Flexural strength, surface roughness, micro-CT analysis, and microbiological adhesion of a 3D-printed temporary crown material.

OBJECTIVE: To evaluate the thermocycling effect of 3D-printed resins on flexural strength, surface roughness, microbiological adhesion, and porosity. MATERIALS AND METHODS: 150 bars (8 × 2 × 2 mm) and 100 blocks (8 × 8 × 2 mm) were made and divided into 5 groups, according to two factors: "material" (AR: acrylic resin, CR: composite resin, BIS: bis-acryl resin, CAD: CAD/CAM resin, and PRINT: 3D-printed resin) and "aging" (non-aged and aged - TC). Half of them were subjected to thermocycling (10,000 cycles). The bars were subjected to mini-flexural strength (σ) test (1 mm/min). All the blocks were subjected to roughness analysis (Ra/Rq/Rz). The non-aged blocks were subjected to porosity analysis (micro-CT; n = 5) and fungal adherence (n = 10). Data were statistically analyzed (one-way ANOVA, two-way ANOVA; Tukey's test, α = 0.05). RESULTS: For σ, "material" and "aging" factors were statistically significant (p < 0.0001). The BIS (118.23 ± 16.26A) presented a higher σ and the PRINT group (49.87 ± 7.55E) had the lowest mean σ. All groups showed a decrease in σ after TC, except for PRINT. The CRTC showed the lowest Weibull modulus. The AR showed higher roughness than BIS. Porosity revealed that the AR (1.369%) and BIS (6.339%) presented the highest porosity, and the CAD (0.002%) had the lowest porosity. Cell adhesion was significantly different between the CR (6.81) and CAD (6.37). CONCLUSION: Thermocycling reduced the flexural strength of most provisional materials, except for 3D-printed resin. However, it did not influence the surface roughness. The CR showed higher microbiological adherence than CAD group. The BIS group reached the highest porosity while the CAD group had the lowest values. CLINICAL RELEVANCE: 3D-printed resins are promising materials for clinical applications because they have good mechanical properties and low fungal adhesion.

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.

Fatigue strength of 5Y-FSZ: glazing and polishing effects.

OBJECTIVE: The aim of this study was to evaluate the effect of four different finishing procedures on the fatigue strength of a fully stabilized zirconia (5Y-FSZ) material. MATERIALS AND METHODS: Disc-shaped specimens of a 5Y-FSZ (Katana UTML, Kuraray Noritake) were made (ISO 6872-2015), grinded with 600- and 1200-grit silicon carbide paper, sintered as recommended, and randomly assigned into four groups according to the finishing technique: C (control, as-sintered), P (polished with polishing rubbers), G (glaze application - powder/liquid technique), and PG (polished with polishing rubbers + glaze application - powder/liquid). Then fatigue strength (staircase method), X-ray diffraction (XRD), and scanning electron microscopy (SEM) analyses were performed. RESULTS: The C group presented the lowest fatigue strength, while the PG group presented the highest. The P and G groups presented intermediate behavior, presenting similar statistical results. XRD showed similar crystalline phase patterns for all groups. SEM images revealed some changes in the zirconia surface, with the P group presenting some scratches on the surface, while the scratches in the PG group were filled with the glaze material. CONCLUSION: None of the techniques analyzed in this study impaired the fatigue strength of fully stabilized zirconia. Importantly, the polishing rubbers combined with glaze application (PG group) improved its fatigue strength. CLINICAL RELEVANCE: The polishing rubbers followed by glaze application improve the fatigue strength in ultra-translucent zirconia.

Effect of finishing/polishing techniques and aging on topography, C. albicans adherence, and flexural strength of ultra-translucent zirconia: an in situ study.

