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Elmoselhy HAS, Hassanien OES, Haridy MF, Salam El Baz MAE, Saber S. Two‑year clinical performance of indirect restorations fabricated from CAD/CAM nano hybrid composite versus lithium disilicate in mutilated vital teeth. A randomized controlled trial. BMC Oral Health 2024; 24:101. [PMID: 38233771 PMCID: PMC10792922 DOI: 10.1186/s12903-023-03847-6] [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: 10/28/2023] [Accepted: 12/31/2023] [Indexed: 01/19/2024] Open
Abstract
TRIAL DESIGN This is a randomized, controlled, superiority, double-blinded, parallel-group, two-arms trial with an allocation ratio of 1:1. The aim of this trial was to compare the two-year clinical performance of partial indirect restorations fabricated from CAD/CAM nano-hybrid composite and ceramic lithium disilicate blocks using the modified USPHS criteria. METHODS In two parallel groups (n = 50 restorations), fifty participants having mutilated vital teeth with a minimum of two remaining walls were randomly enrolled in this trial and received indirect restorations of either nano-hybrid composite resin blocks (Brilliant, Coltene, Switzerland) or Lithium Disilicate (IPS Emax CAD). The restorations were assessed using modified USPHS criteria by two independent blinded assessors at baseline, six months, one-year and two years follow-up visits. Categorical and ordinal data were presented as frequencies and percentages. Categorical data were analyzed using the chi-square test. Ordinal data were analyzed using the Mann-Whitney U test for intergroup comparisons and Freidman's test followed by the Nemenyi post hoc test for intragroup comparisons. Numerical data were presented as mean and standard deviation values. They were analyzed for normality using the Shapiro-Wilk test. Data were found to be normally distributed and were analyzed using the independent t-test. The significance level was set at p ≤ 0.05 within all tests. RESULTS Forty-eight participants received the allocated intervention and completed the follow-up periods. There was a statistically significant difference between both tested materials for all USPHS criteria regarding Marginal integrity and Marginal discoloration at six-months Follow-up, but with no statistically significant difference at one- and two-year follow-up. CONCLUSIONS Both materials showed an acceptable, successful clinical performance along the two-years follow-up period. CLINICAL RELEVANCE The CAD/CAM nano-hybrid composite blocks are as reliable as Lithium disilicate for restoring mutilated vital teeth.
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Affiliation(s)
- Haneen Ahmad Shafik Elmoselhy
- Conservative Dentistry Department, Faculty of Dentistry, The British University in Egypt, Suez Desert Road El Sherouk City, Egypt
| | | | - Mohamed Fouad Haridy
- Conservative Dentistry, Faculty of Dentistry, Cairo University and The British University in Egypt, Suez Desert Road El Sherouk City, Egypt
| | | | - Shehabeldin Saber
- Endodontics, Faculty of Dentistry, Ain Shams University and The British University in Egypt, Suez Desert Road El Sherouk City, Egypt.
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Garoushi S, Barlas D, Vallittu PK, Uctasli MB, Lassila L. Fracture behavior of short fiber-reinforced CAD/CAM inlay restorations after cyclic fatigue aging. Odontology 2024; 112:138-147. [PMID: 37097420 PMCID: PMC10776750 DOI: 10.1007/s10266-023-00815-y] [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: 01/19/2023] [Accepted: 04/17/2023] [Indexed: 04/26/2023]
Abstract
The aim of this study was to assess the fracture behavior of molar teeth restored with MOD inlays made of experimental short fiber-reinforced CAD/CAM composite block (SFRC CAD) before and after cyclic fatigue aging. Standardized MOD cavities were prepared on 60 intact mandibular molars. Three groups of CAD/CAM made inlay restorations (Cerasmart 270, Enamic, and SFRC CAD) were fabricated (n = 20/group). All restorations were luted with self-adhesive dual-cure resin cement (G-Cem One). Half of restored teeth per each group (n = 10) were quasi-statically loaded until fracture without aging. The other half underwent cyclic fatigue aging for 500,000 cycles (Fmax = 150 N) before being loaded quasi-statically until fracture. Then, the fracture type was visually inspected. The microstructure and elemental content of CAD/CAM materials were assessed using SEM and EDS. Two-way analysis of variance (ANOVA) was used to statistically examine the data, and it was followed by the Tukey HSD test (α = 0.05). ANOVA demonstrated that both material type and aging had a significant effect (p < 0.05) on the load-bearing capacity values of the restorations. Teeth restored with SFRC CAD showed significantly the highest (p < 0.05) load-bearing capacity (2535 ± 830 N) after fatigue aging among all groups. SEM images showed the ability of short fibers in SFRC CAD composite to redirect and hinder crack propagation. With regard to fracture mode, Enamic group revealed 85% of catastrophic failure (vs. 45% and 10% for Cerasmart 270 and SFRC CAD, respectively). Large MOD cavities on molar teeth were most favorably restored with SFRC CAD inlays, yielding the highest load-bearing capacity and more restorable failures.
