Influence of 3D printing system, postpolymerization and aging protocols on resin flexural strength and dimensional stability for printing occlusal splints, models and temporary restorations.

OBJECTIVES: Investigate the effect of different postpolymerization protocols, aging, and 3D printing systems on the flexural strength (σ), dimensional stability, and roughness of resins used to fabricate occlusal splints, dental models, and temporary restorations. MATERIAL AND METHODS: 180 bars (25 × 2 x 2 mm-ISO 4049) of each type of resin (T-Temporary/Cosmos Temp, Yller; OS-Occlusal splint/Cosmos Splint, Yller; MO - Models/ Cosmos Model, Yller) were printed and divided into 12 groups (n = 15) according to the factors: "Postpolymerization" (Ctr - Control; UV - Ultraviolet oven and MW - Microwave); "Printer" (SLA- stereolithography (Forms 2/Formslab); LCD- liquid crystal display (FlashForge Foto 6.0/FlashForge)) and "Aging" (TC - 10,000 thermocycling cycles and Without). Each bar was measured with a digital caliper at 11 points before and after postpolymerization to evaluate dimensional stability. The samples were subjected to the σ test (100Kgf;1 mm/min). Data was evaluated using Three- and Two-way ANOVA, and Tukey's test (5%). Weibull analysis, Scanning Electron Microscopic and optical profilometry was performed. RESULTS: LCD printing system and UV oven postpolymerization exhibited the highest σ (P < .05). The groups printed in SLA and post-polymerized in microwave ovens showed the greatest variations in their dimensions, for the occlusal splint resin, the OS-SLA-MW group (-4.29 ± 3.15)A showed a shrinkage of 40.2%. The resins for models (3.31 ± 0.66)A and temporary (-2.06 ± 1.52)A showed a shrinkage of 33% and 20.6%, respectively. CONCLUSIONS: LCD printing with UV light postpolymerization was the most effective method for resins used in occlusal splints, dental models, and temporary restorations. SLA printing with UV postpolymerization showed the most significant dimensional changes, leading to shrinkage in occlusal splint resins, while model resins and temporary restorations expanded. CLINICAL RELEVANCE: Resins for 3D printing should ideally be post-polymerized with UV light and printed using LCD technology, as this approach results in better mechanical properties and less dimensional change compared to microwave oven post-polymerization.

Effect of different surface treatments and adhesive cementation on the surface topography and flexural strength of translucent and ultra-translucent monolithic zirconia.

PURPOSE: To evaluate the effect of different surface treatments and adhesive cementation on the miniflexural strength (MFS) of monolithic zirconia. MATERIALS AND METHODS: Two-hundred and forty (240) sintered bars of translucent zirconia (ZT) and ultra-translucent zirconia (ZUT) were obtained (8 mm ×2 mm ×1 mm). The bars were divided into 16 groups (n = 15) according to the factors "Zirconia" (ZT and ZUT), "Cementation" (Cem) and "surface treatment" (Ctrl:Control, Al:Aluminum oxide/Al2O3 50 µm, Si:Silica/SiO2 coated alumina particles oxide 30 µm, Gl:Glazing+hydrofluoric acid). Half of the bars received an adhesive layer application, followed by application of resin cement and light curing. The surface roughness was measured in non-cemented groups. All the bars were subjected to the MFS test (1.0 mm/min; 100 kgf). Scanning electron microscopy was used for qualitative analyses. MFS data (MPa) and roughness (µm) were statistically evaluated by three-way and two-way ANOVA respectively and Tukey's test (5%). RESULTS: The surface treatment and the interaction were significant for roughness. Glazing promoted less roughness compared to silicatization. Regarding MFS, only the zirconia and surface treatment factors were significant. For ZT, the sandblasted groups had an increase in MFS and glazing reduced it. There was no difference between the groups without cementation for the ZUT; however, ZUT.Si/Cem, and ZUT.Al/Cem obtained superior MFS among the cemented groups. CONCLUSIONS: Sandblasting increases the flexural strength for ZT, while glaze application tends to reduce it. Applying resin cement increases the flexural strength of ZUT when associated with sandblasting. Sandblasting protocols promote greater surface roughness.

