Effect of storage time on chemical structure of a single-bottle and a two-bottle experimental ceramic primer and micro-shear bond strength of composite to ceramic.

PURPOSE: This study assessed the effect of storage time on chemical structure of a single-bottle and a two-bottle experimental ceramic primer and micro-shear bond strength (µSBS) of composite to ceramic. MATERIALS AND METHODS: This study was conducted on 60 sintered zirconia and 60 feldspathic porcelain blocks. Half of the specimens (n = 30) were subjected to surface treatment with the single-bottle Clearfil ceramic primer (n = 15) and two-bottle experimental primer (n = 15) after 24 hours. The remaining half received the same surface treatments after 6 months storage in distilled water. Composite cylinders were bonded to the ceramics, and they were then subjected to µSBS test. Also, the primers underwent Fourier-transform infrared spectroscopy (FTIR) after 24 hours and 6 months to assess their chemical structure. Data were analyzed with 3-way ANOVA and adjusted Bonferroni test (alpha = 0.05). RESULTS: The µSBS of both ceramics significantly decreased at 6 months in one-bottle ceramic primer group (P = .001), but it was not significantly different from the two-bottle experimental primer group (P = .635). FTIR showed hydrolysis of single-bottle primer, cleavage of silane and 10-MDP bonds, and formation of siloxane bonds after 6 months. CONCLUSION: Six months of storage caused significant degradation of single-bottle ceramic primer, and consequently had an adverse effect on µSBS.

Optimization of hydrothermal autoclaving parameters for the synthesis of porous ceramics from porcelain tile polishing residue.

Porous ceramics were synthesized using porcelain tile polishing residue (PTPR) and slaked lime (Ca(OH)2) as a reinforcing agent through a hydrothermal autoclaving method. The process parameters, including the quantity of slaked lime added, the hydrothermal autoclaving temperature, and the reaction duration, were optimized meticulously. The composition, structure, thermal and physical properties of the samples were thoroughly analyzed via Brunauer-Emmett-Teller (BET) measurements, powder X-ray diffraction (PXRD), and scanning electron microscopy (SEM). The results indicated that the incorporation of slaked lime and hydrothermal autoclaving led to the formation of calcium silicate hydrate, which corresponded with an enhancement in the strength of the sample. Notably, when the quantity of slaked lime added was optimized at 30 wt%, the formation of tobermorite (5CaO·6SiO2·5H2O) was detected. At a hydrothermal autoclaving temperature of 150 °C, the formation of only sheet-like calcium silicate hydrate was observed. In contrast, at an elevated temperature of 180 °C and 210 °C, needle-like tobermorite was successfully synthesized. The porous ceramic with the most favorable structure was obtained through autoclaving at 180 °C for 10 h with 30 wt% slaked lime, exhibiting a total pore volume of 0.11 mL/g, a specific surface area of 26.35 m2/g, and a mesoporous volume fraction of 90.40%.

Functionally graded bi-material interface for Porcelain Veneered Zirconia dental crowns: A study using viscoelastic finite element analysis.

OBJECTIVES: During the manufacturing of Porcelain Veneered Zirconia (PVZ) dental crowns, the veneer-core system undergoes high-temperature firing cycles and gets fused together which is then, under a controlled setting, cooled down to room temperature. During this cooling process, the mismatch in thermal properties between zirconia and porcelain leads to the development of transient and residual thermal stresses within the crown. These thermal stresses are inherent to the PVZ dental crown systems and render the crown structure weak, acting as a precursor to veneer chipping, fracture, and delamination. In this study, the introduction of an intermediate functionally graded material (FGM) layer at the bi-material interface is investigated as a potentially viable alternative for providing a smoother transition of properties between zirconia and porcelain in a PVZ crown system. METHODS: Anatomically correct 3D crown models were developed for this study, with and without the FGM layer modeled at the bi-material interface. A viscoelastic finite element model was developed and validated for an anatomically correct bilayer PVZ crown system which was then used for predicting residual and transient stresses in the bilayer PVZ crown. Subsequently, the viscoelastic finite element model was further extended for the analysis of graded sublayers within the FGM layer, and this extended model was used for predicting the residual and transient stresses in the functionally graded PVZ crown, with an FGM layer at the bi-material interface. RESULTS: The study showed that the introduction of an FGM layer at the bi-material interface has the potential to reduce the effects from transient and residual stresses within the PVZ crown system relative to a bilayer PVZ crown structure. Furthermore, the study revealed that the FGM layer causes stress redistribution to alleviate the stress concentration at the interfacial surface between porcelain and zirconia which can potentially enhance the durability of the PVZ crowns towards interfacial debonding or fracture. SIGNIFICANCE: Thus, the use of an FGM layer at the bi-material interface shows a good prospect for enhancing the longevity of the PVZ dental crown restorations by alleviating the abrupt thermal property difference and relaxing thermal stresses.

