Effect of surface treatment and resin cement type on the bond strength of polyetheretherketone to lithium disilicate ceramic.

BACKGROUND: This study aims to evaluate the effect of surface treatment and resin cement on the shear bond strength (SBS) and mode of failure of polyetheretherketone (PEEK) to lithium disilicate ceramic (LDC). This is suggested to study alternative veneering of PEEK frameworks with a ceramic material. METHODS: eighty discs were prepared from PEEK blank and from lithium disilicate ceramic. Samples were divided into four groups according to surface treatment: Group (A) air abraded with 110 µm Al2O3, Group (AP) air abrasion and primer application, Group (S) 98% sulfuric acid etching for 60 s, Group (SP) Sulfuric acid and primer. Each group was subdivided into two subgroups based on resin cement type used for bonding LDC:1) subgroup (L) self- adhesive resin cement and 2) subgroup (B) conventional resin cement (n = 10). Thermocycling was done for all samples. The bond strength was assessed using the shear bond strength test (SBS). Failure mode analysis was done at 50X magnification with a stereomicroscope. Samples were chosen from each group for scanning electron microscope (SEM). The three-way nested ANOVA followed by Tukey's post hoc test were used for statistical analysis of results. Comparisons of effects were done utilizing one way ANOVA and (p < 0.05). RESULTS: The highest mean of shear bond strength values was demonstrated in Group of air abrasion with primer application using conventional resin cement (APB) (12.21 ± 2.14 MPa). Sulfuric acid groups showed lower shear bond strength values and the majority failed in thermocycling especially when no primer was applied. The failure mode analysis showed that the predominant failure type was adhesive failure between cement and PEEK, while the remaining was mixed failure between cement and PEEK. CONCLUSION: The air abrasion followed by primer application and conventional resin cement used for bonding Lithium Disilicate to PEEK achieved the best bond strength. Primer application did not have an effect when self-adhesive resin cement was used in air-abraded groups. Priming step is mandatory whenever sulfuric acid etching surface treatment is utilized for PEEK.

Effect of cervical margin relocation on marginal adaptation and microleakage of indirect ceramic restorations.

PURPOSE: This study evaluated the effect of cervical margin relocation (CMR) with two different materials and contamination with hemostatic agents on the margin adaptation and microleakage of ceramic restorations. MATERIALS AND METHODS: Mesial-occlusal-distal cavities were prepared in 60 human first molars and distributed to 3 groups (n = 20) according to the margin relocation procedure. The groups were: group F; flowable composite applied in two 2 mm increments, group B; bulk-fill flowable composite applied as a bulk increment of 4 mm thickness and group C (control); no CMR was done. Each group was subdivided into two subgroups (subgroup N; no hemostatic agent applied and subgroup H; hemostatic agent was applied). In all groups, ceramic inlays were prepared and cemented. The samples were subjected to thermocycling (10,000 cycles). The adaptation of the cervical margin was evaluated with scanning electron microscopy (200×). Samples were then assessed for microleakage analysis with the dye penetration method. Marginal adaptation data were normally distributed and analyzed using two-way ANOVA followed by Tukey's post hoc test. Ordinal microleakage score data were analyzed using cumulative link models followed by the analysis of deviance using Wald chi-square tests. RESULTS: Both CMR and contamination with a hemostatic agent had significant effects on the margin adaptation of the cervical margin. Group C showed the highest adaptation with no significant difference from group F. The lowest adaptation was revealed in group B with a significant difference from group C. Subgroup N (in all groups) showed a statistically higher adaptation than subgroup H. Regarding microleakage assessment, CMR had no significant effect but hemostatic agent application showed a significantly higher microleakage score for all groups. CONCLUSIONS: Both the CMR procedure and contamination with AlCl3 hemostatic agent had a negative effect on marginal adaptation. For microleakage assessment, only contamination with hemostatic agent negatively affected the microleakage with no effect on the margin relocation procedure.

Effect of different intraoral scanners and scanbody splinting on accuracy of scanning implant-supported full arch fixed prosthesis.

