Effect of sintering programs and surface treatments on monolithic zirconia.

PURPOSE: To investigate the effect of sintering programs and surface treatments on surface properties, phase transformation and flexural strength of monolithic zirconia. MATERIALS AND METHODS: Zirconia specimens were sintered using three distinct sintering programs [classic (C), speed (S), and superspeed (SS)] (n = 56, each). One sample from each group underwent scanning electron microscopy (SEM) and grain size analysis following sintering. Remaining samples were divided into five subgroups (n = 11) based on the surface treatments: control (CL), polish (P), glaze (G), grind + polish (GP), and grind + glaze (GG). One sample from each subgroup underwent SEM analysis. Remaining samples were thermally aged. Monoclinic phase volume, surface roughness, and three-point flexural strength were measured. Monoclinic phase volume and surface roughness were analyzed by Kruskal-Wallis and Dunn tests. Flexural strength was analyzed by two-way ANOVA and Weibull analysis. The relationships among the groups were analyzed using Spearman's correlation analysis. RESULTS: Sintering program, surface treatment, and sintering × surface treatment (P ≤ .010) affected the monoclinic phase volume, whereas the type of surface treatment and sintering × surface treatment affected the surface roughness (P < .001). Type of sintering program or surface treatment did not affect the flexural strength. Weibull analysis revealed no significant differences between the m and σo values. Monoclinic phase volume was positively correlated with surface roughness in the SGG and SSP groups. CONCLUSION: After sintering monolithic zirconia in each of the three sintering programs, each of the surface treatments can be used. However, for surface quality and aging resistance, G or GG can be recommended as a surface finishing method.

Effect of surface treatments on wear and surface properties of different CAD-CAM materials and their enamel antagonists.

STATEMENT OF PROBLEM: Which surface treatment provides optimal surface roughness, microhardness, and wear behavior for computer-aided design and computer-aided manufacturing (CAD-CAM) materials and their enamel antagonists is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of surface treatment on the surface roughness, microhardness, and 2-body wear of different CAD-CAM materials and their enamel antagonists. MATERIAL AND METHODS: Monolithic zirconia, polymer-infiltrated ceramic network, lithium disilicate, leucite-reinforced ceramic, zirconia-reinforced lithium silicate, and feldspathic ceramic specimens were sliced into 2-mm-thick rectangular plates and divided into polished or glazed subgroups (n=6). After surface roughness and microhardness measurements, the specimens were loaded at 49 N for 250 000 cycles and simultaneously thermocycled (5 °C and 55 °C). All specimens were scanned before and after the wear test by using a scanner. The volumetric loss and wear depth of the materials and the volumetric and height loss of the enamel were calculated, and scanning electron microscope images of the specimens were made. Multiple 2-way ANOVAs and Tukey honestly significant difference tests were used to assess the effect of material and surface treatment on surface roughness, microhardness, and wear behavior of materials and enamel (α=.05). RESULTS: Material and surface treatment interactions affected the surface roughness (P<.001), microhardness (P<.001), volumetric loss of materials (P=.044), and height loss of enamel (P<.001). CONCLUSIONS: Polishing resulted in higher surface roughness and microhardness than glazing. Volumetric loss depended on the material, which affected the height loss of the antagonists. Glazing and polishing had similar effects on the volumetric loss of materials and antagonists. No correlation was found between the wear of materials and the antagonists, nor between the surface roughness of materials and the volumetric loss of materials or antagonists.

Effect of multiple firings on surface roughness and flexural strength of CAD-CAM ceramics.

