Fracture toughness of 3D printed denture teeth.

BACKGROUND: Advances in digital dentistry lead to use of three-dimensional (3D) printed resin denture teeth. Fracture toughness of these teeth must be assessed. OBJECTIVE: This study aimed to compare the chipping and indirect tensile fracture resistance of denture teeth fabricated by 3D printing technique with traditionally fabricated resin denture teeth. METHOD: Four groups (Gr) were made (n= 50/group): Gr-1 3D printed denture teeth (denture teeth; Formlabs Inc., Somerville, MA, USA), Gr-2 SR-Orthosit-PE (Ivoclar Vivadent AG), Gr-3 Portrait IPN (Dentsply Sirona), Gr-4 Pala Premium 8 (Heraeus Kulzer GmbH). Stereolithography 3D printing was used to create the methacrylate-based photopolymerized resin teeth models and remaining group teeth were collected commercially. A 1 mm/min chipping and indirect tensile fracture speed tests were carried out till fracture occurred. The data so obtained were statistically analysed using one-way analysis of variance with Tukey's honestly significant difference multiple comparisons test (p< 0.05). At the end of the test, the fractured areas of the specimens were evaluated by the chief researcher to assess the fracture pattern of the teeth. RESULTS: The indirect tensile fracture values of the 3D printed teeth were more than that of Pala Premium-8 and SR-Orthosit-PE but it was lower than that of Portrait IPN teeth. In chipping test, buccal chipping of the loaded cusp was seen in 3D printed resin without distortion and in indirect tensile test in 3D printed resin teeth, line of fracture emerges near the loading point propagates from the inner incline of both cusps and extends cervically, unlike in other groups where first deformation occurs then fracture. CONCLUSION: Prosthetic teeth fabricated by the 3D printing technique using printable resin material provide adequate fracture resistance as denture teeth.

Novel CAD-CAM zirconia coping design to enhance the aesthetics and strength for anterior PLZ crowns.

BACKGROUND: The aesthetics and strength of anterior porcelain layered zirconia (PLZ) crowns are mainly affected by the zirconia (Zr) coping design. There is a need for a modified design to enhance aesthetics with strength. OBJECTIVES: The purpose of this study was to compare the fracture resistance of anterior PLZ crowns having modified CAD-CAM Zr coping designs (in terms of thickness and marginal collar designs) with standard Zr copings. METHODS: Fifty PLZ crowns were fabricated and divided into two groups: Gr 1: Standard Zr Coping (SZC) (control gr) with 0.5 mm thickness (Facial-F, Mesial-M, Distal-D, incisal-I, and Palatal-P) without a collar; Gr 2: Collar Zr Coping (CZC) (test gr) with 2.5 mm collar height on M, D, P and 0.2 mm F and variable facial wall thickness. Subgroups: Gr 2a: (CZC-0.5 mm) facial wall thickness 0.5 mm; Gr 2b: (CZC-0.4 mm) facial wall thickness 0.4 mm; Gr 2c: (CZC-0.3 mm) facial wall thickness 0.3 mm; Gr 2d: (CZC-0.2 mm) facial wall thickness 0.2 mm. The fracture load was determined and analysed using One-way ANOVA and Dunnet test. RESULTS: The minimum fracture load was 927.36 ± 127.80 N observed for Gr 2c (CZC at 0.3 mm) while the maximum fracture load was 1373.61 ± 146.54 N observed for Gr 2a (CZC at 0.5 mm). A highly significant difference in mean fracture load among various Zr coping groups (p< 0.001) was determined. CONCLUSIONS: Novel Zr coping design for anterior PLZ crowns can provide better aesthetics with strength. Reducing the thickness of Zr coping in the aesthetic zone to 0.2 mm and providing a modified collar design (2.5 mm collar height on M, D, P, and 0.2 mm F) would provide strength without jeopardizing aesthetics.

Analysis of surface conditioning methods on core-veneer bond strength of CAD/CAM zirconia restorations.

BACKGROUND: The increased strength of zirconia has resulted in its widespread application in clinical dentistry. Nevertheless, the fracture of veneering porcelains remains one of the key reasons of failure. OBJECTIVE: The objective of this study was to compare and analyze the influence of surface conditioning methods on the core-veneer bond strength of zirconia restorations. METHODS: Thirty specimens of zirconia core with sizes 10 × 5 × 5 mm were layered with porcelain of sizes 5 × 3 × 3 mm. On the basis of different surface conditioning methods, four groups were made: Group I: abrasion with airborne alumina particles of 110 µm size, Group II: sandblasting with silica coated alumina particles of 50 µm in size, Group III (modified group): alteration with a coating of zirconia powder prior to sintering, and Group IV (control group): metal core specimens. The shear force of all specimens was tested using a universal testing machine with a 0.5 mm/min crosshead speed. One-way analysis of variance (ANOVA) and Tukey's post hoc pair wise comparison (p= 0.05) were performed to analyze the shear bond strength. A scanning electron microscope was used to assess the fractured specimens. RESULTS: A statistically significant difference was noted between the groups. The mean value of shear bond strength was 40.25 MPa for Group I, 41.93 MPa for Group II, 48.08 MPa for Group III and 47.01 MPa for Group IV. CONCLUSIONS: The modified zirconia group and control group demonstrated a significantly higher mean bond strength than that of Group I, where airborne particle abrasion was used. The scanning electron microscope showed that cohesive fracture in the porcelain veneers was the main problem of failure in altered zirconia. The modified zirconia specimens in Group III demonstrated significantly improved values of shear bond strength.

Intricate Assessment and Evaluation of Long-term Implant Success as affected by Clinicomicrobial and Salivary Diagnostics in Type II Diabetic Patients: A Longitudinal Study.

INTRODUCTION: Replacement of missing teeth by dental implants is one of the most common methods employed these days. Because of significant advancement in the design of implants and modifications in the procedure of dental implant surgery, the survival rate of the dental implants has reached up to approximately 95%. Osseointegration is one of the important factors affecting the survival of dental implants. Apart from these, the body's physiologic alterations can also predispose the dental implants for failure. Diabetes is one such metabolic disease characterized by abnormal or delayed wound healing. Hence, we assessed the clinicomicrobial and salivary profile of diabetic patients undergoing rehabilitation by dental implants. MATERIALS AND METHODS: This study included diabetic patients who underwent dental implant surgeries for prosthetic rehabilitation. Follow-up records of the patients' up to 1 year were maintained. Various clinicoradiographic and periodontal parameters were measured at various time intervals during follow-up time; 25 mL of salivary and blood sample was taken from all the subjects and was sent to the laboratories for assessment of various salivary biomarkers. All the results were analyzed by Statistical Package for the Social Sciences software. RESULTS: The mean level of interleukin-p at baseline time was found to be 2.38 and 2.21 in diabetic group and control group respectively. While comparing the levels of osteoprotegerin in both study groups, a significant correlation was obtained. In diabetic and control group, 62 and 61 years was the mean age of the patients respectively. No significant correlation was obtained while comparing the microbial flora of diabetic and control group. CONCLUSION: In both diabetic and nondiabetic patients, similar microbial, salivary marker, and clinicoradiological patterns were seen. CLINICAL SIGNIFICANCE: Diabetic patients who maintain their body's metabolic rate show similar success rate of dental implants as seen in nondiabetic patients.