Minimally Invasive Laminate Veneer Therapy for Maxillary Central Incisors.

Minimally invasive dentistry is a considered process that requires the clinician to be prepared with the ideal sequence and the tools needed. This report describes a well-planned ultraconservative approach using only two ceramic laminate veneers for the maxillary central incisors to significantly improve the patient's overall smile. A 30-year-old female presented with the chief complaints of having diastemas between the central and lateral incisors as well as incisal wear. Diagnostic wax-up and mock-up were performed, and the patient approved the minimally invasive treatment with veneers only for central incisors. A reduction guide aided the conservative tooth preparations, and hand-crafted feldspathic veneers were bonded under total isolation with a rubber dam. The two final conservative veneers significantly improved the smile and fulfilled the patient's expectations. Following proper planning and sequencing, predictable outcomes were obtained and fulfilled the patient's esthetic demands. Minimally invasive restorative dentistry with only two single veneers can impact the entire smile frame. Overtreatment in the esthetic zone is unnecessary to meet a patient's esthetic expectations.

Ceramic versus Composite Resin Polishing Systems on the Surface Roughness of Milled Leucite-Reinforced Ceramics.

Background and Objective: This study aimed to compare the surface finish of milled leucite-reinforced ceramics polished with ceramic and composite polishing systems based on the manufacturers' recommendations. Materials and Methods: Sixty subtractive computer-aided manufactured (s-CAM) leucite-reinforced glass-ceramic specimens (IPS-Empress-CAD) were assigned into six groups: no polishing, a ceramic polishing kit, and four composite kit groups. The roughness average (Ra) was evaluated in microns using a profilometer, and scanning electron micrographs were obtained for qualitative analysis. A Tukey HSD posthoc test (α = 0.05) was used to determine significant intergroup differences. Results: After surface evaluation of the ceramics, the Ra values of the polishing systems ranked OptraFine (0.41 ± 0.26) < Enhance (1.60 ± 0.54) < Shofu (2.14 ± 0.44) < Astropol (4.05 ± 0.72) < DiaComp (5.66 ± 0.62) < No Polishing (5.66 ± 0.74). Discussion: Composite polishing systems did not provide as smooth surfaces as the ceramic polishing kit for CAD-CAM leucite-reinforced ceramics. Thus, using ceramic polishing systems, polishing leucite ceramics is recommended, whereas composite polishing systems should not be considered as an alternative for use in minimally invasive dentistry.

SURVIVAL AND COMPLICATION RATES OF RESIN COMPOSITE LAMINATE VENEERS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: The aim of this systematic review was to evaluate the survival and complication rates of resin composite laminate veneers. METHODS: Randomized controlled trials and cohort studies with a minimum 2-year follow-up assessing survival and complication rates of resin composite laminate veneers on permanent dentition from 1998 to May 2022. Literature searches were conducted in MEDLINE (PubMed), Scopus, and the Cochrane Central Register of Controlled Trials electronic databases. References cited in the related reviews and included full-text articles were also hand-searched to further identify potentially relevant studies. RESULTS: A total of 827 articles were identified. Twenty-two studies were considered for full-text review after the title and abstract screening stage. After exclusion, 7 studies (3 randomized controlled trials and 4 cohort studies) were included in the systematic review. Three published scales were adopted for the quality and risk of bias assessment. At the survival rate threshold, the overall heterogeneity (I2) for randomized controlled trials was 50.5% (P = .108). The overall pooled survival rate of the randomized controlled trials was 88% (95% CI: 81%-94%), with the mean follow-up time ranging from 24 to 97 months. Surface roughness, color mismatch, and marginal discoloration were the most reported complications. CONCLUSION: Resin composite laminate veneers demonstrated moderately high survival rates for the entire sample and the direct laminate veneer group demonstrated higher survival rates than the indirect approach. Most of the complications were regarded as clinically acceptable with or without reintervention.

Double veneering, low-temperature porcelain, and total glaze application methods to overcome failures of zirconia-based restorations.

