Progress on the application of porcelain veneers in the restoration of dental fluorosis and its influencing factors / 中华地方病学杂志

Due to the cloud-like appearance of the dental surface of dental fluorosis, serious tooth defect may occur, thus affecting the overall beauty of the face. The clinical effect of dental fluorosis is not better than that of normal teeth in the application of repair, which brings some difficulties to the clinicians. The application of porcelain veneers in the restoration of dental fluorosis has been widely concerned by clinicians and researchers due to its advantages of high aesthetics, small amount of tooth tissue abrasion, and good biocompatibility. Therefore, this article comprehensively discusses the application effect and influencing factors of porcelain veneers in the restoration of dental fluorosis, in order to provide some reference for clinical application.

Stress distribution in occlusal veneers with different finish lines when applying vertical and tangential forces / Distribución de estrés en carillas con diferentes líneas de terminación aplicando fuerzas verticales y tangenciales

Abstract To evaluate stress distribution when applying vertical and tangential forces to 1mm thick occlusal veneers with different finish lines preparations, using the finite element method. One extracted third molar was prepared for occlusal veneers, firstly without any bevel. It was scanned in order to design two groups of lithium disilicate (G1A, G2A) and composite resin (G1B, G2B) occlusal veneers. Then, the third molar preparation was modified, beveling the finish line and it was subsequently scanned again to design the occlusal veneer groups with bevel (LD: G3A, G4A and CR: G3B, G4B). The four groups were subjected to different forces (400 N vertical and 900 N tangential). At 400 N, the non-beveled veneers showed slightly higher Von Mises stress values (G1A: 783 MPa and G1B 736.5 MPa) than the beveled veneers (G3A: 685.7 MPa and G3B: 675.8 MPa). However, when 900 N tangential forces were applied, the beveled occlusal veneers showed higher Von Mises stress values (G4A: 4297 MPa and G4B: 4133 MPa) than the non-beveled occlusal veneers (G2A: 2581.1 MPa and G2B: 3519.1 MPa). Furthermore, it was observed that the tissue under the occlusal veneers with bevel showed higher Von Mises stress values than the models without any bevel. Beveled and non-beveled occlusal veneers of lithium disilicate and composite resin presented similar stress distribution values when vertical forces of 400 N were applied; whereas with tangential forces of 900 N applied near to the finish line, the beveled groups presented notably higher stress values than the non-beveled groups. However, both finish line preparations presented adequate values for possible clinical performance.

Resumen Evaluar la distribución de estrés al aplicar fuerzas verticales y tangenciales en carillas oclusales de 1mm de espesor con diferentes líneas de terminación marginal por el método de elementos finitos. Se preparó un tercer molar extraído para carilla oclusal, primero sin bisel. Se escaneó para diseñar dos grupos de carillas oclusales de disilicato de litio (G1A, G2A) y resina compuesta (G1B, G2B). Después, esta preparación molar fue modificada, biselando la línea de terminación y escaneándola nuevamente para diseñar los grupos de carillas oclusales con bisel (DL: G3A, G4A and RC: G3B, G4B). Los 4 grupos fueron sometidos a fuerzas diferentes (400 N vertical y 900 N tangencial). Con 400 N, las carillas sin bisel presentaron ligera mayor tensión de Von Mises (G1A: 783 MPa y G1B 736.5 MPa) que las carillas con bisel (G3A: 685.7 MPa y G3B: 675.8 MPa). De distinta forma, al aplicar fuerzas tangenciales de 900 N, las carillas oclusales con bisel presentaron mayor tensión de Von Mises (G4A: 4297 MPa y G4B: 4133 MPa) que las carillas oclusales sin bisel (G2A: 2581.1 MPa y G2B: 3519.1 MPa). Además, se observó que los tejidos subyacentes a las carillas oclusales con bisel, presentaron mayor tensión de Von Mises, frente a los modelos sin bisel. Las carillas oclusales con y sin bisel de disilicato de litio y resina compuesta presentaron una distribución de estrés similar con fuerzas verticales de 400 N, por otro lado, con fuerzas tangenciales de 900 N, los grupos con bisel presentaron notablemente mayor tensión que los grupos sin bisel. Sin embargo, ambos diseños de terminación marginal presentaron valores adecuados para un posible desempeño clínico.

No-Prep semidirect composite resin veneer. A Step-by-Step case report in a deciduous canine with a one-year follow-Up / Carilla de resina semidirecta sin preparación. Un reporte paso a paso en un canino deciduo con seguimiento de un año

Abstract The presence of deciduous canines in adulthood may be of aesthetic concern for patients. Many clinical alternatives include surgical and orthodontic treatment. Since patients search for highly esthetic results and more conservative alternatives, the present clinical report describes a treatment for deciduous canine through an indirect composite resin veneer and an indirect composite resin fragment restoration in a premolar to improve esthetic outcomes with a one-year follow up.