STATEMENT OF PROBLEM: Knowledge on the effect of multiple firings on surface roughness and the flexural strength of different types of monolithic computer-aided design and computer-aided manufacturing (CAD-CAM) ceramics is limited. PURPOSE: The purpose of this in vitro study was to evaluate the effect of multiple firings on the surface roughness and flexural strength of 4 different CAD-CAM ceramics after thermocycling. MATERIAL AND METHODS: Four different CAD-CAM ceramics (Lava All Zirconia 3-mol yttria tetragonal zirconia polycrystal [3-YTZP] [Z], VITA SUPRINITY [S], IPS e.max CAD [EX], IPS Empress CAD [E]) (n=33) were wet-sectioned to form rectangular 18×4×1.2-mm specimens. After glaze application, the specimens were divided into 3 subgroups according to the number of firings (1, 2, and 4) (n=11). The specimens were thermocycled (10 000 cycles), and surface roughness and flexural strength values were measured (n=10). One additional specimen from each group was analyzed by using scanning electron microscopy (SEM). Data were analyzed by 2-way analysis of variance (ANOVA) and the Tukey honestly significance difference (HSD) test (α=.05). RESULTS: According to the 2-way ANOVA, the material, number of firings, and the interaction between the material and number of firings affected the surface roughness (P<.001). For flexural strength, material (P<.001) and number of firings (P<.039) were found significant. Multiple firings (2 or 4 firings) affected the surface roughness of E (P<.001). Regardless of the number of firings, the Z material had the highest flexural strength (P<.001). Four firings affected the flexural strength values only for the Z material (P≤.005). CONCLUSIONS: CAD-CAM ceramic type affected the surface roughness and flexural strength values. The surface roughness of E was lower when fired 2 or 4 times than when fired once. The flexural strength of Z was lower when fired 4 times than when fired once.

Effect of firing cycle and aging on long-term chemical degradation of monolithic CAD-CAM ceramics.

STATEMENT OF PROBLEM: Previous studies have shown the susceptibility of dental ceramics to degradation when subjected to certain media. However, knowledge on the effect of repeated firings and thermocycling on the ion elution of computer-aided design and computer-aided manufacturing (CAD-CAM) ceramics is lacking. PURPOSE: The purpose of this in vitro study was to compare the effect of repeated firings on the ion elution of CAD-CAM materials before and after thermocycling. MATERIAL AND METHODS: Bar-shaped specimens were prepared from 4 different CAD-CAM materials (monolithic zirconia [Z], zirconia-reinforced lithium silicate glass-ceramic [S], lithium disilicate glass-ceramic [EX], and leucite-reinforced glass-ceramic [E]) and divided into 3 groups according to the number of repeated glaze firings (1 firing [1F], 2 firings [2F], and 4 firings [4F]). Specimens were placed into deionized water (pH 7.4) and stored at 37 °C for 168 hours. Inductively coupled plasma-optic emission spectrophotometry (ICP-OES) was used to measure the baseline values of the eluted ions in immersion. The specimens were then subjected to thermocycling. Then, surface roughness (Ra) and ion elution values were measured. The Kruskal-Wallis and Mann-Whitney U tests were used to analyze the ion elution data before and after thermocycling, and the effect of thermocycling on ion elution was assessed by the Wilcoxon signed rank test. Ra data were analyzed with 2-way analysis of variance (ANOVA) and the Tukey honestly significant difference tests (α=.05). RESULTS: Elution of some ions varied depending on the material-firing pair before (Al, As, B, Ba, Cr, Cu, Li, Mg, Na, P, and Zn) and after (Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cu, K, Li, Mg, Na, P, Y, and Zn) thermocycling. Before thermocycling, all firing groups within each material showed a similar number of significantly higher eluted ions. After thermocycling, the number of significantly higher eluted ions decreased in all materials, except for EX. The effect of thermocycling on the ion elution of the 1F group of Z (Al, Be, Ca, Cd, Co, Cr, Cu, K, Li, P, Y, and Zn), S (As, Be, Cd, Co, Cr, K, P, and Y), EX (B, Cu, and P), and E (B and Ba); 2F group of Z (Al, Be, Ca, Co, Cr, Cu, K, Li, P, and Y), S (Be, Cd, Co, K, Li, and Y), EX (P), and E (P); 4F group of Z (Al, As, Ba, Be, Ca, Cd, Co, Cr, Cu, K, Li, P, and Y), S (Al, Be, Cd, Co, Cr, Li, Mg, and Y), EX (Be, Ca, Cd, Co, K, Y, and Zn), and E (Ca and P) was nonsignificant (P≥.051). The interaction between material and repeated firings (P<.001) had a significant effect on Ra. For 1F groups, E showed the highest Ra (P≤.003), while Z had higher Ra than S (P=.009). For 2F groups, Z had higher Ra than S (P=.01). The differences among 4F groups were nonsignificant (P≥.677). An increased number of repeated firings (2F and 4F) decreased the Ra of E (P<.001). CONCLUSIONS: The effect of repeated firings and thermocycling on the chemical stability of the tested CAD-CAM materials varied. No clear trend was observed on the elution of different ions within material-firing pairs before thermocycling. However, thermocycling increased the number of significantly higher eluted ions for EX. The effect of thermocycling on the ion elution of materials varied depending on ions. Repeated firings decreased the surface roughness of E.