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Affiliation(s)
- S Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
| | - D Barlas
- Department of Restorative Dentistry, Faculty of Dentistry, University of Gazi, Ankara, Turkey
| | - P K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Wellbeing Services County of South-West Finland, Turku, Finland
| | - M B Uctasli
- Department of Restorative Dentistry, Faculty of Dentistry, University of Gazi, Ankara, Turkey
| | - L Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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Naik A, de Ataide IDN, Fernandes M. Fracture Resistance of Endodontically Treated Premolars Using Nanohybrid Composite, Fiber-Reinforced Composite, Horizontal Glass Fiber Posts, and Ceramic Inlays: An In Vitro Study. J Endod 2023; 49:1739-1746. [PMID: 37595683 DOI: 10.1016/j.joen.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION This study evaluated the resistance to fracture of endodontically treated premolars (ETPs) with mesio-occluso-distal (MOD) cavities filled with nanohybrid composite (NHC), fiber-reinforced composite (FRC), horizontal glass fiber posts (HFP), and ceramic inlays (CI). METHODS Eighty-four intact maxillary premolars were taken, and endodontic treatment was performed followed by MOD cavity preparations (except in the control group). They were distributed into 7 groups based on type of restoration: intact teeth (control group), ETP + MOD (not restored), NHC, FRC + NHC, HFP + NHC, FRC + HFP + NHC, and CI groups. Samples were subjected to universal testing machine until the fracture occurred and failure mode was visually inspected. RESULTS Mean and standard deviation of fracture resistance of the 7 groups ranged from 265.6 ± 68.0 N to 1023.7 ± 76.5 N. The highest reading was noted for intact teeth followed by FRC + HFP + NHC group and then the CI group, with no significant difference among the 3 groups. The lowest reading was noted for the ETP + MOD group. Maximum unrepairable fractures were seen in the ETP + MOD and CI groups. CONCLUSION FRC + HFP + NHC combination and CIs increased the resistance to fracture of ETPs significantly.
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Affiliation(s)
- Asmita Naik
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Ida de Noronha de Ataide
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Marina Fernandes
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India.
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Fathy H, Hamama HH, El-Wassefy N, Mahmoud SH. Effect of different surface treatments on resin-matrix CAD/CAM ceramics bonding to dentin: in vitro study. BMC Oral Health 2022; 22:635. [PMID: 36564766 PMCID: PMC9789622 DOI: 10.1186/s12903-022-02674-5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Evaluating the effect of different surface treatment methods on the micro-tensile bond strength (µTBS) of two different resin-matrix computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics (RMCs). METHODS A standardized inlay preparations were performed on 100 intact maxillary premolars. According to the type of the restorative material, the teeth were randomly divided into two equally sized groups (n = 50): (polymer-infiltrated ceramic (Vita Enamic) and resin-based composites (Lava Ultimate)). The inlays were fabricated using CAD/CAM technology. In each group, the specimens were randomly assigned to five subgroups (n = 10) according to the surface treatment method: group 1 used was the control group (no surface treatment); group 2, was treated with air abrasion with 50 μm Al2O3 (A) and universal adhesive (UA); group 3, was treated with air abrasion with 50 μm Al2O3 (A) and silane coupling agent (S); group 4, was treated with hydrofluoric acid (HF) and universal adhesive (UA) and group 5, was treated with Hydrofluoric acid (HF) + silane coupling agent (S). The inlays were then cemented to their respective preparations using dual-cure self-adhesive resin cement (RelyX U200, 3 M ESPE) according to the manufacturer's instructions. The µTBS test was conducted in all groups, and stereomicroscope and scanning electron microscope were used to inspect the failure mode. The data were statistically analyzed using a two-way analysis of variance (ANOVA) and Tukey's post-hoc multiple comparison tests at a significance level of p < 0.05. RESULTS Surface treatments significantly increased the µTBS of the materials compared to the control group (p < 0.05). For CAD/CAM RBCs, the µTBS value highest in group 2 whereas, for PICN, the µTBS value was highest in group 3. Cohesive failure of CAD/CAM restorative material was the most predominant mode of failure in all treated groups, whereas adhesive failure at restoration-cement interface was the most predominant failure mode in the control group. CONCLUSION Surface treatments increase the µTBS of resin-matrix CAD/CAM ceramics to tooth structure. Air abrasion followed by universal adhesive and hydrofluoric acid followed by silane application appears to be the best strategies for optimizing the bond strength of CAD/CAM RBCs and PICN respectively.
