Biaxial flexure strength and physicochemical characterization of a CAD/CAM lithium disilicate ceramic: effect of etching time, silane, and adhesive applications.

OBJECTIVE: To evaluate the effect of different acid etching time and bonding agent (silane and/or adhesive system) on biaxial flexural strength and physico-chemical properties of a lithium disilicate ceramic. MATERIAL AND METHODS: One hundred twenty ceramic discs were made and divided into 8 groups (n = 15) according to factors "etching time" (20 and 120 s) with hydrofluoric acid (HF) and "bonding agent" (C, no bonding agent; S, silane, A, adhesive; and SA, silane + adhesive). After surface treatment, a resin cement layer was applied to the surface and all specimens were subjected to biaxial flexural strength (BFS) test with treated surfaces loaded in tension (1 mm/min). The Weibull analyses and complementary analyses were also performed. Statistical analysis was done with 2-way ANOVA and the Tukey test (α = 0.05). RESULTS: ANOVA revealed that the factors "etching time" (p = 0.0003) and "bonding agent" (p = 0.007) were statistically significant. In the overall analysis, the HF120S group (272.02 ± 35.30A MPa) presented significantly higher BFS than that of HF120C (218.45 ± 17.15CD MPa) and HF20S (228.40 ± 37.83BCDMPa). On the other hand, the HF20A group (208.92 ± 31.16D MPa) had significantly lower BFS than HF120S (272.02 ± 35.30A), HF120A (254.42 ± 26.87ABC) and HF120SA (259.30 ± 36.55AB) groups (Tukey). The Weibull modulus (m) of all groups was significantly different from each other (p = 0.000). CONCLUSIONS: Regardless of etching time, the application of silane alone is sufficient to increase the flexural strength of glass ceramic, eliminating the need for the application of adhesive systems. Moreover, if only silane or adhesive is applied, 120-s HF application should increase the flexural resistance of the lithium disilicate ceramic. CLINICAL SIGNIFICANCE: Applications of adhesive systems after silanization can be suppressed from the surface treatment protocol of glass ceramics, since it does not improve their mechanical strength.

Does TGF-ß play a role in degenerative temporomandibular joint diseases? A systematic review.

OBJECTIVES: The objective of this review was to assess the literature for evidence investigating the role of TGF-ß in temporomandibular joint disease with osteoarthritis. METHOD: An electronic and manual search was carried out on the databases, MEDLINE/PubMed, Cochrane Library, Web Of Science, and EMBASE, from 1975 to December 2015 by two independent evaluators to identify clinical and laboratory trials in English. RESULTS: The search produced 693 records. Following a process of selection based on certain criteria, eight articles were included. DISCUSSION: This systematic review suggests that TGF-ß administration alone does not result in joint regeneration; other factors may be involved, such as TGF-ß receptor expression ,and TGF-ß receptor mutations that do not allow a correct transduction, resulting in TGF-ß deficiency. The anabolism induced by this growth factor is also able to neutralize the catabolic processes that are elevated in osteoarthritis. Therefore, further studies are essential to determine how the concentration of TGF-ß in the temporomandibular joints acts as a potential marker for the development of degenerative conditions.

Passivity of conventional and CAD/CAM fabricated implant frameworks.

The objective of this research was to evaluate the passivity by measuring the passive fit and strain development of frameworks screwed on abutments, made by CAD/CAM technology, and to compare these parts with samples manufactured by conventional casting. Using CAD/CAM technology, four samples were made from zirconia (Zircad) and four samples were manufactured from cobalt-chrome (CoCrcad). The control groups were four specimens of cobalt-chrome, made by one-piece casting (CoCrci), with a total of 12 frameworks. To evaluate the passive fit, the vertical misfit at the abutment-framework interface was measured with scanning electron microscopy (250×) when only one screw was tightened. The mean strain in these frameworks was analyzed by photoelasticity test. A significant difference in the passive fit was observed between the control and sample groups. CoCrcad exhibited the best value of passive fit (48.76±13.45 µm) and CoCrci the worst (187.55±103.63 µm); Zircad presented an intermediate value (103.81±43.15 µm). When compared to the other groups, CoCrci showed the highest average stress around the implants (17.19±7.22 kPa). It was concluded that CAD/CAM-fabricated frameworks exhibited better passivity compared with conventionally fabricated frameworks. CAD/CAM-fabricated Co-Cr frameworks may exhibit better passive fit compared with CAD/CAM-fabricated zirconia frameworks. Even so, similar levels of stress were achieved for CAD/CAM-fabricated frameworks.