Adhesive Cementation of CAD/CAM Silica-based Ceramics: Effect of Adhesive Type and Long-term Aging on the Bond Strength to Composite Cement.

PURPOSE: To investigate the effect of adhesive type and long-term aging on the shear bond strength (SBS) between silica-based ceramics and composite cement (CC). MATERIALS AND METHODS: Lithium-silicate (LS), feldspathic (FD) and polymer-infiltrated ceramic (PIC) blocks were sectioned (10 x 12 x 2 mm) and divided into 24 groups considering the factors: "ceramics" (LS, FD, and PIC), "adhesive" (Ctrl: without adhesive; 2SC: 2-step conventional; 3SC: 3-step conventional; 1SU: 1-step universal), and "aging" (non-aged or aged [A]). After the surface treatments, CC cylinders (n = 15, Ø = 2 mm; height = 2 mm) were made and half of the samples were subjected to thermocycling (10,000) and stored in water at 37°C for 18 months. The samples were submitted to SBS testing (100 kgf, 1 mm/min) and failure analysis. Extra samples were prepared for microscopic analysis of the adhesive interface. SBS (MPa) data was analyzed by 3-way ANOVA and Tukey's test (5%). Weibull analysis was performed on the SBS data. RESULTS: All factors and interactions were significant for SBS (p<0.05). Before aging, there was no significant difference between the tested groups and the respective control groups. After aging, the LS_1SU (22.18 ± 7.74) and LS_2SC (17.32 ± 5.86) groups exhibited significantly lower SBS than did the LS_Ctrl (30.30 ± 6.11). Only the LS_1SU group showed a significant decrease in SBS after aging vs without aging. The LS_1SU (12.20) group showed the highest Weibull modulus, which was significantly higher than LS_2SC_A (2.82) and LS_1SU_A (3.15) groups. CONCLUSION: No type of adhesive applied after silane benefitted the long-term adhesion of silica-based ceramics to CC in comparison to the groups without adhesive.

Recycling CAD/CAM lithium disilicate ceramic: effect of surface treatment and aging on the bond strength to resin cement.

PURPOSE: To investigate the effect of recycling of lithium disilicate (LD), surface treatment and thermocycling (TC) on the bond strength (SBS) to resin cement. MATERIALS AND METHODS: Blocks of LD were made according to the recycling cycle, with 24 blocks for each strategy: Control-conventional sintering; 1R (1 recycling cycle) and 3R (3 recycling cycles). For the recycling groups, blocks were waxed (10x10x3mm), mounted in a silicone ring, poured with investment material, and then residues of sintered LD blocks were pressed by the lost wax technique. The residual LD was reused as described until reach 3R. Afterwards, the blocks were embedded in acrylic resin, sanded and divided (n=15) according to the factors "surface treatment" (HF20s+Silane and HF120s+Silane and Monobond Etch&Prime- MEP) and TC (with/10.000 cycles and without). After surface treatment, cylinders (Ø:2mm) of resin cement were made and submitted to SBS test (100KgF,1mm/min). Data (MPa) were analyzed by 3-way ANOVA, Tukey's test (5%) and Weibull analysis. Failure analysis was performed with stereomicroscope. RESULTS: ANOVA revealed that all factors were significant (P=.000*). The group 3RMEP(105.09±19.49) presented the highest SBS among the experimental groups. 1RHF20sTc(7.50±1.97) group had the lowest SBS, similar to the CHF20sTc(15.69±3.77), 1RHF20s(15.12±3.03), 1RHF120sTc(14.60±3.43) and 3RHF20sTc(15.65±0.97). The Weibull modulus and characteristic strength varied among the experimental groups (P=0.0). Failure analysis revealed adhesive and mixed types. CONCLUSION: The recycling of DL ceramics increases the SBS to resin cement when the ceramic is treated with HF120s+S or MEP.