OBJECTIVES: The purpose of this in vitro study was to evaluate the efficacy of double veneering, low-temperature porcelain, and total glaze application methods to overcome failures of zirconia-based restorations. MATERIALS AND METHODS: Ninety yttrium-stabilized tetragonal zirconia materials with 1.2 × 5 × 24 mm dimensions were cut from pre-sintered blocks. According to the fabrication process of the samples, 3 main groups were formed in the beginning. Low-temperature porcelain and press-on ceramic were used for veneering. First, the samples were divided into 9 sub-groups. Then they were arranged to form triple groups. Triple groups were arranged according to the sample preparation and applied test methods, respectively. After three-point bending tests, marked samples were oriented for stereomicroscope and scanning electron microscope to evaluate and identify the fracture types. Data were statistically analyzed (p < 0.05). RESULTS: Delamination counts were higher than the chipping counts at all the samples with press layer. Chipping count was higher than the delamination count at low-temperature porcelain-veneered triple group. Delamination count was the highest at double-layered triple group. Scatter sample count was the least at ceramic-veneered triple group. Standard triple group was found to be more fracture-resistant. Accelerated aging increased delamination and/or scatter counts at all sub-groups and significantly (p = 0.01 < 0.05) degreased the mean fracture strength values. Total glaze application significantly (p = 0.01 < 0.05) improved the fracture strength values. CONCLUSION: All-round thinking is very important considering fracture strength, fracture type, delamination, chipping, normal fracture, and scattering. Applying low-temperature porcelain on zirconia substructure is more efficient than a transition material. Press-on material alone as a superstructure is not sufficient for successful restoration. Double veneering method is highly questionable. CLINICAL RELEVANCE: Zirconia-based all-ceramic restorations meet many criteria, especially durability and esthetics, which are necessary for a successful restoration. However, the harmony/integrity of substructure and superstructure is still an issue. Therefore, choosing of the veneering and/or protective method used during the fabrication of the restoration is very determinative for long-term success.

[Marginal features of CAD/CAM laminate veneers with different materials and thicknesses].

OBJECTIVE: To analyze the marginal roughness and marginal fitness of chairside computer-aided design and computer-aided manufacturing (CAD/CAM) laminate veneers with different materials and thicknesses, and to provide a reference for the clinical application of laminate veneers. METHODS: The butt-to-butt type laminate veneers were prepared on resin typodonts, the preparations were scanned, and the laminate veneers were manufactured by chairside CAD/CAM equipment. The laminate veneers were divided into four groups (n=9) according to the materials (glass-matrix ceramics and resin-matrix ceramics) and thickness (0.3 mm and 0.5 mm) of the veneers, with a total of 36. The marginal topo-graphies of each laminate veneer were digitally recorded by stereomicroscope, and the marginal rough-nesses of the laminate veneers were determined by ImageJ software. The marginal fitness of the laminate veneers was measured by a fit checker and digital scanning and measuring method. At the same time, the mechanical properties of glass-matrix ceramic and resin-matrix ceramic bars (n=20) were tested by a universal testing device. RESULTS: The marginal roughness of 0.3 mm and 0.5 mm glass-matrix ceramic laminate veneers was (24.48±5.55) µm and (19.06±5.75) µm, respectively, with a statistically significant difference (P < 0.001). The marginal roughness of 0.3 mm and 0.5 mm resin-matrix ceramic laminate veneers was (6.13±1.27) µm and (6.84±2.19) µm, respectively, without a statistically significant difference (P>0.05). The marginal roughness of the glass-matrix ceramic laminate veneers was higher than that of the resin-matrix ceramic laminate veneers with a statistically significant difference (P < 0.001). The marginal fitness of 0.3 mm and 0.5 mm glass-matrix ceramic laminate veneers were (66.30±26.71) µm and (85.48±30.44) µm, respectively. The marginal fitness of 0.3 mm and 0.5 mm resin-matrix ceramic laminate veneers were (56.42±19.27) µm and (58.36±8.33) µm, respectively. There was no statistically significant difference among the 4 groups (P>0.05). For glass-matrix ceramics, the flexural strength was (327.40±54.25) MPa, the flexural modulus was (44.40±4.39) GPa, and the modulus of resilience was (1.24±0.37) MPa. For resin-matrix ceramics, the flexural strength was (173.71±16.61) MPa, the flexural modulus was (11.88±0.51) GPa, and the modulus of resilience was (1.29±0.27) MPa. The flexural strength and modulus of glass-matrix ceramics were significantly higher than those of resin-matrix ceramics (P < 0.001), but there was no statistically significant difference in the modulus of resilience between the two materials (P>0.05). CONCLUSION: The marginal roughness of CAD/CAM glass-matrix ceramic laminate veneers is greater than that of resin-matrix ceramic laminate veneers, but there was no statistically significant difference in marginal fitness among them. Increasing the thickness can reduce the marginal roughness of glass-matrix ceramic laminate veneers, but has no effect on the marginal roughness of resin-matrix ceramic laminate veneers.