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Affiliation(s)
- Hanan Fathy
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
| | - Hamdi H Hamama
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.
| | - Noha El-Wassefy
- Dental Biomaterials Science Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Salah H Mahmoud
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
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Grassi EDA, de Andrade GS, Tribst JPM, Machry RV, Valandro LF, Ramos NDC, Bresciani E, Saavedra GDSFA. Fatigue behavior and stress distribution of molars restored with MOD inlays with and without deep margin elevation. Clin Oral Investig 2021; 26:2513-2526. [PMID: 34643807 DOI: 10.1007/s00784-021-04219-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/10/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study evaluated the effect of deep margin elevation (DME) and restorative materials (leucite-reinforced glass-ceramics [C] vs. indirect resin composite [R]) on the fatigue behavior and stress distribution of maxillary molars with 2-mm deep proximal margins restored with MOD inlay. METHODS Fifty-two extracted human third molars were randomly assigned into four groups (n = 13): C; DME + C; R; and DME + R. Inlays were fabricated in CAD-CAM and bonded to all teeth. The fatigue behavior was assessed with the stepwise stress test (10,000 cycles/step; step = 50 N; 20 Hz; initial load = 200 N). Fatigue failure loads and the number of cycles were analyzed with 2-way ANOVA and Tukey's test (p < 0.05) and Kaplan-Meier survival plots. The stress distribution was assessed with finite element analysis. The models were considered isotropic, linear, and homogeneous, and presented bonded contacts. A tripod axial load (400 N) was applied to the occlusal surface. The stress distribution was analyzed with the maximum principal stress criterion. RESULTS For fatigue, there was no difference for DME factor (p > 0.05). For the material factor, the load and number of cycles for failure were statistically higher in the R groups (p < 0.05). The finite element analysis showed that resin composite inlays concentrated more stress in the tooth structure, while ceramic inlays concentrated more stress in the restoration. Non-reparable failures were more frequent in the resin composite inlays groups. CONCLUSIONS DME was not negative for fatigue and biomechanical behaviors. Resin composite inlays were more resistant to the fatigue test, although the failure mode was more aggressive. CLINICAL SIGNIFICANCE DME does not impair mechanical behavior. Resin composite inlays failed at higher loads but with a more aggressive failure mode.
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Affiliation(s)
- Elisa Donaria Aboucauch Grassi
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), 777th Eng. Francisco José Longo Av., São José dos Campos, SP, 12245-000, Brazil
| | - Guilherme Schmitt de Andrade
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), 777th Eng. Francisco José Longo Av., São José dos Campos, SP, 12245-000, Brazil
| | - João Paulo Mendes Tribst
- Post-Graduate Program in Dentistry, University of Taubaté (UNITAU), 09th Rua Dos Operários St., Taubaté, SP, 12020-340, Brazil
| | - Renan Vaz Machry
- Graduate Program of Oral Science, Prosthodontics Unit, School of Dentistry, Federal University of Santa Maria (UFSM), Roraima Av, Santa Maria, RS, 100097105-340, Brazil
| | - Luiz Felipe Valandro
- Graduate Program of Oral Science, Prosthodontics Unit, School of Dentistry, Federal University of Santa Maria (UFSM), Roraima Av, Santa Maria, RS, 100097105-340, Brazil
| | - Nathalia de Carvalho Ramos
- School of Dentistry, São Francisco University (USF), 218th São Francisco de Assis Av., Bragança Paulista, SP, 12916-900, Brazil
| | - Eduardo Bresciani
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), 777th Eng. Francisco José Longo Av., São José dos Campos, SP, 12245-000, Brazil
| | - Guilherme de Siqueira Ferreira Anzaloni Saavedra
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), 777th Eng. Francisco José Longo Av., São José dos Campos, SP, 12245-000, Brazil.
