Effect of abutment screw-access hole on the fatigue performance of implant-supported lithium-disilicate luted simplified restorations.

The present study aimed to evaluate the impact of the existence of an abutment screw-access hole and the filling effects on the fatigue mechanical behavior of a luted lithium-disilicate glass-ceramic. Seventy-two discs (Ø = 10 mm, 1.0 mm in thickness) of lithium disilicate (IPS e.max CAD, Ivoclar AG) were obtained from prefabricated blocks. Thirty-six abutment specimens of an opaque zirconia (Yz - IPS e.max ZirCAD, Ivoclar AG) and titanium (Ti - Luminesse Ti-Cam discs, Talladium Inc.) were confectioned, and allocated according to 6 groups: Yz and Ti rigid (without screw access hole); Yz unfilled, Yz filled, Ti unfilled and Ti filled (with the screw access (Ø = 2.5 mm) in the center). For the unfilled groups, only a polytetrafluoroethylene tape was used. Resin composite (Tetric N-Ceram, Ivoclar AG) was applied to the screw access hole for the filled groups (Yz and Ti). A cyclic fatigue test was carried out (load of 200 N, 10,000 cycles each; 20 Hz of frequency, step size of 100 N until failure detection (radial/cone crack). The fatigue failure load (FFL) and number of cycles until failure (CFF) were recorded for statistical purposes. The stress distribution (MPa) was evaluated by finite element analysis. A statistically positive effect of the abutment material and the presence of the screw access hole was observed (p ≤ 0.05). The rigid groups (without screw access holes) depicted almost 100% of survival after the fatigue tests. Among the other groups, the Yz-filled group showed the best performance (p ≤ 0.05), followed by the Yz unfilled group. The Ti groups depicted lower values of FFL and CFF, with the Ti unfilled group showing the most unfavorable fatigue behavior (p ≤ 0.05). The lowest tensile stress concentration in the restorative material was observed with the use of rigid abutments, the filled groups depicted intermediate values, while unfilled groups showed the highest stress concentration (Yz rigid = 306.3 MPa; Ti rigid = 310.4 MPa < Yz filled = 490.7 MPa; Ti filled = 498.9 MPa < Yz unfilled = 707.6 MPa; Ti unfilled = 719.7 MPa). Therefore, the presence of a screw-access hole decreases the mechanical performance of a lithium disilicate ceramic regardless of the abutment material. In the presence of a screw-access hole, zirconia abutments depicted a higher fatigue failure load when compared with titanium. The filling of the abutment screw-access hole with resin composite increased the mechanical performance of the simulated restoration.

Characteristic fatigue strength and reliability of dental glass-ceramics: Effect of distinct surface treatments - Hydrofluoric acid etching and silane treatment vs one-step self-etching ceramic primer.

The aim of this study was to mechanically characterize through flexural fatigue test two CAD-CAM glass-ceramics according to distinct surface etching protocols. To do so, feldspathic (FELD) and lithium disilicate (LD) glass ceramics were subjected to different surface treatments: (1) control - no treatment (Ctrl); (2) conventional protocol etching with 5% hydrofluoric acid followed by silane coupling agent application (HF + SIL; Monobond N, Ivoclar); or (3) using a self-etching ceramic primer (E&P; Monobond Etch & Prime, Ivoclar). Ceramic discs (N = 120; Ø = 12 mm; thickness = 1.2 mm) were produced from CAD-CAM blocks, with 60 being from FELD (VITABLOCS Mark II, Vita Zahnfabrik) and 60 from LD (IPS e.max CAD, Ivoclar). Next, 20 disks of each ceramic were allocated into three groups: Ctrl, HF + SIL, or E&P. Surface roughness data were collected on all samples before and after surface treatments (except for Ctrl). Cyclic fatigue (n = 15) biaxial flexural strength tests were performed by the piston-on-three-balls geometry (ISO 6872) considering the test parameters established from a monotonic test (n = 5). The monotonic test was carried out at a 1 mm/min loading rate and 500 kgf loading cell until fracture to obtain the failure data. The cyclic fatigue test was executed underwater at a frequency up to 20 Hz, with the first stress being 25% of the monotonic test for 5000 cycles, followed by increments of 5% of the monotonic test at each step of 10,000 cycles until failure (fracture). Complementary fractography, topography and Atomic Force Microscopy (AFM) analyses were performed. Characteristic Fatigue Strength (CFS) and Weibull modulus were analyzed by Weibull analysis using the fatigue test data. Roughness and complementary analysis data were analyzed by one-way ANOVA. The statistical results exhibited similar CFS among Ctrl, HF + SIL and E&P for both glass-ceramics. The survival analysis corroborates the findings, however the Weibull modulus pointed out superior structural reliability of FELD treated with the E&P group compared to HF + SIL. According to the complementary analyses, HF + SIL exhibited a higher surface area than E&P and Ctrl for FELD (p = 0.001). Roughness showed statistically significant differences among conditions for FELD (E&P < Ctrl = HF + SIL; p < 0.05) and no difference for LD (p > 0.05). Therefore, the CFS were not influenced by any condition evaluated for FELD and LD glass-ceramics; however, superior structural reliability (higher Weibull modulus) for the feldspathic ceramic treated with the E&P was observed.

