Development and Application of a New Learning Object for Teaching Operative Dentistry Using Augmented Reality.

Learning objects (LOs) associated with augmented reality have been used as attractive new technologic tools in the educational process. However, the acceptance of new LOs must be verified with the purpose of using these innovations in the learning process in general. The aim of this study was to develop a new LO and investigate the acceptance of gold onlay in teaching preparation design at a dental school in Brazil. Questionnaires were designed to assess, first, the users' computational ability and knowledge of computers (Q1) and, second, the users' acceptance of the new LO (Q2). For both questionnaires, the internal consistency index was calculated to determine whether the questions were measuring the same construct. The reliability of Q2 was measured with a retest procedure. The LO was tested by dental students (n=28), professors and postgraduate students in dentistry and prosthetics (n=30), and dentists participating in a continuing education or remedial course in dentistry and/or prosthetics (n=19). Analyses of internal consistency (Kappa coefficient and Cronbach's alpha) demonstrated a high degree of confidence in the questionnaires. Tests for simple linear regressions were conducted between the response variable (Q2) and the following explanative variables: the Q1 score, age, gender, and group. The results showed wide acceptance regardless of the subjects' computational ability (p=0.99; R2=0), gender (p=0.27; R2=1.6%), age (p=0.27; R2=0.1%), or group (p=0.53; R2=1.9%). The methodology used enabled the development of an LO with a high index of acceptance for all groups.

Discrepancies in marginal and internal fits for different metal and alumina infrastructures cemented on implant abutments.

Cemented crowns are increasingly being used on dental implants instead of on screw-retained prostheses because of the reliability of internal Morse taper implant-abutment connections. However, there is a lack of information on the fit of metal ceramic and premachined alumina infrastructures. Therefore, the aim of this study was to evaluate the marginal and internal fits of different metal and alumina infrastructures cemented on universal post abutments. A total of 45 abutments (6 mm in height and 3.3 mm in diameter) were divided into five groups on the basis of their infrastructure material: cobalt-chromium (CoCr), nickel-chromium (NiCr), nickel-chromium-molybdenum-titanium (NiCrMoTi), gold (Au), and premachined alumina. The alumina group showed marginal overextension, and the Au group showed the highest discrepancy in marginal fit among the metal alloys. The CoCr and alumina groups showed the lowest discrepancies in internal fit. In conclusion, the alumina cylinders exhibited the best internal fit, despite their horizontal overextension. Among the metal alloys, CoCr exhibited the best fit at critical regions, such as the cervical and occlusal areas.

Fracture resistance of endodontically treated teeth restored with glass fiber posts of different lengths.

STATEMENT OF PROBLEM: Endodontically treated teeth are known to have reduced structural strength. Glass fiber posts may influence fracture resistance and should be evaluated. PURPOSE: The purpose of this study was to evaluate the influence of glass fiber post length on the fracture resistance of endodontically treated teeth. MATERIAL AND METHODS: Forty intact human maxillary canines were selected and divided into 4 groups, the control group consisting of teeth restored with a custom gold cast post and core, with a length of two-thirds of the root. Other groups received prefabricated glass fiber posts in different lengths: group 1/3, removal of one-third of the sealing material (5 mm); group 1/2, removal of one-half of the sealing material (7.5 mm); and group 2/3, removal of two-thirds of the sealing material (10 mm). All the posts were cemented with resin cement, and the specimens with glass fiber posts received a composite resin core. All the specimens were restored with a metal crown and submitted to a compressive load until failure occurred. The results were evaluated by 1-way ANOVA, and the all pairwise multiple comparison procedures (Tukey honestly significantly difference test) (α=.05). RESULTS: The ANOVA showed significant differences among the groups (P<.002). The Tukey test showed that the control group presented significantly higher resistance to static load than the other groups (control group, 634.94 N; group 1/3, 200.01 N; group 1/2, 212.17 N; and group 2/3, 236.08 N). Although teeth restored with a cast post and core supported a higher compressive load, all of them fractured in a catastrophic manner. For teeth restored with glass fiber posts, the failure occurred at the junction between the composite resin core and the root. CONCLUSION: The length of glass fiber posts did not influence fracture load, but cast post and cores that extended two-thirds of the root length had significantly greater fracture resistance than glass fiber posts.