Preheated Composite as an Alternative for Bonding Feldspathic and Hybrid Ceramics: A Microshear Bond Strength Study.

PURPOSE: To evaluate the bond strength between alternative or conventional luting agents and indirect restorative materials. MATERIALS AND METHODS: Blocks of a polymer-infiltrated ceramic network (PICN, Vita Enamic) and a feldspathic ceramic (FEL, Vita Mark II) were sliced and divided according to the luting agent: resin cement (PICN-RC, FEL-RC), flowable composite (PICN-FC, FEL-FC), or preheated composite (PICN-PH, FEL-PH). The ceramic surfaces were polished, etched with 5% hydrofluoric acid for 60 s, and then a silane layer was applied. Cylinders of the luting agents were built up on the ceramic surfaces. In half the samples, the microshear bond strength (µSBS) was tested after 24 h (baseline). The other half was tested after 5000 thermocycles (5°C-55°C) (aging). The failure modes were determined using a stereomicroscope, and the ceramic surfaces were analyzed using a scanning electron microscope. Data were statistically analyzed with two-way ANOVA. RESULTS: Thermocycling reduced the bond strength values of all experimental groups. Regarding FEL, the preheated composite obtained the highest results. Resin cement showed results similar to the flowable composite at baseline and after aging. The highest results of PICN were obtained from the preheated composite followed by resin cement and flowable composite. Significant differences among the three luting agents were observed before and after aging. The most frequent failures among the experimental groups were adhesive and cohesive in the ceramic. CONCLUSION: Bond strength results indicate that the preheated composite can be an alternative for adhesive cementation when applied on the tested feldspathic ceramic or PICN.

Biaxial flexure strength and physicochemical characterization of a CAD/CAM lithium disilicate ceramic: effect of etching time, silane, and adhesive applications.

OBJECTIVE: To evaluate the effect of different acid etching time and bonding agent (silane and/or adhesive system) on biaxial flexural strength and physico-chemical properties of a lithium disilicate ceramic. MATERIAL AND METHODS: One hundred twenty ceramic discs were made and divided into 8 groups (n = 15) according to factors "etching time" (20 and 120 s) with hydrofluoric acid (HF) and "bonding agent" (C, no bonding agent; S, silane, A, adhesive; and SA, silane + adhesive). After surface treatment, a resin cement layer was applied to the surface and all specimens were subjected to biaxial flexural strength (BFS) test with treated surfaces loaded in tension (1 mm/min). The Weibull analyses and complementary analyses were also performed. Statistical analysis was done with 2-way ANOVA and the Tukey test (α = 0.05). RESULTS: ANOVA revealed that the factors "etching time" (p = 0.0003) and "bonding agent" (p = 0.007) were statistically significant. In the overall analysis, the HF120S group (272.02 ± 35.30A MPa) presented significantly higher BFS than that of HF120C (218.45 ± 17.15CD MPa) and HF20S (228.40 ± 37.83BCDMPa). On the other hand, the HF20A group (208.92 ± 31.16D MPa) had significantly lower BFS than HF120S (272.02 ± 35.30A), HF120A (254.42 ± 26.87ABC) and HF120SA (259.30 ± 36.55AB) groups (Tukey). The Weibull modulus (m) of all groups was significantly different from each other (p = 0.000). CONCLUSIONS: Regardless of etching time, the application of silane alone is sufficient to increase the flexural strength of glass ceramic, eliminating the need for the application of adhesive systems. Moreover, if only silane or adhesive is applied, 120-s HF application should increase the flexural resistance of the lithium disilicate ceramic. CLINICAL SIGNIFICANCE: Applications of adhesive systems after silanization can be suppressed from the surface treatment protocol of glass ceramics, since it does not improve their mechanical strength.

CAD-FEA modeling and fracture resistance of bilayer zirconia crowns manufactured by the rapid layer technology.