OBJECTIVE: This study evaluated the accuracy of different intraoral scanners (IOS) for scanning of implant-supported full arch fixed prosthesis with different implant angulations with and without scanbodies splinting. MATERIALS AND METHODS: Two maxillary models were designed and fabricated to receive an all-on-four implant retained. The models were divided into two groups according to the angulation of the posterior implant (Group 1; 30 and Group 2; 45). Each group was then divided into three subgroups according to the type of IOS used: Subgroup C; Primescan, subgroup T; Trios4, and subgroup M; Medit i600. Then each subgroup was divided into two divisions according to scanning technique; division S: splinted and division N: nonsplinted. Ten scans were made by each scanner for every division. Trueness and precision were analyzed using Geomagic controlX analysis software. RESULTS: Angulation had no significant effect on both the trueness (p = 0.854) and precision (p = 0.347). Splinting had a significant effect on trueness and precision (p < 0.001). Scanner type had a significant effect on trueness (p < 0.001) and precision (p < 0.001). There was no significant difference between trueness of Trios 4 (112.15 ± 12.85) and Primescan (106.75 ± 22.58). However, there was a significant difference when compared to trueness of Medit i600 (158.50 ± 27.65). For the precision results Cerec Primescan showed the highest precision (95.45 ± 33.21). There was a significant difference between the three scanners, precision of Trios4 (109.72 ± 19.24) and Medit i600 (121.21 ± 17.26). CONCLUSION: Cerec Primescan has higher trueness and precision than Trios 4 and Medit i600 in full arch implants scanning. Splinting the scanbodies improve the accuracy of full arch implants scanning. CLINICAL SIGNIFICANCE: Cerec Primescan and 3Shape Trios 4 can be used for scanning of All-on-four implant supported prosthesis when scanbodies are splinted using a modular chain device.

Influence of Preparation Type and Tooth Geometry on the Accuracy of Different Intraoral Scanners.

PURPOSE: To evaluate the influence of preparation design and tooth geometry on the accuracy of scans obtained from three different intraoral scanners (IOS). MATERIALS AND METHODS: Full coverage crown and inlay preparations with known axial wall tapers (6ᵒ and 12ᵒ) were performed on typodont teeth using a computer numerical control machine. Reference models were scanned with a highly accurate reference scanner (Ineos X5) and saved in standard tessellation language (STL) format then each IOS (Omnicam, Trios, and i500) scanned each model 10 times. The STL files obtained from the intraoral scanners were compared to the reference models (trueness) and within each test group (precision). Data were statistically analyzed using three- way ANOVA and one- way ANOVA. RESULTS: When comparing trueness values extracoronal preparations (32.30 ± 11.23 µm) was significantly better than intra-coronal preparation (59.61 ± 16.42 µm). As for opposing wall taper, one-way ANOVA revealed that the more the convergence or divergence between opposing walls the better is the trueness. Significant differences were observed between the scanners. 3 Shape Trios (35.70 ± 14.12 µm) and medit i500 (44.31 ± 11.41 µm) showed no statistically significant differences. However, both showed significantly better precision results when compared to Omnicam (57.83 ± 22.14 µm). CONCLUSION: Extracoronal preparations show better trueness and precision in comparison to intracoronal preparations. Trios and i500 have better trueness and precision than Omnicam. Increasing the taper of the axial wall has a direct effect on trueness of scans obtained from the IOS.

Mechanical behavior of posterior all-ceramic hybrid-abutment-crowns versus hybrid-abutments with separate crowns-A laboratory study.

OBJECTIVE: The purpose of this laboratory study was to evaluate the fatigue resistance, fracture resistance and mode of failure of posterior hybrid-abutment-crown vs. hybrid-abutment with separate crown, both bonded to short titanium bases. MATERIALS AND METHODS: Thirty-two titanium implants were embedded perpendicularly in auto-polymerizing resin. Implant-supported restorations simulating a maxillary first premolar were designed and milled using a CAD/CAM system and divided into 2 groups according to material (n = 16): zirconia (Z) and lithium disilicate (L). Each group was subdivided into two subgroups according to design (n = 8): hybrid-abutment-crown (ZS, LS) and hybrid-abutment with separate crown (ZC, LC). Each group was subjected to 1.2 million cycles of thermo-mechanical fatigue loading in a dual-axis chewing simulator at 120 N load. Surviving specimens were subjected to quasi-static loading in a universal testing machine. Mode of failure was determined under a low magnification optical microscope. RESULTS: During chewing simulation, 18.8% of zirconia and 43.8% of lithium disilicate restorations failed. The fracture resistance median values ranged from 3,730 N for group ZC, 3,400 N for group ZS, 1,295 N for group LS to 849 N for group LC. Group ZC had a statistically significant higher fracture resistance than groups LC and LS; however, it did not differ significantly from group ZS (p ≤ 0.05). Failures were seen in both titanium bases and ceramic superstructure. CONCLUSIONS: Zirconia and lithium disilicate hybrid implant-supported restorations with short (3 mm) titanium bases failed in a considerable number already during chewing simulation. Therefore, despite their high fracture strength the use in the posterior region should be considered critically.