OBJECTIVE: To investigate the influence of different finishing/polishing techniques and in situ aging on the flexural strength (σ), surface roughness, and Candida albicans adherence of 5 mol% yttria-stabilized zirconia (ultratranslucent zirconia). MATERIALS AND METHODS: A total of 120 zirconia bars (Prettau Anterior, Zirkonzahn) with dimensions of 8 × 2 × 0.5 mm were divided into 8 groups (n = 15) according to two factors: "in situ aging" (non-aged and aged (A)) and "finishing/polishing" (control (C), diamond rubber polishing (R), coarse grit diamond bur abrasion (B), and coarse grit diamond bur abrasion + diamond rubber polishing (BR)). Half of the samples from each group were subjected to a 60-day in situ aging by fixing the bars into cavities prepared in the posterior region of the base of complete or partial dentures of 15 patients. The samples were then subjected to the mini flexural (σ) test (1 mm/min). A total of 40 zirconia blocks (5 × 5 × 2 mm) were prepared and subjected to roughness (Ra) analyses and fungal adherence and complementary analyses (X-ray diffraction (XRD) and scanning electron microscopy (SEM)). The data of mean σ (MPa) and roughness Ra (µm) were statistically analyzed by two-way and one-way ANOVA, respectively, and Tukey's test. The Weibull analysis was performed for σ data. The fungal adhesion (Log CFU/mL) data were analyzed by Kruskal-Wallis tests. RESULTS: For flexural resistance, the "finishing/polishing" factor was statistically significant (P = 0.0001); however, the "in situ aging" factor (P = 0.4458) was not significant. The non-aged (507.3 ± 115.7 MPa) and aged (487.6 ± 118.4 MPa) rubber polishing groups exhibited higher mean σ than the other techniques. The non-aged (260.2 ± 43.3 MPa) and aged (270.1 ± 48.8 MPa) bur abrasion groups presented lower σ. The coarse-grit diamond bur abrasion group (1.82 ± 0.61 µm) presented the highest roughness value (P = 0.001). Cell adhesion was not different among groups (P = 0.053). Group B presented the most irregular surface and the highest roughness Ra of 0.61 m. CONCLUSIONS: The finishing of ultratranslucent zirconia might be preferably done with a diamond rubber polisher. Moreover, the protocols used did not interfere with Candida albicans adhesion. CLINICAL RELEVANCE: Coarse-grit diamond burs might be avoided for finishing ultratranslucent monolithic zirconia, which might be preferably performed with a diamond rubber polisher.

Effects of ionizing radiation on surface properties of current restorative dental materials.

To investigate the impact of radiotherapy on surface properties of restorative dental materials. A conventional resin composite-CRC (Aura Enamel), a bulk-fill resin composite-BFRC (Aura Bulk-fill), a conventional glass ionomer cement-CGIC (Riva self cure), and a resin-modified glass ionomer cement-RMGIC (Riva light cure) were tested. Forty disc-shaped samples from each material (8 mm diameter × 2 mm thickness) (n = 10) were produced according to manufacturer directions and then stored in water distilled for 24 h. Surface wettability (water contact angle), Vickers microhardness, and micromorphology through scanning electron microscopy (SEM) before and after exposition to ionizing radiation (60 Gy) were obtained. The data were statistically evaluated using the two-way ANOVA and Tukey posthoc test (p < 0.05). Baseline and post-radiation values of contact angles were statistically similar for CRC, BFRC, and RMGIC, whilst post-radiation values of contact angles were statistically lower than baseline ones for CGIC. Exposition to ionizing radiation statistically increased the microhardness of CRC, and statistically decreased the microhardness of CGIC. The surface micromorphology of all materials was changed post-radiation. Exposure to ionizing radiation negatively affected the conventional glass ionomer tested, while did not alter or improved surface properties testing of the resin composites and the resin-modified glass ionomer cement tested.

Cleaning and Surface Treatment Protocols for Repair of Aged Y-TZP with Composite Resin.

The purpose of this study was to evaluate the cleaning and surface treatment techniques in the repair of aged and contaminated yttrium oxide-stabilized tetragonal polycrystalline zirconia (Y-TZP). From a total of 80 specimens of Y-TZP, 60 were subjected to aging simulation in a buccal environment with degradation in an autoclave for 24 hours (127°C/1.5 bar) and contaminated with Streptococcus mutans. The surfaces were cleaned with a triple syringe (air/water jet; n = 20) or isopropyl alcohol (n = 20), or by prophylaxis (n = 20) with pumice and water. The remaining 20 specimens comprised the control group. All specimens were then treated with silicatization (n = 10 per group) or adhesive (n = 10 per group) and repaired with composite resin. Analyses of shear strength, failure mode, and roughness were performed by electron microscopy. Data were analyzed by two-way analysis of variance (ANOVA) and t test (α = .05). Statistical significance was set at P < .05. Two-way ANOVA was significant for aging and surface treatments (P = .049), but was not significant for surface cleaning (P = .05). ANOVA results were statistically significant for surface treatments (P < .0001), with higher resistance for the silicatization groups. The failure mode was mostly adhesive for all specimens. The roughness was not significant for aging and control groups (P > .05). Triple-syringe and prophylaxis cleansing followed by silicatization was the most efficient treatment for the repair of aged and contaminated Y-TZP. There is reduced repair efficiency with the aging of Y-TZP.