Effect of the region of the CAD/CAM block on the flexural strength and structural reliability of restorative materials.

The aim of the study was to evaluate whether the region (internal or external) of the CAD/CAM block influences the mechanical performance of restorative materials. Blocks of different CAD/CAM materials (Composites: KAV - Katana Avencia; LULT - LULT Ultimate; Ceramics: ENAM - Vita Enamic; NICE - N!CE; EMP - IPS Empress CAD; VMII - Vita Mark II; EMAX - IPS e.max CAD) were selected, and direct resin composite blocks (APX - Clearfil AP-X; FSUP - Filtek Supreme) were built using the incremental technique on a mold from one of the CAD/CAM blocks. All blocks were sectioned into bar-shaped specimens (1 × 1 × 14 mm), which were separated into two groups according to the region of the block (inside or outside). 3-point bending tests were performed following ISO 6872:2015 and flexural strength data were analyzed using one-way ANOVA and Bonferroni post-hoc tests (p < 0.05). Weibull module and characteristic strength were also calculated. In general, the mean flexural strength values were not statistically different (p > 0.05) between the inside and outside regions of each material, except for LULT (inside > outside) and EMAX (outside > inside). Comparing the materials, a similar strength (only discrete variations) was observed for inside, outside or merged (inside and outside data assembled together) regions: EMAX > KAV = LULT > NICE = APX > EMP = ENAM = VMII ≥ FSUP (merged condition). Characteristic strength at 63.2% failure probability and at 5% failure probability generally corroborates such observations. There were no statistical differences for Weibull module data (inside, outside, or merged), except for KAV and NICE (outside > inside). Thus, the region from where the restoration is milled within the CAD/CAM block generally does not influence the mechanical performance hereof (flexural strength, failure probability, risk of premature failures, and mechanical reliability) of the material, except for LULT and EMAX.

Mattress Coil Spring Fatigue and Weight-Bearing Support: Comparison of Weight-Bearing and Non-Weight-Bearing Springs.

OBJECTIVE: The purpose of this study was to compare the firmness of used mattress coil springs from the areas bearing greatest body weight versus areas subjected to little compression. METHODS: Weight-bearing springs (WBS) extracted from the center of the mattresses (N = 32), and non-weight-bearing springs (NWBS) extracted from the head/foot were of the same mattresses. To determine spring weakness, a 1296-g ingot was placed on the coil, and the compression distance was measured (cm). In addition, a gauge was used to measure the amount of pressure required to compress the coil springs a distance of 2 cm. Comparison between WBS and NWBS data were statistically treated using independent t tests and a 1-way analysis of variance. RESULTS: There were no significant group differences in weight or height in unloaded coils. However, there were significant (P < .05) differences in coil spring compression distance under load (WBS = 2.78 ± 0.34 cm; NWBS = 1.52 ± 0.39 cm) and force gauge compression (WBS = 1090.51 ± 88.42 g; NWBS = 1213.12 ± 71.38 g) between groups. CONCLUSION: This study found that WBSs were weaker when compressed than the NWBS from used mattresses, and such characteristics may not be visually apparent in a mattress when not in use. Thus, coil springs in bedding systems may eventually fail to provide the initial structural support after use. Such sagging may compromise sleep posture with accompanying poor sleep quality and quantity.

Influence of different diameter reductions in the labial neck region on the stress distribution around custom-made root-analogue implants.

This study was designed to investigate the influence of diameter reductions on the stress distribution around root-analogue implants via 3D finite element analysis. Four root-analogue implant models with different diameter reductions (0, 1, 2, or 3 mm), a traditional threaded implant and congruent bone models were created through reverse engineering. A 100-N force was applied parallel with and in a 45° angle to the implant axis, respectively. The stress concentration in the labial neck area around implants with 1-2 mm diameter reduction was lower than seen with no reduction. When the implant diameter was reduced by 3 mm, there were obvious stress concentrations in both implant and bone (the maximum stress was 206  and 111 MPa, respectively). In other groups, the maximum stress was 65.1 MPa in the bone and 108 MPa in the implant. Additionally, the stress concentration in the bone around the root-analogue implant when the implant diameter was reduced by 0-2 mm (maximum stress of 65.1 MPa) was obviously smaller than that around the traditional implant (maximum stress 130.4 MPa). Reducing the diameter of maxillary central incisor root-analogue implants by up to 2 mm next to the labial cortical bone could help disperse stress.