In the RLT (Rapid Layer Technology), veneering ceramic and framework are fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) and then cemented to obtain the restoration. This study aimed to evaluate the effect of the thickness of veneering ceramic manufactured by the RLT technique on the fracture resistance (FR) of bilayer crowns with zirconia frameworks. Twenty zirconia frameworks and twenty feldspathic posterior crowns with two different veneering ceramic occlusal thicknesses (1mm=TF1; 2mm=TF2) were manufactured using CAD/CAM system. The specimens were luted to an epoxy resin abutment with resin cement and mechanically cycled (200N and 4.5×105 Pa, 37°C, 2×106 cycles, 3Hz). The FR test was performed (10kN, 0.5mm/min), and the specimens were analyzed in a stereomicroscope. For the stress analysis (finite element analysis, FEA), a 10kN load was equal to the in vitro test, and the principal stress was evaluated. The FR data were analyzed by Student's t-test and Weibull's analysis. The thickness influenced the FR of bilayer crowns. The FR was higher in the TF2 than in the TF1 group. The TF2 group presented the highest characteristic strength compared to the group TF1. The predominant type of failure was delamination. The FEA showed higher stress concentrations below the loading application point at the veneering cement interface in the 1-mm-thick model. The bilayer crowns manufactured using the approach of 2mm of veneering ceramic promoted higher FR compared to the group with 1mm veneering ceramic. Also, the FEA showed that the veneer ceramic thickness has an effect on stress distribution in zirconia-based bilayer crowns.

CAD-FEA modeling and fracture resistance of bilayer zirconia crowns manufactured by the rapid layer technology

Abstract In the RLT (Rapid Layer Technology), veneering ceramic and framework are fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) and then cemented to obtain the restoration. This study aimed to evaluate the effect of the thickness of veneering ceramic manufactured by the RLT technique on the fracture resistance (FR) of bilayer crowns with zirconia frameworks. Twenty zirconia frameworks and twenty feldspathic posterior crowns with two different veneering ceramic occlusal thicknesses (1mm=TF1; 2mm=TF2) were manufactured using CAD/CAM system. The specimens were luted to an epoxy resin abutment with resin cement and mechanically cycled (200N and 4.5×105 Pa, 37°C, 2×106 cycles, 3Hz). The FR test was performed (10kN, 0.5mm/min), and the specimens were analyzed in a stereomicroscope. For the stress analysis (finite element analysis, FEA), a 10kN load was equal to the in vitro test, and the principal stress was evaluated. The FR data were analyzed by Student's t-test and Weibull's analysis. The thickness influenced the FR of bilayer crowns. The FR was higher in the TF2 than in the TF1 group. The TF2 group presented the highest characteristic strength compared to the group TF1. The predominant type of failure was delamination. The FEA showed higher stress concentrations below the loading application point at the veneering cement interface in the 1-mm-thick model. The bilayer crowns manufactured using the approach of 2mm of veneering ceramic promoted higher FR compared to the group with 1mm veneering ceramic. Also, the FEA showed that the veneer ceramic thickness has an effect on stress distribution in zirconia-based bilayer crowns.