Resumen La presencia de caninos deciduos en adultos puede ser de preocupación estética por parte de los pacientes. Diversas alternativas clínicas pueden incluir tratamientos quirúrgicos y ortodóncicos. Desde que los pacientes buscan por resultados de alta estética y cada vez más conservadores, es que el presente caso clínico describe el tratamiento de un canino deciduo mediante una carilla indirecta de resina compuesta junto a un fragmento indirecto de resina de un premolar con el fin de mejorar los resultados estéticos, y con un año de seguimiento.

MicroCT evaluation for CAD/CAM occlusal veneer fit using two materials and three cement space settings

Abstract This study was aimed to evaluate the fit of occlusal veneer restoration for two CAD/CAM materials with different cement space settings, using microCT scans. Sixty resin dies were made and divided into two groups (n=30) according to the materials, (I): Hybrid all-ceramic, and (II): zirconia-reinforced lithium silicate glass-ceramic. Each group was subdivided into three subgroups (n=10) according to the cement space parameters (30, 40, and 50 µm). Occlusal veneers for the six subgroups were milled. A circle with 20 different sections was placed at the center of every scanned specimen to measure four different locations (Occlusal, Axial, Marginal, and Absolute marginal discrepancy). Data were analyzed using two-way ANOVA at a 0.05 level of significance. There was no statistically significant effect of material type on the mean values of internal and marginal gaps for the three cement space parameters (P>0.05). There were no statistically significant differences in the occlusal and axial gap between the cement space parameters, furthermore, there were statistically significant differences in marginal gap distances and absolute marginal discrepancies (P>0.05). Hybrid all-ceramic showed smaller marginal and internal discrepancies than zirconia-reinforced lithium silicate glass-ceramic without statistically significant differences, and, for both materials, 50 µm cement space significantly improved the marginal fit and absolute marginal discrepancy.

Resumo Este estudo teve como objetivo avaliar o ajuste da restauração de facetas oclusais para dois materiais CAD/CAM com diferentes configurações de espaço de cimento, usando microCT. Foram feitos sessenta moldes de resina e divididos em dois grupos (n=30) de acordo com os materiais, (I): cerâmica pura híbrida, e (II): cerâmica de vidro de silicato de lítio reforçada com zircónia. Cada grupo foi subdividido em três subgrupos (n=10), de acordo com os parâmetros do espaço de cimento (30, 40, e 50 µm). As facetas oclusais para os seis subgrupos foram fresadas. Um círculo com 20 secções diferentes foi colocado no centro de cada amostra digitalizada para medir quatro locais diferentes (Oclusal, Axial, Marginal, e discrepância marginal absoluta). Os dados foram analisados utilizando ANOVA bidireccional a um nível de significância de 0,05. Não houve efeito estatisticamente significativo do tipo de material nos valores médios das aberturas internas e marginais para os três parâmetros do espaço de cimento (P>0,05). Não houve diferenças estatisticamente significativas no intervalo oclusal e axial entre os parâmetros do espaço de cimento, além disso, houve diferenças estatisticamente significativas nas distâncias do intervalo marginal e discrepâncias marginais absolutas (P>0,05). A cerâmica pura híbrida mostrou discrepâncias marginais e internas menores do que a cerâmica de vidro de silicato de lítio reforçada com zircónia sem diferenças estatisticamente significativas, e, para ambos os materiais, 50 µm de espaço de cimento melhoraram significativamente o ajuste marginal e a discrepância marginal absoluta.

Midline diastema closure using a lithium disilicate glass ceramic fragment: increased long-term color stability"

ABSTRACT: Nowadays, maxillary midline diastema (MMD) can be treated with different multidisciplinary approaches. When restorative dentistry is needed, glass-matrix ceramic materials is one of the best choices, since they present good optical behavior and high survival rates in the anterior dentition. To obtain an adequate interphase, and color integration are one of the main restorative goals, and for that purpose, specific finishing and polishing procedures must be employed to avoid staining and ensure the restoration's color stability. In the case report presented in this article, a single lithium disilicate ceramic fragment was performed to close a MMD produced by the shape alteration of one of the maxillary central incisors. Also, the finishing and polishing procedure is discussed.

Anterior aesthetic restoration with ultrathin porcelain veneers on asymmetric faces assisted by a four-dimensional smile design: a case report and literature review / 口腔疾病防治

