High-versus low-viscosity resin cements: Its effect on the load-bearing capacity under fatigue of a translucent zirconia.

The purpose of the present study was to characterize the elastic modulus and Poisson's ratio of a resin cement with distinct viscosities, and to evaluate their impact on the static and fatigue strength of a translucent zirconia (4Y-PSZ) after air-abrasion surface treatment. Bar-shaped specimens of two different viscosities of resin cement (high and low) were obtained (25 × 10 × 3 mm). Sonelastic and Maxwell principles tests were performed to determine the elastic modulus and Poisson's ratio of each resin cement. Disc-shaped specimens of 4Y-PSZ were made (Ø = 15 mm, 1.2 mm in thickness) for the mechanical tests and allocated into groups according to two factors: surface treatment (presence or absence of air-abrasion with alumina particles; 45 µm grain-size); cement (absence, low or high viscosity). The static (n = 10) and cyclical (n = 15) biaxial flexural strength tests were performed by piston-on-three-balls geometry. A fatigue strength test was executed (20 Hz, initial stress of 60 MPa [12% of the mean static biaxial flexural strength], followed by increments of 25 MPa [5% of the mean static biaxial flexural strength] at each step of 10,000 cycles until the failure). The obtained data were analyzed by Weibull analysis. Survival rates were tabulated by the Kaplan-Meier test. Complementary analyses of surface roughness, topography, cross-sectional interfacial zone, fractography, and zirconia crystalline content (X-ray diffraction) were also performed. The evaluated resin cements with high and low viscosity presented similar elastic modulus (13.63 GPa; 12.74 GPa) and Poisson's ratio (0.32; 0.30), respectively. The air-abraded groups depicted higher mechanical strength of the zirconia ceramics than non-abraded groups (p˂ 0.05), regardless of the resin cement. 4Y-PSZ adhesively bonded to a high or low viscosity resin cement have statistically similar behavior (p˃ 0.05). The mechanical structural reliability of the 4Y-PSZ was not affected by the factors. Therefore, resin cement with high and low viscosity presented similar properties and potential to fill the zirconia surface, and did not affect the mechanical behavior of 4Y-PSZ. However, the air-abrasion surface treatment increased the static and fatigue flexural strength of the translucent zirconia.

CAD-FEA modeling and fracture resistance of bilayer zirconia crowns manufactured by the rapid layer technology.

In the RLT (Rapid Layer Technology), veneering ceramic and framework are fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) and then cemented to obtain the restoration. This study aimed to evaluate the effect of the thickness of veneering ceramic manufactured by the RLT technique on the fracture resistance (FR) of bilayer crowns with zirconia frameworks. Twenty zirconia frameworks and twenty feldspathic posterior crowns with two different veneering ceramic occlusal thicknesses (1mm=TF1; 2mm=TF2) were manufactured using CAD/CAM system. The specimens were luted to an epoxy resin abutment with resin cement and mechanically cycled (200N and 4.5×105 Pa, 37°C, 2×106 cycles, 3Hz). The FR test was performed (10kN, 0.5mm/min), and the specimens were analyzed in a stereomicroscope. For the stress analysis (finite element analysis, FEA), a 10kN load was equal to the in vitro test, and the principal stress was evaluated. The FR data were analyzed by Student's t-test and Weibull's analysis. The thickness influenced the FR of bilayer crowns. The FR was higher in the TF2 than in the TF1 group. The TF2 group presented the highest characteristic strength compared to the group TF1. The predominant type of failure was delamination. The FEA showed higher stress concentrations below the loading application point at the veneering cement interface in the 1-mm-thick model. The bilayer crowns manufactured using the approach of 2mm of veneering ceramic promoted higher FR compared to the group with 1mm veneering ceramic. Also, the FEA showed that the veneer ceramic thickness has an effect on stress distribution in zirconia-based bilayer crowns.