Is the application of a silane-based coupling agent necessary to stabilize the fatigue performance of bonded simplified lithium disilicate restorations?

This study evaluated the influence of ceramic surface conditioning and storage regimen (baseline vs. aging) on the fatigue performance of simplified lithium disilicate glass-ceramic restorations. A total of 90 ceramic discs (Ø= 10 mm; thickness= 1.0 mm) were allocated into 6 groups (n= 15), considering 2 factors: "ceramic surface treatment" - CA (only silane-based coupling agent, Monobond N), HF (5% hydrofluoric acid etching), or HF+CA (5% HF acid etching plus silane-based coupling agent); and "storage regimen" - baseline (24 hours - 5 days of distilled water at 37 °C), or long-term aging (180 days of distilled water at 37 °C + 25,000 thermal cycles). After intaglio ceramic conditioning, adhesive bonding (Multilink N) was performed onto epoxy resin discs (Ø= 10 mm; thickness= 2.5 mm) and the bonded sets were subjected to step-stress fatigue tests (initial load: 200 N; step-size: 50 N; 10,000 cycles per step; 20 Hz). Fatigue data were analyzed using Kaplan-Meier and Weibull statistical analyses. Fractography and topography analyses were also conducted. The fatigue findings demonstrated that the performance among groups for both baseline and aging conditions maintained a tendency: the CA groups had the worst behavior (baseline: 893 N/143,667 cycles; aging: 639 N/84,179 cycles), while the surface etching with HF (baseline: 1247 N/214,333 cycles; aging: 816.67 N/128,333 cycles) and HF+CA groups (baseline: 1290 N/222,333 cycles; aging: 900 N/145,000 cycles) had no statistically significant difference between them. The aging protocol reduced the performance of all groups. The groups with better fatigue performance (HF and HF+CA) did not have statistical differences regarding structural reliability (Weibull modulus). Most failures were radial cracks from the cementation interface, except for CA aging specimens, with 27% failing from debonding. The HF etching led to noteworthy surface topographical alterations. Micromechanical interlocking resulting from HF acid etching remained prevalent in the fatigue behavior. Thus, the silane-based coupling agent (Monobond N) does not need to be applied after HF etching in terms of fatigue behavior outcomes.

Mechanical properties of three-dimensionally printed titanium plates used in jaw reconstruction: preliminary study.

The aim of this study was to compare the mechanical properties of three-dimensionally (3D)-printed and conventional surgical plates used for the repair of maxillary or mandibular defects under the same experimental conditions, and to provide experimental evidence for the future application and clinical trial of 3D-printed individualized surgical plates. For the experimental group, two groups of surgical plates with thicknesses of 2.0 mm and 2.5 mm were designed and 3D-printed by electron beam melting, using Ti-6Al-4V as raw material. Conventional commercially available surgical plates with the same thickness were adopted as the control group. A Vickers hardness tester and universal testing machine were used to measure the mechanical properties of the plates (hardness, bending strength, tensile strength, and yield strength). The mechanical properties of 3D-printed surgical plates were significantly better than those of conventional surgical plates of the same thickness (P < 0.001). Comparing the surgical plates of different thickness, the 2.5 mm-thick plates had the highest bending strength in the experimental group (P < 0.001) and the best hardness (P < 0.001), bending strength (P = 0.001), tensile strength (P = 0.001), and yield strength (P = 0.001) in the control group. No statistical difference was found between the two kinds of plates in the experimental group in terms of hardness (P = 0.060), tensile strength (P = 0.096), and yield strength (P = 0.496). The 3D-printed surgical plates have better mechanical properties than the conventional ones.

Alumina particle air-abrasion and aging effects: Fatigue behavior of CAD/CAM resin composite crowns and flexural strength evaluations.

The aim of this study was to characterize the flexural strength and elastic modulus of CAD/CAM resin composite material and to evaluate the influence of different surface treatments and storage conditions on the fatigue behavior of bonded composite crowns. Bars (flexural strength, n= 30; elastic modulus, n= 5) (1.2 × 4 × 12 mm) were produced for three-point bending test and CAD/CAM milled crowns (n= 5) (thickness= 1 mm) adhesively cemented to an epoxy resin substrate for fatigue tests. Bars and crowns were randomly allocated into two "surface treatments": no surface treatment (CTRL) and air-abrasion with 110 µm Al2O3 particles (AlOx); while the crowns were also subdivided into "aging condition" (baseline - storage for 24 h to 7 days, and aging - storage for 150 days + 25,000 thermal cycles). The three-point bending test was performed according to ISO 6872 and the luted crowns were subjected to step-stress fatigue test (initial load of 200 N; step-size of 50 N; 10,000 cycles per step; 20 Hz). Complementary analysis by Stereomicroscopy and Field Emission Scanning Electron Microscopy (FE-SEM) were performed. The flexural strength and fatigue data were submitted to statistical tests (α= 0.05). The results showed that air-abrasion reduces the flexural strength and the characteristic strength of the resin composite, without modifying its elastic modulus or its structural reliability (Weibull Modulus). Air-abrasion did not influence the fatigue behavior of the cemented crowns. Notwithstanding, a decrease in the survival rate was observed after 445,000 cycles (2,400 N) when subjected to aging at both the CTRL or AlOx conditions. FE-SEM micrographs of the crowns showed that alumina particle air-abrasion treatment can modify the topography of its treated inner surface. Therefore, air-abrasion with alumina powder introduces defects onto the surface of the CAD/CAM resin composite material, decreasing the flexural strength, but without changing its elastic modulus and reliability. Adhesive cementation onto an epoxy resin substrate prevented an influence of the introduced defects on the fatigue performance of the resin composite restoration. Nevertheless, the fatigue behavior may be damaged by aging regimen.