Objective@#To explore the application effect of a four-dimensional smile design as the leading and facial streamline as the reference system in the aesthetic restoration of anterior teeth.@*Methods@# A case of scattered space in anterior teeth was treated with a four-dimensional smile design and digital aesthetic restoration with ultrathin porcelain veneer. The digital information of the patients was obtained through oral and facial scanning, and a four-dimensional smile design and prediction were carried out. After the treatment plan was jointly determined by doctors and patients, minimally invasive abutment preparation was carried out, and ultrathin porcelain veneer was made and bonded in place. After the operation, the esthetic degree and marginal fit were observed and reexamined one year after the repair.@* Results @#The edges of the ultrathin ceramic veneers were naturally tight, and the color was coordinated, with satisfying pink and white esthetics. The face was more harmonious and natural when smiling. One year after the restoration, the facial aesthetics were wonderful, the abutment teeth and periodontal tissues were healthy, and the patients were satisfied. The results of the literature review showed that the fitting of temporal facial scanning and intraoral scanning data can accurately predict four-dimensional smile aesthetics, simulate the real state of the dynamic smile and pronunciation process, and combine it with facial streamlines to design a natural and coordinated personalized smile for patients with asymmetric faces. However, for patients with occlusal changes, unstable occlusion or temporomandibular joint disorder, it is necessary to add data fitting, such as electronic facial arch and cone beam CT, to more accurately simulate postoperative mandibular movement.@*Conclusion@# With a four-dimensional smile design as the leading and facial streamline as the reference system, the whole process digital design assisted the restoration of asymmetric anterior teeth with ultrathin porcelain veneer and had a good effect. The postoperative smiling of patients is harmonious and beautiful, which is in line with the expected effect. Patient participation and satisfaction are high; thus, this method is worthy of clinical promotion.

Polifluoruro de amonio como alternativa de acondicionamiento para laminados ultradelgados de disilicato de litio. Reporte de caso / Ammonium polyfluoride as an alternative for the surface conditioning of ultrathin lithium disilicate veneers. A case report

RESUMEN: Los laminados vitrocerámicos ultradelgados constituyen una alternativa conservadora para la resolución de alteraciones estéticas. Sin embargo, su acondicionamiento con ácido fluorhídrico suele no estar exento de complicaciones, por lo que el uso de un sistema autograbante en base a polifluoruro de amonio (Monobond Etch&Prime, MEP) permite disminuir el riesgo de sobregrabado, simplificando la técnica. El presente reporte presenta el seguimiento a dieciocho meses de un caso clínico resuelto mediante laminados vitrocerámicos acondicionados únicamente con MEP. Caso. Paciente joven con alteraciones estéticas en el sector anterosuperior. Se realizaron preparaciones conservadoras para la confección de laminados ultradelgados en disilicato de litio (e.maxPress). Las vitrocerámicas fueron acondicionadas sólo con MEP y se cementaron con Variolink Esthetic LC. Al año y medio las restauraciones se observaron indemnes, manteniendo un buen ajuste marginal y ausencia de tinciones. Conclusiones. MEP aparece como una alternativa prometedora para reemplazar al ácido fluorhídrico en la cementación de laminados vitrocerámicos.

ABSTRACT: Ultrathin glass-ceramic veneers are a conservative approach for the restorative treatment of aesthetic disorders in the anterior region. However, surface conditioning with hydrofluoric acid of the thin structures can be usually a challenging step. Therefore, the use of a self-etching ceramic primer containing ammonium polyfluoride (Monobond Etch&Prime, MEP) offers a simplified technique with a reduced risk of overetching. Here we present an 18-month follow-up of ultrathin glass-ceramic veneers conditioned with MEP only. Case. Young female patient with an aesthetic disorder in the front region. The four upper incisors were conservatively prepared for ultrathin lithium disilicate (e.maxPress) veneers. Pre-treatment of the glass-ceramics consisted only of MEP application, followed by adhesive cementation with Variolink Esthetic LC. At the 1.5-year recall, the restorations appeared undamaged, with no marginal gap or staining. Conclusions. MEP constitutes a promising alternative to hydrofluoric acid for the adhesive cementation of glass-ceramic veneers.

La operatoria dental y su rol en la rehabilitación integral: caso clínico / Operative dentistry and its role in comprehensive rehabilitation: a clinical case

El objetivo del presente informe clínico es describir una manera de lograr resultados predecibles en las restauraciones estéticas, con una rehabilitación integral. Se emplearon distintos materiales, centrados en la nueva generación de materiales cerámicos para la confección de frentes estéticos. Se realizó un diagnóstico seguido de un plan de tratamiento que integró tanto la correcta función como la estética. Se tuvo en cuenta que la responsabilidad estética no se limita sólo a la forma, el tamaño y el color de los dientes, sino que, además, es importante preservar o recuperar la armonía dentogingival (AU)

Effect of ceramic materials on the optical properties of porcelain veneers for tetracycline-stained teeth / 华西口腔医学杂志

OBJECTIVES@#To analyze the chromatic properties and translucency of porcelain veneers made from different ceramic materials against the background of tetracycline-stained teeth.@*METHODS@#Porcelain specimens (A1, A3, B2, B4) measuring 0.50 mm in thickness were prepared by heat-press casting and layering. The L*, a*, and b* values of the specimens against simulated tetracycline tooth and black-and-white backgrounds were measured by a spectrophotometer, and color differences ΔE@*RESULTS@#The ΔE@*CONCLUSIONS@#When changing the color of tetracycline-stained teeth, 0.50 mm-thick IPS d.SIGN feldspathic veneers with an opaque layer provide better chromatic properties than IPS e.max Press LT glass ceramic veneers. However, the translucency of feldspathic veneers is generally poorer than that of glass ceramic veneers.