Influence of abutment type and esthetic veneering on preload maintenance of abutment screw of implant-supported crowns.

PURPOSE: The effect of veneering materials on screw joint stability remains inconclusive. Thus, this study evaluated the preload maintenance of abutment screws of single crowns fabricated with different abutments and veneering materials. MATERIALS AND METHODS: Sixty crowns were divided into five groups (n = 12): UCLA abutment in gold alloy with ceramic (group GC) and resin (group GR) veneering, UCLA abutment in titanium with ceramic (group TiC) and resin (group TiR) veneering, and zirconia abutment with ceramic veneering (group ZiC). Abutment screws made of gold were used with a 35 Ncm insertion torque. Detorque measurements were obtained initially and after mechanical cycling. Data were analyzed by ANOVA and Fisher's exact test at a significance level of 5%. RESULTS: For the initial detorque means (in Ncm), group TiC (21.4 ± 1.78) exhibited statistically lower torque maintenance than groups GC (23.9 ± 0.91), GR (24.1 ± 1.34), and TiR (23.2 ± 1.33) (p < 0.05, Fisher's exact test). Group ZiC (21.9 ± 2.68) exhibited significantly lower torque maintenance than groups GC, GR, and TiR (p < 0.05, Fisher's exact test). After mechanical cycling, there was a statistically significant difference between groups TiC (22.1 ± 1.86) and GR (23.8 ± 1.56); between groups ZiC (21.7 ± 2.02) and GR; and also between groups ZiC and TiR (23.6 ± 1.30) (p < 0.05, Fisher's exact test). CONCLUSIONS: Detorque reduction occurred regardless of abutment type and veneering material. More irregular surfaces in the hexagon area of the castable abutments were observed. The superiority of any veneering material concerning preload maintenance was not established.

Diamondlike carbon coating as a galvanic corrosion barrier between dental implant abutments and nickel-chromium superstructures.

PURPOSE: The objectives of this study were to evaluate the galvanic corrosion behavior between titanium and nickel-chromium (Ni-Cr) alloy, to investigate the effect of diamondlike carbon (DLC) coating over titanium on galvanic corrosion behavior between titanium and Ni-Cr alloy, and to evaluate the effect of DLC coating over titanium abutments on the fit and integrity of prosthetic assemblies by scanning electron microcopy (SEM). MATERIALS AND METHODS: Five Ni-Cr and 10 titanium disks with a diameter of 5 mm and thickness of 3 mm were prepared. DLC coating was applied to five titanium disks. Electrode samples were prepared, and open circuit potential measurements, galvanic current measurements over platinum electrodes, and potentiodynamic polarization tests were carried out. For the SEM evaluation, 20 Ni-Cr alloy and 10 gold alloy superstructures were cast and prepared over 30 abutments. DLC coating was applied to 10 of the abutments. Following the fixation of prosthetic assemblies, the samples were embedded in acrylic resin and cross sectioned longitudinally. Internal fit evaluations were carried out through examination of the SEM images. RESULTS: Titanium showed more noble and electrochemically stable properties than Ni-Cr alloy. DLC coating over the cathode electrode served as an insulating film layer over the surface and prevented galvanic coupling. Results of the SEM evaluations indicated that the DLC-coated and titanium abutments showed no statistically significant difference in fit. Hence, no adverse effects on the adaptation of prosthetic components were found with the application of DLC coating over abutment surfaces. CONCLUSIONS: DLC coating might serve as a galvanic corrosion barrier between titanium abutments and Ni-Cr superstructures.

Modeling impurity-assisted chain creation in noble-metal break junctions.