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Eltoukhy RI, Elkaffas AA, Ali AI, Mahmoud SH. Indirect Resin Composite Inlays Cemented with a Self-adhesive, Self-etch or a Conventional Resin Cement Luting Agent: A 5 Years Prospective Clinical Evaluation. J Dent 2021; 112:103740. [PMID: 34233204 DOI: 10.1016/j.jdent.2021.103740] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to clinically evaluate the 5-years clinical performance of indirect resin composite inlays luted with three different resin cement strategies in MOD Class II restorations. MATERIALS AND METHODS A randomized clinical trial was conducted following CONSORT guidelines. Forty patients with three large cavities indicated for indirect MOD Class II restorations were enrolled in the current study. Then, 120 indirect resin composite inlay restorations (SR Nexco) were placed and luted with three different resin cement strategies (n=40); an etch-and-rinse (Variolink N), self-etch (Panavia F2.0) and self-adhesive (RelyX Unicem). These restorations were evaluated to the periods of 1 week (baseline), 1, 3 and 5 years using modified USPHS criteria. Statistical analyses were performed with Wilcoxon and Friedman tests with level of significance set at 0.05. RESULTS The outcome of the clinical trial showed that, there was neither loss of restorations nor recurrent caries after 5 years for all luting cements groups. Both self-etch Panavia F2.0 and self-adhesive RelyX Unicem resin cements exhibited significant differences between the evaluation periods regarding to marginal discoloration and marginal adaptation (p=0.03). At baseline, only 8 cases of etch-and-rinse (Variolink N) resin cement group exhibited post-operative sensitivity which were relieved after short time (p=0.04). CONCLUSION All the three resin cement strategies tested, showed acceptable clinical performance after 5-years recall period. In time, etch-and-rinse resin cement group showed better clinical performance regarding marginal discoloration and marginal adaptation at 5-years recall period. Clinical Relevance statement:In vitro and in vivo studies reveal contradictory evidence of the clinical performance of indirect resin composite inlays luted with different resin cement strategies. Thus, this study revealed that etch-and-rinse resin cement still has the best prognosis for adhesive luting of indirect resin composite inlays.
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Affiliation(s)
- Radwa I Eltoukhy
- Operative Dentistry Dept., Faculty of Dentistry, Mansoura University, Algomhoria Street, Mansoura, Aldakhlia, Egypt Po (box) 35516.
| | - Ali A Elkaffas
- Operative Dentistry Dept., Faculty of Dentistry, Mansoura University, Algomhoria Street, Mansoura, Aldakhlia, Egypt Po (box) 35516.
| | - Ashraf I Ali
- Operative Dentistry Dept., Faculty of Dentistry, Mansoura University, Algomhoria Street, Mansoura, Aldakhlia, Egypt Po (box) 35516.
| | - Salah H Mahmoud
- Operative Dentistry Dept., Faculty of Dentistry, Mansoura University, Algomhoria Street, Mansoura, Aldakhlia, Egypt Po (box) 35516.