A randomized controlled study on color stability of tetracycline teeth restored with ceramic veneer / 华西口腔医学杂志

OBJECTIVES@#This study aimed to evaluate the color stability of tetracycline teeth restored with ceramic veneers of different thicknesses combined with different resin cement systems after aging.@*METHODS@#Twenty patients with tetracycline teeth, including two maxillary central incisors, were selected clinically. The patients were randomly divided into four groups and restored with 0.5 and 0.75 mm ceramic veneers by using a veneer adhesive system, either with light-cured or dual-cured reaction. The color difference (ΔE) values after cementation and 1, 6, 12, and 24 months of use were obtained by quantification of L*, a*, and b* values with a colorimeter. The results were analyzed statistically with two-way ANOVA and Student's @*RESULTS@#The ΔE values of ceramic veneers detected after aging were less than 2.25. The 0.5 mm groups exhibited greater color change than the 0.75 mm-thick veneers (@*CONCLUSIONS@#Resin cements and veneer thickness influence the color of ceramic veneers after aging. Cementation of veneers with either dual- or light-cured resin cements does not affect the long-term color stability of tetracycline teeth differently.

Morphology accuracy evaluation of direct composite occlusal veneer using two types of modified stamp-technique / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the morphology accuracy of direct occlusal veneer using two types of modified stamp-technique, comparing the Results of two types of stamp and different composite resin.@*METHODS@#Model scanner was used to get the original data from the standard resin teeth in plastic model. Two types of stamps were made: solid silicon stamp and transparent silicon stamp. In the study, 54 resin tooth were randomly divided into 9 groups: Groups 1-8 were restored by direct composite resin, using general and bulk-filled composite resin in occlusal veneer (1 mm or 2 mm) with two types of stamp-technique (the solid silicon, and the transparent silicon), and the control group was restored by indirect way using CAD/CAM composite resin restoration by biocopy technique to mimic the original shape of the teeth. After the resin teeth were prepared for occlusal veneer, the direct and indirect composite resins were restored. After the restoration was finished, the data were obtained again by the same model scanner in the plastic model. 3D comparisons were made using the original and restoration data, the average difference and the root mean square of difference (RMS) were recoded from the software. The RMS of all the groups were analyzed using one way ANOVA (α=0.05).@*RESULTS@#The RMS of occlusal surface in solid silicon stamp group was (0.136±0.031) mm, in transparent silicon group was (0.130±0.024) mm, and in control group was (0.130±0.009) mm. There were no significant difference. While the RMS of buccal/lingual surface in solid silicon stamp group was the smallest [(0.135±0.020) mm, P < 0.05], and in transparent silicon group it was (0.147±0.021) mm, and control group (0.153±0.014) mm. The general composite resin using the two types of stamp had the largest occlusal RMS in 2 mm occlusal veneer, which were significantly larger than control group (P < 0.05).@*CONCLUSION@#The direct occlusal veneer using two types of modified "stamp-technique" had relatively good morphology accuracy. Direct occlusal veneer using bulk-filled composite resin made with two types of stamp technique had even more accurate morphology than using general composite resin. The solid silicon stamp had a better morphology accuracy in buccal/lingual surface than the transparent silicon stamp.

In-vitro efficacy of two spectrophotometer-based shade matching systems for color matching of ceramics after artificial accelerated aging / Eficácia in vitro de dois espectrofotômetros baseados em escalas de cor para avaliação de cor de cerâmicas após envelhecimento artificial acelerado

Objective: The objective of the present in-vitro study was to verify the efficacy of two spectrophotometer-based shade matching systems for color matching of ceramics after artificial accelerated aging (AAA). Material and Methods: The ceramics used were porcelain laminated veneers. Seventy standard-shaped discs (thickness x diameter: 0.5 mm x 10 mm) of B1 shades were used. Based upon the type of resin cement used, the specimens were divided into seven groups (10/group). The following light-cured cements were used: RelyX-Veneer (L-RV), Variolink-Veneer (L-VV), and Variolink-Esthetic (L-VE). The dual-cured cements were: RelyX Ultimate (D-RU), RelyX-Unicem (D-RC), and Variolink-Esthetics DC (D-VE). The control group consisted of ceramic only. All specimens were thermocycled in water for 3,500 cycles between 5 oC -55 oC, with dwell times of 30 s in each bath and a transfer time of 10 s between baths. All specimens were thermocycled in water for 3,500 cycles between 5 oC and 55 oC, and color measurement was done using the VITA Easyshade and ColorEye spectrophotometers. Baseline color reading was performed 24-hours after cementation. Differences in color (DE) of EasyShade and ColorEye before and after AAA were determined and compared statistically. Group comparisons were done using the paired t-tests. Level of significance was set at P< 0.05. Results: The mean differences in color (ΔE) values obtained from EasyShade spectrophotometer for light- and dual-cured cements, were 0.843±0.89 (L-RV ), 4.11±0.69 (L-VV) and 0.833±0.47 (L-VE); and 2.22±0.64 (D-RU), 3.37±0.83 (D-RC) and 0.38±0.92 (D-VE), respectively. The mean differences in color (ΔE) values obtained from ColorEye spectrophotometer for light- and dual-cured cements, were 0.68±0.86 (L-RV ), 4.55±0.83 (L-VV) and 2.68±0.26 (L-VE); and 2.06±0.84 (D-RU), 1.8±1.08 (D-RC) and 0.96±0.71 (D-VE), respectively. There was no significant difference in the mean DE values among the groups. Conclusion: The VITA Easyshade and ColorEye shade matching systems are comparable in terms of their efficacy for color matching of cerammics after AAA.(AU)