Resumo Na RLT (Rapid Layer Technology), a cerâmica de cobertura e infraestrutura são fabricados pelo Computer-Aided Design / Computer-Aided Manufacturing (CAD / CAM) e cimentados para obter a restauração. Este estudo teve como objetivo avaliar o efeito da espessura da cerâmica de cobertura fabricada pela técnica RLT na resistência à fratura (RF) de coroas bilaminadas com infraestrutura de zircônia. Vinte infraestruturas de zircônia e vinte coroas posteriores feldspáticas com duas espessuras oclusais da cerâmica de cobertura (1mm = TF1; 2mm = TF2) foram fabricadas usando o sistema CAD / CAM. Os espécimes foram cimentados em preparos de resina epóxi com cimento resinoso dual e ciclados mecanicamente (200N e 4,5×105 Pa, 37° C, 2×106 ciclos, 3Hz). O teste de RF foi realizado (10kN, 0,5mm / min) e, posteriormente, os espécimes foram analisados em estereomicroscópio. Para a análise de tensão (análise de elementos finitos, FEA), uma carga de 10kN foi aplicada igual ao teste in vitro, e a tensão principal foi avaliada. Os dados de RF foram analisados pelo teste t de Student e análise de Weibull. A espessura mostrou forte influência na RF das coroas bilaminadas. A RF foi maior em TF2 do que no grupo TF1. O grupo TF2 apresentou a maior resistência característica em relação ao grupo TF1. O tipo de falha predominante foi a delaminação. O FEA mostrou maiores concentrações de tensões abaixo do ponto de aplicação da carga, na interface cimento e cerâmica de cobertura no modelo de coroa de 1 mm de espessura. As coroas de bilaminadas confeccionadas com 2 mm de cerâmica de cobertura promoveram maior RF em comparação ao grupo com cerâmica de cobertura de 1 mm. Além disso, a FEA mostrou que a espessura da cerâmica de cobertura tem um efeito na distribuição de tensões em coroas bilaminadas à base de zircônia.

Effect of different surface treatments and multimode adhesive application on the Weibull characteristics, wettability, surface topography and adhesion to CAD/CAM lithium disilicate ceramic.

METHODOLOGY: This paper aims to evaluate the effect of different surface treatments on surface topography, wettability, and shear bond strength of resin cement to glass ceramic. For SBS test, 32 blocks (7x7x2 mm) of lithium disilicate were obtained and randomly divided into eight groups (four blocks per group) according to each surface treatment (HF 20 s, 60 s, 120 s + silanization/S or Scotch Bond Universal/ SBU) and the Monobond Etch & Prime - MEP application followed or not by SBU. On each treated surface ceramic block, up to four dual-curing resin cement cylinders were prepared and light-cured for 40s (N=120/n=15). The specimens were thermocycled (10,000 cycles, 5-55°C, 30 s) and the SBS test (50KgF, 0.5 mm/min) was performed. Furthermore, failure analysis, wettability, AFM, and SEM were carried out. SBS data (MPa) were analyzed using Student's t-test, two-way ANOVA, Tukey's test (5%) and Weibull's analysis. RESULTS: For HF experimental groups, two-way ANOVA presented the factors "etching time" and "bonding agent" as significant (p<0.05). After silane application, the HF groups presented similar bond strength. SBU application compromised the SBS, except for 120s etching time (HF120sS: 23.39ᵃ±6.48 MPa; HF120sSBU: 18.76ᵃ±8.81MPa). For MEP groups, SBU application did not significantly affect the results (p=0.41). The MEP group presented the highest Weibull modulus (4.08A) and they were statistically different exclusively from the HF20sSBU (0.58B). CONCLUSION: The HF 20s, 60s, 120 s followed by silane, promoted similar resin-bond strength to ceramic and the SBU application after HF or MEP did not increase the SBS.

Hydrofluoric acid concentration, time and use of phosphoric acid on the bond strength of feldspathic ceramics.

The objective of this study was to evaluate the influence of hydrofluoric acid (HF) concentration, etching time, and application of phosphoric acid (PA) followed by neutralization with sodium bicarbonate on the bond strength between a feldspar ceramic and resin cement. Thus, 80 blocks (10 x 12 x 2 mm) of glass ceramic (VM - Vita Mark II - Vita Zahnfabrik) were made and randomly assigned to eight groups (n = 10) according to the factors: HF concentration (5 and 10%), etching time (60 and 120 s), and use of phosphoric acid (PA) (with and without). According to the experimental group, 37% PA (Condac, FGM) was applied after HF etching for 60s. Afterwards, samples were immersed in sodium bicarbonate for 1 min then in an ultrasonic bath in distilled water (5 min) for cleaning. After surface bonding treatment, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block. The samples were then stored in water (37ºC) for 90 days and submitted to the shear bond test (50 KgF, 1 mm/min). Failure analysis was performed by stereomicroscope and scanning electron microscopy. Data (MPa) were analyzed with 3-way ANOVA and Tukey's test. Only the factor "HF concentration" was significant (p = 0.02). Most failures were of cohesive in ceramic (40%) and mixed types (42.5%). The 10% HF resulted in higher shear bond strength value than the 5% HF. Surface cleaning with phosphoric acid followed by sodium bicarbonate and HF time (60 or 120 seconds) did not influence the resin bond strength to feldspar ceramic.

