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Chen TA, Lu PY, Lin PY, Chi CW, Cheng HY, Lai YJ, Wang F, Chiang YC. Effects of ceramic thickness, ceramic translucency, and light transmission on light-cured bulk-fill resin composites as luting cement of lithium disilicate based-ceramics. J Prosthodont Res 2024; 68:255-263. [PMID: 37197947 DOI: 10.2186/jpr.jpr_d_22_00304] [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] [Indexed: 05/19/2023]
Abstract
PURPOSE To assess the effects of ceramic thickness, ceramic translucency, and light transmission on restorative composites used as luting cement for lithium disilicate-based ceramics. METHODS Four luting types of cement were tested (n=8); a dual-cured resin cement (Multilink N), a light-cured conventional flowable composite (Tetric N-Flow), and two light-cured bulk-fill flowable composites (Tetric N-Flow Bulk Fill and X-tra base). The 20 s- or 40 s-light (1000 mW/cm2) was transmitted through 1- or 2-mm-thick high- or low-translucency (HT- or LT-) ceramic discs (IPS e.Max press) to reach the 1-mm-thick luting cement. Light transmitted to cement without ceramic served as a control. Vickers hardness number (VHN), flexural strength (FS), fractography, and degree of conversion (DC) were evaluated. One-way and multi-way analysis of variance was conducted to determine the effects of factors on VHN and FS. RESULTS Ceramic thickness, light transmission time, and cement type significantly affected the VHN of the luting cement (P < .000). Only Multilink N (LT- and HT-1mm) and Tetric N-Flow (HT-1mm) reached 90% VHN of corresponding control by 20 s-light transmissions, but Tetric N-Flow exhibited lowest VHN and approximately 1/3-1/2 VHN of Multilink N (P < 0.05). X-tra base expressed superior physicochemical properties to Tetric N-Flow Bulk Fill (P < 0.05) and reached >90% VHN of control in all conditions with 40 s-light transmissions except for LT-2 mm. DC, FS, and fractography supported these findings. CONCLUSIONS The light-cured bulk-fill composite served as a luting cement for lithium-disilicate-based ceramics in a product-dependent manner. Light transmission time is crucial to ensure sufficient luting cement polymerization.
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Affiliation(s)
- Ting-An Chen
- Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Ying Lu
- Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University and National University Hospital, Taipei, Taiwan
| | - Po-Yen Lin
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Wen Chi
- Department of Dentistry, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
| | - Hon Yin Cheng
- Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Jung Lai
- Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University and National University Hospital, Taipei, Taiwan
| | - Fajen Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University and National University Hospital, Taipei, Taiwan
| | - Yu-Chih Chiang
- Division of Restorative and Aesthetic Dentistry, Dental Department, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University and National University Hospital, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Michaud PL, Dort H. Do onlays and crowns offer similar outcomes to posterior teeth with mesial-occlusal-distal preparations? A systematic review. J ESTHET RESTOR DENT 2024; 36:295-302. [PMID: 37497796 DOI: 10.1111/jerd.13114] [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: 01/25/2023] [Revised: 05/22/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Teeth prepared for mesial-occlusal-distal (MOD) restorations have a significant risk of cusp fracture. Crowns and onlays can provide cusp coverage to reinforce posterior teeth at risk. Onlays are often more conservative of tooth structure which may be an advantage for teeth with large MOD preparations. It remains uncertain how onlays and crowns compare for posterior teeth with MOD tooth structure loss. The purpose of this systematic review was to compare the resistance to fracture, success rate, survival rate, and failure rate of teeth with MOD preparations restored with onlays or crowns. MATERIALS AND METHODS An electronic search queried Medline (PubMed), Embase (Ovid), Scopus, the Cochrane Library, and grey literature (OpenGrey) from database inception through April 29, 2023. RESULTS After eliminating duplicates and irrelevant records, 32 manuscripts were assessed. Only three publications met the criteria for inclusion. Most exclusions were due to poor reporting of restorative design and the amount of tooth structure remaining, or due to combining various restorative designs. Due to the limited sample size and high heterogeneity, no meta-analysis was conducted. One study observed a better outcome for onlays and two observed no difference. All three studies reported the mode of failure for crowns as more catastrophic whereas teeth with onlays could be salvaged. CONCLUSIONS Onlays may be an advantageous alternative to crowns for teeth with MOD preparations, but the level of evidence is insufficient to draw meaningful conclusions. CLINICAL SIGNIFICANCE Current evidence is insufficient to determine whether onlays or crowns are providing a different outcome when used to restore posterior teeth with MOD tooth structure loss. However, the fracture of teeth with MOD tooth structure loss restored with onlays appears to be less catastrophic than when restored with crowns.