The Effect of Different Wax Pattern Fabrication Techniques on the Marginal Fit of Customized Lithium Disilicate Implant Abutments.

PURPOSE: To evaluate the effect of different wax pattern fabrication techniques on the fit of customized pressed lithium disilicate implant abutments on titanium inserts before and after pressing. The marginal fit results of pressed lithium disilicate implant abutments were then compared with those of milled lithium disilicate abutments. MATERIALS AND METHODS: After scanning the titanium inserts and designing an implant abutment, wax patterns were fabricated with three techniques (n = 15 each): computer-aided design/computer-aided manufacturing (CAD/CAM) milling, 3D printing and conventional layering. The marginal fit (µm) was measured using a stereomicroscope for all the wax patterns before pressing them into the lithium disilicate abutments. The pressed implant abutments were measured again for marginal fit, and the results were compared to those of the milled lithium disilicate abutments. One-way analysis of variance (ANOVA) was used to assess different wax pattern fabrication techniques in each stage before and after pressing. One-way ANOVA was also used to compare the groups of pressed and milled lithium disilicate abutments. Multiple pairwise comparisons were performed using the Tukey post hoc test in each stage. RESULTS: There were statistically significant differences between the marginal fit of the three wax patterns groups (p < 0.001; f = 123.33), wherein the mean marginal fit was the highest for conventionally layered wax patterns (30 ± 13.09) µm. Furthermore, after pressing, there were statistically significant differences between the marginal fit of the three pressed abutments groups (p < 0.001; f = 518.62), wherein the mean marginal fit was the highest for pressed e.max abutments fabricated from conventionally layered wax patterns (25.26 ± 3.9) µm. There was no statistically significant difference between the mean marginal fit of the pressed abutments fabricated from conventional layered wax patterns and that of the milled CAD/CAM abutments. However, the mean marginal fit of the milled CAD/CAM abutments was higher than that of the pressed abutments fabricated from both CAD/CAM wax and 3D printed wax. CONCLUSION: All the tested fabrication methods provided degrees of accuracy that lie well within accepted limits. The use of pressed lithium disilicate abutments fabricated from conventional layering wax pattern technique should provide a more consistent better marginal fit between the titanium insert and the abutment and may therefore be the preferable fabrication method.

Fracture Resistance of Different Designs of a Resin-Bonded Fixed Dental Prosthesis: An In Vitro Study.

PURPOSE: To evaluate the effect of three two-retainer designs of a resin-bonded fixed dental prosthesis (RBFDP) on fracture resistance. MATERIALS AND METHODS: A total of 21 three-unit, all-ceramic RBFPDs were fabricated to replace a missing maxillary lateral incisor. The prostheses were divided into three groups of 7 each: Group L (labial RBFPD); Group ML (modified labial RBFPD, fabricated the same as in Group L with additional preparation that included a shallow proximal groove at the pontic side); and Group P, an all-ceramic palatal RBFPD that acted as control. Preparations were done on the maxillary left central incisor and canine of a typodont model, and 21 epoxy resin models were duplicated for the three groups. The RBFPDs were designed using CAD software and constructed using the heat-pressed technique, after which the prostheses were bonded to their corresponding epoxy resin model according to the manufacturer's instructions. A fracture resistance test was performed on all specimens following aging. Data were analyzed using one-way ANOVA. RESULTS: The highest fracture load values were recorded in Group P (547.5 N), followed by Group ML (462.6 N) and then Group L (418.3 N). The difference among the three designs was not statistically significant (F = 2.5, P = 0.1). CONCLUSION: Both labial and modified labial RBFDPs could be a viable alternative treatment option for replacement of missing maxillary lateral incisors.