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Dejak B, Młotkowski A. A comparison of mvM stress of inlays, onlays and endocrowns made from various materials and their bonding with molars in a computer simulation of mastication - FEA. Dent Mater 2020; 36:854-864. [PMID: 32473834 DOI: 10.1016/j.dental.2020.04.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/14/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The purpose of the study was to compare the mvM stresses occurring in inlays, onlays and endocrowns made from different materials and their bonding with molars in a computer simulation of mastication. METHODS The study was conducted using the finite elements method with contact elements. Sixteen 3D first molar models were created of a intact tooth - T; a tooth with a ceramic inlay - IN; a tooth with an onlay - ON; and a tooth with an endocrown - EN. The restorations were made of: Comp - resin nanoceramic; Hc - hybrid ceramic; Le - leucite ceramic; Dlit - lithium disilicate; and Zr - zirconia. Computer simulations of mastication were performed. The equivalent stresses according to the modified von Mises criterion (mvM) were calculated in model materials and contact stresses at the interface cement-dental tissue around the examined restorations. RESULTS The highest equivalent mvM stresses were concentrated in buccal margins of inlays. The mvM stresses recorded in onlays were 1.6-5 times lower than those found in inlays, while in endocrowns they were 2.3-6.5 times lower. Around the onlays and endocrowns, in tooth structures and luting cement, mvM stresses were significantly lower compared to teeth restored with inlays. The tensile and shear contact stresses between inlays and teeth were several times lower than under another restorations. The highest stresses (58.5MPa) occurred in the zirconia inlay. The stresses observed in the enamel of a tooth restored with an INZr inlay were half those noted in INComp, and a third of those observed in cement. Tensile contact stresses at the interface between the INZr inlay and dental tissue were 4.5 times lower than in the INComp, and the shear stresses were more than 7 times lower. SIGNIFICANCE The highest values and unfavorable of stress levels occurred in teeth restored with inlays. Cavities MOD in molars should be reconstructed with cusp-covering restorations. The endocrown in molars should withstand physiological loading. The higher the modulus of elasticity of the restoration material, the higher the stresses in the restorations, while the lower stresses were observed in the tooth structures, luting cement and at the interface between the restoration and the dental tissue. Ceramic restorations should provide better protection and marginal seal of the reconstructed tooth than composite ones.
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Affiliation(s)
- Beata Dejak
- Department of Prosthetic Dentistry, Medical University of Łódź, Łódź, Poland.
| | - Andrzej Młotkowski
- Department of Strength of Materials and Structures, Technical University of Łódź, Łódź, Poland
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Yu P, Xiong Y, Zhao P, Xu Z, Yu H, Arola D, Gao S. On the wear behavior and damage mechanism of bonded interface: Ceramic vs resin composite inlays. J Mech Behav Biomed Mater 2019; 101:103430. [PMID: 31557660 DOI: 10.1016/j.jmbbm.2019.103430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 07/25/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 02/05/2023]
Abstract
Advances in adhesive technologies have increased indications for the use of inlays. Decrease in the bonded interface integrity due to wear has been cited as the main cause of its failure. However, this process of interface degradation and the influence of inlay material on damage mechanism appear to be poorly understood. Thus, we aimed to compare the wear behavior and interface damage between ceramic and resin composite inlays bonded to enamel under sliding contact and use the experimental findings to support recommendation of the appropriate inlay material. Bonded interface specimens involving tooth enamel and either ceramic or resin composite inlays were prepared and subjected to reciprocating wear tests up to 5×104 cycles. The wear track profiles and morphologies were characterized after increments of cyclic sliding contact using white light interferometry and scanning electron microscopy, respectively. Optical microscopy was used to evaluate sub-surface cracks and their propagation within the samples. A finite element analysis was used to analyze the stress distributions of the bonded interfaces. Composite inlays showed higher wear depth than the ceramic in the early stage (N ≤ 5×102 cycles), while no significant difference was found at the later stage. For ceramic inlay a greater portion of the contact load was concentrated in the ceramic structure, which facilitated cracks and chipping of the ceramic inlay, with rather minimal damage in the adjacent interface and enamel. In contrast, for the resin composite inlay there was larger stress concentrated in the adjacent enamel, which caused the development of cracks and their propagation to the inner enamel. The restoration material could contribute to the stress distribution and extent of damage within enamel-inlay bonded interfaces. A tough ceramic appears to be more effective at protecting the residual dental tissue.