Hazardous element inertisation in vitrified silicate ceramics: Effect of different matrices.

The ceramic industry is a production sector that can efficiently recycle its own processing residues, achieving a reuse index of almost 100%. Recently, the range of waste from other industrial sectors that can be used as secondary raw materials in ceramic bodies has expanded. However, such an expansion potentially introduces hazardous components. This study aimed to quantitatively assess the efficiency of inertising hazardous elements (HEs) through ceramisation. The ceramics were characterised through XRPD, SEM-EDS and leaching tests to determine their leaching behaviour and the mechanisms of element immobilisation in neoformation phases during the ceramisation process. The results indicate high immobilisation efficiency for Ba, Co, Cr, Cu, Pb, Sb, Sn and Zn. However, Mo is the main element of concern owing to its poor retention in ceramic bodies. This is likely due to the formation of oxyanionic complexes that are difficult to immobilise in silicate matrices. In addition, the ceramic bodies exhibit substantial differences that appear to be associated with variations in pseudo-structural components and the degree of polymerisation of their vitreous phase.

Chemical etching of CAD-CAM glass-ceramic-based materials using fluoride solutions for bonding pretreatment.

The surface treatment of glass-ceramic-based materials, namely, lithium disilicate glass (IPS e.max CAD), feldspar porcelain (VITABLOCS Mark II), and a polymer-infiltrated ceramic network (VITA ENAMIC), using aqueous fluoride solutions and their influence on luting agent bonding were investigated. Six experimental aqueous fluoride solutions were applied to these materials, and their effects were assessed by surface topological analysis. The obtained results were compared using non-parametric statistical analyses. Ammonium hydrogen fluoride (AHF) etchant demonstrated the greatest etching effect. Subsequent experiments focused on evaluating different concentrations of the AHF etchant for the bonding pretreatment of glass-ceramic-based materials with a luting agent (PANAVIA V5). AHF, particularly at concentrations above 5 wt%, effectively roughened the surfaces of the materials and improved the bonding performance. Notably, AHF at a concentration of 30 wt% exhibited a more pronounced effect on both etching and bonding capabilities compared to hydrofluoric acid.

Full-ceramic resin-bonded fixed dental prostheses: A systematic review.

Despite the development of implant-supported prostheses, there are still patients for whom conservative treatments such as resin-bonded fixed dental prostheses (RBFDPs) are more appropriate. This study's objective was to analyze the available research on full-ceramic RBFDPs. In this study, Web of Science, MEDLINE/PubMed, Scopus, Embase, Cochrane Library, and Google Scholar databases were searched for articles published in English between 2010 and 2020. A total of 14 studies were reviewed based on the eligibility criteria. The results showed that using a cantilever design with one abutment had an advantage over two abutments. Additionally, it was proposed that preparations designed with retentive aids, such as a proximal box, groove, and pinhole, could improve RBFDP survival rates. IPS e.max ZirCAD, In-Ceram alumina, and zirconia CAD/CAM were the most commonly used framework materials. Most studies used air abrasion, salinization, or hydrofluoric acid for surface treatment. Adhesive resin cements were the most frequently used type of cement. The survival rate of In-Ceram ceramics (85.3%-94.8%) was lower than that of In-Ceram zirconia and IPS e.max ZirCAD. Debonding, followed by framework fracture, was the leading cause of failure. Following 3-10 years follow-up, the survival percentage of all-ceramic RBFDPs ranged from 76% to 100%. Although RBFDPs have demonstrated satisfactory success as a conservative treatment, long-term follow-ups and higher sample sizes in clinical research are required to gain more reliable outcomes on the clinical success rate of various RBFDP designs.