In this work we present the generalization of the model for chain formation in break junctions, introduced by Thiess et al (2008 Nano Lett. 8 2144), to zigzag transition-metal chains with s and p impurities. We apply this extended model to study the producibility trends for noble-metal chains with impurities, often present in break junction experiments, namely, Cu, Ag and Au chains with H, C, O and N adatoms. Providing the material-specific parameters for our model from systematic full-potential linearized augmented plane-wave first-principles calculations, we find that the presence of such impurities crucially affects the binding properties of the noble-metal chains. We reveal that both the impurity-induced bond strengthening and the formation of zigzag bonds can lead to a significantly enhanced probability for chain formation in break junctions.

Three-year clinical follow-up of posterior teeth restored with leucite-reinforced ips empress onlays and partial veneer crowns.

PURPOSE: The aim of this study was to analyze the survival rate and failure mode of IPS leucite-reinforced ceramic onlays and partial veneer crowns regarding thickness under the following clinical conditions: vital versus nonvital teeth, tooth location, and type of opposing dentition. MATERIALS AND METHODS: Teeth were prepared according to established guidelines for ceramic onlays and partial veneer crowns. Before cementation, the restorations were measured for occlusal thickness at the central fossa, mesial, and distal marginal ridges, and functional and nonfunctional cusps. A total of 210 ceramic restorations were cemented in 99 patients within a mean observation period of 2.9 ± 1.89 years. The mode of failure was classified and evaluated as (1) adhesive, (2) cohesive, (3) combined failure, (4) decementation, (5) tooth sensitivity, and (6) pulpal necrosis. Kaplan, log-rank, and Cox regression tests were used for statistical analysis. RESULTS: The failure rate was 3.33% (7/210). Increased material thickness produced less probability of failures. Vital teeth were less likely to fail than nonvital teeth. Second molars were five times more susceptible to failure than first molars. Tooth sensitivity postcementation and the type of opposing dentition were not statistically significant in this study. CONCLUSIONS: In this study, thickness of the restorations, tooth vitality, and location of teeth in the dental arch influenced restoration failures.

Influence of crown ferrule heights and dowel material selection on the mechanical behavior of root-filled teeth: a finite element analysis.

PURPOSE: This study used the 3D finite element (FE) method to evaluate the mechanical behavior of a maxillary central incisor with three types of dowels with variable heights of the remaining crown structure, namely 0, 1, and 2 mm. MATERIALS AND METHODS: Based on computed microtomography, nine models of a maxillary central incisor restored with complete ceramic crowns were obtained, with three ferrule heights (0, 1, and 2 mm) and three types of dowels (glass fiber = GFD; nickel-chromium = NiCr; gold alloy = Au), as follows: GFD0--restored with GFD with absence (0 mm) of ferrule; GFD1--similar, with 1 mm ferrule; GFD2--glass fiber with 2 mm ferrule; NiCr0--restored with NiCr alloy dowel with absence (0 mm) of ferrule; NiCr1--similar, with 1 mm ferrule; NiCr2--similar, with 2 mm ferrule; Au0--restored with Au alloy dowel with absence (0 mm) of ferrule; Au1--similar, with 1 mm ferrule; Au2--similar, with 2 mm ferrule. A 180 N distributed load was applied to the lingual aspect of the tooth, at 45° to the tooth long axis. The surface of the periodontal ligament was fixed in the three axes (x = y = z = 0). The maximum principal stress (σ(max)), minimum principal stress (σ(min)), equivalent von Mises (σ(vM)) stress, and shear stress (σ(shear)) were calculated for the remaining crown dentin, root dentin, and dowels using the FE software. RESULTS: The σ(max) (MPa) in the crown dentin were: GFD0 = 117; NiCr0 = 30; Au0 = 64; GFD1 = 113; NiCr1 = 102; Au1 = 84; GFD2 = 102; NiCr2 = 260; Au2 = 266. The σ(max) (MPa) in the root dentin were: GFD0 = 159; NiCr0 = 151; Au0 = 158; GFD1 = 92; NiCr1 = 60; Au1 = 67; GFD2 = 97; NiCr2 = 87; Au2 = 109. CONCLUSION: The maximum stress was found for the NiCr dowel, followed by the Au dowel and GFD; teeth without ferrule are more susceptible to the occurrence of fractures in the apical root third.