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Affiliation(s)
- Ping Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuhuan Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peng Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhou Xu
- Shanghai Putuo District Eye & Tooth Disease Control and Prevention Hospital, Shanghai, China
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dwayne Arola
- Department of Materials Science and Engineering, University of Washington, Seattle, WA, USA; Departments of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA; Departments of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Shanshan Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Fuchs A, Häussermann P, Hömig D, Ochs BG, Müller CA, Helwig P, Konstantinidis L. [5-year follow-up of 210 Columbus knee prostheses : A prospective multicentre study]. Orthopade 2019; 47:859-866. [PMID: 29947877 DOI: 10.1007/s00132-018-3587-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION As part of 10-year documentation using the Columbus system, the interim evaluation was carried out 5 years after implantation with a collection of clinical scores, evaluation of radiological imaging and collection of statistics concerning complications. METHODS There was a multicentre prospective recruitment of consecutive patients with the indication of implantation of a surface replacement prosthesis (Columbus CR, Deep Dish fixed inlay). Preoperatively, clinical scores were recorded (KSS and Oxford score). Five years postoperatively a new evaluation of clinical scores, the range of motion (ROM) and a radiological check-up including full leg imaging under load was performed. During this period, detailed complication documentation was made. RESULTS A total of 210 patients were recruited in five centres. 187 patients were available for examination 5 years after surgery. Cumulative KSS increased from 87.5 (±26.6) preoperatively to 170 (±29.1) 5 years postoperatively. The cumulative KSS improvement was 81.5 (±35.2) points and was highly significant (p < 0.0001; t‑test). The average functional improvement in the Oxford score between the preoperative and 5‑year follow-up was 21.7 (±8.8) points and was also highly significant (p < 0.0001). The ROM improved from 106.3° (±20.2) preoperatively to 114.0° (±12.1) 5 years postoperatively (p < 0.0001; t test). Five years after implantation, the average mechanical leg axis was 178.0° (±2.1). There was no clinically apparent or native radiologic visible aseptic loosening of the femoral or tibial joint component. There were 33 complications, but no implant-related complications such as inlay dislocation, material fracture or aseptic loosening. In total, 6 revision surgeries were performed during the follow-up period, which corresponds to a survival rate of 97.1% (CI 95%) for the implanted Columbus knee in the present patient collective for 5 years. CONCLUSION The interim analysis at 5 years of long-term observation of the Columbus system provided good clinical and radiographic results.
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Affiliation(s)
- Andreas Fuchs
- Klinik für Orthopädie und Unfallchirurgie, Klinikum der Albert-Ludwigs-Universität Freiburg, Hugstetter Straße 55, 79016, Freiburg, Deutschland.
| | - Philip Häussermann
- Klinik für Orthopädie und Unfallchirurgie, Sana Kliniken Leipziger Land, Borna, Deutschland
| | - Dirk Hömig
- Klinik für Orthopädie, Spezielle Orthopädische Chirurgie, Ortenau Klinikum Offenburg-Gengenbach, Gengenbach, Deutschland
| | - Björn Gunnar Ochs
- Klinik für Orthopädie und Unfallchirurgie, Klinikum der Albert-Ludwigs-Universität Freiburg, Hugstetter Straße 55, 79016, Freiburg, Deutschland
| | - Christof A Müller
- Klinik für Unfall‑, Hand- und Orthopädische Chirurgie, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe, Deutschland
| | - Peter Helwig
- Klinik für Orthopädie und Unfallchirurgie, Klinikum Heidenheim, Heidenheim, Deutschland
| | - Lukas Konstantinidis
- Klinik für Orthopädie und Unfallchirurgie, Klinikum der Albert-Ludwigs-Universität Freiburg, Hugstetter Straße 55, 79016, Freiburg, Deutschland
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Collares K, Corrêa MB, Laske M, Kramer E, Reiss B, Moraes RR, Huysmans MC, Opdam NJ. A practice-based research network on the survival of ceramic inlay/onlay restorations. Dent Mater 2016; 32:687-94. [PMID: 26975695 DOI: 10.1016/j.dental.2016.02.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 12/23/2015] [Accepted: 02/24/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate prospectively the longevity of ceramic inlay/onlay restorations placed in a web-based practice-based research network and to investigate risk factors associated with restoration failures. MATERIALS AND METHODS Data were collected by a practice-based research network called Ceramic Success Analysis (CSA). 5791 inlay/onlay ceramic restorations were placed in 5523 patients by 167 dentists between 1994 and 2014 in their dental practices. For each restoration specific information related to the tooth, procedures and materials used were recorded. Annual failure rates (AFRs) were calculated and variables associated with failure were assessed by a multivariate Cox-regression analysis with shared frailty. RESULTS The mean observation time was 3 years (maximum 15 years) of clinical service, and AFRs at 3 and 10 years follow up were calculated as 1.0% and 1.6%. Restorations with cervical outline in dentin showed a 78% higher risk for failure compared to restorations with margins in enamel. The presence of a liner or base of glass-ionomer cement resulted in a risk for failure twice as large as that of restorations without liner or base material. Restorations performed with simplified adhesive systems (2-step etch-and-rinse and 1-step self-etch) presented a risk of failure 142% higher than restorations performed with adhesives with bonding resin as a separate step (3-step etch-and-rinse and 2-step self-etch). 220 failures were recorded and the most predominant reason for failure was fracture of the restoration or tooth (44.5%). CONCLUSIONS Ceramic inlay/onlay restorations made from several glass ceramic materials and applied by a large number of dentists showed a good survival. Deep cervical cavity outline, presence of a glass ionomer lining cement, and use of simplified adhesive systems were risk factors for survival.