Antimicrobial and Mechanical Effects of Zeolite Use in Dental Materials: A Systematic Review.

OBJECTIVE: Ion-incorporated zeolite is a widely used antimicrobial material studied for various dental applications. At present, there is no other systematic review that evaluates the effectiveness of zeolite in all dental materials. The purpose of this study was to review all available literature that analyzed the antimicrobial effects and/or mechanical properties of zeolite as a restorative material in dentistry. MATERIAL AND METHODS: Following PRISMA guidelines, an exhaustive search of PubMed, Ovid Medline, Scopus, Embase, and the Dentistry & Oral Sciences Source was conducted. No language or time restrictions were used and the study was conducted from June 1, 2020 to August 17, 2020. Only full text articles were selected that pertained to the usage of zeolite in dental materials including composite resin, bonding agents, cements, restorative root material, cavity base material, prosthesis, implants, and endodontics. RESULTS: At the beginning of the study, 1534 studies were identified, of which 687 duplicate records were excluded. After screening for the title, abstract, and full texts, 35 articles remained and were included in the qualitative synthesis. An Inter-Rater Reliability (IRR) test, which included a percent user agreement and reliability percent, was conducted for each of the 35 articles chosen. CONCLUSION: Although ion-incorporated zeolite may enhance the antimicrobial properties of dental materials, the mechanical properties of some materials, such as MTA and acrylic resin, may be compromised. Therefore, since the decrease in mechanical properties depends on zeolite concentration in the restorative material, it is generally recommended to add 0.2-2% zeolite by weight.

Fatigue behavior and colorimetric differences of a porcelain-veneered zirconia: effect of quantity and position of specimens during firing.

PURPOSE: To evaluate the influence of quantity and positioning of veneered zirconia specimens during firing of porcelain on their fatigue performance and colorimetric differences. METHODS: Bilayer discs (Ø=15 mm) were made, following ISO 6872 guidelines, using a Y-TZP core (yttria-stabilized tetragonal zirconia polycrystal ceramic; VITA In-Ceram YZ) and a feldspathic veneering material (VITA VM9), being both layers with 0.7 mm thickness. Y-TZP discs were sintered, the veneering material was applied over it, and the bilayer specimens were fired according to two factors (n=20): 'quantity' (1 or 5 samples per firing cycle; G1 and G5 groups respectively) and 'positioning' of the specimens inside the furnace (center or periphery of the refractory tray; G5C and G5P groups, respectively). The CIEL*a*b* parameters were recorded with a spectrophotometer and the color difference (ΔE 00 ) and translucency (TP 00 ) were calculated using CIEDE2000 equations. The step-stress fatigue test was performed with the veneer facing down (region of tensile stress concentration), 10 Hz frequency, initial tension of 20 MPa for 5,000 cycles, followed by steps of 10,000 cycles using a step size of 10 MPa, up to 100 MPa; data from strength and number of cycles for failure were recorded for statistical analysis. RESULTS: Unacceptable color differences (ΔE 00 >1.8) were observed comparing G5C vs. G1 (quantity) and G5C vs. G5P (positioning), meanwhile translucency parameters were not affected. Besides, only the 'quantity' factor influenced the fatigue performance (G1>G5C). None of the tested specimens survived beyond 90N and/or 75000 cycles. CONCLUSIONS: The quantity and position of the specimens during firing influence the final color of porcelain-veneered zirconia, and firing one specimen per cycle improved the fatigue performance of the bilayer system.

Effect of A Rapid-Cooling Protocol on the Optical and Mechanical Properties of Dental Monolithic Zirconia Containing 3-5 mol% Y2O3.