Evaluation of the effect of retightening and mechanical cycling on preload maintenance of retention screws.

PURPOSE: The aim of this study was to evaluate the effect of retightening and mechanical cycling on the maintenance of preload in the retention screws of implant-supported crowns. MATERIALS AND METHODS: Five groups (n = 12 in each group) of implant-crown assemblies were created according to different abutments and veneering materials: Gold UCLA abutments cast in gold alloy veneered with ceramic (group 1) and light-curing resin (group 2), UCLA abutments cast in titanium veneered with ceramic (group 3) and light-curing resin (group 4), and zirconia abutments with ceramic veneering (group 5). The crowns were attached to implants by gold retention screws. The assemblies were submitted to mechanical cycling for a total of 1 million cycles. Removal torque measurements were performed initially and after each period of 100,000 cycles; this was followed by screw retightening with 35 Ncm of torque. Data were evaluated with analysis of variance, the paired t test, and the Student t test. RESULTS: All groups exhibited reduced removal torque values in comparison to insertion torque initially and after all periods of mechanical cycling. Analysis of variance revealed statistically significant differences among the groups, but there were no differences among the periods of mechanical cycling or for the interaction between groups and cycling. Group 1 was the only group that did not show a difference between removal torque values of different cycling periods. The Student t test did not reveal statistically significant differences between mean removal torque values obtained before and after mechanical cycling, except for group 4. CONCLUSIONS: Torque maintenance allowed screw joint stability in the present study. Mechanical cycling associated with the retightening of abutment screws did not influence the maintenance of insertion torque.

Passivity versus unilateral angular misfit: evaluation of stress distribution on implant-supported single crowns: three-dimensional finite element analysis.

The aim of this study was to evaluate the effect of unilateral angular misfit of 100 µm on stress distribution of implant-supported single crowns with ceramic veneering and gold framework by three-dimensional finite element analysis. Two three-dimensional models representing a maxillary section of premolar region were constructed: group 1 (control)-crown completely adapted to the implant and group 2-crown with unilateral angular misfit of 100 µm. A vertical force of 100 N was applied on 2 centric points of the crown. The von Mises stress was used as an analysis criterion. The stress values and distribution in the main maps (204.4 MPa for group 1 and 205.0 MPa for group 2) and in the other structures (aesthetic veneering, framework, retention screw, implant, and bone tissue) were similar for both groups. The highest stress values were observed between the first and second threads of the retention screw. Considering the bone tissue, the highest stress values were exhibited in the peri-implant cortical bone. The unilateral angular misfit of 100 µm did not influence the stress distribution on the implant-supported prosthesis under static loading.

Diagnostic ability of a cone-beam computed tomography scan to assess longitudinal root fractures in prosthetically treated teeth.

INTRODUCTION: This study evaluated the influence of cast-gold posts on the diagnostic ability of a cone beam computed tomography (CBCT) system in assessing longitudinal root fractures. In addition, the influence of gutta-percha and variations in voxel resolution were assessed. METHODS: One hundred eighty endodontically prepared teeth were divided into 3 experimental and 3 control groups and placed in a dry human skull. The teeth in the experimental groups were artificially fractured. Certain experimental and control groups were filled with gutta-percha cones. Other experimental and control groups were filled with cast-gold posts. All the teeth were viewed by using a tomography scan with 2 voxel resolution protocols (0.3-mm and 0.2-mm). A calibrated examiner, blinded to the protocol, assessed the images by using the nominated scan software. RESULTS: The kappa values obtained for intraobserver reproducibility were 0.84 and 0.93 for 0.3-mm and 0.2-mm voxel resolution, respectively. The presence of gutta-percha or posts reduced the overall sensitivity and specificity in both voxel resolutions, but with no significant association. The CBCT specificity values were similar and did not depend on the voxel resolution adopted. In contrast, the sensitivity values were significantly higher for 0.2-mm voxel resolution in nonfilled (P < .05), gutta-percha (P < .001), and overall (P < .001) groups. CONCLUSIONS: The CBCT diagnostic ability was not influenced by the presence of posts or gutta-percha, and the 0.3-mm voxel resolution images were demonstrated not to be a reliable protocol for the investigation of longitudinal root fractures.