CAD-FEA modeling and fracture resistance of bilayer zirconia crowns manufactured by the rapid layer technology

Abstract In the RLT (Rapid Layer Technology), veneering ceramic and framework are fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) and then cemented to obtain the restoration. This study aimed to evaluate the effect of the thickness of veneering ceramic manufactured by the RLT technique on the fracture resistance (FR) of bilayer crowns with zirconia frameworks. Twenty zirconia frameworks and twenty feldspathic posterior crowns with two different veneering ceramic occlusal thicknesses (1mm=TF1; 2mm=TF2) were manufactured using CAD/CAM system. The specimens were luted to an epoxy resin abutment with resin cement and mechanically cycled (200N and 4.5×105 Pa, 37°C, 2×106 cycles, 3Hz). The FR test was performed (10kN, 0.5mm/min), and the specimens were analyzed in a stereomicroscope. For the stress analysis (finite element analysis, FEA), a 10kN load was equal to the in vitro test, and the principal stress was evaluated. The FR data were analyzed by Student's t-test and Weibull's analysis. The thickness influenced the FR of bilayer crowns. The FR was higher in the TF2 than in the TF1 group. The TF2 group presented the highest characteristic strength compared to the group TF1. The predominant type of failure was delamination. The FEA showed higher stress concentrations below the loading application point at the veneering cement interface in the 1-mm-thick model. The bilayer crowns manufactured using the approach of 2mm of veneering ceramic promoted higher FR compared to the group with 1mm veneering ceramic. Also, the FEA showed that the veneer ceramic thickness has an effect on stress distribution in zirconia-based bilayer crowns.

Resumo Na RLT (Rapid Layer Technology), a cerâmica de cobertura e infraestrutura são fabricados pelo Computer-Aided Design / Computer-Aided Manufacturing (CAD / CAM) e cimentados para obter a restauração. Este estudo teve como objetivo avaliar o efeito da espessura da cerâmica de cobertura fabricada pela técnica RLT na resistência à fratura (RF) de coroas bilaminadas com infraestrutura de zircônia. Vinte infraestruturas de zircônia e vinte coroas posteriores feldspáticas com duas espessuras oclusais da cerâmica de cobertura (1mm = TF1; 2mm = TF2) foram fabricadas usando o sistema CAD / CAM. Os espécimes foram cimentados em preparos de resina epóxi com cimento resinoso dual e ciclados mecanicamente (200N e 4,5×105 Pa, 37° C, 2×106 ciclos, 3Hz). O teste de RF foi realizado (10kN, 0,5mm / min) e, posteriormente, os espécimes foram analisados em estereomicroscópio. Para a análise de tensão (análise de elementos finitos, FEA), uma carga de 10kN foi aplicada igual ao teste in vitro, e a tensão principal foi avaliada. Os dados de RF foram analisados pelo teste t de Student e análise de Weibull. A espessura mostrou forte influência na RF das coroas bilaminadas. A RF foi maior em TF2 do que no grupo TF1. O grupo TF2 apresentou a maior resistência característica em relação ao grupo TF1. O tipo de falha predominante foi a delaminação. O FEA mostrou maiores concentrações de tensões abaixo do ponto de aplicação da carga, na interface cimento e cerâmica de cobertura no modelo de coroa de 1 mm de espessura. As coroas de bilaminadas confeccionadas com 2 mm de cerâmica de cobertura promoveram maior RF em comparação ao grupo com cerâmica de cobertura de 1 mm. Além disso, a FEA mostrou que a espessura da cerâmica de cobertura tem um efeito na distribuição de tensões em coroas bilaminadas à base de zircônia.

Mechanical-physicochemical properties and biocompatibility of catechin-incorporated adhesive resins.

OBJECTIVES: Several anti-proteolytic dentin therapies are being exhaustively studied in an attempt to reduce dentin bond degradation and improve clinical performance and longevity of adhesive restorations. This study assessed the effect of epigallocatechin-3-gallate (EGCG) on long-term bond strength when incorporated into adhesives. MATERIAL AND METHODS: Adhesive systems were formulated with EGCG concentrations of 0 wt%: (no EGCG; control); 0.5 wt% EGCG; 1.0 wt% EGCG, and 1.5 wt% EGCG. Flexural strength (FS), modulus of elasticity (ME), modulus of resilience (MR), compressive strength (CS), degree of conversion (DC), polymerization shrinkage (PS), percentage of water sorption (%WS), percentage of water solubility (%WL) and cytotoxicity properties were tested. Dentin microtensile bond strength (µTBS) was evaluated after 24 h and again after 6 months of water storage. The adhesive interface was analyzed using scanning electron microscopy (SEM). RESULTS: No significant differences were found among the groups in terms of FS, ME, MR, CS and PS. EGCG-doped adhesives increased the DC relative to the control group. EGCG concentrations of 1.0 wt% and 0.5 wt% decreased the WS of adhesives. WL decreased in all cases in which EGCG was added to adhesives, regardless of the concentration. EGCG concentrations of 1.0 wt% and 0.5 wt% reduced cytotoxicity. EGCG concentrations of 1.0 wt% and 0.5 wt% preserved µTBS after 6 months of storage, while 1.5 wt% EGCG significantly decreased µTBS. SEM: the integrity of the hybrid layer was maintained in the 0.5 wt% and 1.0 wt% EGCG groups. CONCLUSION: EGCG concentrations of 1.0 wt% and 0.5 wt% showed better biological and mechanical performance, preserved bond strength and adhesive interface, and reduced cytotoxicity.