Effect of different surface treatments and multimode adhesive application on the Weibull characteristics, wettability, surface topography and adhesion to CAD/CAM lithium disilicate ceramic

Abstract This paper aims to evaluate the effect of different surface treatments on surface topography, wettability, and shear bond strength of resin cement to glass ceramic. Methodology: For SBS test, 32 blocks (7x7x2 mm) of lithium disilicate were obtained and randomly divided into eight groups (four blocks per group) according to each surface treatment (HF 20 s, 60 s, 120 s + silanization/S or Scotch Bond Universal/ SBU) and the Monobond Etch & Prime - MEP application followed or not by SBU. On each treated surface ceramic block, up to four dual-curing resin cement cylinders were prepared and light-cured for 40s (N=120/n=15). The specimens were thermocycled (10,000 cycles, 5-55°C, 30 s) and the SBS test (50KgF, 0.5 mm/min) was performed. Furthermore, failure analysis, wettability, AFM, and SEM were carried out. SBS data (MPa) were analyzed using Student's t-test, two-way ANOVA, Tukey's test (5%) and Weibull's analysis. Results: For HF experimental groups, two-way ANOVA presented the factors "etching time" and "bonding agent" as significant (p<0.05). After silane application, the HF groups presented similar bond strength. SBU application compromised the SBS, except for 120s etching time (HF120sS: 23.39ᵃ±6.48 MPa; HF120sSBU: 18.76ᵃ±8.81MPa). For MEP groups, SBU application did not significantly affect the results (p=0.41). The MEP group presented the highest Weibull modulus (4.08A) and they were statistically different exclusively from the HF20sSBU (0.58B). Conclusion: The HF 20s, 60s, 120 s followed by silane, promoted similar resin-bond strength to ceramic and the SBU application after HF or MEP did not increase the SBS.

Hydrofluoric acid concentration, time and use of phosphoric acid on the bond strength of feldspathic ceramics

Abstract The objective of this study was to evaluate the influence of hydrofluoric acid (HF) concentration, etching time, and application of phosphoric acid (PA) followed by neutralization with sodium bicarbonate on the bond strength between a feldspar ceramic and resin cement. Thus, 80 blocks (10 x 12 x 2 mm) of glass ceramic (VM - Vita Mark II - Vita Zahnfabrik) were made and randomly assigned to eight groups (n = 10) according to the factors: HF concentration (5 and 10%), etching time (60 and 120 s), and use of phosphoric acid (PA) (with and without). According to the experimental group, 37% PA (Condac, FGM) was applied after HF etching for 60s. Afterwards, samples were immersed in sodium bicarbonate for 1 min then in an ultrasonic bath in distilled water (5 min) for cleaning. After surface bonding treatment, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block. The samples were then stored in water (37ºC) for 90 days and submitted to the shear bond test (50 KgF, 1 mm/min). Failure analysis was performed by stereomicroscope and scanning electron microscopy. Data (MPa) were analyzed with 3-way ANOVA and Tukey's test. Only the factor "HF concentration" was significant (p = 0.02). Most failures were of cohesive in ceramic (40%) and mixed types (42.5%). The 10% HF resulted in higher shear bond strength value than the 5% HF. Surface cleaning with phosphoric acid followed by sodium bicarbonate and HF time (60 or 120 seconds) did not influence the resin bond strength to feldspar ceramic.