Influence of material of overdenture-retaining bar with vertical misfit on three-dimensional stress distribution.

PURPOSE: This study evaluated the effects of different bar materials on stress distribution in an overdenture-retaining bar system with a vertical misfit between implant and bar framework. MATERIALS AND METHODS: A three-dimentional finite element model was created including two titanium implants and a bar framework placed in the anterior part of a severely reabsorbed jaw. The model set was exported to mechanical simulation software, where displacement was applied to simulate the screw torque limited by 100-microm vertical misfit. Four bar materials (gold alloy, silver-palladium alloy, commercially pure titanium, cobalt-chromium alloy) were simulated in the analysis. Data were qualitatively evaluated using Von Mises stress given by the software. RESULTS: The models showed stress concentration in cortical bone corresponding to the cervical part of the implant, and in cancellous bone corresponding to the apical part of the implant; however, in these regions few changes were observed in the levels of stress on the different bar materials analyzed. In the bar framework, screw, and implant, considerable increase in stress was observed when the elastic modulus of the bar material was increased. CONCLUSIONS: The different materials of the overdenture-retaining bar did not present considerable influence on the stress levels in the periimplant bone tissue, while the mechanical components of the system were more sensitive to the material stiffness.

Effect of retorque on loosening torque of prosthetic screws under two levels of fit of implant-supported dentures.

This study evaluated the influence of retorque on loosening torque (Lt) of prosthetic screws in implant-supported dentures with different fit levels. Ten mandibular implant-supported dentures were fabricated and then 20 cast models were then prepared using prosthetic structures to create 2 fit levels: passive fit (Pf) and misfit (Mf). Two tightening techniques were also evaluated: initial torque only (T1); and initial torque and retorque after 10 min (T2). Gold or titanium screws were used, resulting in 4 groups to each one: Pf/T1, Pf/T2, Mf/T1, Mf/T2. The Lt was measured 24 h after the tightening torque using digital torque meter. Data were analyzed statistically by two-way ANOVA and Tukey's test (alpha=0.05), separately for each screw material. For titanium screws, no significant difference (p>0.05) was found between Pf/T1 and Pf/T2, or between Pf/T2 and Mf/T2. However, statistically significant difference (p<0.05) was found between Pf/T1 and Mf/T1, and between Mf/T1 and Mf/T2. Mf reduced the Lt using T1, while and T2 increased the Lt for Mf. Retorque and fit were shown to have no significant influence on the Lt of the gold screws. Retorque application made insignificant the misfit effect on the Lt of the titanium screws, suggesting that this procedure should be performed routinely during the screw tightening in multi-unit dentures.

Effect of retorque on loosening torque of prosthetic screws under two levels of fit of implant-supported dentures

This study evaluated the influence of retorque on loosening torque (Lt) of prosthetic screws in implant-supported dentures with different fit levels. Ten mandibular implant-supported dentures were fabricated and then 20 cast models were then prepared using prosthetic structures to create 2 fit levels: passive fit (Pf) and misfit (Mf). Two tightening techniques were also evaluated: initial torque only (T1); and initial torque and retorque after 10 min (T2). Gold or titanium screws were used, resulting in 4 groups to each one: Pf/T1, Pf/T2, Mf/T1, Mf/T2. The Lt was measured 24 h after the tightening torque using digital torque meter. Data were analyzed statistically by two-way ANOVA and Tukey's test (α=0.05), separately for each screw material. For titanium screws, no significant difference (p>0.05) was found between Pf/T1 and Pf/T2, or between Pf/T2 and Mf/T2. However, statistically significant difference (p<0.05) was found between Pf/T1 and Mf/T1, and between Mf/T1 and Mf/T2. Mf reduced the Lt using T1, while and T2 increased the Lt for Mf. Retorque and fit were shown to have no significant influence on the Lt of the gold screws. Retorque application made insignificant the misfit effect on the Lt of the titanium screws, suggesting that this procedure should be performed routinely during the screw tightening in multi-unit dentures.