Effect of loading protocol on peri-implant marginal bone loss: randomized clinical trial / Efeito do protocolo de carregamento na perda óssea marginal peri-implantar: ensaio clínico randomizado

Objective: This clinical study was conducted to evaluate the effect of loading protocol using hybrid ceramic resinous material on marginal bone loss. Material and Methods: This study was conducted in the fixed prosthodontics department, at Ain Shams University on 30 titanium endosseous tapered threaded implants which were placed in 30 patients in the upper premolar area. Patients were divided randomly according to the loading protocol into 3 groups (10 patients each): Group I (IFLV): patients received CAD/CAM polymer infiltrated ceramic (VITA-ENAMIC) crowns (immediate functional loading), Group II (IFLP): patients received CAD/CAM PMMA crowns (in occlusion for 3 months) followed by CAD/CAM polymer infiltrated ceramic (VITA-ENAMIC) crowns (functional loading), and Group III (INFLP): patients received CAD/CAM PMMA crowns (out of occlusion for 3 months) followed by CAD/CAM VITA-ENAMIC crowns (functional loading). Results: After three months; the highest value of marginal bone loss (mm) was found in IFLV, followed by IFLP, while the lowest value was found in INFLP. After six months, the highest value was found in IFLP, followed by IFLV, while the lowest value was found in INFLP. Also, after twelve months, the highest value was found in IFLV, followed by IFLP, while the lowest value was found in INFLP. Marginal bone loss values were within the accepted values for clinical success for all the tested groups. Conclusion: Immediate non-functional loading provided more acceptable outcomes than immediate functional loading. Also, immediately functional and non-functional implant loading using hybrid ceramic as permanent material has shown promising results with proper patient selection (AU)

Objetivo: Este estudo clínico foi realizado para avaliar o efeito do protocolo de carregamento utilizando material resinoso cerâmico híbrido na perda óssea marginal. Material e Métodos: Este estudo foi realizado no departamento de prótese fixa da Universidade Ain Shams em 30 implantes endósseos cônicos de titânio que foram instalados em 30 pacientes na região de pré-molares superiores. Os pacientes foram divididos aleatoriamente de acordo com o protocolo de carregamento em 3 grupos (10 pacientes cada): Grupo I (IFLV): os pacientes receberam coroas usinadas em CAD/CAM de cerâmica infiltrada com polímero (VITA-ENAMIC) (carga imediata), Grupo II (IFLP): os pacientes receberam coroas usinadas em CAD/CAM de PMMA (em oclusão por 3 meses) seguidas por coroas de cerâmica infiltrada com polímero (VITA-ENAMIC) (carga funcional), e Grupo III (INFLP): os pacientes receberam coroas usinadas em CAD/CAM de PMMA (infraoclusão por 3 meses) seguido de coroas de VITA-ENAMIC (carga funcional). Resultados: Após três meses; o maior valor de perda óssea marginal (mm) foi encontrado no IFLV, seguido pelo IFLP, enquanto o menor valor foi encontrado no INFLP. Após seis meses, o maior valor foi encontrado no IFLP, seguido do IFLV, enquanto o menor valor foi encontrado no INFLP. Além disso, após doze meses, o maior valor foi encontrado no IFLV, seguido pelo IFLP, enquanto o menor valor foi encontrado no INFLP. Os valores de perda óssea marginal estavam todos dentro de valores aceitáveis para sucesso clínico para todos os grupos testados. Conclusão: A carga funcional não imediata proporcionou resultados mais aceitáveis do que a carga imediata. Além disso, o carregamento funcional imediato e não imediato de implantes utilizando coroas finais de cerâmica híbrida mostrou resultados promissores com a seleção adequada dos pacientes.(AU)

Effect of prosthetic design and restorative material on the stress distribution of implant-supported 3-unit fixed partial dentures: 3D-FEA / Efeito do desenho protético e do material restaurador na distribuição de tensão de próteses parciais fixas de 3 elementos suportada por implante: FEA 3D