Effect of age-related alterations on the biomechanics of teeth affected by non-carious cervical lesions / Efeito de alterações relacionadas à idade na biomecânica de dentes afetados por lesões cervicais não-cariosas

Objective: The prevalence of non-carious cervical lesions (NCCLs) has increased in the recent years, especially in the elderly population. The successful prevention and treatment of those lesions requires an understanding of the biomechanics of aged teeth. Considering the importance of such aspect, the impact of the age-related dentin deposition on the stress distribution of NCCLs was evaluated by means of finite element analysis. Material and Methods: A 2-dimensional model of a sound maxillary first premolar was created using CAD software. Two tooth geometries (sound, aged) and two lesion shapes (wedge, saucer) were simulated to the model. The mesh was built with 35,000 triangle and square elements of 0.1 mm in length. All tissues were considered isotropic, homogeneous and linear. Occlusal surfaces were loaded with 300 N for simulating normal chewing forces. The stress distribution was analyzed by a color scale and by the maximum principal stress at the cavosurface line angle. Results: The aged models presented lower stress concentration in the overall system in comparison to sound models. The sharp angle of wedge shaped lesions promoted higher stress concentration at the center of cavosurface angle, favoring the lesions progression. Conclusion: Considering the limitations of the current methodology, it is possible to conclude that aged tooth is a more compact structure that can better respond to stress loadings. This protective intrinsic mechanism should be considered when adopting preventive and restorative measures for NCCLs for the elderly. (AU)

Objetivo: A prevalência de lesões cervicais nãocariosas (NCCLs) tem aumentado nos últimos anos, especialmente em idosos. A prevenção e o tratamento bem-sucedidos dessas lesões requerem um entendimento da biomecânica dos dentes envelhecidos. Considerando a importância de tal aspecto, o impacto da deposição de dentina que ocorre com a idade na distribuição de estresse de NCCLs foi avaliado por meio da análise de elementos finitos. Material e Métodos: Um modelo bidimensional de um primeiro pré-molar superior foi criado usando o software CAD. Duas geometrias de dentes (padrão, envelhecido) e duas formas de lesão (cunha, pires) foram simuladas ao modelo. A malha foi construída com 35.000 elementos triangulares e quadrados de 0,1 mm de comprimento. Todos os tecidos foram considerados isotrópicos, homogêneos e lineares. Superfícies oclusais foram carregadas com 300 N para simular forças normais de mastigação. A distribuição das tensões foi analisada por uma escala de cores e pela tensão principal no ângulo da linha cavo-superficial. Resultados: Os modelos envelhecidos apresentaram menor concentração de tensão no sistema geral em comparação aos modelos padrão. O ângulo agudo das lesões em cunha promoveu maior concentração de tensão no centro do ângulo cavo-superficial, favorecendo a progressão das lesões. Conclusão: Considerando as limitações da metodologia atual, é possível concluir que o dente envelhecido é uma estrutura mais compacta que pode responder melhor às cargas de estresse. Este mecanismo intrínseco de proteção deve ser considerado ao adotar medidas preventivas e restaurativas para as NCCLs em idosos. (AU)

Comparative three-dimensional finite element analysis of implant-supported fixed complete arch mandibular prostheses in two materials.