Este estudo avaliou a influência do retorque no Ta dos parafusos protéticos em próteses implantossuportadas com diferentes níveis de adaptação. Foram confeccionadas 10 próteses mandibulares implantossuportadas. Vinte modelos de gesso foram fabricados utilizando as estruturas protéticas para criar os 2 níveis de adaptação: adaptação passiva (AP) e desajuste (D). Foram avaliadas 2 técnicas de aperto do parafuso: inicial torque (T1); e inicial torque e retorque após 10 min (T2). Foram usados parafusos de ouro e titânio, resultando em 4 grupos para cada material do parafuso: AP/T1, AP/T2, D/T1, D/T2. O Ta foi mensurado 24 h após o torque de aperto utilizando torquímetro digital. Os resultados foram analisados pela ANOVA (2 fatores) e teste de Tukey (α=0,05), separadamente para cada material dos parafusos. Para os parafusos de titânio, não foi encontrada diferença estatística significante entre AP/T1 e AP/T2, ou AP/T2 e D/T2; porém, diferença significante foi encontrada entre AP/T1 e D/T1, ou D/T1 e D/T2. Onde, D reduziu a Ta utilizando T1; e T2 aumentou o Ta para D. Retorque e adaptação não apresentaram influência significante no Ta dos parafusos de ouro. A aplicação do retorque tornou insignificante o efeito do desajuste no Ta dos parafusos de titânio, sugerindo que este procedimento deveria ser usado rotineiramente durante os parafusos protéticos de titânio em próteses múltiplas.

The electrochemical properties of four dental casting suprastructure alloys coupled with titanium implants.

OBJECTIVES: As the choice of suprastructure alloy to be combined with titanium for the oral cavity is still a much debated issue, the aim of this study was to investigate the electrochemical interaction of the suprastructure/implant couples under the determined experiment conditions. MATERIAL AND METHODS: The potentiodynamic polarization curves and open-circuit potentials (OCP) of four UCLA type suprastructures coupled with straight Swiss Plus implant fixtures were taken in Afnor type artificial saliva solution at 37 degrees C. The concentration of ions leached into artificial saliva solutions was estimated with ICP-MS. SEM images of the margins of suprastructure/implant couples were obtained before and after the electrochemical tests. RESULTS: The OCP value of titanium became passive at the most negative potential. The lowest difference between the initial and constant OCP value was exhibited by the Au based suprastructure. Suprastructures made greater contributions to the potentiodynamic polarization curves of the implant/suprastructure couples. According to the ICP-MS results, Pd based and Au based couples dissolved less than Co-Ni based and Co-Cr based couples. CONCLUSIONS: Within the conditions this study, it may be concluded that the titanium implant forms a stable passive oxide layer in artificial saliva exposed to open air and does not affect the corrosion properties of the suprastructures. Pd based and Au based couples have been found to be more corrosion-resistant than base alloy couples.

The electrochemical properties of four dental casting suprastructure alloys coupled with titanium implants

OBJECTIVES: As the choice of suprastructure alloy to be combined with titanium for the oral cavity is still a much debated issue, the aim of this study was to investigate the electrochemical interaction of the suprastructure/implant couples under the determined experiment conditions. MATERIAL AND METHODS: The potentiodynamic polarization curves and open-circuit potentials (OCP) of four UCLA type suprastructures coupled with straight Swiss Plus implant fixtures were taken in Afnor type artificial saliva solution at 37°C. The concentration of ions leached into artificial saliva solutions was estimated with ICP-MS. SEM images of the margins of suprastructure/implant couples were obtained before and after the electrochemical tests. RESULTS: The OCP value of titanium became passive at the most negative potential. The lowest difference between the initial and constant OCP value was exhibited by the Au based suprastructure. Suprastructures made greater contributions to the potentiodynamic polarization curves of the implant/suprastructure couples. According to the ICP-MS results, Pd based and Au based couples dissolved less than Co-Ni based and Co-Cr based couples. CONCLUSIONS: Within the conditions this study, it may be concluded that the titanium implant forms a stable passive oxide layer in artificial saliva exposed to open air and does not affect the corrosion properties of the suprastructures. Pd based and Au based couples have been found to be more corrosion-resistant than base alloy couples.