Objective: Evaluate the effect of Implant prosthetic designs and restorative material on the stress concentration of 3-unit implant-supported restoration with two restorative materials. Material and Methods: Six different screw-retained prostheses models were virtually designed and divided according to design: fixed bridge (FB), cantilever bridge (CB), and separate crowns (SC). Then, each model was also divided into two subgroups according to the material: Ultra-translucent multi-layered zirconia (Kuraray Noritake Dental Inc., Japan); or a combination of PEEK (Polyetheretherketone) framework (BioHPP, Bredent, GmbH & Co., KG, Germany) and zirconia (ZR) crowns (ultra-translucent multi-layered zirconia, Kuraray Noritake Dental Inc., Japan). A vertical load of 100 N was applied statically perpendicular to the central fossa of each crown. The von-Mises stress was computed using Solidworks software (SolidWorks Corp, Massachusetts, USA), based on the physical parameters of the materials. Results: FB showed the lowest von Mises stress values out of all 3 design models. Moreover, the combination of PEEK and zirconia showed strain values smaller than full zirconia. The highest von Mises stress value was recorded in CB with the zirconia subgroup at (1098 MPa) while the lowest von Mises stress value was recorded in FB with combined PEEK and zirconia subgroup at (190 MPa). Conclusion: For three-unit implant supported restorations, the use of PEEK framework and zirconia crowns was found to be more favorable biomechanically regarding the prosthetic components, implant and bone stresses. (AU)

Objetivo: Avaliar o efeito do desenho da prótese sobre implantes e do material restaurador na concentração de tensão de próteses fixas de 3 elementos implantossuportada, com dois materiais restauradores. Material e Métodos: Seis diferentes modelos de próteses aparafusadas foram virtualmente projetados e divididos de acordo com o desenho: ponte fixa (PF), ponte cantilever (PC) e coroas individuais (CI). Em seguida, cada modelo também foi dividido em dois subgrupos de acordo com o material: Zircônia multicamada ultra translúcida (Kuraray Noritake Dental Inc., Japão); ou associada a uma estrutura de PEEK (Polyetheretherketone) (BioHPP, Bredent, GmbH & Co., KG, Alemanha) e coroas de zircônia (CZ) (zircônia multicamada ultra translúcida, Kuraray Noritake Dental Inc., Japão). Uma carga vertical estática de 100 N foi aplicada perpendicular à fossa central de cada coroa. A tensão de von-Mises foi calculada usando o software Solidworks (SolidWorks Corp, Massachusetts, EUA), com base nos parâmetros físicos dos materiais. Resultados:PF apresentou os menores valores de tensão de von Mises de todos os 3 modelos propostos. Além disso, a combinação de PEEK e zircônia apresentou valores de deformação menores do que a zircônia pura. O maior valor de tensão de von Mises foi registrado em PC com o subgrupo de zircônia em (1098 MPa), enquanto o menor valor de tensão de von Mises foi registrado em PF com PEEK combinado e subgrupo de zircônia em (190 MPa). Conclusão: Para ponte fixa de 3 elementos implantossuportadas, o uso de estrutura PEEK e coroas de zircônia mostrou-se mais favorável biomecanicamente em relação aos componentes protéticos, implante e tensão sobre o osso. (AU)

Prosthetic design and restorative material effect on the biomechanical behavior of dental implants: strain gauge analysis / Efeito do desenho protético e do material restaurador no comportamento biomecânico de implantes dentários: análise de extensometria