Many attempts have been made to improve the translucency of zirconia in dentistry. The purpose of this study was to evaluate the effect of a rapid-cooling heat treatment on the optical and mechanical properties of dental monolithic zirconia. Zirconia containing 3, 4, and 5 mol% Y2O3 were sintered, sectioned, and polished. The specimens were rapidly cooled from high temperature inducing a diffusionless cubic-to-metastable tetragonal (t') phase transformation. The changes in L*a*b* color coordinates, translucency parameter (TP), and total transmittance (T%) were measured. Three-point bending strength, Vickers hardness, and indentation fracture toughness tests were performed. Quantitative phase analyses were carried out by X-ray diffraction with Rietveld refinement. Scanning electron microscopy (SEM) images were obtained. With increasing Y2O3 contents, TP and T% values increased while strength and toughness decreased. The Rietveld analysis showed that the amount of t'-phase increased after rapid-cooling and annealed 5Y-partially stabilized zirconia (PSZ) contained the highest amount of t'-phase (64.4 wt%). Rapid-cooling improved translucency but the translucency of annealed 5Y-PSZ did not approach that of lithium disilicate glass-ceramic. Rapid-cooling decreased flexural strength significantly, being 306.1 ± 61.8 MPa for annealed 5Y-PSZ. SEM revealed that grains tended to get larger after rapid-cooling. A rapid-cooling treatment can produce t'-phase which can contribute to an increase in translucency but has a negative effect on the mechanical properties of zirconia.

Assessment of stress/strain in dental implants and abutments of alternative materials compared to conventional titanium alloy-3D non-linear finite element analysis.

The aim of this study was to assess the stress/strain in dental implant/abutments with alternative materials, in implants with different microgeometry, through finite element analysis (FEA). Three-dimensional models were created to simulate the clinical situation of replacement of a maxillary central incisor with implants, in a type III bone, with a provisional single crown, loaded with 100 N in a perpendicular direction. The FEA parameters studied were: implant materials-titanium, porous titanium, titanium-zirconia, zirconia, reinforced fiberglass composite (RFC), and polyetheretherketone (PEEK); and abutment materials-titanium, zirconia, RFC, and PEEK; implant macrogeometry-tapered of trapezoidal threads (TTT) and cylindrical of triangular threads (CTT) (ø4.3 mm × 11 mm). Microstrain, von Mises, shear, and maximum and minimum principal stresses in the structures and in peri-implant bone were compared. There was increased stress and strain in peri-implant bone tissue caused by implants of materials with lower elastic modulus (mainly for PEEK and RFC). They also presented higher concentration of stresses in the implant itself (especially RFC). Zirconia implants led to lower stress and strains in peri-implant bone tissue. Less rigid abutments (RFC and PEEK) associated with titanium implants led to higher stress in the implant and in peri-implant bone tissue. The TTT macrogeometry showed a higher stress concentration in the implant and peri-implant bone tissue. The stress/strain in peri-implant bone tissue and implant structures were affected by the material used, where reduced values were caused by stiffer materials. Lower stress/strain values were obtained with cylindrical implants of triangular treads.

One-step ceramic primer as surface conditioner: Effect on the load-bearing capacity under fatigue of bonded lithium disilicate ceramic simplified restorations.

The aim of the study was to evaluate the effect of a ceramic primer and its increased passive application on the fatigue performance of adhesively cemented lithium disilicate simplified restorations. Ceramic discs (Ø = 10 mm; thickness = 1.0 mm) were submitted to an in-lab simulation of CAD/CAM milling and allocated into 8 groups (n = 15), considering 2 factors: "surface treatment"- PRIMER, only coupling agent application (Monobond N); HF5+PRIMER, 5% hydrofluoric acid and coupling agent; E&P 20s + 40s and E&P 20s+5min, ceramic etching/priming (Monobond Etch & Prime, E&P) for 20 s of active application followed by 40 s or 5 min of passive application, respectively; and "aging condition"- baseline, storage for 24 h to 5 days; aged, storage for 90 days +12,000 thermal cycles. Adhesive cementation (Multilink N) was performed onto epoxy discs (Ø = 10 mm; thickness = 2 mm) and the cemented assemblies were subjected to step-stress fatigue tests (initial load of 200 N; step-size of 50 N; 10,000 cycles per step; 20 Hz). The results showed that the groups had similar fatigue performance in the baseline condition (except for E&P 20s+5min: 940.0 N; 123,000 cycles > PRIMER: 786.7 N; 92,333 cycles). When aged, the PRIMER group presented the worst fatigue performance (480.8 N; 31,154 cycles) compared to the other groups (810.0-840.0 N; 97,000-103,000 cycles). In addition, only the PRIMER treatment showed unstable fatigue performance (baseline > aged). Therefore, ceramic surface treatment promoting micromechanical interlocking and chemical bonds is mandatory for stable fatigue performance of adhesively cemented lithium disilicate restorations. The one-step ceramic primer/conditioner promoted similar fatigue performance to the 5% hydrofluoric acid + coupling agent, but increased E&P etching time did not improve the fatigue behavior.

