Impact of different complete coverage onlay preparation designs and the intraoral scanner on the accuracy of digital scans.

STATEMENT OF PROBLEM: The trueness and precision of intraoral scanners (IOSs) and the effect of intracoronal restorations have been reported. However, studies addressing the accuracy of IOSs in reproducing different complete coverage onlay preparation designs are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the influence of complete coverage onlay preparation design and intraoral scanning devices on the accuracy of digital scans in terms of trueness and precision. MATERIAL AND METHODS: Three preparation designs on the mandibular first molar were considered: a traditional preparation design with isthmus reduction (IST), a traditional preparation design without isthmus reduction (wIST), and simplified nonretentive preparation (nRET). Digital scans of epoxy resin mandibular arch reference models of the preparations (containing second premolar, first molar, and second molar) were obtained by using 3 IOSs (iTero Element 2 [ELE], Trios 3 [TRI], and Primescan [PRI]) (n=10). Trueness (µm) and precision (µm) were analyzed by superimposing the digital scan on the digital reference models obtained with a high-accuracy industrial scanner (ATOS Core 80) in a tridimensional metrology software program. Accuracy was quantified by the absolute deviation (µm). Local and overall mean positive and negative deviations for trueness were also obtained. Data were analyzed by using the Kruskal-Wallis and Dunn tests with a statistical software program (α=.05). RESULTS: The nonretentive preparation groups obtained higher trueness (3.8 µm) and precision (2.7 µm) than the IST and wIST groups (trueness=7.5 to 6.3 µm, precision=5.5 to 4.6 µm). Trueness values were lower with ELE×IST (16 µm), followed by ELE×wIST (13 µm), and PRI×IST (7.8 µm). In general, no difference was found between PRI and TRI scanners (6.3 to 5.9 µm), with lower performance for ELE (13 µm). Positive deviations were higher on the proximal box of the IST and wIST preparation and on the occlusal box of the IST group. Negative deviation was higher on the ELE×IST occlusal box. CONCLUSIONS: Different intraoral scanners and preparation designs influenced the accuracy of digital scans. A more complex preparation such as IST and wIST showed higher deviation. The iTero Element 2 scanner exhibited higher deviation for both trueness and precision.

Ceramic Repair Without Hydrofluoric Acid.

PURPOSE: To evaluate the bond strength between composite resin and feldspathic ceramic following repair protocols with and without hydrofluoric acid and aging by thermocycling. MATERIALS AND METHODS: Forty-eight glass feldspathic ceramic blocks (8 x 8 x 6 mm) were divided into three groups on the basis of their surface repair treatment: 1. 10% hydrofluoric acid + Signum Ceramic Primer I + Signum Ceramic Primer II (control group); 2. abrasive rubber tips + Signum Ceramic Primer I + Signum Ceramic Primer II (test group); 3. Signum Ceramic Primer I + Signum Ceramic Primer II (negative control group). The treated surface of each block was built up with composite and then sectioned to produce nontrimmed bars (adhesive area = 1 mm²). Half of the bars from each group were aged by 6000 cycles of 30-s immersions in water baths at 5°C and 55°C, with a transfer time of 2 s. The other bars were immediately subjected to microtensile bond strength testing. The mean bond strength for each block was then recorded and submitted to two-way ANOVA and Tukey's test (α = 0.05). RESULTS: The aging protocol influenced the bond strength values of all groups (p = 0.000). The non-aged groups submitted to surface treatment protocols 1 (13.1 ± 2.5 MPa) and 2 (11.5 ± 5.1 MPa) presented the highest bond strength values. CONCLUSIONS: The interface bond strength of all groups was susceptible to aging. Surface treatment protocol 2, with abrasive rubber tips and no hydrofluoric acid, appeared to be the most promising option, as the resulting bond strength values were similar to those of the control group.

Novel speed sintered zirconia by microwave technology.