Objective: The purpose of this in vitro study was to evaluate the effect of different implant prosthetic designs with two restorative materials on biomechanical behaviour using strain gauge analysis. Material and Methods:6 different screw-retained implant restorations were designed and fabricated using a CAD/CAM system. These implants were divided into three main groups according to each design: group FB (fixed bridge); CB (cantilever bridge); SC (separate crowns). Each group was divided into two subgroups according to their restorative material: subgroup I ­ ultra translucent multi-layered zirconia (Kuraray Noritake Dental Inc, Japan); subgroup II ­ a combination of PEEK framework (BioHPP, Bredent, GmbH & Co.KG, Germany) and zirconia crowns (ultra-translucent multi-layered zirconia, Kuraray Noritake Dental Inc, Japan). Each subgroup was subjected to a vertical load of 100 N and their biomechanical behaviour was evaluated using a strain gauge (Kyowa, Japan) with a resistance of 120 Ω, length of 1 mm and width of 2.4 mm. For the implants, two strain gauges were positioned buccally and lingually, parallel to the long axis of the implant. For the restoration, two strain gauges were positioned buccally and lingually in the middle of it. The results were analyzed using three-way analysis of variance (ANOVA), followed by serial two-way and one-way ANOVAs at each level of the study, followed by Tukey's post hoc test P-values were adjusted for multiple comparisons using BENFORRONI correction and the significance level was set at P ≤ 0.05 for all tests. Results: FB showed the lowest strain values out of all 3 design groups. Moreover, the combination of PEEK and zirconia showed strain values smaller than full zirconia. The highest mean strain value was recorded in CB at 299.50 while the lowest mean strain peak value was recorded in group FB (74.50). The highest strain peak was recorded in CB subgroup I (3901.0 ± 195.91) and the difference had statistical significance (P-value < 0.01). Conclusion: the fixed bridge designed with PEEK framework and zirconia crowns was found to be more favorable in restoring the posterior edentulous area regarding strain measurements on the level of prosthetic components, implant and bone level. (AU)

Objetivo: O objetivo deste estudo in vitro foi avaliar o comportamento biomecânico de diferentes desenhos protéticos com dois materiais restauradores em implantes dentários usando análise por extensometria. Material e Métodos: 6 diferentes restaurações parafusadas em implantes foram projetadas e fabricadas usando um sistema CAD/CAM. Esses implantes foram divididos em três grupos principais de acordo com cada desenho: grupo PF (ponte fixa); PC (ponte cantilever); CI (coroas individuais). Cada grupo foi dividido em dois subgrupos de acordo com o material restaurador: subgrupo I ­ zircônia multicamada ultra translúcida (Kuraray Noritake Dental Inc, Japão); subgrupo II ­ uma combinação de estrutura PEEK (BioHPP, Bredent, GmbH & Co.KG, Alemanha) e coroas de zircônia (zircônia multicamada ultra translúcida, Kuraray Noritake Dental Inc, Japão). Cada subgrupo foi submetido a uma carga vertical de 100 N e seu comportamento biomecânico foi avaliado usando um extensômetro (Kyowa, Japão) com resistência elétrica de 120 Ω, comprimento de 1 mm e largura de 2,4 mm. Para os implantes, dois extensômetros foram posicionados pela vestibular e lingual, paralelos ao longo eixo do implante. Para a restauração, dois extensômetros foram posicionados no centro da estrutura, pela vestibular e lingual. Os resultados foram analisados usando análise de variância de três fatores (ANOVA), seguida de ANOVA dois fatores e um fator em cada estágio do estudo, seguidas pelo teste de Tukey. Os valores P foram ajustados para comparações múltiplas usando a correção de BENFORRONI e o nível de significância foi estabelecido em P ≤ 0,05 para todos os testes. Resultados: PF apresentou os menores valores de deformação de todos os 3 grupos de desenho. Além disso, a combinação de PEEK e zircônia apresentou valores de deformação menores do que a zircônia total. O maior valor médio de deformação foi registrado no PC em 299,50, enquanto o menor valor médio de pico de deformação foi registrado no grupo PF (74,50). O maior pico de deformação foi registrado no subgrupo PC I (3901,0 ± 195,91) e a diferença teve significância estatística (P-valor < 0,01). Conclusão: a ponte fixa projetada com estrutura de PEEK e coroas de zircônia mostrou-se mais favorável na restauração da área edêntula posterior em relação às medidas de deformação dos componentes protéticos, implante e nível ósseo (AU)

Influence of CAD/CAM Material and Preparation Design on the Long-term Fracture Resistance of Endocrowns Restoring Maxillary Premolars / Influência do material de CAD / CAM e tipo de preparo na resistência à fratura a longo prazo de coroas endodônticas adesivas na restauração de pré-molares superiores