Evaluation of color change before and after polymerization of laminate veneer restorations: A clinical study.

Background and Aim: The purpose of this in vivo study was to investigate the effect of translucent adhesive resin cement on the final color of ceramic laminate veneer restoration before and after polymerization in intraoral conditions. Materials and Methods: This study was conducted in 92 ceramic laminate veneer restorations of 27 patients. The ceramic laminate veneer restorations in standard thickness lithium disilicate ceramic structure (IPS e.max Press HT, Ivoclar Vivadent) were cemented to the tooth with translucent light-polymerized resin cement (Choice 2 Starter Kit, Bisco). Results: It was observed a clinically noticeable color change between ΔE values before and after polymerization (ΔE >3.3). There was a statistically significant difference in b* values, ΔL value, and Δb value. Conclusion: Within the limitations of this in vivo study, the results suggest that light polymerization of the translucent resin cement (Choice 2, Bisco) used is an important factor for the final color of the restoration and should be considered during shade selection and fabrication.

Influence of glass fiber posts on the fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers: Preliminary results of a randomized clinical trial.

OBJECTIVE: The purpose of this randomized clinical trial was to evaluate the influence of glass fiber posts on fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers. MATERIALS AND METHODS: Fifty participants had 1 maxillary anterior tooth restored with a direct veneer. They were divided into 2 groups (n = 25) according to the use of intraradicular glass fiber posts. Clinical evaluation was performed at baseline, 6 and 12 months. The treatment success was determined by the absence of tooth fracture. If there was fracture, it was classified according to its extent. Fischer exact test was performed to analyze the criteria among the groups at each evaluation time. Friedman repeated analysis of variance assessed the difference in the performance of each group at three recall times (α = 0.5). RESULTS: For control group, at the 6-month follow-up, one tooth had suffered a catastrophic failure, which resulted in tooth extraction. Fisher statistical analysis showed no significant difference between the cumulative success rate of the groups for the 6 (P > .999) and the 12-month (P > .999) period. Friedman test showed no significant difference among the periods of evaluation (P > .999). CONCLUSIONS: Both groups had a similar success rate for maxillary anterior endodontically treated teeth with direct veneers after 12 months. CLINICAL IMPLICATIONS: Glass fiber post use does not influence the fracture susceptibility of maxillary anterior endodontically treated teeth with direct veneers in the short term.

Micro-CT and Microscopy Study of Internal and Marginal Gap to Tooth Surface of Crenelated versus Conventional Dental Indirect Veneers.

Background and Objectives: Ceramic veneers represent the most appropriate treatment option for minimally invasive aesthetic rehabilitation. For long-term clinical success, the accurate marginal and internal adaptation of dental restorations are of paramount importance. The aim of this in vitro study is to assess the effect of a novel (patented) design of veneers compared to conventional ones on their marginal and internal gap to the prepared tooth surface. Materials and Methods: Twenty-four lithium disilicate ceramic veneers are obtained using Computer-Aided-Design (CAD) and then milled using Computer-Aided-Manufacturing (CAM). The samples are divided into two groups: 12 conventional (CO) veneers (i.e., with a linear marginal contour) and 12 crenelated (CR) veneers, the latter with the novel sinusoidal marginal design. All samples are bonded to frontal teeth, and the adhesive interfaces are analyzed using two methods, optical microscopy and micro-Computed Tomography (CT): the former for the accuracy of the marginal gap and the latter for the internal gap (as well as for the homogeneity of the luting cement) of ceramic veneers. Results: STATA and one-way ANOVA tests reveal significant differences between CO and CR veneers: (i) the marginal gap is smaller for CR (64 µm) than for CO veneers (236 µm); (ii) the internal adaptation is better for CR veneers: for a cement width of up to 120 µm, the covered surface for the CR group is 81.5%, while for the CO group it is 64.5%; (iii) the mean of the porosities within the cement is not significantly different (3.4·106 µm3 for CO and 3.9·106 µm3 for CR veneers), with a higher standard deviation for the CO group. Analytical modeling is achieved for internal gaps using the micro-CT results. The characteristic functions obtained allow us to compare the volume of luting cement for the two types of veneers. Conclusion: The novel veneers design produces an improvement in the marginal and internal adaptation of the restorations to the prepared tooth surface. Thus, it provides favorable premises for better clinical performances.

