Perceptibility and acceptability thresholds for color differences of light and dark maxillofacial skin replications.

The aim of this study was to assess the perceptibility and acceptability thresholds of maxillofacial silicones for light and dark skin colors and to evaluate the effect of gender and professional experience on these thresholds. Two different sets of specimens (as light and dark) each, consisting of 14 (25 × 25 × 6-mm3) silicone skin replications, were produced. Four specimens of each set were produced from the same silicon mixture of the relevant set and polymerized simultaneously to provide standardized fabrication conditions. These 4 light/dark specimens were assigned as "baseline color specimens (BCs)" in each set, while the other 10 specimens were produced with a color difference level that increased gradually from BC. These stepped levels were obtained by controlled increasing of the pigment concentration in the relevant baseline silicon mixture. Color difference levels of specimens were calculated by using the CIELAB and CIEDE2000 formulas. Observers comprised of 3 different professional experiences as first-year dental students, interns, and dentists (n = 30/group, gender-balanced) were included. Combinations consisting of 5 specimens with 4 BCs and 1 different color were shown to the observers to assess whether the color difference was perceptible or acceptable. Perceptibility and acceptability percentages were regressed with color difference levels to estimate the best fit curve and confidence intervals were calculated (α = 0.05). The highest estimation of the coefficient of determination (R2) was found in the cubic curve for all parameters. A significant difference was found between the light and dark colors. The perceptibility thresholds (ΔE*ab/ΔE00) were 0.8/0.59 and 2.63/1.75 for light and dark colors, respectively. The acceptability thresholds (ΔE*ab/ΔE00) were 3.35/2.25, 10.07/7.04 for light and dark colors, respectively. No significant differences were found between gender and among experience groups concerning visual thresholds. Regardless of gender and experience, observers could perceive color differences more easily in light skin colors.

Comparison of screw loosening and fracture resistance in different hybrid abutment crown restorations after thermomechanical aging.

PURPOSE: The purpose of the study is to investigate the screw loosening and fracture resistance of different hybrid abutment crown restorations after thermomechanical aging. MATERIALS AND METHODS: Restorations were produced from zirconia, lithium disilicate, and hybrid ceramics with CAD-CAM system (n=10). Restorations and titanium bases (Tibases) were cemented and the abutment screws were torqued to 30 Ncm. They were retorqued after 10 minutes, and removal torque values (RTV) were measured. When 250000 and 500000 cycles of thermomechanical aging were completed, the RTVs were measured again and removal torque loss (RTL) ratios were calculated. The specimens were subjected to fracture resistance test after 750000 cycles of thermomechanical aging. The load at failure was recorded as the fracture resistance (N). The results were statistically analyzed (α=0.05). RESULTS: Aging was effective on the RTVs and RTL ratios (P<0.001). The highest RTV was observed before aging; however, the RTVs significantly decreased and RTL ratios significantly increased after aging (P<0.05). The fracture resistance values significantly differed among the ceramic materials. All lithium disilicate and hybrid ceramic specimens showed restoration fracture, while most of the zirconia specimens were displayed Tibase related failure. CONCLUSION: Hybrid abutment crowns made of zirconia, lithium disilicate, and hybrid ceramics can withstand the average occlusal forces in the molar region; however ceramic type may affect the failure type. Retightening of the abutment screws after 10 minutes after first tightening and annually may be beneficial to prevent the adverse effects of screw loosening on the integrity of implant-abutment connection.

Effects of ceramic type, connector dimension, and thermomechanical-aging on the fracture resistance and fit of CAD-CAM produced inlay-retained fixed partial dentures.

The purpose of the present study is to evaluate the fracture resistance and the fit of CAD-CAM produced inlay-retained fixed partial dentures. Eighteen experimental groups were generated according to different CAD-CAM ceramic materials (zirconia, lithium disilicate, and zirconia-reinforced lithium silicate), different connector dimensions (12, 14, and 16 mm2), and application of thermomechanical-aging (1,200,000 cycles of cyclic loading with simultaneous thermal cycling). Gap values of thermomechanically-aged groups were measured by using periapical radiographs. Then, the specimens were tested for fracture resistance and failure types were examined. The results were statistically analyzed (α=0.05). Higher gap values were observed after aging. Zirconia showed the highest fracture resistance values among the most of the experimental groups. In non-aged groups, the most frequent failure type was decementation in zirconia group. In the aged groups, the most frequent failure type was molar connector fracture. Thermomechanical-aging increased the gap values and decreased the fracture resistance values.

Translucency Parameters and Masking Abilities of Monolithic CAD/CAM Ceramics.