Objective: To evaluate the effect of different occlusal preparation designs and CAD/CAM materials on the fracture resistance of maxillary premolars end crowns. Materials and Methods: sixty-four endodontically treated upper first premolars were randomly divided into four groups according to ceramic materials (Vita Enamic and IPS emax CAD) and occlusal preparation designs (Anatomical and horizontal butt joint). After teeth preparation, the restorations were all made by CAD/CAM system (Cerec MCXL). Half of each group had undergone cyclic fatigue testing of 105 cycles with 50N loading force at a frequency of 0.5Hz in a mechatronic chewing simulator machine, and then all samples were loaded to fracture using a universal testing machine with a cross head speed of 0.5 mm/min recording the fracture resistance values in N . The specimens were measured and statistically analyzed using using three-way analyses of variance (ANOVA), followed by serial two-way and one-way ANOVAs at each level of the study. P-values were adjusted for multiple comparisons using BENFORRONI correction and the significance level was set at P ≤ 0.05 for all tests. Results: Vita Enamic endocrowns showed higher fracture resistance values than IPS e max specimens. Conclusions: Vita Enamic endocrowns with anatomical preparations were found to be more favourable restoring endodontically treated maxillary premolars (AU)

Objetivo: Avaliar o efeito de diferentes tipos de preparo oclusal e materiais CAD/CAM na resistência à fratura de coroas endodônticas adesivas em pré-molares. Materiais e Métodos: Sessenta e quatro primeiros pré-molares superiores tratados endodonticamente foram divididos randomicamente em quatro grupos de acordo com os materiais cerâmicos (Vita Enamic e IPS emax CAD) e tipos de preparo oclusal (Recobrimento Incisal Anatômico e Horizontal). Após o preparo dental, as restaurações foram confeccionadas pelo sistema CAD/CAM (Cerec MCXL). Metade de cada grupo foi submetido a testes de fadiga cíclica de 105 ciclos com força de carga de 50N a uma frequência de 0,5Hz em uma máquina simuladora de mastigação mecatrônica, e então todas as amostras foram submetidas a fratura por uma máquina de teste universal com uma velocidade de 0,5 mm / min registrando os valores de resistência à fratura em N. As amostras foram medidas e analisadas estatisticamente usando análises de variância de três fatores (ANOVA), seguidas por ANOVAs de dois fatores e de um fator em cada nível do estudo. Os valores de p foram ajustados para comparações múltiplas usando a correção BENFORRONI e o nível de significância estabelecido foi de P ≤ 0,05 para todos os testes. Resultados: Coroas endodônticas adesivas da Vita Enamic mostraram maiores valores de resistência à fratura do que as amostras de IPS emax. Conclusões: Verificou-se que as coroas endodônticas adesivas da Vita Enamic com preparos com recobrimento incisal anatômico foram mais favoráveis para restaurar os pré-molares superiores tratados endodonticamente (AU)

Effect of changes in sintering parameters on monolithic translucent zirconia.

OBJECTIVES: Aim of this study was to evaluate the effect of different sintering parameters on color reproduction, translucency and biaxial flexural strength of monolithic zirconia. METHODS: Translucent zirconia discs having 15mm diameter, 1mm thickness, and shade A3 were milled and divided according to the sintering temperatures (1460°C, 1530°C, and 1600°C) into three groups (n=30). Each group was later divided into three subgroups (n=10) according to the sintering holding time (1, 2, and 4h). Easyshade spectrophotometer (Vita, Bad Säckingen, Germany) was used to obtain the ΔE between the specimens and the shade A3. Mean ΔE values below 3.0 were considered "clinically imperceptible", ΔE values between 3.0 and 5.0 were considered "clinically acceptable" and ΔE values above 5.0 were considered "clinically unacceptable". Contrast ratio (CR) was obtained after comparing the reflectance of light through the specimens over black and white background. Biaxial flexural strength was tested using the piston-on-three balls technique in a universal testing machine. RESULTS: Mean ΔE results ranged from 4.4 to 2.2. Statistically significant decrease in the Delta E was observed as the sintering time and temperature increased. CR decreased from 0.75 to 0.68 as the sintering time and temperature increased. No significant change in the biaxial flexural strength was observed. SIGNIFICANCE: Sintering zirconia using long cycles and high temperatures will result in reduction of ΔE and CR. Biaxial flexural strength is not affected by changes in the evaluated sintering parameters.