Influence of Immediate Dentin Sealing on Bond Strength of Resin-Based CAD/CAM Restoratives to Dentin: A Systematic Review of In Vitro Studies.

Immediate dentin sealing (IDS) is a method of improving the bond strength of indirect dental restorative materials to dentin and belongs to the biomimetic protocols of contemporary dentistry. The purpose of this systematic review was to evaluate the effect of IDS on the bond strength of resin-based CAD/CAM materials to dentin. PubMed and MEDLINE, Scopus, and the Web of Science were searched by two individual researchers, namely for studies that have been published in English between 1 January 2005 and 31 December 2023 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The inclusion criteria encompassed articles related to in vitro studies, measuring the bond strength through microtensile bond strength (µ-TBS), micro-shear bond strength (µ-SBS), tensile bond strength (TBS) or shear bond strength (SBS) tests after the use of the IDS technique. The included restorative materials comprised resin-based CAD/CAM materials bonded to dentin. A total of 1821 studies were identified, of which 7 met the inclusion criteria. A meta-analysis was not deemed appropriate due to the high level of diversity inthe publications and techniques. The use of IDS yielded higher bond strength outcomesin various experimental conditions and resin-based CAD/CAM materials. Overall, IDS in CAD/CAM restorations may contribute to better clinical outcomesand improved restoration longevity due to this property.

Clinical evaluation of removable partial dentures with digitally fabricated metal framework after 4 years of clinical service.

This case report describes the clinical outcomes of three patients who received removable partial dentures with a completely digitally designed and manufactured metal framework. The initial intraoral impressions were prepared, and the resulting standard tessellation language files were sent to a dental laboratory, where the alloy framework was designed using inLab software and printed using a 3D printer or milled directly from a Co-Cr disc. The quality of fit of the framework was evaluated intraorally to confirm the laboratory design. The acrylic teeth were set, and the definitive partial dentures were delivered after the acrylic resin bases were processed. The follow-up time was 4 years. No complications or failures related to the components of the partial dentures were observed.

Fracture Resistance of Class II MOD Cavities Restored by Direct and Indirect Techniques and Different Materials Combination.

This study aimed to evaluate the fracture resistance of class II MOD cavities restored using different techniques and materials. Sixty extracted maxillary molars were selected and standardized class II MOD cavities were prepared using a custom-made paralleling device. The specimens were divided into four groups based on the restoration technique used: Group 1 (direct resin composite), Group 2 (short-fiber-reinforced composite resin), Group 3 (composite polyethylene fiber reinforcement), and Group 4 (CAD/CAM resin inlays). Fracture resistance was assessed for each group after thermocycling aging for 10,000 cycles. The mode of fracture was assigned to five types using Burke's classification. To compare the fracture force among the tested materials, a paired sample t-test was performed. The significance level for each test was set at p < 0.05. Significant differences in fracture resistance were observed among the different restoration techniques. CAD/CAM inlays (2166 ± 615 N), short-fiber-reinforced composite resin (2471 ± 761 N), and composite polyethylene fiber reinforcement (1923 ± 492 N) showed superior fracture resistance compared to the group restored with direct resin composite (1242 ± 436 N). The conventional resin composite group exhibited the lowest mean fracture resistance. The choice of restoration material plays a critical role in the clinical survival of large MOD cavities. CAD/CAM inlays and fiber-reinforced composites offer improved fracture resistance, which is essential for long-term success in extensive restorations.

Adhesion of Conventional, 3D-Printed and Milled Artificial Teeth to Resin Substrates for Complete Dentures: A Narrative Review.

BACKGROUND: One type of failure in complete or partial dentures is the detachment of resin teeth from denture base resin (DBR). This common complication is also observed in the new generation of digitally fabricated dentures. The purpose of this review was to provide an update on the adhesion of artificial teeth to denture resin substrates fabricated by conventional and digital methods. METHODS: A search strategy was applied to retrieve relevant studies in PubMed and Scopus. RESULTS: Chemical (monomers, ethyl acetone, conditioning liquids, adhesive agents, etc.) and mechanical (grinding, laser, sandblasting, etc.) treatments are commonly used by technicians to improve denture teeth retention with controversial benefits. Better performance in conventional dentures is realized for certain combinations of DBR materials and denture teeth after mechanical or chemical treatment. CONCLUSIONS: The incompatibility of certain materials and lack of copolymerization are the main reasons for failure. Due to the emerging field of new techniques for denture fabrication, different materials have been developed, and further research is needed to elaborate the best combination of teeth and DBRs. Lower bond strength and suboptimal failure modes have been related to 3D-printed combinations of teeth and DBRs, while milled and conventional combinations seem to be a safer choice until further improvements in printing technologies are developed.