Objetivos: O objetivo do presente estudo in vitro foi verificar a eficácia de dois espectrofotômetros baseados em escalas de cor para avaliação de cor de cerâmicas após envelhecimento artificial acelerado (EAA). Material e Métodos: As cerâmicas utilizadas foram laminados cerâmicos. Foram usados setenta discos de formato padrão (0,5mm de espessura x 10 mm de diâmetro) de tonalidades B1. Com base no tipo de cimento resinoso utilizado, os corpos-de-prova foram divididos em sete grupos (10 / grupo). Foram utilizados os seguintes cimentos fotopolimerizáveis: RelyX-Veneer (L-RV), Variolink-Veneer (L-VV) e Variolink-Esthetic (L-VE). Os cimentos de cura dual foram: RelyX Ultimate (D-RU), RelyX-Unicem (D-RC) e Variolink-Esthetics DC (D-VE). O grupo controle consistia apenas de cerâmica. Todos os corpos-de-prova foram termociclados em água por 3.500 ciclos entre 5oC-55oC, com tempos de permanência de 30s em cada banho e um tempo de transferência de 10s entre os banhos. A medição da cor foi feita usando os espectrofotômetros VITA Easyshade e ColorEye. A leitura da cor inicial foi realizada 24 horas após a cimentação. As diferenças na cor (ΔE) do EasyShade e ColorEye antes e depois do EAA foram determinadas e comparadas estatisticamente. As comparações dos grupos foram feitas usando o teste t pareados. O nível de significância foi estabelecido em p <0,05. Resultados: os valores médios de diferenças na cor (ΔE) obtidos no espectrofotômetro EasyShade para cimentos fotopolimerizáveis e duais foram de 0,843 ± 0,89 (L-RV), 4,11 ± 0,69 (L-VV) e 0,833 ± 0,47 (L-VE ); e 2,22 ± 0,64 (D-RU), 3,37 ± 0,83 (D-RC) e 0,38 ± 0,92 (D-VE), respectivamente. os valores médios de diferenças na cor (ΔE) obtidos no espectrofotômetro ColorEye para cimentos fotopolimerizáveis e duais foram de 0,68 ± 0,86 (L-RV), 4,55 ± 0,83 (L-VV) e 2,68 ± 0,26 (L-VE); e 2,06 ± 0,84 (D-RU), 1,8 ± 1,08 (D-RC) e 0,96 ± 0,71 (D-VE), respectivamente. Não houve diferença significativa nos valores médios de ΔE entre os grupos. Conclusão: Os sistemas de combinação de cores VITA Easyshade e ColorEye são comparáveis em termos de eficácia para avaliação de cores de cerâmicas após EAA. (AU)

Effective Reduction of Mental Trauma with a Multidisciplinary Approach to Treatment of Dental Trauma

The purpose of this case report and review is to present the successful management of complicated crown-root fracture of maxillary central incisor with a multidisciplinary approach. A 57-year-old male patient reported with a complaint of unpleasant appearance due to a broken 21. Clinical and radiological examination revealed a complicated oblique crown-root fracture extending below the gingival margin. The tooth was endodontically treated. Surgical crown lengthening with osseous recontouring was performed. After 7 days prefabricated temporary crown was cemented, 6 weeks after surgery fiber post was placed followed by composite core build up. The tooth was restored with a permanent restoration of porcelain fused to the metal crown with gingival porcelain. Examination after 3 months revealed the good periodontal health, esthetic, normal function and patient satisfaction. The key factor in the successful functional and esthetic rehabilitation of a complicated crown-root fracture is weighing of all the available options with a multidisciplinary approach.