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Khalil AA, Abdelaziz KM. Bonding values of two contemporary ceramic inlay materials to dentin following simulated aging. J Adv Prosthodont 2015; 7:446-53. [PMID: 26816574 PMCID: PMC4722148 DOI: 10.4047/jap.2015.7.6.446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 05/05/2015] [Revised: 09/27/2015] [Accepted: 10/29/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To compare the push-out bond strength of feldspar and zirconia-based ceramic inlays bonded to dentin with different resin cements following simulated aging. MATERIALS AND METHODS Occlusal cavities in 80 extracted molars were restored in 2 groups (n=40) with CAD/CAM feldspar (Vitablocs Trilux forte) (FP) and zirconia-based (Ceramill Zi) (ZR) ceramic inlays. The fabricated inlays were luted in 2 subgroups (n=20) with either etch-and-bond (RelyX Ultimate Clicker) (EB) or self-adhesive (RelyX Unicem Aplicap) (SA) resin cement. Ten inlays in each subgroup were subjected to 3,500 thermal cycles and 24,000 loading cycles, while the other 10 served as control. Horizontal 3 mm thick specimens were cut out of the restored teeth for push out bond strength testing. Bond strength data were statistically analyzed using 1-way ANOVA and Tukey's comparisons at α=.05. The mode of ceramic-cement-dentin bond failure for each specimen was also assessed. RESULTS No statistically significant differences were noticed between FP and ZR bond strength to dentin in all subgroups (ANOVA, P=.05113). No differences were noticed between EB and SA (Tukey's, P>.05) bonded to either type of ceramics. Both adhesive and mixed modes of bond failure were dominant for non-aged inlays. Simulated aging had no significant effect on bond strength values (Tukey's, P>.05) of all ceramic-cement combinations although the adhesive mode of bond failure became more common (60-80%) in aged inlays. CONCLUSION The suggested cement-ceramic combinations offer comparable bonding performance to dentin substrate either before or after simulated aging that seems to have no adverse effect on the achieved bond.
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Affiliation(s)
- Ashraf Abdelfattah Khalil
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia.; Department of Crown and Bridge, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Khalid Mohamed Abdelaziz
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Zarrati S, Mahboub F. Marginal adaptation of indirect composite, glass-ceramic inlays and direct composite: an in vitro evaluation. J Dent (Tehran) 2010; 7:77-83. [PMID: 21998779 PMCID: PMC3184745] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2009] [Accepted: 11/23/2009] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This experimental in vitro study compared marginal adaptation of indirect composite, glass-ceramic inlays and direct composite. MATERIALS AND METHODS Seventy-five recently extracted human molars were randomly divided into three groups (n=25) and mesio-occluso-distal cavities with the same dimensions were prepared in the teeth. Indirect composite and glass-ceramic inlays were fabricated following manufacturer's instructions and the marginal gap was measured by a stereomicroscope at magnification 40× before cementation. After cementation of inlays and restoring the third group by direct composite, all the specimens were thermocycled and the marginal gaps were measured exactly as previously described. Repeated measure ANOVA and post-hoc Tukey test were used for pairwise comparison of occlusal, proximal, and gingival marginal gaps in each group. One-way ANOVA and post-hoc Tukey test were used for comparison of mean marginal gap in the three groups and for comparison of marginal gap before and after cementation in inlays, paired T-test was used. RESULTS The marginal gap of direct composite (19.96 μm) was significantly lower than that of indirect composite inlay (48.47 μm), which in itself was significantly lower than that of glass-ceramic inlay (60.96 μm). In all the restorations, marginal gap in the gingival margin was significantly higher than occlusal and proximal margins. The marginal gap of inlays did not change after cementation and thermocycling. CONCLUSION This study indicated that the marginal gaps of the evaluated restorations are less than 100 μm, which is clinically acceptable.
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Affiliation(s)
- S. Zarrati
- Assistant Professor, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran,Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - F. Mahboub
- Assistant Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding author: F. Mahboub, Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
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