Influence of surface finishing and printing layer orientation on surface roughness and flexural strength of stereolithography-manufactured dental zirconia.

OBJECTIVE: To evaluate the effect of surface finishing and printing layer orientation on the surface roughness and flexural strength of three-dimensionally (3D) printed 3 mol% yttria-stabilized zirconia manufactured by stereolithography (SLA). METHODS: Ninety bar-shaped zirconia specimens (1 mm x 1 mm x 12 mm) were 3D-printed via SLA. After debinding and sintering, they were randomly divided according to the printing layer orientation: parallel (PR) or perpendicular (PD) to the tensile surface for bending test. Each group was submitted to a surface finishing protocol (n=15/group): unpolished (subgroup 0), with polished tensile surface (subgroup 1), and with polished lateral and tensile surfaces (subgroup 3). Roughness of tensile surface was determined using a contact sensor and surface morphology was analyzed under Scanning Electron Microscopy (SEM). Flexural strength, apparent elastic modulus, and Weibull parameters were assessed using a 3-point bending test. Fractured specimens were examined to identify failure origins. Finite element analysis was used to evaluate tensile stress peaks and failure risk. RESULTS: PR orientation exhibited higher strength, higher apparent elastic modulus, higher maximum principal stress peaks, and lower failure risk. For both layer orientations, groups with polished lateral and tensile sides (PR3 and PD3) were the strongest. SEM revealed that polishing led to changes in defect type, location, and size. SIGNIFICANCE: SLA zirconia shows different mechanical properties according to surface roughness and defects. Orienting the printed layers parallel to the tensile side improves its mechanical performance. Polishing can significantly improve its flexural strength. It is necessary to reduce the final product's surface roughness and large pores for its best performance.

Effect of glazing technique and firing on surface roughness and flexural strength of an advanced lithium disilicate.

OBJECTIVE: The objective of this study was to investigate the effects of glazing technique and firing on the surface roughness and flexural strength of an advanced lithium disilicate (ALD) and lithium disilicate (LD). METHODS: Eight groups of bar-shaped specimens (1 mm × 1 mm × 12 mm, N=160, 20/group) were manufactured from ALD (CEREC Tessera, Dentsply Sirona) and LD (IPS e.max CAD, Ivoclar). The specimens were then submitted to various posttreatments: crystallization (c), crystallization followed by a second firing (c-r), crystallization with glaze in one step (cg), and crystallization followed by a glaze layer firing (c-g). Surface roughness was measured by means of a profilometer, and flexural strength was determined using a three-point bending test. Surface morphology, fractography, and crack healing analysis were conducted using scanning electron microscopy. RESULTS: Refiring (c-r) did not affect the surface roughness (Ra) while applying glaze at both cg and c-g procedures increased the roughness. ALDc-g (442.3 ± 92.5 MPa) promoted higher strength than ALDcg (282.1 ± 64.4 MPa), whereas LDcg (402.9 ± 78.4 MPa) was stronger than LDc-g (255.5 ± 68.7 MPa). Refiring completely closed the crack in ALD, but it had a limited effect on LD. CONCLUSIONS: Two-step crystallization and glazing improved ALD strength compared to the one-step protocol. Refiring and one-step glazing do not increase LD's strength, while two-step glazing has a negative effect. CLINICAL RELEVANCE: Besides both materials being lithium-disilicate glass ceramics, the glazing technique and firing protocol affected their roughness and flexural strength differently. A two-step crystallization and glazing should be the first choice for ALD, while for LD, glazing is optional and when necessary, should be applied in one-step.

Digital Image Correlation and Finite Element Analysis of Bone Strain Generated by Implant-Retained Cantilever Fixed Prosthesis.