Design of robotic arm for the porcelain bushing in substation.

With the development and the application popularization of artificial intelligence robot technology and 5G technology, a robotic arm is designed and developed for rinsing porcelain bushing in high voltage substation in this paper. Firstly, the components and implementation of robotic arm are presented, subsequently, a circular cleaning structure with a 120-degree split is proposed to rinse the porcelain bushing. Secondly, a two-stage simple and effective method to realize automatic orientation is proposed utilizing photoelectric switches. Moreover, a prototype of robotic arm with control system is developed based on the regime switching function, and the result of edge computing is transmitted by 5G technology. Finally, feasibility and effectiveness of the robotic arm are verified in the Nanjing power grid. The case study manifests that the robotic arm developed by the proposed method in the paper can achieve efficient rinsing and all the corresponding information can be transmitted preciously. The proposed method lays a foundation for wide application of cleaning robot in high voltage substation.

Investigation of the Surface Roughness and Hardness of Different Denture Teeth Materials: An In vitro Study.

Background: Surface roughness and hardness are key factors that influence the clinical performance and durability of denture teeth. Understanding variations in these properties among different denture teeth materials can assist in selecting the most suitable materials for optimal patient outcomes. This study aimed to investigate the surface roughness and hardness of four commonly used denture teeth materials: acrylic resin, composite resin, porcelain, and nanohybrid composite. Materials and Methods: Ten specimens were prepared for each denture teeth material, resulting in a total of 40 specimens. Surface roughness was assessed using a profilometer, and measurements were recorded in micrometers (µm). Hardness was determined using a Vickers hardness tester, and results were expressed as Vickers hardness numbers (VHN). The surface roughness and hardness data were analyzed using appropriate statistical tests (e.g., analysis of variance), with significance set at P < 0.05. Results: The results revealed significant differences in both surface roughness and hardness among the different denture teeth materials (P < 0.05). Acrylic resin exhibited the highest surface roughness (mean ± standard deviation: 3.45 ± 0.78 µm) and the lowest hardness (mean ± standard deviation: 45.6 ± 2.3 VHN). Composite resin demonstrated intermediate values of surface roughness (mean ± standard deviation: 1.87 ± 0.54 µm) and hardness (mean ± standard deviation: 65.2 ± 3.9 VHN). Porcelain demonstrated the smoothest surface (mean ± standard deviation: 0.94 ± 0.28 µm) and the highest hardness (mean ± standard deviation: 78.5 ± 4.1 VHN). Nanohybrid composite displayed surface roughness and hardness values similar to composite resin. Conclusion: This study demonstrated significant variations in surface roughness and hardness among the different denture teeth materials evaluated. Acrylic resin exhibited the roughest surface and lowest hardness, while porcelain demonstrated the smoothest surface and highest hardness. Composite resin and nanohybrid composite exhibited intermediate values. These findings provide valuable insights for prosthodontic practitioners in selecting denture teeth materials based on specific clinical requirements, aiming to achieve optimal aesthetics, reduced plaque accumulation, and improved wear resistance.

The effect of porcelain filler particulates madar fiber reinforced epoxy composite - A comprehensive study for biomedical applications.