Resin Cement: Correspondence with Try-In Paste and Influence on the Immediate Final Color of Veneers.

PURPOSE: To assess the correspondence of shades between try-in pastes and resin cements and their influence on the final color of veneers. MATERIALS AND METHODS: Bovine teeth (n = 140) were prepared and divided into 2 groups (a or b) according to ceramic veneer thickness (0.35 or 0.70 mm). Seventy teeth (n = 70) were distributed in 7 groups (groups 1 to 7a and groups 1 to 7b; n = 10). Try-in pastes and their corresponding resin cements were used according to the value: groups 1a and 1b (value -3); groups 2a and 2b (-2); groups 3a and 3b (-1); groups 4a and 4b (0); groups 5a and 5b (+1); groups 6a and 6b (+2); groups 7a and 7b (+3). Color measurements were performed with spectrophotometer, and the coordinates L* , a* , and b* were obtained. The final color change (ΔE) was calculated from these coordinates: ΔE0 (trial - substrate), ΔE1 (cementation - substrate), and ΔE2 (cementation - trial). The data were analyzed using the Kolmogorov-Smirnov test, the Wilcoxon test, or t-test for paired samples and repeated-measures ANOVA, post hoc Bonferroni, or the Friedman test (p < 0.05). RESULTS: The results indicated no statistically significant difference between the groups comparing ΔE0 and ΔE1 for 0.35 mm thickness laminate veneers, except for groups 2a and 5a. For 0.70 mm thickness laminate veneers, no statistically significant differences were observed between the groups comparing ΔE0 and ΔE1. ΔE2 values for 0.35 mm and 0.70 mm thickness laminate veneers ranged from 1.77 ± 0.81 to 4.99 ± 3.80 and from 1.01 ± 0.73 to 4.66 ± 2.96, respectively. CONCLUSIONS: Try-in pastes correspond with their respective resin cements for most colors investigated. The color of the resin cement may influence the final color of laminate veneers. Thickness of the ceramic was the most relevant variable for color change.

Arab Societal Awareness of Dental Veneers.

AIM: The aim of this study is to assess the Arab society's knowledge, awareness, and attitudes toward dental veneers. MATERIALS AND METHODS: A cross-sectional study was performed by collecting data through an online questionnaire created using the Survey Monkey website and distributed among Middle Eastern societies through social media to ascertain participants' knowledge and awareness regarding dental veneers. The sample included Arab laypeople who were over 18 years old, to represent the awareness of the majority regarding dental veneers. RESULTS: The sample of this study included 1,332 subjects from different Middle Eastern nationalities, mainly Saudis, Kuwaitis, and Emiratis (15.6% of males and 84.4% of females). The results of this study showed that the total knowledge of dental veneers is 50.12%. The respondents with the highest level of knowledge acquired their information mainly from newspapers and magazines, followed by the Internet, then dentists, then social media, and, finally, friends and relatives. Cost was the only factor limiting 38.4% of subjects from receiving veneers, and 56% of the subjects would receive veneers if they were free of cost. In total, 72.6% of the respondents believed that veneers are currently overused. CONCLUSION: The knowledge and awareness of dental veneers were below a satisfactory level. Participants who relied on social media as a source of information had lower knowledge levels. CLINICAL SIGNIFICANCE: This study emphasized the need for continual societal education regarding dental veneers.

Noninvasive approach to esthetic rehabilitation of conoid anterior teeth.