Effect of different surface treatments and thermomechanical aging on the ion elution of CAD-CAM materials.

STATEMENT OF PROBLEM: Dental ceramics have been reported to elute ions when subjected to nonneutral pH. However, the effect of surface treatments and thermomechanical aging on the ion elution of CAD-CAM ceramics is unclear. PURPOSE: The purpose of this in vitro study was to compare the effect of surface treatment (glazed or polished) and thermomechanical aging on the ion elution of CAD-CAM materials before and after 2-body wear simulation. MATERIAL AND METHODS: Specimens were prepared from 6 CAD-CAM materials-leucite (LC), feldspathic (FP), zirconia-reinforced lithium silicate (ZLS), lithium disilicate (LDS) glass-ceramics, polymer-infiltrated ceramic network (PICN), and zirconia (ZIR)-and divided into 2 groups according to the surface treatments (glazed or polished) (n=6). For baseline ion elution values, specimens were placed into polyethylene bottles containing deionized water (pH 7.4) that had been stored in an incubator for 168 hours at 37 °C. The eluted ions in the immersion solution were measured by using inductively coupled plasma-optic emission spectrophotometry. The specimens were then subjected to thermomechanical aging by using human enamel as an antagonist. After aging, the ion elution of the specimens was remeasured. Ion elution data before and after 2-body wear were analyzed by using the Mann-Whitney U test, while the effect of 2-body wear was assessed by using the Wilcoxon signed rank test (α=.05). RESULTS: The presence of some ions varied depending on the material-surface treatment pair before (Al, As, B, Ba, Ca, K, Li, Mg, Na, P, and Zn) and after (Al, B, Ba, Ca, Co, Li, Mg, and P) 2-body wear. Polished materials had higher ion elution than the glazed materials before 2-body wear (P≤.041), except for LC (P and Zn) and PICN (Ca, Cu, and K) (P≤.009). After 2-body wear, polished LC (B and Ba), FP (Al, B, and Mg), ZLS (Al, Ba, Ca, and Li), ZIR (B and Ba), glazed PICN (Ca, Mg, and P), ZLS (P), and ZIR (Co) presented higher ion elution than their counterparts (P≤.041). The effect of 2-body wear on the ion elution of polished LC (Al, K), FP (Na), ZLS (Li), LDS (K, Na), PICN (Al, Na), ZIR (Na, Y), glazed LC (Na), FP (Ba, Na), ZLS (B, Ba, Y), LDS (Na), PICN (Y), and ZIR (Na) was nonsignificant (P≥.075). However, the elution of remaining ions showed a significant difference before and after 2-body wear (P≤.046). CONCLUSIONS: The chemical stability of tested CAD-CAM materials was affected by the 2-body wear. Glazing led to a lower ion elution except for LDS and PICN. While polishing resulted in lower ion elution for PICN, both surface treatments resulted in similar ion elution for LDS.

Effect of thermocycling on the surface properties of resin-matrix CAD-CAM ceramics after different surface treatments.