Coated nickel titanium archwires and their uncoated counterparts: In-vitro contemporary comparison of unloading forces.

OBJECTIVE: To compare the unloading forces between aesthetic nickel titanium (NiTi) wires coated with rhodium and epoxy resin, as well as their uncoated equivalents. Additionally, intragroup comparisons between the different deactivation forces were evaluated, and the inner alloy cores were determined. MATERIAL AND METHODS: Forty-four 0.018" NiTi wire segments were equally divided into 4 groups: E- NiTi coated with epoxy resin, C- NiTi uncoated, R- heat-activated NiTi coated with rhodium, and T- heat-activated NiTi uncoated. The unloading values were recorded at 0.5, 1, 2, and 3mm using a 3-point bending test, according to the method in ISO Standard 15.841. Cross-sectional scanning electron microscopy was used to assess the inner alloy core thickness of the wires. RESULTS: The intergroup comparison was successively: at 0.5mm: E (1.21)>C (0.60)=R (0.63)=T (0.58); at 1mm: E (1.30)=C (1.23)>R (0.91)=T (0.80); at 2mm:C (1.93)>E (1.36)=R (1.20) and R (1.20)=T (1.00) and E (1.36)>T (1.00); at 3mm:C (2.44)>R (2.02)>E (1.62)=T (1.68). The intragroup comparisons showed for all groups that the forces were statistically higher at 3mm than the other deactivations (p<0.01). Group E presented a reduced inner alloy core (.0155). CONCLUSION: The unloading forces demonstrated variability between the wires tested and between the different deactivations. Therefore, depending on the type of movement required and the periodontal conditions, orthodontists should pay attention during archwire selection.

Effects of denture cleansers on denture material properties ­an observational case­control study / Efectos de los limpiadores de prótesis dentales sobre las propiedades del material: un estudio observacional de casos y controles

Everyday use of denture cleansers to prevent microbial colonization on dentures can affect the properties of the denture base material. Limited literature is available on the effects of denture cleanser on reinforced resins. This study aimed to evaluate and compare the effect of denture cleanser on the flexural and impact strength of conventional and reinforced heat cure acrylic resins. Materials and Methods: Rectangular shaped specimens were prepared for flexural and impact strength as per ISO 1567. The denture base resins used included conventional, high impact, nylon fiber reinforced and glass fiber reinforced heat cure acrylic resins. They were further categorized into subgroups A and B depending on immersion in distilled water or denture cleanser (3.8% sodium perborate based). The flexural strength and impact strength of specimens were measured. The study design is a observational case-control study. SPSS version 25 statistical analysis software was used, and the STROBE statement checklist was followed. Results: The mean flexural strength was highest for glass fiber reinforced heat cure resin followed by conventional heat cure resin, high impact heat cure resin and nylon reinforced heat cure resin, respectively. The mean impact strength was highest for high impact heat cure resin followed by glass fiber reinforced heat cure resin, conventional heat cure resin, and nylon fiber-reinforced resin respectively.Conclusion: All the denture base resins tested exhibited a decrease in flexural and impact strength following use of a denture cleanser.

El uso diario de limpiadores para prótesis dentales para prevenir la colonización microbiana en las prótesis puede afectar las propiedades del material base de estas. Existe literatura limitada sobre los efectos de los limpiadores de prótesis sobre resinas reforzadas. Este estudio tuvo como objetivo evaluar y comparar el efecto de un limpiador de prótesis sobre la resistencia a la flexión y al impacto de las resinas acrílicas de curado con calor convencionales y reforzadas. Material y Métodos: Muestras de forma rectangular se prepararon para testear la resistencia a la flexión y al impacto según ISO 1567. Las resinas de base de prótesis utilizadas fueron resinas acrílicas convencionales, de alto impacto, y de curado térmico reforzadas con fibra de vidrio o nylon. Posteriormente se clasificaron en los subgrupos A y B según la inmersión en agua destilada o limpiador de prótesis (3,8% de perborato de sodio). Se midieron la resistencia a la flexión y la resistencia al impacto de las muestras. El diseño del estudio fue de un estudio observacional de casos y controles. Se utilizó el software de análisis estadístico SPSS versión 25, y se siguió la guía de la declaración STROBE. Resultado: La resistencia a la flexión fue más alta para la resina de curado por calor reforzada con fibra de vidrio seguida de la resina de curado por calor convencional, la resina de curado por calor de alto impacto y la resina de curado por calor reforzada con nylon, respectivamente. La resistencia al impacto fue más alta para la resina de curado por calor de alto impacto seguida de la resina de curado por calor reforzada con fibra de vidrio, la resina de curado por calor convencional y la resina reforzada con fibra de nylon, respectivamente. Conclusión: Todas las resinas de base de prótesis probadas exhibieron una disminución en la resistencia a la flexión y al impacto después del uso de un limpiador de prótesis.