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Affiliation(s)
- Pierre-Luc Michaud
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hillary Dort
- Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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Spitznagel F, Prott L, Hoppe J, Manitckaia T, Blatz M, Zhang Y, Langner R, Gierthmuehlen P. Minimally invasive CAD/CAM lithium disilicate partial-coverage restorations show superior in-vitro fatigue performance than single crowns. J ESTHET RESTOR DENT 2024; 36:94-106. [PMID: 38009505 PMCID: PMC10872741 DOI: 10.1111/jerd.13169] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE To analyze the influence of restoration design (partial-coverage restoration vs. crown) and ceramic layer thickness on the performance and failure loads of CAD/CAM-fabricated lithium disilicate (LDS) reconstructions on molars after fatigue. MATERIALS AND METHODS Seventy-two posterior monolithic CAD/CAM-fabricated LDS restorations (IPS e.max CAD, Ivoclar Vivadent) with different occlusal/buccal ceramic layer thicknesses (1.5/0.8, 1.0/0.6, and 0.5/0.4 mm) and restoration designs (PCR: non-retentive full-veneer/partial-coverage restoration, C: crown,) were investigated and divided into six groups (n = 12, test: PCR-1.5, PCR-1.0, PCR-0.5; control: C-1.5, C-1.0, C-0.5). LDS restorations were adhesively bonded (Variolink Esthetic DC, Ivoclar Vivadent) to dentin-analogue composite dies (Z100, 3M ESPE). All specimens were subjected to thermomechanical loading (1.2 million cycles, 49 N, 1.6 Hz, 5-55°C) and exposed to single load to failure testing. Failure analysis was performed with light and scanning electron microscopies. Data were statistically analyzed using ANOVA, Tukey-Test, and t-test (p < 0.05). RESULTS Eight crown samples (C-0.5) and one PCR specimen (PCR-0.5) revealed cracks after fatigue, resulting in an overall success rate of 87.5% (crowns: 75%, PCRs: 96.88%). Direct comparisons of PCRs versus crowns for thicknesses of 0.5 mm (p < 0.001) and 1.0 mm (p = 0.004) were significant and in favor of PCRs. Minimally invasive PCRs (0.5 and 1.0 mm) outperformed crowns with the identical ceramic thickness. No difference was detected (p = 0.276) between thickness 1.5 mm PCRs and crowns. CONCLUSIONS Minimally invasive monolithic CAD/CAM-fabricated posterior LDS PCRs (0.5 and 1.0 mm) resulted in superior failure load values compared to minimally invasive crowns. Minimally invasive crowns (0.5 mm) are prone to cracks after fatigue. CLINICAL SIGNIFICANCE Minimally invasive CAD/CAM-fabricated LDS PCR restorations with a non-retentive preparation design should be considered over single crowns for molar rehabilitation.
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Affiliation(s)
- F.A. Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- Department of Preventive and Restorative Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - L.S. Prott
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - J.S. Hoppe
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - T. Manitckaia
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - M.B. Blatz
- Department of Preventive and Restorative Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Y. Zhang
- Department of Preventive and Restorative Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - R. Langner
- Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany
- Institute of Neuroscience and Medicine, Brain and Behavior (INM-7), Research Center Jülich, Germany
| | - P.C. Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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Comba A, Baldi A, Carossa M, Michelotto Tempesta R, Garino E, Llubani X, Rozzi D, Mikonis J, Paolone G, Scotti N. Post-Fatigue Fracture Resistance of Lithium Disilicate and Polymer-Infiltrated Ceramic Network Indirect Restorations over Endodontically-Treated Molars with Different Preparation Designs: An In-Vitro Study. Polymers (Basel) 2022; 14. [PMID: 36501478 DOI: 10.3390/polym14235084] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
The aim of the present study was to evaluate the fatigue to cyclic and static resistance of indirect restorations with different preparation designs made either of lithium disilicate (LS) or polymer-infiltrated ceramic network (PICN). Eighty-four (n = 84) molars were chosen, endodontically treated, and prepared with standardized MOD cavities. The molars were randomly divided into 6 study groups (n = 14) taking into account the "preparation design'' (occlusal veneer with 1.2 mm occlusal thickness; overlay with 1.6 mm occlusal thickness; adhesive crown with 2 mm occlusal thickness) and the "CAD/CAM material'' (E-max CAD, Ivoclar vivadent; Vita Enamic, Vita). A fatigue test was conducted with a chewing simulator set at 50 N for 1,500,000 cycles. Fracture resistance was assessed using a universal testing machine with a 6 mm diameter steel sphere applied to the specimens at a constant speed of 1 mm/min. A SEM analysis before the fracture test was performed to visually analyze the tooth-restoration margins. A statistical analysis was performed with a two-way ANOVA and a post-hoc pairwise comparison was performed using the Tukey test. The two-way ANOVA test showed that both the preparation design factor (p = 0.0429) and the CAD/CAM material factor (p = 0.0002) had a significant influence on the fracture resistance of the adhesive indirect restorations. The interaction between the two variables did not show any significance (p = 0.8218). The occlusal veneer had a lower fracture resistance than the adhesive crown (p = 0.042) but not lower than the overlay preparation (p = 0.095). LS was more resistant than PICN (p = 0.002). In conclusion, in the case of endodontically treated teeth, overlay preparation seems to be a valid alternative to the traditional full crown preparation, while occlusal veneers should be avoided in restoring non-vital molars with a high loss of residual tooth structure. LS material is more resistant compared to PICN.