Color changes of ceramic veneers following glazing with respect to their composition

PURPOSE: The purpose of this study was to compare the translucency and color changes of ceramic laminate veneers of different composition following glazing process. MATERIALS AND METHODS: 10 mm × 10 mm square specimens of 0.6 mm and 1.0 mm thicknesses were fabricated with IPS e.max Press (EM) and IPS e.max ZirPress (ZP) (n=10 per group). The color coordinates (CIE L* a* b*) of the specimens were recorded with a colorimeter before and after glazing. The color changes and translucency parameter (TP) were calculated. For the comparisons with the composition and thicknesses between the ‘not glazed’ and ‘glazed’ groups, statistical analyses were done through paired T-test, independent two-sample T-test, and multiple regression analysis using SPSS 18.0 (P < .05). RESULTS: The TP of 0.6 mm EM was higher than that of 0.6 mm ZP. Total color difference (ΔE*) between bare and glazed specimens of 1.0 mm EM was greater than that of 1.0 mm ZP with statistical significance. Following glazing, specimens from all groups showed statistically significant amount of decrease in L* and a*, and statistically significant increase in b*. The result of multiple regression analysis of EM and ZP showed that ΔL* improved ΔE*. CONCLUSION: Within the limitations of present study, we conclude that translucency and color of ceramic laminate veneers change significantly after glazing process, and the nature and amount of changes vary with different compositions.

Effects of different surface treatments on the shear bond strength of veneering ceramic materials to zirconia

PURPOSE: To evaluate and compare the effect of different materials and techniques on the shear bond strength of veneering ceramic materials to zirconia. MATERIALS AND METHODS: 136 sintered zirconia cubes were prepared and randomly divided into four study groups according to corresponding methods of surface treatment and materials: GLN (grinding followed by laser scanning using Noritake Cerabien ZR), SLN (sandblasting followed by laser scanning using Noritake Cerabien ZR), GLV (grinding followed by laser scanning using VITA VM 9), and SLV (sandblasting followed by laser scanning using VITA VM 9). Spraying technique was performed to coat the core. Profilometer, SEM, XRD, EDS, universal testing machine, and stereomicroscope were used to record surface roughness Ra, surface morphology, phase transformation, elemental compositions, shear bond strength SBS values, and failure types, respectively. Specimens were investigated in unaged (not immersed in artificial saliva) and aged (stored in artificial saliva for a month) conditions to evaluate SBS values. RESULTS: Grinding and GLN as first and second surface treatments provided satisfactory Ra values in both conditions (1.05 ± 0.24 µm, 1.30 ± 0.21 µm) compared to sandblasting and other groups (P < .05). The group GLN showed the highest SBS values in both conditions (30.97 ± 3.12 MPa, 29.09 ± 4.17 MPa), while group SLV recorded the lowest (23.96 ± 3.60 MPa, 22.95 ± 3.68 Mpa) (P < .05). Sandblasting showed phase transformation from t-m. Mixed failure type was the commonest among all groups. CONCLUSION: GLN showed to be a reliable method which provided satisfactory bond strength between the veneer ceramic and zirconia. This method might preserve the integrity of fixed dental crowns.

Effect of dentin exposure on the shear bond strength of cast porcelain veneers / 口腔疾病防治

Objective@#To explore the best indication for veneers and to improve the repair success rate by investigating the effects of different types of dentin exposure on the shear bond strength of cast porcelain veneers with two new veneer bonding systems.@*Methods@#Bonding interfaces with 0%, 25%, 50%, 75% and 100% dentin exposure were designed and fabricated. The bonding interfaces were divided into groups A, B, C, D and E. Sixty 4-mm x 4-mm x 2-mm (length x width x thickness) ceramic specimens were bonded by using two bonding systems, The VN-A, VN-B, VN-C, VN-D and VN-E groups were bonded with Variolink bonding system, and the PF-A, PF-B, PF-C, PF-D and PF-E were bonded with Panavia F bonding system (six specimens per group). The bonded specimens were stored in a distilled water bath at (37 + 1)℃ for 24 hours. The fracture load was tested by a universal testing machine, and the fracture type was observed by scanning electron microscopy.@*Results @#The VN-A (25.14 ± 3.40 MPa), VN-B (22.54 ± 4.48 MPa), VN-C (19.59 ± 2.21 MPa), PF-A (20.61 ± 2.42 MPa), PF-B (18.08 ± 4.11 MPa), PF-C (17.06 ± 2.29 MPa) groups’ shear bond strengths were above 17 MPa. The VN-A group had the highest shear bond strength value. There was no statistically significant difference in bond strength between the VN-A group and the VN-B and VN-C groups (P > 0.05) or the PF-A and PF-B groups (P > 0.05); however, the differences between VN-A and the VN-D and VN-E groups (P < 0.05) and between PF-A and the PF-C and PF-D and PF-E groups (P < 0.05) were statistically significant. The differences between the VN-A group and PF-A group (P < 0.05) were statistically significant. The fracture modes of the VN-A, PF-A, VN-B, PF-B, and VN-C groups mainly included resin cement cohesive failure and mixed failure; the VN-D, VN-E, PF-C, PF-D and PF-E groups were dominated by interface failure and mixed failure.@*Conclusion@#When the dentin exposure is greater than 50%, the shear bond strength value of the veneer was significantly affected. To obtain a better clinical effect, the dentin exposure rate should be less than 25%.