Several factors, including anomalies of shape, color, or size, or positioning of the teeth, may interfere with smile esthetics. A 26-year-old woman was dissatisfied with the esthetics of her maxillary lateral incisors, which had defective composite resin restorations with alterations of color and shape. The aim of this article is to present a step-by-step description of the technique used to fabricate esthetic restorations for the conoid maxillary lateral incisors with a minimum of dental preparation. The successful outcome demonstrates the importance of correct planning for successful restorations.

Influence of activation mode of resin cement on the shade of porcelain veneers.

PURPOSE: The aim of this study was to evaluate the influence of resin luting cement's activation mode in the final shade of porcelain veneers after accelerated artificial aging (AAA). MATERIALS AND METHODS: Porcelain veneers (IPS Empress Esthetic) were produced using a standardized shade (ET1) and thickness (0.6 mm). Twenty bovine teeth were collected, prepared, and divided into two groups: group I (n = 10)-light-cured group, only base paste was applied to the veneers; group II (n = 10)-dual-cured group, in which the same base paste used in group I and a transparent catalyst were proportionally mixed for 20 seconds and then applied to the veneers. The specimens were light-cured for 60 seconds each and were next subjected to AAA. They were submitted to color readings with a spectrophotometer in three instances: in the tooth surface (only the substrate), after the cementation and polymerization of the veneers, and after the AAA. The values of L*, a*, and b* were obtained and the total color change was calculated (∆E*). Values obtained were subjected to statistical analysis, with a significance of 0.05. RESULTS: There were no significant differences between dual- and light-cured modes considering ∆E*, L*, a*, and b* values obtained after aging (p > 0.05). Within the dual-cured mode there were no significant differences in ∆E*, L*, a*, and b* values (p > 0.05). CONCLUSION: No relevant differences were found between the two activation modes in color change. When submitted to aging, dual- and light-cured modes of the resin cement showed visually perceptible (∆E* > 1.0) color changes; however, within the threshold of clinical acceptance (∆E* > 3.3).

Shade evaluation of ceramic laminates according to different try-in materials.

The porcelain laminate replaces the visible portion of enamel with a ceramic, which is attached to the dental surface. To enhance cosmetic results, a preliminary color matching procedure is performed prior to cementing the veneers. This procedure can be performed using water, water-soluble gel, or try-in paste. The different shades of cement and try-in pastes are intended to obtain better color and esthetics of the final restoration. This study sought to evaluate the shade of ceramic veneers produced by different try-in materials. Forty bovine teeth and 40 ceramic discs (0.6 mm thick) were prepared. The samples were divided into 4 groups (n = 10). For Group 1 samples, no material was used between the tooth and the ceramic, Group 2 interposed samples with water, Group 3 used a water-soluble gel, and Group 4 used try-in paste (value 0). The color was measured with a spectrophotometer, obtaining L*, a*, and b* values to calculate the color difference (ΔE*). The data were subjected to normality tests and 1-way ANOVA. No significant statistical differences were found among the groups, indicating that the different try-in materials had similar effects on the color of the ceramic laminates.

Direct or indirect composite veneers in anterior teeth: which method causes higher tooth mass loss? An in vitro study.

There is little information in the literature regarding the relationship between preparations made for direct and indirect veneers and the loss of tooth structure required for each technique. This in vitro study sought to quantify the different mass losses from preparation techniques used for direct and indirect veneers. Thirty artificial teeth were weighted using a digital balance and placed in a dental manikin in the position corresponding to the right maxillary central incisor. Five clinicians-all experts in esthetic dentistry-were asked to perform conventional preparations for both a direct composite resin veneer and an indirect ceramic veneer. After preparations, specimens were weighted again in the same digital balance. Teeth undergoing veneer preparations demonstrated a statistically significant mass loss compared to unprepared teeth. Indirect ceramic veneer preparations produced more mass loss than direct composite veneer preparations (P < 0.01).

Assessing the Aesthetic Performance of CAD/CAM Provisional Restorative Materials: A Spectrophotometric Analysis.