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Jurado CA, Amarillas-Gastelum C, Afrashtehfar KI, Argueta-Figueroa L, Fischer NG, Alshabib A. Ceramic and Composite Polishing Systems for Milled Lithium Disilicate Restorative Materials: A 2D and 3D Comparative In Vitro Study. Materials (Basel) 2022; 15:ma15155402. [PMID: 35955341 PMCID: PMC9369544 DOI: 10.3390/ma15155402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 05/20/2023]
Abstract
Purpose: This study aims to evaluate the effectiveness of two ceramic and two composite polishing systems for a novel chairside computer-aided design/computer-aided manufacturing (CAD/CAM) lithium disilicate ceramic with three-dimensional and two-dimensional microscopy images. This ceramic material can be used for implant-supported or tooth-borne single-unit prostheses. Materials and Methods: Sixty flat samples of novel chairside CAD/CAM reinforced lithium disilicate ceramic (Amber Mill, Hass Bio) were divided into five groups (n = 15/group) and treated as follows: Group 1 (NoP), no polished treatment; group 2 (CeDi), polished with ceramic Dialite LD (Brasseler USA); group 3, (CeOp) polished with ceramic OptraFine (Ivoclar Vivadent); group 4, (CoDi) polished with composite DiaComp (Brasseler USA), and group 5 (CoAs), polished with composite Astropol (Ivoclar Vivadent). The polished ceramic surface topography was observed and measured with three-dimensional and two-dimensional images. Results: All polishing systems significantly reduced the surface roughness compared with the non-polished control group (Sa 1.15 μm). Group 2 (CeDi) provided the smoothest surface arithmetical mean eight with 0.32 μm, followed by group 3 (CeOp) with 0.34 μm. Group 5 (CoAs) with 0.52 μm provided the smoothest surface among the composite polishing kits. Group 4 (CoDi) with 0.66 μm provided the least smooth surface among all polishing systems tested. Conclusions: Despite the effectiveness of ceramic polishing systems being superior to composite polishing systems of the CAD/CAM lithium disilicate restorative material, both polishing systems significantly improved the smoothness.
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Affiliation(s)
- Carlos A. Jurado
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA
| | | | - Kelvin I. Afrashtehfar
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Berne, Switzerland
| | | | - Nicholas G. Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA
| | - Abdulrahman Alshabib
- Department of Restorative Dentistry, King Saud University College of Dentistry, Riyadh 12372, Saudi Arabia
- Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, King Saud University, Riyadh 11545, Saudi Arabia
- Correspondence:
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Zhu J, Gao J, Jia L, Tan X, Xie C, Yu H. Shear bond strength of ceramic laminate veneers to finishing surfaces with different percentages of preserved enamel under a digital guided method. BMC Oral Health 2022; 22:3. [PMID: 34996438 PMCID: PMC8742459 DOI: 10.1186/s12903-021-02038-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/28/2021] [Indexed: 02/08/2023] Open
Abstract
Background The purpose of this in vitro study was to evaluate the effect of the percentages of preserved enamel on ceramic laminate veneers’ (CLVs) shear bond strength (SBS). Methods Seventy extracted human maxillary central incisors were scanned and reconstructed into three-dimensional models. The extracted teeth were then embedded and randomly divided into seven groups (n = 10 per group). Based on digital analyses of the three-dimensional models, guided tooth preparation and bonding procedures were performed individually to form seven different percentages (100%, 80%, 60% 50%, 40%, 20% and 0%) of remaining enamel thickness on the bonding surface. Finally, the SBS test was performed, and the data were statistically analysed by one-way ANOVA with LSD post hoc test (α = 0.05). Results The complete enamel surface exhibited the highest SBS (19.93 ± 4.55 MPa), followed by 80% enamel (19.03 ± 3.66 MPa), 60% enamel (18.44 ± 3.65 MPa), 50% enamel (18.18 ± 3.41 MPa), 40% enamel (17.83 ± 3.01 MPa) and 20% enamel (11.32 ± 3.42 MPa) group. The lowest SBS (9.63 ± 3.46 MPa) was detected in 0% enamel group. No significant difference was observed among the 40–100% enamel groups, while the 20% or 0% enamel group demonstrated a significantly lower mean SBS than the 40% enamel group (p < 0.05). Conclusion The SBS value of CLVs bonded to 100% enamel on the finishing surfaces (nearly 20 MPa) was twice that which bonded to 0% enamel (nearly 10 MPa). Bonding to 100% enamel is the most reliable treatment. When dentin exposure is inevitable, enamel should be preserved as much as possible to maintain good bonding. In addition, 40% of preserved enamel on the bonding surface was the minimal acceptable value to fulfil the requirements of good bonding strength.
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Affiliation(s)
- Jiakang Zhu
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd section, Chengdu, 610041, Sichuan, People's Republic of China
| | - Jing Gao
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd section, Chengdu, 610041, Sichuan, People's Republic of China
| | - Luming Jia
- BYBO Dental Hospital, Beijing, People's Republic of China
| | - Xin Tan
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd section, Chengdu, 610041, Sichuan, People's Republic of China
| | - Chenyang Xie
- Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd section, Chengdu, 610041, Sichuan, People's Republic of China.
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