Clinical application of digital smile design in aesthetic restoration of porcelain veneer of anterior teeth and analysis on its repair effect / 吉林大学学报(医学版)

Objective: To analyze the postoperative satisfaction and repair effect of prosthesis of the patients who received digital smile design(DSD) combined with porcelain veneers in the anterior teeth, and to illustrate the their application in anterior teeth aesthetic restoration. Methods: A total of 91 anterior teeth of 32 patients whose clinical diagnosis conformed to the indications of porcelain veneers and aesthetic restoration because of tetracycline pigmentation teeth, dental fluorosis, color stained teeth, enamel defects and anterior teeth space were selected. DSD software was used to design the preoperative aesthetic analysis of the teeth morphology and to show the virtual effect of restoration. The preparation of tooth under the guidance of the design results was finished. The IPS e-max porcelain veneers were prepared after the conventional impression preparation. At last, the permanent restorations were manufactured and bonded to teeth. After the adhesive program was completed, the satisfaction of the patients in the shape of restorations, the degree of coordination with the adjacent teeth, color, pronunciation, smile effect and doctor-patient communication effect were evaluated by the questionnaires. The patients were required to regularly return after one month, three months, six months and twelve months, and observe the clinical effects of restoration was observed referring to the modified American Public Health Service (USPHS) standard. Results: The patients' satisfaction rates of each evaluation content were all over 90%. Among them, the satisfaction rates of the smile effect and the doctor patient communication were as high as 100%. The clinical performances of the rehabilitations in each period were as follows: One month after treatment, there were four teeth occurred mild gingivitis and three teeth appeared the postoperative sensitivity symptoms; three months after treatment, there were one tooth showed a minor fracture in the restoration without affecting the appearance and function and three teeth had mildly congestive gums reaction, at the same time one tooth showed slight discoloration of the restoration; six months after treatment, one tooth showed ceramics fracture of restoration and four teeth developed mild gingivitis; twelve months after treatment, two teeth showed ceramics fracture, the edge of three restorations had slightly crack and one tooth appeared gingivitis. The periodontal conditions of the patients with gingival inflammation after treatment were improved significantly after receiving the correct oral hygiene guidance. The above defects didn't affect the aesthetics effect and the functions of restorations, and the restorations could be used normally after intraoral adjustments. Both the doctors and the patients were satisfied with the repair effects of the restorations. Conclusion: The combination of DSD and porcelain veneer in repairing anterior aesthetic teeth is good treatment plan that can achieve high patient satisfaction and ideal clinical effect.

Interdisciplinary planning as a landmark for treatment: Case report with a 2-years follow-up

Abstract Case report: young adult woman with esthetic complaints regarding her smile and frontal teeth aspect. At first glance, the problem seemed to be only the shape of the lateral upper incisors and a small diastema between the central incisors. The diagnosis shared between the orthodontist and the prosthetist led us to consider some other important aspects, such as the deep bite, the teeth inclination and the lips support. All these findings led us to consider that the right way to improve the esthetics of the patient's smile was to plan an orthodontic treatment. This would serve not only for the distribution of the spaces, but mostly it would improve all other problems, before the restoration of the upper lateral teeth with two ceramic veneers. Results: the treatment plan achieved the right distribution of spaces for upper lateral incisors, significant correction of the incisors inclination with important reduction of overbite and better lip support, upper laterals restorations with ceramic feldspathic veneers, obtaining a good integration with natural teeth satisfying patient complaint. Conclusion: in cases which involve interdisciplinary approach, the fundamental step comes from the beginning, when only an initial diagnosis shared among the team of specialists can define the patient problems from different points of view. In this way, we can better understand the competency fields and plan the right treatment and time sequence.

Resumo Relato de caso: paciente adulta jovem, sexo feminino, buscou tratamento devido à queixa com a estética do sorriso e o aspecto dos dentes anteriores. À primeira vista, o problema parecia ser apenas o formato dos incisivos laterais superiores e um pequeno diastema entre os incisivos centrais. O diagnóstico conjunto do ortodontista e do protesista fez com que considerássemos outros aspectos importantes, tais como mordida profunda, inclinação dentária e suporte labial. A partir de todas essas constatações, consideramos que a maneira mais adequada de melhorar a estética do sorriso seria planejar o tratamento ortodôntico. Assim, o tratamento serviria não apenas para melhor distribuição dos espaços, mas também melhoraria todos os outros problemas antes da restauração dos dentes laterais superiores ser realizada com duas facetas de cerâmica. Resultados: o tratamento planejado levou à correta distribuição dos espaços nos incisivos laterais superiores, com correção significativa da inclinação dos incisivos, importante redução da sobremordida e um melhor suporte labial, com restauração dos laterais superiores usando facetas de cerâmica feldspática, obtendo-se uma integração ideal com os dentes naturais, resolvendo as reclamações da paciente. Conclusão: em casos envolvendo abordagem multidisciplinar, as etapas iniciais são fundamentais, e apenas um diagnóstico inicial discutido entre a equipe de especialistas pode determinar os problemas do paciente sob diferentes perspectivas. Dessa forma, podemos compreender melhor os campos de competência e planejar a sequência e o tempo de tratamento mais adequados.