Influence of shading technique on mechanical fatigue performance and optical properties of a 4Y-TZP ceramic for monolithic restorations.

This study aimed to evaluate the effect of shading procedures on the fatigue performance and optical properties of an yttria-stabilized tetragonal zirconia polycrystal ceramic (4Y-TZP - stabilized by 4 mol% Y2O3). Disc-shaped specimens were produced at pre-sintered stage and randomly allocated into 5 groups (n=15) considering the shading technique: Ctrl (no pigmentation); Brush 1× and Brush 3× (brushing on 1 or 3 applications, respectively); Immer 2min and Immer 4min (immersion for 2 or 4 min, respectively). Following each pigment application, the specimens were dried in accordance with the manufacturers' guidelines (15 min in a stove at 70 °C) and sintered in a specific furnace. Biaxial flexural fatigue test followed a step-stress approach (initial strength: 200 MPa; step-size: 25 MPa; 10.000 cycles/step; frequency: 20 Hz). Optical measurements were conducted in a spectrophotometer following the CIEDE2000 parameters. Roughness, topography, crystalline grain size, crystalline phase content and fractography analysis were also performed. The flexural fatigue strength (FFS) and the number of cycles to fracture (CFF) were statistically affected by pigmentation techniques (mean FFS in MPa/mean CFF): Ctrl (446.7/105,619) > Brush 1 × (436.7/102,854) ≥ Brush 3 × (405.0/89,962) ≥ Immer 2 min (395.0/85,103) ≥ Immer 4 min (383.3/81,382), although the exposure intensity (increase in number of applications or in application time) to the pigment had no effect (Brush 1 × = Brush 3 × ; Immer 2 min = Immer 4 min). Regarding optical properties, shading techniques similarly affected translucency and opalescence parameters, regardless of the exposure intensity to the pigment (Brush 1 × = Brush 3 × = Immer 2 min = Immer 4 min > Ctrl), whereas the exposure intensity to the pigment only promoted relevant alterations in the color change parameter (ΔE00) for the brushing technique (Brush 3 × > Brush 1 × ). No difference was observed in crystalline phase content, topographic pattern or roughness, although an increase in the zirconia grain size could be detected. Thus, the shading technique might affect the fatigue behavior and promote optical changes in a 4Y-TZP ceramic.

O trabalho mecânico segmentar como novo instrumento de avaliação do controle postural / The segmentary mechanical work as a new instrument to postural control evaluation

Objetivo: Calcular o trabalho mecânico (W), aplicando o trabalho mecânico total (Wtot) e o trabalho segmentar (Wseg) como um novo recurso de avaliação complementar dos mecanismos de controle postural em sujeitos submetidos a perturbação motora e visual. Método: Dez voluntários adultos saudáveis do sexo masculino foram selecionados com idade 25,6 (± 2,26) anos, cuja altura era de 1,69 (± 0,25) m e peso corporal de 68,22 (± 0,25) kg. Os dados cinemáticos da extensão do tronco com os olhos abertos e vendados foram capturados com frequência de 200 Hz. Dessa forma, foi selecionado o intervalo pós-perturbação e o Wseg (tronco, cabeça, etc) e o trabalho mecânico total (Wtot) calculados, que foram obtidos por meio de energia mecânica total integral. Resultados: A análise estatística das informações foi feita pelo teste t student para dados emparelhados. Não houve diferença significativa (p<0,08) para a Wtot durante o intervalo pós-perturbação. Por outro lado, houve uma diferença significativa (p<0,05) no intervalo pós-perturbação de Wseg. Entretanto, houve diferenças significativas no intervalo (p<0,05). Esta diferença está relacionada com Wseg de cabeça (Wcabeça) e membros inferiores (Wperna e Wcoxa ) no intervalo pós-perturbação com intervalo inicial de [0. 60] ms e [0. 100] ms após a auto-perturbação. Conclusão: Essas diferenças encontradas em Wcabeça entre as duas condições podem estar associadas a modulações do sistema vestibulo-ocular-motor. Por outro lado, as diferenças encontradas em Wperna e Wcoxa podem ser associadas a mecanismos de ajuste somato-sensorial.

