigue strength (staircase method), surface topography and fractography were carried out. The as-sintered condition had the smoothest surface, while grinding led to the rougher and more heterogeneous topography. Both glaze application methods showed a potential for topography evenness (smoothening effect), while the glaze spray method led to thinner layers of material, showing a limitation in reducing the roughness compared to the brush method. No deleterious effect on fatigue strength of the Y-TZP could be observed, as the glaze-spray application on the as-sintered surface showed the highest values. Fractography depicted two distinct fracture origin regions: from defects in the surface/sub-surface region for the Ctrl and Gr groups; and at the zirconia-glaze layer interface for Br, Sp, Gr + Br and Gr + Sp. The clinical relevance of this work is that the tested glaze application methods did not damage the fatigue strength of the tested Y-TZP.
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Affiliation(s)
- Camila Pauleski Zucuni
- MSciD and PhD Post-graduate Program in Oral Science, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Gabriel Kalil Rocha Pereira
- MSciD Post-graduate Program in Dentistry, School of Dentistry, Meridional Faculty - IMED, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Kiara Serafini Dapieve
- MSciD and PhD Post-graduate Program in Oral Science, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Marilia Pivetta Rippe
- MSciD and PhD Post-graduate Program in Oral Science, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Marco Cícero Bottino
- School of Dentistry, Dept. of Cariology, Restorative Sciences, Endodontics, University of Michigan, Ann Arbor, USA.
| | - Luiz Felipe Valandro
- MSciD and PhD Post-graduate Program in Oral Science, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
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Mangano F, Margiani B, Admakin O. A Novel Full-Digital Protocol (SCAN-PLAN-MAKE-DONE ®) for the Design and Fabrication of Implant-Supported Monolithic Translucent Zirconia Crowns Cemented on Customized Hybrid Abutments: A Retrospective Clinical Study on 25 Patients. Int J Environ Res Public Health 2019; 16:E317. [PMID: 30678357 DOI: 10.3390/ijerph16030317] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 02/06/2023]
Abstract
Purpose: To present a novel, full-digital protocol for the design and fabrication of implant-supported monolithic translucent zirconia crowns cemented on customized hybrid abutments. Methods: The present retrospective clinical study was based on data from patients who had been treated with single Morse-taper connection implants (Exacone®, Leone Implants, Florence, Italy) and were prosthetically restored with monolithic translucent zirconia crowns, cemented on customized hybrid abutments. The full-digital protocol (SCAN-PLAN-MAKE-DONE®) consisted of 8 phases: (1) intraoral scan of the implant position with scanbody; (2) computer-assisted design (CAD) of the individual abutment (saved as “supplementary abutment design” in external folder) and temporary crown; (3) milling of the individual zirconia abutment and of the temporary polymethyl-methacrylate (PMMA) crown, with extraoral cementation of the zirconia abutment on the relative titanium bonding base, to generate an individual hybrid abutment; (4) clinical application of the individual hybrid abutment and cementation of the temporary PMMA crown; (5) two months later, intraoral scan of the individual hybrid abutment in position; (6) CAD of the final crown with margin line design on the previously saved “supplementary abutment design”, superimposed on the second scan of the abutment in position; (7) milling of the final crown in monolithic translucent zirconia, sintering, and characterization; and (8) clinical application of the final crown. All patients were followed for a period of 1 year. The primary outcomes of this study were the marginal adaptation of the final crown (checked clinically and radiographically), the quality of occlusal and interproximal contact points at delivery, and the aesthetic integration; the secondary outcomes were the 1-year survival and success of the implant-supported restoration. An implant-supported restoration was considered successful in the absence of any biological or prosthetic complication, during the entire follow-up period. Results: In total, 25 patients (12 males, 13 females; 26–74 years of age; mean age 51.1 ± 13.3 years) who had been restored with 40 implant-supported monolithic translucent zirconia crowns were included in this study. At delivery, the marginal adaptation was perfect for all crowns. However, there were occlusal issues (2/40 crowns: 5%), interproximal issues (1/40 crowns: 2.5%), and aesthetic issues (1/40 crowns: 2.5%). The overall incidence of issues at delivery was therefore 10% (4/40 crowns). At 1 year, one implant failed; thus the survival of the restorations was 97.5% (39/40 crowns in function). Among the surviving implant-supported restorations, three experienced complications (one loss of connection between the hybrid abutment and the implant, one decementation of the zirconia abutment, and one decementation of the zirconia crown). The success of restorations amounted to 92.4%. Conclusions: The restoration of single Morse-taper connection implants with monolithic translucent zirconia crowns cemented on customized hybrid abutments via the novel SCAN-PLAN-MAKE-DONE® full-digital protocol seems to represent a reliable treatment option. However, further studies on a larger number of patients and dealing with different prosthetic restorations (such as implant-supported fixed partial prostheses) are needed to confirm the validity of this protocol.
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