BACKGROUND: The increase of requests for implant-supported prosthesis (ISP) with zirconia as infrastructure has attracted a lot of attention due to its esthetics, biocompatibility, and survival rate similar to metallic infrastructure. The aim of this study was to evaluate the influence of two different framework materials on stress distribution over a bone tissue-simulating material. MATERIALS AND METHODS: Two ISP were modeled and divided into two infrastructure materials: titanium (Ti) and zirconia. Then, these bars were attached to a modeled jaw with polyurethane properties to simulate bone tissue. An axial load of 200 N was applied on a standardized area for both systems. Maximum principal stress (MPS) on solids and microstrain (MS) generated through the jaw were analyzed by finite element analysis. RESULTS: According to MS, both models showed strains on peri-implant region of the penultimate (same side of the load application) and central implants. For MPS, more stress concentration was slightly higher in the left posterior region for Ti's bar. In prosthetic fixation screws, the MPS prevailed strongly in Ti protocol, while for zirconia's bar, the cervical of the penultimate implant was the one that highlighted larger areas of possible damages. CONCLUSIONS: The stress generated in all constituents of the system was not significantly influenced by the framework's material. This allows suggesting that in cases without components, the use of a framework in zirconia has biomechanical behavior similar to that of a Ti bar.

FEA and microstructure characterization of a one-piece Y-TZP abutment.

OBJECTIVES: The most important drawback of dental implant/abutment assemblies is the need for a fixing screw. This study aimed to develop an esthetic one-piece Y-TZP abutment to suppress the use of the screw. METHODS: Material characterization was performed using a bar-shaped specimen obtained by slip-casting to validate the method prior to prototype abutment fabrication by the same process. The mechanical behavior of the prototype abutment was verified and compared with a conventional abutment by finite element analysis (FEA). The abutment was evaluated by micro-CT analysis and its density was measured. RESULTS: FEA showed stress concentration at the first thread pitch during installation and in the cervical region during oblique loading for both abutments. However, stress concentration was observed at the base of the screw head and stem in the conventional abutment. The relative density for the fabricated abutment was 95.68%. Micro-CT analysis revealed the presence of elongated cracks with sharp edges over the surface and porosity in the central region. SIGNIFICANCE: In the light of these findings, the behavior of a one-piece abutment is expected to be better than that of the conventional model. New studies should be conducted to clarify the performance and longevity of this one-piece Y-TZP abutment.

Effect of remineralizing agents on the bleaching efficacy of gels.

Adding remineralizing agents to bleaching gels has been proposed to reduce the mineral loss of enamel and tooth sensitivity. This study sought to investigate the efficacy of hydrogen peroxide (HP) gel after the addition of calcium and fluoride. Ninety enamel-dentin discs were prepared from bovine incisors. The specimens were divided into 3 groups: a negative control group (nonbleached) and 2 experimental groups, 1 bleached with 7.5% HP (at-home bleaching) and the other with 35% HP (in-office bleaching). Each group was subdivided into 3 subgroups, according to the addition of remineralizing agents on gels: no remineralizing agents, addition of 2% calcium gluconate, and addition of 2% sodium fluoride. For 14 days, the gels were applied 1 hour/day for at-home bleaching and 50 minutes/week for in-office bleaching. Between bleaching, the specimens were immersed in artificial saliva. The results showed significant differences in all bleached groups compared to the nonbleached negative control group. No significant differences were observed for any parameters tested when the different treatments were compared using 2-way ANOVA. It was concluded that adding remineralizing agents to the gels did not interfere with their whitening effect and that both concentrations tested offered similar bleaching outcomes.

Influence of glass fiber reinforcement and resin viscosity on the resistance to fracture of Adhesive Partial Fixed Prostheses / Influência do reforço de fibra de vidro e viscosidade da resina sobre a resistência a fratura de Prótese Parciais Fixas Adesivas

Objective: The aim of this study was to evaluate the influence of glass fiber reinforcement and resin viscosity on the resistance to fracture of adhesive fixed partial prosthesis (AFPP). Materials & Methods: A stainless steel molding was constructed simulating oclusal preparation for AFPP on a maxillary first pre-molar (4 x 4 x 2 mm) and molar (6 x 4 x 2 mm), with a proximal slot (2 x 1 x 4 mm) and with 7 mm of distance between them. These moldings were duplicated in polyurethane (n = 60) and divided into two groups according to the resin viscosity: G - Grandio SO (VOCO) (n = 30) and GHF – Grandio SO Heavy flow (VOCO) (n= 30). These groups were subdivided into three subgroups according to the glass fiber reinforcement used (n = 10): Subgroup N – without glass fiber reinforcement; Subgroup V – GRANDTEC (VOCO); subgroup S – everStick C & B (Stick Tech). Four increments divided into 2 layers, 2 in the lower part and 2 in the upper part of the preparations were light-cured according to the manufacturers’ instructions. A vertical load was applied on the center of the pieces at a speed of 1mm/min. Data were obtained in Kgf and submitted to two-way ANOVA and Tukey test (α = 0.05). Results: ANOVA showed significant differences for glass fiber reinforcement. Subgroup N (24.45 ± 3.60)a was significantly different from subgroup S (32.54 ± 6.94) b and subgroup V (37.18 ± 5.33) c. Conclusion: The glass fibers tested were capable of improving the resistance to fracture of AFPP. GRANDTEC fiber exhibited the greatest values of resistance to fracture and for the resins studied the viscosity did not influence on the resistance to fracture of AFPP.