Zirconia Nanoparticles as Reinforcing Agents for Contemporary Dental Luting Cements: Physicochemical Properties and Shear Bond Strength to Monolithic Zirconia.

Nanofillers in resin materials can improve their mechanical and physicochemical properties. The present work investigated the effects of zirconia nanoparticles (NPs) as fillers in commercial dental luting cements. Two dual-cured self-adhesive composites and one resin modified glass ionomer (RMGI) luting cement were employed. Film thickness (FT), flexural strength (FS), water sorption (Wsp), and shear bond strength (SBS) to monolithic zirconia were evaluated according to ISO 16506:2017 and ISO 9917-2:2017, whereas polymerization progress was evaluated with FTIR. Photopolymerization resulted in double the values of DC%. The addition of 1% wt NPs does not significantly influence polymerization, however, greater amounts do not promote crosslinking. The sorption behavior and the mechanical performance of the composites were not affected, while the film thickness increased in all luting agents, within the acceptable limits. Thermocycling (TC) resulted in a deteriorating effect on all composites. The addition of NPs significantly improved the mechanical properties of the RMGI cement only, without negatively affecting the other cements. Adhesive primer increased the initial SBS significantly, however after TC, its application was only beneficial for RMGI. The MDP containing luting cement showed higher SBS compared to the RMGI and 4-META luting agents. Future commercial adhesives containing zirconia nanoparticles could provide cements with improved mechanical properties.

Study of dental zirconia reinforced lithium silicate for its use as a personal accidental dosimeter.

A recently introduced material for dental restorations, Zirconia reinforced Lithium Silicate (ZLS), is examined for its properties, in order to be used as a personal accidental thermoluminescence dosimeter. For this purpose, its main thermoluminescence characteristics are studied, such as its sensitivity, signal reproducibility, fading, dose response and lower detectable dose limit. Furthermore, the material is characterized by means of microscopic, spectroscopic and crystallographic techniques. The results propose that ZLS is promising to be used as a personal accidental thermoluminescence dosimeter for post-irradiation detection, with single aliquot protocols.

Evaluation of the biological behaviour of various dental implant abutment materials on attachment and viability of human gingival fibroblasts.

OBJECTIVE: This study aimed to investigate the biological effects of yttria-stabilized zirconia (Y-TZP) compared to other dental implant abutment materials, i.e. lithium disilicate (LS2) and titanium alloy (Ti), as well as the effects of aging of Y-TZP on viability/proliferation and attachment properties of Human Gingival Fibroblasts (HGFs). METHODS: Cylindrical specimens of each material were prepared as per manufacturer's instructions. Y-TZP specimens were divided into three groups: 1. no aging (Zr0), 2. aging for 5 h, 134 °C, 2 bars, 100% humidity (Zr5), 3. aging for 10 h under the same conditions (Zr10). Surface roughness was evaluated by optical profilometry; cell metabolic activity/viability by MTT assay, morphological changes by Scanning Electron Microscopy (SEM) and ratio of live/dead cells by confocal microscopy. RESULTS: Results showed statistically significant reduction of HGF metabolic activity/viability in contact with Y-TZP after aging. Nevertheless, non-aged zirconia showed no significant differences compared with LS2, Ti and control cultures. In contrast, significant stimulation of cell metabolic activity/viability was observed in HGFs exposed to LS2 eluates. Differential morphological patterns were observed for HGF in contact with different materials/treatments, with obviously increased number of dead cells and sparser distribution of HGFs cultured on Zr10 specimens. These effects were not correlated with surface topography, since Y-TZP aging did not alter surface micro-roughness. SIGNIFICANCE: These findings indicate that Y-TZP shows comparable biological properties to Ti and LS2 as implant abutment material. Nevertheless, Y-TZP aging might influence gingival cell attachment and proliferation properties, providing an alert to a potentially negative effect on the long-term maintenance of gingival architecture.