PURPOSE: To evaluate the effect of thermocycling on the water contact angle (WCA), surface roughness (SR), and microhardness (MH) of resin-matrix computer-assisted design and computer-assisted manufacturing (CAD-CAM) ceramics after different surface treatments (conventional polishing or 2 different surface sealants). MATERIAL AND METHODS: Two different types of resin-matrix CAD-CAM ceramics; a nanoparticle-filled resin (CeraSmart; CS) and a resin nanoceramic (Lava Ultimate; LU) were tested. Rectangular-shaped plates (1 mm-thick) were divided into 3 groups (n = 8) in terms of surface treatment methods applied: conventional polishing (control) or 2 surface sealants (Optiglaze (OG) and Palaseal (PS)). Scanning electron microscope images ( × 1000 and × 700 magnifications) of each material were taken from 2 additional specimens before surface treatments. After surface treatments, WCAs of deionized water, SR, and MH values of specimens were measured. All specimens were subjected to 5000 thermocycling and measurements were repeated. SR, WCA, and MH data before and after thermocycling were compared by using a 2-way ANOVA (α=.05). RESULTS: A significant interaction was found between the surface treatment and the material for WCA after thermocycling (P < .001), for SR before thermocycling (P = .014), and for MH both before and after thermocycling (P < .001). SEM images before surface treatments revealed that the surface of CS was mechanically rougher with a more microretentive topography compared with the surface of LU. No significant correlation was found between SR and WCA (P > 0.05). CONCLUSIONS: Thermocycling affected the SR, MH, and WCA of all resin-matrix CAD-CAM ceramics.

Clinical factors affecting the translucency of monolithic Y-TZP ceramics.

The use of monolithic yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics in aesthetically critical regions is questionable because of the insufficient translucency and opacity of the restorations. Intrinsic (manufacturing process) and extrinsic factors (laboratory procedures and clinical factors) can affect the translucency of monolithic zirconia. In this narrative review, the clinical factors (thickness, cementation type, colour of the monolithic zirconia, surface finishing methods and wear, dental background, cement colour, low temperature degradation) affecting the translucency of monolithic Y-TZP ceramics were reported.

Effects of fabrication and shading technique on the color and translucency of new-generation translucent zirconia after coffee thermocycling.

STATEMENT OF PROBLEM: The color stability and translucency of preshaded and externally shaded monolithic and veneered new generation translucent zirconia are not well known. PURPOSE: The purpose of this in vitro study was to investigate the effect of fabrication (veneered or monolithic) and shading (preshaded or externally shaded) techniques on the color and relative translucency of translucent zirconia after coffee thermocycling. MATERIAL AND METHODS: Specimens of different thicknesses (0.5 mm for veneered and 1.5 mm for monolithic) were sectioned from preshaded and externally shaded translucent zirconia. Externally shaded specimens were colored by using the dipping technique. Externally shaded (Ext Mono) and preshaded (Pre Mono) monolithic zirconia specimens were sintered and glazed. Externally shaded (Ext Vene) and preshaded (Pre Vene) 0.5-mm-thick specimens were sintered, veneered with feldspathic porcelain (1 mm), and glazed. The color coordinates of specimens were measured with a spectroradiometer before and after 10 000 thermocycles in coffee solution. Color differences were calculated using CIEDE2000, and relative translucency parameter (RTP) values were calculated using the RTPCIEDE2000 formula. Analysis of variance (ANOVA) was used to analyze the CIEDE2000 color differences and RTP values (α=.05). RESULTS: Shading technique had a significant effect on the color difference values (P=.018). For the translucency data, the 3-way ANOVA revealed a significant interaction between the fabrication technique and shading technique (P=.002). Each pair of material subgroups within each combination of fabrication technique and shading technique was found to have a significantly different RTP, except between Ext Vene and Pre Vene (P=.115). CONCLUSIONS: Externally shaded translucent zirconia had a greater color change in coffee than the preshaded translucent zirconia, either in monolithic or veneered form. Fabrication technique significantly affected the RTP, and the monolithic zirconia was more translucent than the veneered zirconia.

Effect of different resin cements and surface treatments on the shear bond strength of ceramic-glass polymer materials.