OBJECTIVE: Continuous efforts have been made to hasten the zirconia densification process without compromising properties. This study evaluated the long-term structural durability of microwave speed-sintered zirconia (MWZ) relative to a conventionally sintered zirconia (CZ). METHODS: As-machined dental 3Y-TZP discs (Ø12 × 1.2 mm) were speed sintered at 1450 °C for 15 min using an industrial microwave oven, while conventional sintering was conducted in a standard dental furnace at 1530 °C for 2 h. Both were followed by natural cooling. The total sintering time was 105 min for MWZ and 600 min for CZ. Groups were compared regarding density, grain size, phase composition, and fracture resistance. Structural durability was investigated employing two fatigue protocols, step-stress and dynamic fatigue. RESULTS: Compared to CZ, MWZ exhibited a slightly lower density (MWZ = 5.98 g/cm3, CZ = 6.03 g/cm3), but significantly smaller grain sizes (MWZ = 0.53 ± 0.09 µm, CZ = 0.89 ± 0.10 µm), lower cubic-zirconia contents (MWZ = 15.3%, CZ = 22.7%), and poorer translucency properties (TP) (MWZ = 13 ± 1, CZ = 29 ± 0.8). However, the two materials showed similar flexural strength (MWZ = 978 ± 112 MPa, CZ = 1044 ± 161 MPa). Additionally, step-stress testing failed to capture the fatigue effect in 3Y-TZP, whereas dynamic fatigue revealed structural degradation due to moisture-assisted slow-crack-growth (SCG). Finally, MWZ possessed a slightly higher Weibull modulus (MWZ = 7.9, CZ = 6.7) but similar resistance to SCG (MWZ = 27.5, CZ = 24.1) relative to CZ. SIGNIFICANCE: Dental 3Y-TZP with similar structural durability can be fabricated six-times faster by microwave than conventional sintering.

Failure Probability, Stress Distribution and Fracture Analysis of Experimental Screw for Micro Conical Abutment.

The aim of this study was to evaluate the failure probability of two types of abutment screws after compressive load and to analyze the stress distribution with finite element method. Sixty (60) single-tooth implant restorations were assembled on titanium implants (e-fix, A.S. Technology - Titanium Fix). The groups were divided into Conventional screw (Screw neck 1.5 ø mm) and Experimental screw (Screw neck constricted with 1.2 ø mm). Specimens were subjected to single load to failure with compressive test according ISO 14801. The fractured specimens were subjected to stereomicroscopy for measurement of remaining screws inside the implant and characterization of fracture origin. Representative specimens were analyzed by scanning electronic microscopy. For finite element method (FEM), an identical 3D model of the two in vitro test groups were used with similar conditions (30º, 100 N load). The stress in the abutment screw was analyzed by von-Mises criteria. The results of strength means were 4132.5 ± 76 MPa and 4528.2 ± 127.2 for conventional and experimental groups, respectively. During microscopy, the mean (mm) of the remaining screw piece inside the implants were 0.97 ± 0.23 and 1.32 ± 0.12 for conventional and experimental groups, respectively. In FEM, the conventional group showed stress concentered in an unfavorable region (peak of 39.23 MPa), while the experimental group showed more stress areas but less concentration than the conventional group (36.6 MPa). In using the tested experimental geometry, the abutment screw can have its strength improved, and the origin of failure can be more favorable to clinical resolution.

O efeito do envelhecimento por fadiga na microestrutura de cerâmicas y-tzp sinterizadas por energia de micro-ondas / The effect of fatigue aging on the microstructure of y-tzp ceramics sintered by microwave energy