Characterization of residual stresses in veneering ceramics for prostheses with zirconia framework

Abstract The aim of this study was to evaluate the influence of the coefficient of thermal expansion (CTE or α) and glass transition temperature (Tg) of three veneering ceramics used with zirconia frameworks of full-arch fixed prostheses. The generation of residual stresses and linear contraction after the simulation of the cooling process and mechanical loading were measured. The analysis was based on the finite element method in three-dimensional model of a maxillary full-arch fixed prosthesis with zirconia framework (e.max ZirCAD) and veneer by felsdpathic ceramics (GEC - IPS e.max Ceram, GVM - Vita VM9 and GLC - Lava Ceram). The linear contraction simulation was performed by cooling the structures from the Tg of each veneer ceramic at room temperature (25°C). A loading of 100 N on the occlusal region of the first molar was performed. The magnitude of the maximum principal stress (smax) and linear contraction were evaluated. The levels of CTE mismatch between veneering ceramics and framework showed no relevant influence on smax and linear contraction. The Tg values of the veneer ceramic showed to be directly proportional to amount of smax and linear contraction. The GEC presented the highest values of smax and linear contraction. The GVM and GLC did not present significant differences between them. In conclusion, GVM was similar to GLC, while GEC presented differences in relation to other veneer ceramics in terms of residual stress and linear contraction.

Resumo O objetivo neste estudo foi avaliar a influência do coeficiente de expansão térmica (CET) e da temperatura de transição vítrea (Tg) de três cerâmicas feldspáticas utilizadas para o recobrimento da infraestrutura de zircônia em prótese total fixa. A tensão residual e contração linear após a simulação do processo de esfriamento e carga oclusal foram mensuradas. A análise foi efetuada pelo método por elementos finitos num modelo tridimensional de uma prótese total maxilar com infraestrutura em zircônia (e.max ZirCAD) recoberta por três cerâmicas felsdpáticas (GEC - IPS e.max Ceram, GVM - Vita VM9 ou GLC - Lava Ceram). A simulação da contração linear foi realizada pelo esfriamento da estrutura a partir da Tg de cada cerâmica de cobertura até a temperatura ambiente (25 °C). Em seguida, um carregamento de 100 N foi realizado na região oclusal de primeiro molar. A magnitude da tensão máxima principal (smax) e contração linear foram avaliadas. Os níveis de diferença de CTE entre cerâmica de cobertura e infraestrutura não apresentaram influência significante na smax e na contração linear. Os valores da Tg da cerâmica de cobertura foram diretamente proporcionais à quantidade de smax e contração linear. O grupo GEC apresentou os maiores valores de smax e contração linear, enquanto os grupos GVM e GLC com menores valores não apresentaram diferenças significantes entre si. Em conclusão, o grupo GVM foi similar ao GLC, enquanto o grupo GEC apresentou diferenças em relação a outras cerâmicas de cobertura quanto à tensão residual e contração linear.

Influence of thickness and incisal extension of indirect veneers on the biomechanical behavior of maxillary canine teeth

OBJECTIVES: To analyze the influence of thickness and incisal extension of indirect veneers on the stress and strain generated in maxillary canine teeth. MATERIALS AND METHODS: A 3-dimensional maxillary canine model was validated with an in vitro strain gauge and exported to computer-assisted engineering software. Materials were considered homogeneous, isotropic, and elastic. Each canine tooth was then subjected to a 0.3 and 0.8 mm reduction on the facial surface, in preparations with and without incisal covering, and restored with a lithium disilicate veneer. A 50 N load was applied at 45° to the long axis of the tooth, on the incisal third of the palatal surface of the crown. RESULTS: The results showed a mean of 218.16 µstrain of stress in the in vitro experiment, and 210.63 µstrain in finite element analysis (FEA). The stress concentration on prepared teeth was higher at the palatal root surface, with a mean value of 11.02 MPa and varying less than 3% between the preparation designs. The veneers concentrated higher stresses at the incisal third of the facial surface, with a mean of 3.88 MPa and a 40% increase in less-thick veneers. The incisal cover generated a new stress concentration area, with values over 48.18 MPa. CONCLUSIONS: The mathematical model for a maxillary canine tooth was validated using FEA. The thickness (0.3 or 0.8 mm) and the incisal covering showed no difference for the tooth structure. However, the incisal covering was harmful for the veneer, of which the greatest thickness was beneficial.