Environmental consciousness motivates scientists to devise an alternative method for producing natural fiber composite materials in order to decrease the demand for synthetic fibers. This study explores the potential of a novel composite material derived from madar fiber-reinforced epoxy with porcelain filler particulates, designed specifically for biomedical instrumentation applications. The primary focus is to assess the material's structural, mechanical, and antibacterial properties. X-ray Diffraction analysis was employed to discern the crystalline nature of the composite, revealing enhanced crystallinity due to the inclusion of porcelain particulates. Fourier-Transform Infrared Spectroscopy confirmed the chemical interactions and bonding mechanisms between madar fiber, epoxy matrix, and porcelain filler. Mechanically, the composite exhibited superior properties when addition of porcelain fillers, maximum results obtain in tensile strength of 51.28 MPa, flexural strength of 54.21 MPa, and impact strength of 0.0155 kJ/m2, making it ideal for robust biomedical applications. Scanning Electron Microscopy provided detailed insights into the morphology and distribution of the reinforcing agents within the epoxy matrix, emphasizing the fibrillated structure of madar fiber and the uniform dispersion of porcelain particulates. Importantly, antibacterial assays demonstrated the composite's potential resistance against common pathogenic bacteria, which is crucial for biomedical instrumentation. Collectively, this research underscores the promising attributes of the madar fiber reinforced epoxy composite with porcelain particulates, suggesting its suitability for advanced biomedical applications.

Comparative life cycle analysis between commercial porcelain stoneware and new ones designed by using volcanic scraps.

To achieve carbon neutrality by 2050, many companies have started implementing sustainability policies. The aim of this work, as result of collaboration between Universities and companies, is to assess the environmental impacts associated with the production of alternative formulations of porcelain stoneware. The proposed formulations contain extraction scraps and chamotte and have promising technological properties. A comparative analysis of the life cycle in three different scenarios was carried out to assess the environmental footprint of the final products. The analyzed scenarios were a glazed porcelain stoneware (which was taken as a reference and is commercially available), a porcelain stoneware containing pumice scraps, and one containing volcanic lapillus scraps. It was observed that the transportation of raw materials has the largest environmental impact, followed by the production and extraction of the raw materials themselves. From the performed analysis, it was possible to observe that by replacing the currently used materials by the ones hereby studied, environmental benefits can be obtained. In particular, depending on the considered pollutant, the environmental impact can be reduced between a minimum of about 8 % (Freshwater Aquatic Ecotoxicity category) to a maximum of 48 % (Acidification category). In a time when raw materials supply is difficult, the use of scraps, which would otherwise be disposed of, is particularly interesting and can lead to the production of an environmentally friendly product.

Clinical evaluation of posterior zirconia-based and porcelain-fused-to-metal crowns with a vertical preparation technique: an up to 5-year retrospective cohort study.

OBJECTIVE: To evaluate the clinical conditions of single-unit posterior restorations on teeth prepared without finishing line, after 5.6 years of clinical service. MATERIALS AND METHODS: 50 crowns (25 zirconia-based (Zr) and 25 porcelain-fused-to-metal (PFM)) were selected from 34 patients. The restorations were evaluated according to the California Dental Association (CDA) Quality Criteria, and periodontal variables were studied in the abutment teeth compared with the unrestored contralateral teeth. Variables were examined using Mann-Whitney and Pearson´s Chi-Square tests (α = 0.05). The success of the prosthesis was calculated using Kaplan-Meier test. RESULTS: CDA Quality Criteria was considered satisfactory-excellent in all restorations except for one of them, due to chipping on a PFM crown. At, 66 months, the success rates for PFM and Zr crowns were 85.7 % and 100 %, respectively. The plaque index (PI) showed that the restored abutment teeth accumulated significantly less plaque than the control teeth, but the gingival index (GI) was statistically higher in the abutment teeth. In 80 % of cases the probing depth (PB) was ≤3 mm. In addition, in 21 % of the cases, gingival recession was less than 2 mm. The restoration material had a statistically significant effect on GI and PB, with Zr crowns showing less inflammation and less deep pockets than PFM restorations. On the contrary, greater gingival recession was found at the margins of the Zr crowns when compared to the PFM. No statistical differences were found between the two materials in the GI. CONCLUSIONS: Cemented crowns on vertical preparations show good clinical behavior after 5 years. The periodontal parameters (PI, GI, PD) of the Zr restorations are significantly better than those of PFM, with the exception of gingival recession. CLINICAL RELEVANCE: The use of restorations on vertically prepared teeth is a suitable alternative to classical horizontal preparations.