Stress distribution of an internal connection implant prostheses set: a 3D finite element analysis.

OBJECTIVE: This study evaluated the stress distribution by loads, under a internal connection implant system with two sort of abutment screws and prosthetic crown models at ten observation points. MATERIALS AND METHOD: The analysis were made in two models with internal butt joint, and with gold and titanium screw, respectively. The load was 382N with 90 masculine to the occlusal surface and 15 masculine to the implant axis at 4 and 6 mm from the implant center. RESULTS: In both models, a large amount of stress was located around the implant neck and little stress was concentrated along the abutment screw. CONCLUSION: The simulations made suggest that the internal connection protects the abutment screw from the accumulated stresses; however, it exposes the implant walls to these stresses.

Evaluation of esthetic brackets' resistance to torsional forces from the archwire.

INTRODUCTION: The aim of this study was to evaluate the resistance to deformation or fracture of esthetic brackets produced by archwire torsion. METHODS: Six types of maxillary right central incisor brackets were analyzed: traditional ceramic brackets (cer); ceramic brackets reinforced with a stainless steel slot (cer/ss); ceramic brackets reinforced with a gold slot (cer/gold); traditional polycarbonate brackets (poly); polycarbonate brackets reinforced with a stainless steel slot (poly/ss); and polycarbonate brackets reinforced with ceramic fillers and a stainless steel slot (poly/cer/ss). Stainless steel wire segments were used, and the testing instrument (Emic DL 10000, São José do Rio Preto, PR, Brazil) was moved at a rate of 1 inch per minute to generate the wire torsion. RESULTS: The brackets showed deformation or fracture resistance values (gf x mm) in decreasing order as follows: cer/ss (3528.1 +/- 516.6), cer/gold (2858.7 +/- 611.6), cer (2424.0 +/- 352.1), poly/cer/ss (2279.5 +/- 174.5), poly/ss (2142.0 +/- 275.7), and poly (1463.6 +/- 193.3). The cer/ss ceramic brackets showed the greatest statistically significant (P <0.01) values of resistance to fracture, and the poly brackets had the lowest statistically significant (P <0.01) values of resistance to deformation. The cer brackets showed no significant differences (P >0.01) from the cer/gold, the poly/cer/ss, and the poly/ss brackets. CONCLUSIONS: This suggested that the stainless steel slot might enhance resistance to deformation or fracture, although gold slots and ceramic fillers are ineffective for reinforcing esthetic brackets.

Optical influence of the type of illuminant, substrates and thickness of ceramic materials.

OBJECTIVES: The present study is an instrumental evaluation of the optical influence of the type of illuminant, substrate and different thickness on the color of dental ceramics. METHODS: Thirty ceramic disks were prepared from IPS-Empress and IPS-Empress2 in three different thicknesses (1.5, 2.0 and 2.5mm). Disks made of composite resin; silver-palladium alloy and gold were used as substrates. The disks with a 1.5mm thickness were placed on a neutral gray photographic paper and measured with a spectrophotometer under three illuminants: daylight (D65), incandescent light (A) and fluorescent light (F6). All ceramic disks were combined with the substrate disks and a spectrophotometer was used to measure the coordinates of lightness (L*) and chromaticity (a* and b*). Two-way ANOVA (p<0.05) was used to analyze the combinations of ceramics, substrates and illuminants tested considering the coordinates of lightness (L*) and chromaticity (a* and b*), and also differences of color (DeltaE), lightness (DeltaL*), chromaticity values (Deltaa* and Deltab*). RESULTS: For the illuminants tested, the results present significant differences for coordinates of chromaticity a* and b*, suggesting a metamerism effect. In combination with the substrates, the results present statistical differences in all the tested conditions, especially where there is no ceramic substructure. SIGNIFICANCE: The presence of discolored tooth remnants or metallic posts and cores can interfere with the desired aesthetic result, based on the selection of color aided by a single luminous source. Thus, the substrate color effect, thickness of the ceramic materials and type of illuminant are important factors to be considered during the clinical application of the ceramic systems.