STATEMENT OF PROBLEM: The effect of different surface treatment techniques on the bond strength of different types of ceramic-glass polymer computer-assisted design and computer-assisted manufacturing (CAD-CAM) materials and resin cements after aging is unknown. PURPOSE: The purpose of this in vitro study was to evaluate the surface roughness of different ceramic-glass polymer CAD-CAM materials after 2 different surface treatments and the effect of material, surface treatment, resin cement, and aging on bond strength. Additionally, it was to determine any correlation between the surface roughness and bond strength. MATERIAL AND METHODS: CAD-CAM ceramic-glass polymer materials, a polymer-infiltrated ceramic network (PICN) (VITA ENAMIC), a resin nanoceramic (Lava Ultimate), and a nanoparticle-filled resin (Cerasmart) (1.5 mm in thickness; n=144) were divided into 2 subgroups in terms of surface treatments: airborne-particle abraded or silica-coated. The surface roughness values of specimens were measured. Composite resin cylinders were prepared and bonded to the restorative specimens using 2 different types of resin cements (dual-polymerizing [DP] and light-polymerizing [LP]). Half of the specimens were stored in distilled water for 24 hours, while the other half were submitted to 5000 thermocycles. The shear bond strength was measured, and the failure modes of the specimens were evaluated. The data were analyzed with ANOVA and Tukey HSD tests (α=.05). The correlation between roughness and bond strength values was analyzed using Pearson correlation analysis. RESULTS: Material (P=.012) and surface treatment type (P=.031) significantly affected the surface roughness. For bond strength, significant interactions were found among the material type, surface treatment, resin cement, and aging factors (P=.009). No significant correlation was found between roughness and bond strength (P=.943). CONCLUSIONS: The surface treatment and resin cement type affected the bond strength and surface roughness of tested restorative materials. DP resin cement provided higher bond strength for airborne-particle abraded nanohybrid composite resin materials. LP resin cement achieved a higher bond strength when used with silica-coated, nanoparticle-filled resin and PICN materials.

Effect of shading technique and thickness on color stability and translucency of new generation translucent zirconia.

OBJECTIVE: To evaluate the effect of shading technique and thickness on the color stability and translucency of translucent zirconia after coffee thermocycling. METHODS: Specimens in different thicknesses (1; 1.5; 2 mm) (n = 4 for each thickness) were sectioned from translucent preshaded zirconia (Pre) and externally shaded zirconia (Ext). After sintering, specimens were glazed and subjected to 10,000 thermocycling in coffee solution. The color coordinates of specimens were measured with a spectroradiometer before and after coffee thermocyling. Color differences and relative translucency parameter (RTP) values were calculated with CIEDE2000 color difference and TPCIEDE2000 formulas. ANOVA was used to analyze the CIEDE2000 color difference and RTP values (α = 0.05). RESULTS: According to 2-way ANOVA, no significant effect of shading technique and thickness on the color difference values was found (P > .05). According to 3-way ANOVA, a significant interaction between the shading technique and thickness (P < .0001) was found for RTP. The RTP parameter decreased with the increase in the thickness. Ext specimens presented significantly higher RTP than Pre specimens (P < .0001), except for between Ext 1 mm and Pre 1 mm (P = .179). CONCLUSIONS: Neither shading technique nor tested thicknesses affected the color of translucent zirconia. Shading technique and thickness affected the RTP of translucent zirconia. The RTP was inversely affected with the thickness of the material. Externally shaded zirconia presented higher RTP than preshaded zirconia for specimens thicker than 1 mm. CLINICAL SIGNIFICANCE: Discoloration with coffee was insignificant for the tested translucent zirconia in tested thicknesses (1, 1.5, 2 mm). When a translucent restoration is intended, thinner externally shaded translucent zirconia restorations should be preferred instead of preshaded translucent zirconia.

Effect of surface treatments and coffee thermocycling on the color and translucency of CAD-CAM monolithic glass-ceramic.