PURPOSE: The purpose of the study was to compare the translucency parameters and masking abilities of different monolithic CAD-CAM ceramics placed on different colored substructures. MATERIALS AND METHODS: Squared-shaped specimens (12x12x1.5 mm) were prepared from feldspathic (C), leucite (Emp), lithium disilicate (e.max), zirconia reinforced lithium silicate (VS), resin nano ceramic (LU), polymer infiltrated ceramic (VE), nanoparticle resin hybrid (GC), monolithic zirconia (TZI), and composite resin (TC) blocks (n=10). After mechanical polishing, the translucency parameter (TP) was calculated. Then, each ceramic specimen was measured on 8 substructures and the color difference between ND2 and each substrate was calculated with CIEDE2000 formula. TP values were analyzed with 1-way ANOVA and Games-Howell tests and the color differences indicating masking ability were analyzed with 2-way ANOVA and Tukey HSD tests. RESULTS: The highest TP was observed in TC, and followed by LU, Emp, C =GC, e.max, VS, VE, and TZI. The ∆E00 color difference values of TZI, VS, and VE on all abutment colors, except for ND9, were below the acceptable threshold value. CONCLUSION: All of the monolithic ceramic materials used in the study masked the ND1 and ND3 substrates. The ND9, representing the severely discolored or devitalized preparations, could not be masked by any of the monolithic CAD-CAM ceramics used in the study.

Effect of plasma treatment on the peel bond strength between maxillofacial silicones and resins.

The study aimed to investigate the effects of surface treatments, including plasma, on the peel bond strength between two maxillofacial silicones and two resins with and without thermocycling. Forty-eight experimental groups (n=10) were generated incorporating the two different resins (auto-polymerizing acrylic resin and light-curing urethane dimethacrylate resin [AR and LR, respectively]), two different silicones (M511 and Z004), aging (thermocycled/no thermocycling), and six different surface treatments, including polishing, grinding, polishing+argon plasma, polishing+oxygen plasma, grinding+argon plasma, and grinding+oxygen plasma. Surface topography of a specimen from each surface treatment group was examined by atomic force microscopy. After surface treatments, silicones were polymerized. The peel bond strength values of the control and thermocycled groups were determined. Atomic force microscopy showed that surface topographies of the ground specimens were irregular. Polished specimens showed higher peel bond strength than ground specimens. Plasma application appeared to have improved the bond strength between the resins and silicones.

Effect of surface treatments on shear bond strength of resin composite bonded to CAD/CAM resin-ceramic hybrid materials.

PURPOSE: The purpose of this study was to assess the effect of surface treatments on shear bond strength of resin composite bonded to thermocycled and non-thermocycled CAD/CAM resin-ceramic hybrid materials. MATERIALS AND METHODS: 120 specimens (10×10×2 mm) from each material were divided into 12 groups according to different surface treatments in combination with thermal aging procedures. Surface treatment methods were airborne-particle abrasion (abraded with 50 micron alumina particles), dry grinding (grinded with 125 µm grain size bur), and hydrofluoric acid (9%) and silane application. According to the thermocycling procedure, the groups were assigned as non-thermocycled, thermocycled after packing composites, and thermocycled before packing composites. The average surface roughness of the non-thermocycled specimens were measured after surface treatments. After packing composites and thermocycling procedures, shear bond strength (SBS) of the specimens were tested. The results of surface roughness were statistically analyzed by 2-way Analysis of Variance (ANOVA), and SBS results were statistically analyzed by 3-way ANOVA. RESULTS: Surface roughness of GC were significantly lower than that of LU and VE (P<.05). The highest surface roughness was observed for dry grinding group, followed by airborne particle abraded group (P<.05). Comparing the materials within the same surface treatment method revealed that untreated surfaces generally showed lower SBS values. The values of untreated LU specimens showed significantly different SBS values compared to those of other surface treatment groups (P<.05). CONCLUSION: SBS was affected by surface treatments. Thermocycling did not have any effect on the SBS of the materials except acid and silane applied GC specimens, which were subjected to thermocycling before packing of the composite resin.

Clinical and radiographic evaluation of new dental implant system: Results of a 3-year prospective study.

BACKGROUND/PURPOSE: The aim of this study was to evaluate implant survival, crestal bone level changes, and clinical parameters of IDcam dental implants over a mean follow-up period of 3 years. MATERIALS AND METHODS: Seventy-two patients, 32 females and 40 males, received 255 implants. Implant-supported metal-ceramic fixed restorations were inserted. Following completion of restorations, each patient was re-examined at 6-month intervals. Radiographic crestal bone level changes were calculated, as well as soft tissue parameters including pocket probing depth, bleeding on probing, plaque index, and gingival index. Examination results were recorded from 18 months to 42 months. Implant survival was estimated using the Kaplan-Meier method. Associations between implant survival and recorded variables were estimated using Cox proportional regression analysis. RESULTS: The Kaplan-Meier survival analysis demonstrated a cumulative survival rate of 97.6%. Three implants in three patients failed to osseointegrate at stage 2 surgery, and three implants in three patients were lost after loading. The mean marginal bone losses were 0.35 ± 0.14 mm, 0.47 ± 0.15 mm, and 0.58 ± 0.16 mm, as determined 6 months, 12 months, and 24 months after prosthetic loading, respectively. Cox proportional regression analysis revealed that the variables such as age, sex, type of the restoration, and implant region had no significant influence on implant failure (P > 0.05). Coefficients of correlation between implant survival and crestal bone loss, pocket probing depth, bleeding on probing, plaque index, and gingival index were found to be nonsignificant (P > 0.05). CONCLUSION: Survival and radiographic and clinical assessments of implants after 2 years of function demonstrated promising results for an IDcam dental implant system.