Achieving color match between natural teeth and restorative materials is crucial in dentistry. Factors such as the light source, brightness, and opacity influence tooth color, determined by light absorption and scattering within the material. Advances in CAD/CAM systems have enhanced prosthodontic treatments, particularly with new temporary materials, but data on their color stability and masking ability remains limited. However, data on the color stability and masking ability of these CAD/CAM materials is limited. Telio® CAD-Temp and VITA CAD-Temp® blocks were cut into slices and polished. Composite resin specimens were prepared using a custom-designed metal resin former and light-cured. Samples were paired randomly and assigned to experimental groups based on base type and thickness (n = 30). Samples were stored in a controlled environment for 24 h before color evaluation using an EasyShade® V spectrophotometer. Color difference (ΔE) was calculated using L*, a*, and b* values. Statistical analyses included the Shapiro-Wilk test, Levene's test, and three-way ANOVA, with post-hoc comparisons using the Bonferroni method (α = 0.05). ΔE was classified according to perceptibility (PT = 1.2) and acceptability (AT = 2.7) values.

A comparative study of translucency and color perception in monolithic zirconia and lithium disilicate veneers.

Ceramic laminate veneers which are a conservative approach to restoring anterior teeth, combining minimal preparation and esthetics. This study aims to evaluate the impact of the thickness of monolithic zirconia laminate veneers on their optical properties and color perception, comparing them to lithium disilicate. A total of 60 laminate veneers were prepared using two ceramic materials, divided into three groups for each material (n = 10) with thicknesses of 0.5, 0.7, and 1.0 mm. CIELab color parameters of the veneers were measured using a spectrophotometer and translucency parameters were calculated. The veneers were cemented onto uniform dies and final L, a, b values of the restorations were measured. The color difference between the different thicknesses was calculated using the CIEDE2000 formula. Two-way ANOVA and Bonferroni HSD post hoc tests were conducted to compare the color parameters (α = 0.05). The results showed that both material type (p < 0.001) and thickness (p < 0.001) influenced translucency values. The translucency values of zirconia veneers were significantly lower than those of lithium disilicate. The color differences (ΔE00) resulting from thickness changes (0.5-1.0 mm) were near or below the perception threshold for lithium disilicate, but distinct for zirconia restorations. In conclusion, monolithic zirconia veneers demonstrated lower translucency compared to lithium disilicate. Changing the material thickness affected the translucency of both materials, but not the color perception only for zirconia.

Transforming smiles: Aesthetic rehabilitation with layered zirconia veneers and crowns for spaced dentition and faulty crowns-A case report.

The objective of this case report was to provide a plan for aesthetic rehabilitation of a patient utilizing layered zirconia restorations to produce a homogeneous, pleasing smile. In this case, a female patient, aged 38 years, presented in dental clinic with a spaced dentition and faulty crowns that were causing functional and aesthetic concerns. She was a banker by profession and socially active. The treatment plan involved layered zirconia indirect restorations to enhance her natural teeth appearance. The aim of this case report was to propose an effective strategy for addressing her concerns, with the potential to achieve a desired aesthetic outcome. Additionally, the implementation of this treatment approach had a positive influence on self-esteem and confidence of the patient.

Impact of restoration thickness and tooth shade background on the translucency of zirconia laminate veneers: An in vitro comparative study.

Purpose: Our in vitro comparative study aimed to investigate the impact of thickness and tooth shade background on the translucency of highly translucent zirconia veneers. Materials and Methods: A total of 75 5Y-TZP zirconia veneers of shade A1 were fabricated with thicknesses of 0.50 mm (n = 25), 0.75 mm (n = 25), and 1.0 mm (n = 25). The translucencies were measured on composite resin teeth with shades A1, A2, A3, A3.5, and A4 using a digital color imaging spectrophotometer. Data were analyzed using ANOVA and post hoc Tukey's test (p < 0.05). Results: The translucency values were optimal for the veneers placed over the substrate teeth with shades A1 and A2, regardless of the veneer thickness. Additionally, veneers with a thickness of 0.50 mm exhibited significantly higher translucency than those with thicknesses of 0.75 mm and 1.0 mm. Conclusions: Our study demonstrated that the translucency of the highly translucent zirconia veneers was influenced by both veneer thickness and tooth shade background. The optimal veneer thickness for achieving the highest translucency was 0.50 for the veneers with A1 and A2 shades placed over the substrate teeth. Clinical Relevance: The optimal thickness for achieving the highest translucency of the highly translucent zirconia laminate veneers was 0.50 mm for the veneers with A1 and A2 shades placed over the substrate teeth. Clinicians and dental technicians could consider this when selecting materials for aesthetic restorations.