Objectie: Calculate the mechanical work (W), applying the total mechanical work (Wtot) and segmental work (Wseg) as a new complementary evaluation resource of the postural control mechanisms in subjects undergoing motor and visual disturbance. Methods: Ten healthy adult male volunteers were selected with ages 25.6 (±2.26) years, whose height was 1.69 (± 0.25) m and body weight was 68.22 (± 0.25) kg. Kinematic data of trunk extension with eyes open and blindfolded were captured with a frequency of 200 Hz. This way the post perturbation interval has been selected and the Wseg (i.e. trunk, head, etc) and the total mechanical work (Wtot) calculated, which were obtained by means of total integral mechanical energy. Results: The statistical analyzing of information was done by paired-data Student's t test. There has been no significant difference (p<0,08) for the Wtot during the post perturbation interval. On the other hand, there has been a significant difference (p<0.05) in the post perturbation interval of Wseg. However, there were significant differences in interval (p<0.05). This difference is related to Wseg of head (Whead) and lower limbs (Wleg and Wthigh ) in the post-perturbation interval with early range of [0. 60] ms and [0. 100] ms after the self-perturbation. Conclusion: These differences that were found in Whead between the two conditions can be associated with modulations of the vestibulo-ocular-motor system. On the other hand, the differences that were found in Wleg and Wthigh can be associated with somato-sensory adjustment mechanisms.

Effect of in vitro aging by water immersion and thermocycling on the mechanical properties of PETG aligner material.

PURPOSE: The mechanical properties of orthodontic aligners made from thermoplastic polymers decrease over time in the intraoral milieu. However, there is a lack of information on this topic in the literature. Thus, the elastic properties of polyethylene terephthalate glycol (PETG) aligner films were investigated in vitro under extreme temperature changes simulated by thermocycling, environmental temperature and water absorption. MATERIALS AND METHODS: A total of 60 specimens made from PETG aligner films (CA Clear Aligner, Scheu Dental, Iserlohn, Germany) were divided into three groups (immersed in distilled water, subjected to accelerated ageing by thermocycling, control). These groups were again divided and tensile testing was performed for all groups at 22 and at 37 °C. Young's modulus (E), 0.2% offset yield strength (Rp02) and ultimate tensile strength (UTS) were evaluated. Water absorption was determined using an analytical scale. RESULTS: All treated specimens showed water absorption, whereby specimens that were thermocycled absorbed 48% more water than the immersed ones. Young's modulus and UTS were significantly lower for all three groups at 37 °C compared to the corresponding groups tested at 22 °C. Thermocycled and immersed groups showed a significantly lower Young's modulus compared to the control group tested at the same temperature. The mean Rp02 was statistically different when comparing the control group tested at 22 °C to the one tested at 37 °C. CONCLUSIONS: The results of this study add to the understanding of the clinically well-known degradation of orthodontic aligners during wear time. Extreme alternating temperatures along with warming up to intraoral temperature and water absorption can reduce the material's Young's modulus and may therefore promote a decrease of resulting orthodontic forces.

Ultimate tensile strength of total and self-etch adhesives: effect of light irradiation distance

Objective: To evaluate the ultimate tensile strength (UTS) of total and self- etch adhesives irradiated at different distances. Materials and Methods: Sixty cylindrical specimens of 0.78mm diameter and 10 mm length were prepared of two types of adhesive systems total etch Excite DSC (EX ­ Ivoclar Vivadent, Schaan, Liechtenstein) and one-step self-etch Clearfil S3 Bond (S3, Kuraray Medical Inc., Tokyo, Japan). Specimens of each adhesive were divided into three groups according to the light irradiation distance (0, 2, 4mm) (n=10). Each specimen was attached to universal testing machine (Digital Force Gauge, IMADA CO., LTD, Japan) and loaded at cross head speed of 1mm/min until failure. Data were analyzed using two-way ANOVA and Independent Student t-test at p< 0.05. Results: Mean UTS for total etch (24.63, 18.19, 17.26 Mpa) and for self-etch (12.68, 8.53, 7.58Mpa) at (0, 2, 4mm) distances. Specimens irradiated directly show significantly the highest UTS while those irradiated at 4mm show the lowest values (p<0.05). Excite DSC total etch adhesive have higher UTS than Clearfil S3 self-etch adhesive regardless of irradiation distance (p<0.05).Conclusions: The UTS of the evaluated adhesives was light irradiation distance and adhesive system dependant.

Biomechanical behaviour of human bile duct wall and impact of cadaveric preservation processes.

Biliary diseases are the third most common cause of surgical digestive disease. There is a close relationship between the mechanical performance of the bile duct and its physiological function. Data of biomechanical properties of human main bile duct are scarce in literature. Furthermore, mechanical properties of soft tissues are affected by these preservation procedures. The aim of the present work was, on the one hand, to observe the microstructure of the human bile duct by means of histological analysis, on the other hand, to characterize the mechanical behavior and describe the impact of different preservation processes. A mechanical study in a controlled environment consisting of cyclic tests was made. The results of the mechanical tests are discussed and explained using the micro-structural observations. The results show an influence of the loading direction, which is representative of an anisotropic behavior. A strong hysteresis due to the viscoelastic properties of soft tissues was also observed. Embalming and freezing preservation methods had an impact on the biomechanical properties of human main bile duct, with fiber network deterioration. That may further provide a useful quantitative baseline for anatomical and surgical training using embalming and freezing.