Objetivo: O objetivo deste estudo foi avaliar a influência do reforço com fibra de vidro e viscosidade da resina na resistência à fratura de prótese parcial fixa adesiva (PPFA). Material e Método: Um molde de aço inoxidável foi confeccionado simulando preparos oclusais para PPFA em primeiro pré-molar superior (4 x 4 x 2 mm) e molar (6 x 4 x 2 mm), com uma caixa proximal (2 x 1 x 4 mm) e 7 mm de distância entre eles. Esses moldes foram duplicados em poliuretano (n = 60) e divididos em dois grupos de acordo com a viscosidade da resina: G – Grandio SO (VOCO) (n = 30) e GHF - Grandio SO Heavy flow (VOCO) (n = 30). Estes grupos foram subdivididos em três subgrupos de acordo com o reforço de fibra de vidro utilizado (n = 10): Subgrupo N - sem reforço de fibra de vidro; Subgrupo V - GRANDTEC (VOCO); subgrupo S – everStick C & B (Stick Tech). Quatro incrementos divididos em 2 camadas, 2 na parte inferior e 2 na parte superior dos preparos foram fotopolimerizados de acordo com as instruções dos fabricantes. Uma força vertical foi aplicada no centro das peças a uma velocidade de 1 mm/min. Os dados foram obtidos em Kgf e submetidos a ANOVA a 2 fatores e teste de Tukey (α = 0,05). Resultado: A ANOVA mostrou diferenças significativas para reforço de fibra de vidro. Subgrupo N (24,45 ± 3,60) a foi significativamente diferente do subgrupo S (32,54 ± 6,94)b e subgrupo V (37,18 ± 5,33)c. As fibras de vidro testadas foram capazes de melhorar a resistência à fratura de PPFA. Conclusão: A Fibra GRANDTEC apresentou os maiores valores de resistência à fratura e, para as resinas estudadas, a viscosidade não teve influência na resistência à fratura de PPFA.

Influence of remineralizing gels on bleached enamel microhardness in different time intervals.

This study evaluated the influence of bleaching gel pH, the effect of applying remineralizing gels after bleaching and the effect of artificial saliva on enamel microhardness. Seventy bovine incisors were divided into three groups: Group 1 (n=10) received no bleaching procedure (control); Group 2 was bleached with a 35% hydrogen peroxide neutral gel (n=30) and Group 3 was bleached with a 35% hydrogen peroxide acid gel (n=30). Each experimental group was subdivided into three groups (n=10) according to the post-bleaching treatment: storage in artificial saliva, application of a fluoride gel and application of a combination of calcium and fluoride gel. The specimens were stored in artificial saliva for 7, 15 and 30 days and enamel microhardness was evaluated. The Vickers microhardness data were analyzed by three-way RM ANOVA, which revealed a significant difference only for treatment factor. The Tukey's test showed that the groups bleached followed by no additional treatment exhibited microhardness means significantly lower than the bleached groups treated with remineralizing gels. The Dunnet's test showed a significant difference only for the group bleached with acid gel without remineralizing treatment compared to the control group measured immediately after bleaching. It was concluded that acid bleaching gel significantly reduced enamel microhardness and that use of remineralizing gels after bleaching can significantly enhance the microhardness of bleached enamel.

Sistema IPS Empress 2: técnicas de confecção de restaurações / IPS Empress 2 system: restoration confection techniques

Na atualidade, em conseqüência da grande demanda estética imposta pela sociedade, a busca por materiais que reproduzam cada vez mais os dentes naturais torna-se mais constante. Com isso as porcelanas ganham importância cada vez maior nas pesquisas, o que vem melhorando suas propriedades físicas e funcionais. Os autores descrevem um sistema de confecção de próteses livres de metal (IPS Empress 2), discutindo as técnicas de estratificação e pintura por meio da apresentação de casos clínicos, com ênfase na diferença dos procedimentos laboratoriais entre estas técnicas