Spot-etch technique and other adhesive strategies for provisional veneers.

AIM: The objective of the present study was to evaluate the influence of different adhesive strategies regarding shear bond strength (SBS) of provisional resin--based materials bonded to the enamel surface as well as on the enamel surface roughness. MATERIALS AND METHODS: Bovine incisors were randomly divided into six groups (n = 10) according to the adhesive strategy used: BRControl (bis-acrylic resin); Spot-etch+BR (spot-etch + bis-acrylic resin); Spot--etchSB2+BR (spot-etch + adhesive + bis-acrylic resin); Spot-etchZ350Flow+BR (spot-etch + flowable composite resin + bis-acrylic resin); SBU+BR (universal adhesive + bis-acrylic resin); Spot-etchSBMP+Z350 (spot-etch + adhesive + composite resin). The enamel surface roughness was determined by a surface profil-ometer. An SBS test was performed in a universal testing machine, and failure modes were classified under magnification. The SBS data were analyzed by one-way analysis of variance (ANOVA). A paired t test was used for enamel surface roughness intragroup comparisons, and the Friedman one-way repeated meas-ures analysis of variance by ranks was used for differences in enamel surface roughness between groups, with the Tukey post hoc test (a = 0.05). RESULTS: BRControl had the lowest SBS values (MPa), with a significant difference (P ≤ 0.001) from the other groups. Spot-etch+BR had the highest SBS values but with no significant differences from the other groups in which the spot-etch technique was also used. Adhesive failure mode was predominant for all groups. BRControl had the lowest surface roughness difference, significantly different (P = 0.001) from all the other groups. CONCLUSIONS: Spot-etch and other adhesive strategies could be applied to increase the SBS values of provisional restorations to enamel compared with no surface pretreatment. However, the adhesive strategy may change the enamel surface roughness, revealing the importance of cleaning the tooth surface.

Load-bearing capacity, internal accuracy and time-efficiency of heat-pressed, milled and 3D-printed lithium disilicate ultra-thin occlusal veneers.

OBJECTIVES: The primary aim of this in vitro study was to compare the load-bearing capacity of lithium disilicate occlusal veneers, fabricated via different manufacturing processes. Secondary objectives included assessing internal accuracy and production time-efficiency. METHODS: Four fabrication methods for ultra-thin lithium disilicate occlusal veneers on extracted human molars with simulated erosive defects were compared (n = 20/group): CAM: milled lithium disilicate (IPS e.max CAD); HPR: heat-pressed lithium disilicate (IPS e.max Press) out of a milled PMMA template (Ddpmma CAST); 3DP: 3D-printed lithium disilicate (experimental lithium disilicate); PTE: heat-pressed lithium disilicate (IPS e.max Press) out of a 3D-printed template (SilaPrint cast). Internal accuracy was measured prior to thermo-mechanical aging, followed by static loading to measure the load-bearing capacity (Fmax). Fabrication time (time-efficiency) was also recorded. Statistical analysis was performed using the Kruskal-Wallis (KW) test. RESULTS: No statistically significant differences were found in median load-bearing capacities (Fmax) between the groups (KW p = 0.5902): CAM 1821 N, HPR 1896 N, 3DP 2003 N, PTE 1687 N. Significant differences were found in internal accuracy between the groups that employed printing processes (3DP, PTE) and all other groups in margins (p < 0.001), cusps (p < 0.0018), and fossae (p < 0.0346). The time-efficiency measurements indicated an increase in fabrication time, starting from CAM 67.2 ± 5.8 min, followed by HPR 200.8 ± 33.0 min, PTE 289.2 ± 38.7 min, and peaking with the highest duration observed for 3DP 701.6 ± 8.1 min. SIGNIFICANCE: The fabrication method of ultra-thin lithium disilicate occlusal veneers does not significantly impact their load-bearing capacity, but affects the clinical fit and adaptation of the veneers.