STATEMENT OF PROBLEM: The effects of surface treatments and coffee thermocycling on the color and relative translucency of a recently introduced computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic glass-ceramic are unknown. PURPOSE: The purpose of this in vitro study was to evaluate the effect of coffee thermocycling on the color and relative translucency parameter (RTP) of CAD-CAM monolithic glass-ceramics after different surface treatments. MATERIAL AND METHODS: Specimens (1.5-mm-thick) were sectioned from zirconia-reinforced lithium silicate glass-ceramic (ZLS) (n=18) and lithium disilicate glass-ceramic (LDS) blocks (n=18). Two different types of surface treatments (glazing or polishing) were applied to the specimens. The specimens were subjected to 5000 thermocycles in a coffee solution. The color coordinates of specimens were measured before and after coffee thermocycling by using a spectroradiometer, and color differences and relative translucency values were calculated by using CIEDE2000 color difference and RTP formulas. ANOVA was used to analyze the color difference and relative translucency values by using maximum likelihood estimation and the Satterthwaite degrees of freedom methods. Any significant interaction between surface subgroups was further analyzed by using the Tukey-Kramer adjustment (α=.05). RESULTS: Material type had a significant effect on color difference (P=.018). All color difference values of all materials were smaller than the clinical acceptability threshold (<1.8 units). For relative translucency, material (P<.001) and coffee thermocycling had a significant effect (P=.014), and an interaction was found between the surface treatments and materials (P<.001). The Tukey-Kramer test revealed significant differences between glazed and polished subgroups of LDS material, except for ZLS-glazed and ZLS-polished subgroups. CONCLUSIONS: Different surface treatments of CAD-CAM monolithic zirconia-reinforced lithium silicate and lithium disilicate glass-ceramics resulted in clinically acceptable color changes after coffee thermocycling. The color changes in all groups, except for LDS-polished, were not perceivable. Lithium disilicate was more translucent than zirconia-reinforced lithium silicate before and after coffee thermocycling. Coffee thermocycling decreased the translucency of both of the materials. Different surface treatments affected the translucency of only lithium disilicate for tested thickness.

Effect of thickness on optical properties of monolithic CAD-CAM ceramics.

OBJECTIVE: To compare the effect of material and thickness on the color stability and relative translucency parameters (RTP) for monolithic ceramics subjected to coffee thermocycling. METHODS: Four specimens each at thicknesses of 0.5, 0,7 and 1 mm were sectioned from monolithic ceramics [preshaded monolithic zirconia (MonZr), lithium disilicate (LDS) and zirconia reinforced lithium silicate (ZLS)]. The specimens were glazed and subjected to 5000 coffee thermocycling. The color coordinates of specimens were determined with a spectroradiometer and color differences and RTP values were calculated with CIEDE2000 color difference and TPCIEDE2000 formulas. ANOVA was used to analyze CIEDE2000 color difference and RTP values (α = .05). RESULTS: For the color difference data, the 2-way ANOVA revealed a significant interaction between material and different thickness (P = .002). Except for 0.5 mm thick ZLS material, all materials in all thicknesses studied presented color changes within the clinically acceptable limits after coffee thermocycling. For the RTP data, the 3-way ANOVA revealed a highly significant interaction between material and different thicknesses (P < .001). CONCLUSIONS: Material type and thickness can be expected to affect color change and relative translucency of the restorations made with preshaded MonZr, LDS and ZLS materials. Except for 0.5 mm thick ZLS material, color changes of all studied materials were within the clinically acceptable limits. Except ZLS material, color changes of other materials were not significantly affected by thickness. Staining in coffee was not found to affect translucency, and the materials' translucency parameters were ranked from high to low as LDS, ZLS and MonZr at each thickness studied.

Repair bond strengths of non-aged and aged resin nanoceramics.

PURPOSE: To explore the influence of different surface conditionings on surface changes and the influence of surface treatments and aging on the bond strengths of composites to non-aged and aged resin nanoceramics. MATERIALS AND METHODS: Rectangular-shaped non-aged and aged (5000 thermocycles) resin nanoceramic specimens (Lava Ultimate) (n=63, each) were divided into 3 groups according to surface treatments (untreated, air abrasion, or silica coating) (n=21). The surface roughness was measured and scanning electron microscopy was used to examine one specimen from each group. Afterwards, the specimens were repaired with a composite resin (Filtek Z550) and half were sent for aging (5000 thermocycles, n=10, each). Shear bond strengths and failure types were evaluated. Roughness and bond strength were investigated by two- and three-way analysis of variance, respectively. The correlation between the roughness and bond strength was investigated by Pearson's correlation test. RESULTS: Surface-treated samples had higher roughness compared with the untreated specimens (P=.000). For the non-aged resin nanoceramic groups, aging was a significant factor for bond strength; for the aged resin nanoceramic groups, surface treatment and aging were significant factors. The failures were mostly adhesive after thermal cycling, except in the non-aged untreated group and the aged air-abraded group, which had mostly mixed failures. Roughness and bond strength were positively correlated (P=.003). CONCLUSION: Surface treatment is not required for the repair of non-aged resin nanoceramic; for the repair of aged resin nanoceramic restorations, air abrasion is recommended.