O objetivo deste trabalho foi avaliar o efeito da fadiga na microestrutura de uma cerâmica odontológica (Y-TZP) sinterizada pelo método convencional ou por energia de micro-ondas. A hipótese nula foi que a fadiga não irá gerar alterações na microestrutura deste material. Para isto, foram confeccionados, por meio de um sistema CAD/CAM, 84 discos de zircônia (VIPI block zircon) com características finais de 12 mm de diâmetro e 1,2 mm de espessura conforme a norma ISO 6872. Os espécimes foram separados em dois grupos: Grupo I ­ Sinterização convencional: ciclo estabelecido pelo fabricante (2 horas a 1530 °C) e Grupo II ­ sinterização por energia de micro-ondas (15 min a 1450 °C). Dez amostras por grupo foram submetidas ao teste monotônico (1000 KgF ­ 1mm/min) para a determinação da carga para fratura, utilizada como parâmetro para os testes de fadiga (método step-stress e fadiga dinâmica). O teste de fadiga step-stress foi realizado utilizando 4 perfis de carga, ultra-suave, suave, moderado e agressivo, até que ocorresse a fratura. A fadiga dinâmica foi realizada com o ensaio dos discos até fratura sob cinco taxas de tensão (1, 0,1, 0,01, 0,001 e 0,0001 MPa/s), e a partir disso foram calculados o coeficiente de crescimento de trincas e módulo de Weibull (confiabilidade) para cada grupo. Foram realizadas análises complementares de densidade, translucidez, microscopia eletrônica de varredura (MEV) e difratometria de Raios-X (DRX) de ambos os grupos para a caracterização dos materiais. Os resultados da fadiga step-stress não mostraram diferenças no comportamento dos espécimes de cada grupo. Na fadiga dinâmica, os métodos de fadiga também não mostraram diferenças no comportamento e tiveram coeficientes de crescimento de trinca similares. O modulo de Weibull mostrou maiores valores de confiabilidade para o grupo micro-ondas (m = 7,9) do que para o grupo de sinterização convencional (m = 6,7). Os valores de densidade também foram semelhantes para os grupos estudados, já a translucidez foi menor para o grupo micro-ondas. As imagens de MEV mostraram microestruturas similares entre grupos, apenas uma diferença no tamanho dos grãos foi observada, 0,53 µm para os grãos de microondas e 0,89 µm para os grãos dos espécimes sinterizados convencionalmente. Conclui-se que o processo de sinterização por microondas pode ser aplicado como alternativa de sinterização de zirconia ao dia-a dia laboratorial(AU)

The objective of this work was to evaluate the microstructure and fatigue behavior of a dental ceramic (Y-TZP) sintered by conventional method or by microwave energy. The null hypothesis was that the fatigue will not effect the microstructure of this material. 84 zirconia discs (VIPI block zircon) with final characteristics of 12 mm in diameter and 1.2 mm in thickness according to ISO 6872 were made using a CAD/CAM system. The specimens were divided in two groups: Group I - Conventional sintering: cycle established by the manufacturer (2 hours at 1530 °C) and Group II - sintering by microwave energy (15 min at 1450 °C). Ten samples per group were submitted to monotonic test (1000 KgF - 1mm/min) to determine the load to fracture, used as a parameter for fatigue tests (step-stress and dynamic fatigue). The step-stress fatigue test was performed using 4 load profiles, ultramild, mild, moderate and aggressive, until the fracture. The dynamic fatigue was performed by testing the disks to fracture under five constant stress rates (1, 0.1, 0.01, 0.001 and 0.0001 MPa/s), and from this the crack growth coefficient and Weibull module (reliability) were measured for each group. Additional analyzes of density, translucency, scanning electron microscopy (SEM) and X-ray diffractometry (XRD) for both groups were carried out to characterize the materials. The results of stepstress fatigue test did not show differences in the specimens behavior of each group. Dynamic fatigue also showed no differences in behavior and had similar crack growth coefficients. The Weibull modulus showed higher reliability values for the microwave group (m = 7.9) than for the conventional sintering group (m = 6.7). The density values were also similar for the studied groups, since the translucency was lower for the microwave group. SEM images showed similar microstructures between groups, only a difference in grain size was observed, 0.53 µm for microwave grains and 0.89 µm for the conventionally-sintered grains. It is concluded that the microwave sintering process can be applied as an alternative to zirconia sintering to daily laboratory work(AU)