Evaluation of interface characterization and adhesion of glass ceramics to commercially pure titanium and gold alloy after thermal- and mechanical-loading.

OBJECTIVES: This study evaluated the effect of thermal- and mechanical-cycling on the shear bond strength of three low-fusing glassy matrix dental ceramics to commercial pure titanium (cpTi) when compared to conventional feldspathic ceramic fused to gold alloy. METHODS: Metallic frameworks (diameter: 5 mm, thickness: 4 mm) (N=96, n=12 per group) were cast in cpTi and gold alloy, airborne particle abraded with 150 microm aluminum oxide. Low-fusing glassy matrix ceramics and a conventional feldspathic ceramic were fired onto the alloys (thickness: 4 mm). Four experimental groups were formed; Gr1 (control group): Vita Omega 900-Au-Pd alloy; Gr2: Triceram-cpTi; Gr3: Super Porcelain Ti-22-cpTi and G4: Vita Titankeramik-cpTi. While half of the specimens from each ceramic-metal combination were randomly tested without aging (water storage at 37 degrees C for 24 h only), the other half were first thermocycled (6000 cycles, between 5 and 55 degrees C, dwell time: 13 s) and then mechanically loaded (20,000 cycles under 50 N load, immersion in distilled water at 37 degrees C). The ceramic-alloy interfaces were loaded under shear in a universal test machine (crosshead speed: 0.5 mm/min) until failure occurred. Failure types were noted and the interfaces of the representative fractured specimens from each group were examined with stereomicroscope and scanning electron microscope (SEM). In an additional study (N=16, n=2 per group), energy dispersive X-ray spectroscopy (EDS) analysis was performed from ceramic-alloy interfaces. Data were analyzed using ANOVA and Tukey's test. RESULTS: Both ceramic-metal combinations (p<0.001) and aging conditions (p<0.001) significantly affected the mean bond strength values. Thermal- and mechanical-cycling decreased the bond strength (MPa) results significantly for Gr3 (33.4+/-4.2) and Gr4 (32.1+/-4.8) when compared to the non-aged groups (42.9+/-8.9, 42.4+/-5.2, respectively). Gr1 was not affected significantly from aging conditions (61.3+/-8.4 for control, 60.7+/-13.7 after aging) (p>0.05). Stereomicroscope images showed exclusively adhesive failure types at the opaque ceramic-cpTi interfacial zone with no presence of ceramic on the substrate surface but with a visible dark titanium oxide layer in Groups 2-4 except Gr1 where remnants of bonder ceramic was visible. EDS analysis from the interfacial zone for cpTi-ceramic groups showed predominantly 34.5-85.1% O(2) followed by 1.1-36.7% Al and 0-36.3% Si except for Super Porcelain Ti-22 where a small quantity of Ba (1.4-8.3%), S (0.7%) and Sn (35.3%) was found. In the Au-Pd alloy-ceramic interface, 56.4-69.9% O(2) followed by 15.6-26.2% Si, 3.9-10.9% K, 2.8-6% Na, 4.4-9.6% Al and 0-0.04% Mg was observed. SIGNIFICANCE: After thermal-cycling for 6000 times and mechanical-cycling for 20,000 times, Triceram-cpTi combination presented the least decrease among other ceramic-alloy combinations when compared to the mean bond strength results with Au-Pd alloy-Vita Omega 900 combination.