An Aesthetic and Economic Approach of Smile Designing for a Patient With Dentinogenesis Imperfecta: A Rare Case Entity.

This is a case report presenting a female patient in her twenties suffering from severely stained, unaesthetic, and worn-out teeth since her childhood. It was a major aesthetic and functional concern for her. This clinical presentation describes the prosthetic rehabilitation of a patient with generalized discolored and worn-out teeth to have enhanced aesthetics and masticatory function of the patient. This is a referred case of dentinogenesis imperfecta- II (DGI-II) from the Department of Oral Medicine and Radiology and Oral Pathology, as diagnosed by them after a thorough clinical, radiographical, and histopathological examination. DGI is a disorder of teeth characterized by discoloration and rapid wear and belongs to a group of disorders of the development of teeth. Due to the rapid wear and generalized intrinsically stained and discolored teeth, there is a loss of vertical dimension of occlusion (VDO) and an unesthetic look of the patient respectively. Therefore, the main objective of the case report is to re-establish the aesthetic and regain the VDO and functionality of the damaged teeth using the Pankey Mann Schuyler philosophy in which the first anterior teeth were rehabilitated with porcelain fused to metal (PFM) crowns based on aesthetics and phonetics of the patient. This was followed by posterior PFM crowns based on Broadrick's flag analysis for posterior occlusal plane determination and centric occlusion.

The Effect of Modified Framework Design on the Fracture Resistance of IPS e.max Press Crown after Thermocycling and Cyclic Loading.

AIM: This study aimed to investigate the effect of modified framework (MF) design on the fracture resistance of IPS e.max Press anterior single crown after thermocycling and cyclic loading. MATERIALS AND METHODS: Two types of IPS e.max Press frameworks were designed (n = 10); standard framework (SF) with a 0.5 mm uniform thickness and MF with a lingual margin of 1 mm in thickness and 2 mm in height connected to a proximal strut of 4 mm height and a 0.3 mm wide facial collar. The crowns were cemented to resin dies, subjected to 5,000 cycles of thermocycling, and loaded 10,000 cycles at 100 N. A universal testing machine was used to load specimens to fracture, and the modes of failure were determined. RESULTS: The mean and standard deviation (SD) of fracture resistance were 219.24 ± 110.00 N and 216.54 ±120.02 N in the SF and MF groups. Thus, there was no significant difference (p = 0.96). Mixed fracture was the most common failure mode in both groups. We found no statistically significant difference between the groups (p = 0.58). CONCLUSION: The MF design did not increase the fracture resistance of IPS e.max Press crown. CLINICAL SIGNIFICANCE: Framework design is an essential factor for the success of all-ceramic restorations and its modification might be regarded as an approach to increase fracture resistance. Furthermore, the modified design was evaluated in metal-ceramic or zirconia crowns while less attention was paid to the IPS e.max Press crowns. How to cite this article: Golrezaei M, Mahgoli HA, Yaghoobi N, et al. The Effect of Modified Framework Design on the Fracture Resistance of IPS e.max Press Crown after Thermocycling and Cyclic Loading. J Contemp Dent Pract 2024;25(1):79-84.

The effect of repeated baking of porcelain on its bonding strength to a Co-Cr alloy 3D-printed by selective laser melting.