Color Stability of Composites After Short-term Oral Simulation: An in vitro Study.

BACKGROUND: Although most of the studies investigated color stability of different restorative materials, evaluation of color stability of composites after immersion in multiple beverages in the same day by an in vitro oral simulation study is unclear. OBJECTIVE: To assess color change of different restorative materials at the end of days 1, 14, and 30 of immersion in multiple liquid types to mimic the oral environment in vitro. METHOD: Ten disc-shaped specimens were made from each of four different resin composites (Filtek Z250, Voco x-tra base, Beautifil Flow Plus, Beautifil II). Baseline color value of each sample was measured using a spectrophotometer. Each composite was respectively immersed in coffee, an orange/pomegranate juice mixture, black tea, and a mouth rinse on the same day to mimic daily liquid consumption of individuals. Color measurements were taken after 1, 14, and 30 days by spectrophotometer and color change values were calculated. Statistical analyses were executed by one-way ANOVA/Tukey HSD and repeated-measures ANOVA. RESULTS: All materials showed significant color change after 1, 14, and 30 days (P < 0.01) of immersion in liquids, with the lowest color alteration observed at the 1st day and the highest observed after the 30th day. Among the materials tested, at each time point (1, 14, and 30 days), the lowest color alteration was detected in Filtek Z250 and the highest color alteration was detected in Beautifil II. CONCLUSION: Color alteration of composite resins is affected by composite type and storage time. With the exception of 1 day of storage, color changes of all materials were substantial and clinically unacceptable.

Mechanical properties of zirconia after different surface treatments and repeated firings.

PURPOSE: This study investigated the influence of surface conditioning procedures and repeated firings on monoclinic content and strength of zirconia before cementation. MATERIALS AND METHODS: Sintered bar-shaped zirconia specimens were subjected to no surface treatment (control), air abrasion, or grinding (n=21). Their roughness was evaluated using a profilometer, and microscope analysis was performed on one specimen of each group. Then, 2 or 10 repeated firings (n=10) were executed, the monoclinic content of specimens was analyzed by X-ray diffraction, and a three-point flexural strength test was performed. Surface roughness values were compared using one-way analysis of variance (ANOVA) and Tukey honestly significant difference (HSD) tests, the monoclinic content values were tested using Kruskal-Wallis and Mann-Whitney U tests, and the flexural strength values were tested using two-way ANOVA and Tukey HSD tests (P=.05). Spearman's correlation test was performed to define relationships among measured parameters. RESULTS: Surface-treated specimens were rougher than untreated specimens and had a higher monoclinic content (P<.005), and the relationship between roughness and monoclinic content was significant (P<.000). Neither surface treatment nor firing significantly affected the flexural strength, but Weibull analysis showed that for the air-abraded samples the characteristic strength was significantly lower after the 10(th) firing than after the 2(nd) firing. CONCLUSION: After firing, a negligible amount of monoclinic content remained on the zirconia surfaces, and rougher surfaces had higher monoclinic contents than untreated surfaces. Multiple firings could be performed if necessary, but the fracture probability could increase after multiple firings for rougher surfaces.

Influence of surface treatments and resin cement selection on bonding to zirconia.