PURPOSE: The present study evaluated the displacement and strain generated in an implant- supported fixed prosthesis under axial and non-axial loads using two methods. MATERIALS AND METHODS: Three implants were inserted in a resin block. The Digital Image Correlation (DIC) was used to measure displacement and strain generated on the surface of the resin blocks for the different load applications (500N, 1 image/second). A 3-dimensional model was constructed and a load of 500 N was applied at an axial point and a non-axial point through finite element analysis (FEA). RESULTS: Both methods gave similar trends for the strains, and both gave slightly higher strains with non-axial loading. FEA predicted higher strain magnitude (±11%) in comparison with DIC, but with the same mechanical behavior. According to ANOVA, the loading influenced the strain concentration. Higher strain was generated for non-axial loading around the implant nearest to the loading. CONCLUSIONS: For implant-retained cantilever fixed prosthesis, the same load applied in the lever arm induces higher strain in the cervical area of the last implant, which suggests more damaging potential than a load applied at the center of the prosthesis.

Influence of Ceramic Materials on Biomechanical Behavior of Implant Supported Fixed Prosthesis with Hybrid Abutment.

PURPOSE: This study evaluated the stress distribution in different cement-retained implant-supported prostheses with a hybrid abutment. MATERIALS AND METHODS: Two factors were evaluated: restorative material for the crown and hybrid abutment - zirconia, lithium disilicate and hybrid ceramic, yielding 9 combinations. For finite element analysis, a monolithic crown cemented on a hybrid abutment was modeled and cemented on a titanium base (Ti base). An oblique load (45°, 300 N) was applied to the fossa bottom and system fixation occurred on the bone's base. RESULTS: Each structure was evaluated separately to find the possible weaknesses in geometry and failure criteria. In this context, results demonstrated a significant decrease of maximum principal and von-Mises stresses concentration when crowns with high elastic modulus are cemented onto a hybrid abutment with lower elastic modulus. CONCLUSIONS: Considering this theoretical study for a Morse taper implant, the association of a rigid crown with a more resilient hybrid abutment reduces the tensile stress concentration in the restoration cervical region.

Resin bonding to root dentin: influence of the alveolar bone level and thickness of the cement layer.

AIM: Aim of the present study was to evaluate the influence of the alveolar bone level and thickness of the cement layer on the push-out bond strength of fiber posts luted to root dentin. METHODS: We prepared post spaces in 60 bovine roots (16 mm), embedded in acrylic resin to simulate different scenarios of alveolar bone resorption. They were divided into six groups (N.=10), according to the factors "alveolar bone level" (14, 10, and 7 mm) and "cement thickness" (post no. 3/control and post no. 1/ thicker cement layer): G14P3 - 14-mm root + post n. 3; G10P3 - 10-mm root + post n. 3; G7P3 - 7-mm root + post n. 3; G14P1 - 14-mm root + post n. 1; G10P1 - 10-mm root + post n. 1; and G7P1 - 7-mm root + post n. 1. The fiber posts (White Post DC, FGM) were luted, and composite cores were made. Each specimen was subjected to mechanical cycling, and four slices were obtained from each root specimen and subjected to push-out testing in a universal testing machine. The data (MPa) were analyzed by ANOVA (two way) and Tukey's test (5%). RESULTS: The factor "cement thickness" (P=0.0057) significantly influenced bond strength, but the factor "alveolar bone level" (P=0.0605) did not. The thicker cement layer/post n. 3 presented bond strength values higher than those with cement layer/post n. 1. CONCLUSION: Bond strength was not influenced by different scenarios of alveolar bone resorption, although higher bond strength values were found for thinner cement layers.

Right hepatic segmentectomy for the treatment of intrahepatic biliary stones due to ascaris lumbricoides: report of a case.

We report herein the case of a 46-year-old woman investigated for recurrent acute cholangitis. Ultrasound, endoscopic retrograde cholangiopancreatography, and computed tomography scan revealed dilatation and multiple images suggestive of intrahepatic biliary stones in the ducts that drained segments V and VI of the liver. Endoscopic treatment was attempted unsuccessfully, and based on the severity of the last crisis of cholangitis a laparotomy was performed. A right hepatic lobectomy including segments V and VI was carried out without any complications, resulting in complete relief of symptoms. Pathological examination of the liver demonstrated the presence of worm nests in the liver parenchyma with chronic granulomatous lesions.