Objectives: This study aimed to evaluate the effect of multiple baking cycles of porcelain on its shear bond strength to a cobalt-chromium (Co-Cr) alloy that is three-dimensionally printed using Selective Laser Melting (SLM) technique. Materials and methods: The research sample comprised forty-eight discs measuring 5 mm × 3 mm, divided into four groups according to: the manufacturing method (SLM, casting) and the number of porcelain baking cycles (1, 3) as follows: Group A: Co-Cr alloy by SLM with one baking cycle; Group B: Co-Cr alloy by SLM with three baking cycles; Group C: Ni-Cr alloy by casting with one baking cycle; Group D: Ni-Cr alloy by casting with three baking cycles. Then, porcelain was melted on disks, shear testing was performed and the values of the Shear Bond Strength (SBS) in MegaPascals (MPa) were calculated. Results: The mean SBS values for each group were (A: 25.69 - B: 19.51 - C: 35.72 - D: 28.67 MPa). Statistical analysis showed that the manufacturing method and the number of porcelain baking cycles had a significant influence on shear bond durability (P > 0.05): the strength of this bond decreased when baking cycles increased. The Co-Cr samples manufactured by SLM also showed a decrease in binding strength compared to the Ni-Cr samples made by casting. Conclusion: Repeated baking of porcelain reduces the strength of the porcelain bond with the Co-Cr alloy made by Selective Laser Melting (SLM) technique.

Evaluation of stress distribution on an endodontically treated maxillary central tooth with lesion restored with different crown materials: A finite element analysis.

Objectives: The biomechanical response of teeth with periapical lesions that have been restored using various substructure materials, as well as the stress mapping in the alveolar bone, has not been thoroughly described. In this context, the objective of this study is to investigate the structural stress distributions on root canal-treated maxillary right central incisors with lesions restored using different crown materials under linear static loading conditions through finite element analysis (FEA). Methods: In the study, five FEA models were utilised to represent healthy teeth and teeth restored with different substructure materials: (A) a healthy tooth, (B) a lesioned, root canal-treated, composite-filled tooth, (C) a lesioned, fiber-posted, zirconia-based crown, (D) a tooth with lesions, a fiber post, and Ni-Cr infrastructure crown, (E) a tooth with a lesion, a fiber post, and an IPS E-max infrastructure crown. A force of 100 N was applied at an angle of 45° to the long axis of the tooth from 2 mm cervical to the incisal line on the palatal surface. Deformation behaviour and maximum equivalent stress distributions on the tooth sub-components, including the bony structure for each model, were simulated. Results: Differences were observed in the stress distributions of the models. The maximum stress values of the models representing the restorations with different infrastructures varied, and the highest value was obtained in the model of the E-max crown (Model E: 136.050 MPa). The minimum stress magnitudes were obtained from Model B the composite-filled tooth (80.39 MPa); however, it was observed that the equivalent stresses in all the models showed a similar distribution for all components with varying magnitudes. In periapical lesion areas, low stresses were observed. In all models, the cervicobuccal collar region of the teeth had dense equivalent stresses. Conclusion: Different restorative treatment methods applied to root canal-treated teeth with periapical lesions can impact the stress in the alveolar bone and the biomechanical response of the tooth. Relatively high stress values in the cortical bone at the cervical line of the tooth have been observed to decrease towards the apical region. This observation may suggest a potential healing effect by reducing pressure in the periapical lesion area. Clinical significance: Composite resin restorations can be considered the first-choice treatment option for the restoration of root canal-treated teeth with lesions. In crown restorations, it would be advantageous to prefer zirconia or metal-supported prostheses in terms of biomechanics.

Fracture strength of porcelain veneer on surface-treated zirconia.

In this study, we investigated the effects of surface treatment on the fracture strength of porcelain-veneered zirconia. Highly translucent 4 mol% yttria-stabilized zirconia disks (KATANA HT, Kuraray Noritake Dental) were divided into three surface-treatment groups: 1)as-sintered, 2) alumina sandblasted, and 3) ground. Crystallographic and surface-roughness analyses were conducted for each group. Veneering ceramics (Cerabien ZR, Kuraray Noritake Dental) were applied to the zirconia surfaces. The fracture strengths of the porcelain-veneered zirconia disks were measured using biaxial flexural-strength tests. Crystallographic analysis revealed that grinding and sandblasting increased the fractions of the monoclinic and rhombohedral zirconia phases. The ground specimens had a higher surface roughness than the sandblasted specimens. Weibull analysis showed no significant differences in biaxial flexural strength among the three groups. The results suggest that these surface treatments do not affect the fracture strength of porcelain-veneered zirconia.