This study aimed to evaluate the surface changes caused in zirconia by different surface treatments and the influence of the surface treatment and cement selection on bonding to zirconia under aging. Sintered zirconia specimens were divided into five groups (n = 31) based on the surface treatment, namely, control, air abrasion, silica coating, laser and air abrasion + laser. After surface treatment, surface roughness and microscope analyses were performed on one specimen of each group. Composite cylinders were then bonded to conditioned ceramics using RelyX U100 (RXU), Clearfil Esthetic Cement (CEC) and Panavia F (PF) (n = 10). After 24 h, the bonded specimens were subjected to thermal cycling (6,000 times), and then, a shear bond strength test was conducted. The roughness values were analysed using Kruskal-Wallis and Mann-Whitney U tests, and the bond strengths were analysed by two-way analysis of variance and Duncan's test. The relationship between the roughness and the bond strength was determined by Spearman's correlation analysis. Specimens subjected to surface treatments were rougher than the control specimen (p < 0.000). However, there were no significant differences between the air abrasion and air abrasion + laser groups and the silica coating and laser groups. Specimens treated with laser showed lower bond strengths irrespective of the resin cement used. CEC and/or PF showed higher bond strengths than RXU for each surface treatment group. No significant relationship was observed between the roughness and the bond strength. The results of this study showed that all the surface treatments, except for laser irradiation, were suitable for treating zirconia ceramics. Cement selection was found to be more important than surface treatment, and phosphate monomer-containing cements were suitable for cementing zirconia.

Prosthetic Rehabilitation of Partial Ear Defect: 2 Case Reports.

The loss or absence of an auricle may result from trauma, disease or congenital anomalies and causes a considerable aesthetic problem. If the deformity involves the external auditory canal, it can affect hearing. This case report describes the surgical and prosthetic treatment of two patients with partial defects of their right external ears from different causes. Implant-retained auricular prostheses fabricated from heat-temperature-vulcanised silicone were used in both the cases; they were designed to be harmonious with the remaining tissues. The patients experienced improved retention, aesthetics, hearing and quality of life with these prostheses. During the approximately 3 year follow-up, both the prostheses were re-fabricated once; however, problems related to implant stability and peri-implant tissue health were not encountered.

Amelogenesis imperfecta and generalized gingival overgrowth resembling hereditary gingival fibromatosis in siblings: a case report.

Amelogenesis imperfecta (AI) is a group of hereditary disorders primarily characterized by developmental abnormalities in the quantity and/or quality of enamel. There are some reports suggesting an association between AI and generalized gingival enlargement. This paper describes the clinical findings and oral management of two siblings presenting both AI and hereditary gingival fibromatosis (HGF) like generalized gingival enlargements. The treatment of gingival enlargements by periodontal flap surgery was successful in the management of the physiologic gingival form for both patients in the 3-year follow-up period. Prosthetic treatment was also satisfactory for the older patient both aesthetically and functionally.

Evaluation of the topographical surface changes and roughness of zirconia after different surface treatments.

The purpose of this study was to investigate the surface morphology and roughness of zirconia after different surface treatments. Eighty sintered zirconia specimens were divided into four groups (n = 20) according to the surface treatments received: no treatment, erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation (400 mJ, 10 Hz, 4 W, 100 MPS, distance: 1 mm), tribochemical silica coating with 30 µm aluminum oxide (Al(2)O(3)) modified by silica, and air abrasion with 110 µm Al(2)O(3) particles. After the surface treatments, the surface roughness (Ra in µm) of the specimens was evaluated using a surface texture measuring instrument. Surface morphology of a specimen from each group was evaluated with atomic force microscope (AFM) and scanning electron microscope (SEM) analyses. The surface roughness values were statistically analyzed by the Kruskal-Wallis and Mann-Whitney U tests (p = 0.05). All of the surface treatments produced rougher surfaces than the control group (p < 0.005). While there were no significant differences between the surface roughness of laser and silica groups (p > 0.05). SEM and AFM analyses revealed changes in surface topography after surface treatments, especially in the laser group with the formation of rare pits and in the silica and air abrasion groups with the formation of microretentive grooves. According to the results of the statistical and microscopic analyses, all of the surface treatments can be used for roughening zirconia prior to cementation; however, air abrasion is the most effective surface treatment to obtain micromechanical retention.