Study on the Ultimate Load Failure Mechanism and Structural Optimization Design of Insulators.

This study aims to enhance the productivity of high-voltage transmission line insulators and their operational safety by investigating their failure mechanisms under ultimate load conditions. Destructive tests were conducted on a specific type of insulator under ultimate load conditions. A high-speed camera was used to document the insulator's failure process and collect strain data from designated points. A simulation model of the insulator was established to predict the effects of ultimate loads. The simulation results identified a maximum first principal stress of 94.549 MPa in the porcelain shell, with stress distribution characteristics resembling a cantilever beam subjected to bending. This implied that the insulator failure occurred when the stress reached the bending strength of the porcelain shell. To validate the simulation's accuracy, bending and tensile strength tests were conducted on the ceramic materials constituting the insulator. The bending strength of the porcelain shell was 100.52 MPa, showing a 5.6% variation from the simulation results, which indicated the reliability of the simulation model. Finally, optimization designs on the design parameters P1 and P2 of the insulator were conducted. The results indicated that setting P1 to 8° and P2 to 90.062 mm decreased the first principal stress of the porcelain shell by 47.6% and Von Mises stress by 31.6% under ultimate load conditions, significantly enhancing the load-bearing capacity. This research contributed to improving the production yield and safety performance of insulators.

Effect of porcelain veneering technique in bilayered zirconia on bond strength and residual stress distribution.

The use of all porcelain materials in dentistry has significantly increased in recent years. However, chipping has remained a common problem that affects bilayered zirconia restorations. Bonding between porcelain and the underlying zirconia framework is crucial to the success of the restoration. The bond strength may be affected by such factors as residual thermal stress and the veneering technique. This research focuses on investigating the potential and constraints of materials through an examination of the porcelain veneering technique, particularly hand-layering and heat-pressing. Forty-two cylindrical disc samples of zirconia (n = 7/group) were fabricated in the dimensions of 10 × 1.2 mm (diameter [D] × height [H]). The zirconia specimens were milled from IPS e.max® ZirCad [Z] block and Luxen Zr [L] block (n = 21/zirconia). The zirconia cores were layered with IPS e.max® Zirliner and heat-pressed with IPS e.max® ZirPress to produce a final veneer dimension of 5 × 3 mm (D × H). Conventional layering was performed for the rest of the zirconia cores using IPS e.max® Ceram and Shofu Vintage Zr. The final study groups were Luxen-Vintage (LV), Luxen-Ceram (LC), Luxen Zirpress (LP), ZirCad-Vintage (ZV), ZirCad-Ceram (ZC) and ZirCad-Zirpress (ZP). Five samples were subjected to shear bond testing (SBS) with a universal testing machine with a 5 kN load cell and 0.5 mm/min crosshead speed (n = 5/group). A sample underwent nanoindentation, and another was sectioned using Isomet machine to study the bonding interface. One-way ANOVA was used to run the statistical analyses of the SBS test. Statistical differences were found between ZV with LC and LP (p < 0.05). Residual stress is estimated to be higher in the middle of the porcelain compared with that on the surface and the interface. FESEM imaging reveals portions of visible bare zirconia on Luxen zirconia, whilst crack propagation occurred through voids in all hand-layered groups. Heat-pressed veneering showed comparable but not superior results to conventional hand-layered veneering. Heat-pressed veneering produced similar stress distribution profiles compared with hand-layered veneering.

Transaortic TAVR and Mitral Repair Under Deep Hypothermic Circulatory Arrest in a Porcelain Aorta Patient.

Vascular and valvular calcifications, commonly seen in renal patients, increase operative mortality and can preclude conventional valvular management. We show a novel approach to treat aortic stenosis and degenerative mitral regurgitation under hypothermic circulatory arrest in a hemodialysis patient with aortic, mitral disease and porcelain aorta with surgical and transcatheter contraindications.