Effect of Consecutive Firings on the Optical and Mechanical Properties of Silicate and Lithium Disilicate Based Glass-Ceramics.

PURPOSE: To evaluate the effect of multiple firings on the optical and mechanical properties of two dental CAD/CAM glass-ceramics. MATERIALS AND METHODS: A total of 45 specimens of each lithium disilicate-LD (IPS E.max CAD, Ivoclar Vivadent) and zirconia lithium silicate-ZLS (Vita Suprinity, Vita Zahnfabrik) material were prepared in a disk shape. These specimens were divided into three groups according to two factors: "type of ceramic" (LD and ZLS) and "numbers of firings" (Control 2F-two firings, 5F-five firings and 7F-seven firings). The firing cycles were performed according to the manufacturer's recommendations. X-ray diffraction was additionally performed to determine crystalline phases in each group, spectrophotometry was used to determine color and translucency variation, and biaxial flexural strength (BFS) evaluated the mechanical behavior. The data were analyzed individually using two-way ANOVA tests and Tukey's test at α = 0.05. RESULTS: The crystalline phases did not present any change after multiple firings for either of the analyzed materials. Both commercial materials showed a significant difference regarding translucency at 7F (p = <0.01), and ZLS presented a difference in color higher than one (ΔE > 1) at 5F and 7F. Regardless of the number of firings, LD presented a higher BFS compared to ZLS (p = <0.001), and a significant increase in BFS comparing 2F and 7F (p = <0.024). CONCLUSION: The use of multiple firings can significantly alter the color, translucency, and mechanical strength of CAD/CAM ceramics.

Effect of finishing/polishing techniques and low temperature degradation on the surface topography, phase transformation and flexural strength of ultra-translucent ZrO2 ceramic.

OBJECTIVE: To investigate the effect of different surface finishing and polishing regimes and low temperature degradation on flexural strength, phase transformation and surface topography of ultra-translucent ZrO2 ceramic. METHODS: 300 (n=15/group) of conventional zirconia (Z: Ice Zirkon Transluzent) and ultra-translucent zirconia (UT: Prettau Anterior) bar-specimens were made and divided according to the "Finishing/Polishing" - (C - Control, B - diamond rubber polishers, P - adjusting with burs, PB - adjusting with burs+diamond polishers, PG - adjusting with burs+glaze), "Low temperature Degradation (LTD)" (with or without a treatment at 127°C, 1.7bar/24h). Then, a 3-point mini flexural test was performed in a universal testing machine (1mm/min, 500kgf load cell). SEM, EDS, XDR, AFM, optical profilometry and Weibull analysis were performed. Data were analyzed by 3-way ANOVA and Tukey's post-test (5%). RESULTS: Groups ZPBD (1670±253MPa), ZBD (1664±217MPa), and ZB (1655±3678MPa) showed significantly higher flexural strength than the UTPG group (372±56MPa). The Weibull modulus was significantly higher for the ZPD group compared to the UB, UCD, UPD and UPBD, while UTB, UTCD and UTPD had the lowest value. Monoclinic phases were observed only in the conventional zirconia groups and were more evident after LTD. Diamond rubber polishers presented less roughness for both zirconias. SIGNIFICANCE: The use of diamond rubber polishers is the most suitable finishing/polishing method for zirconia ceramic restorations and that final glazing reduces the fracture resistance of these materials.

Effect of different repair methods on the bond strength of resin composite to CAD/CAM materials and microorganisms adhesion: An in situ study.

OBJECTIVE: To evaluate the influence of different repair protocols andin situ aging on colony forming units (CFU) and shear bond strength (SBS) between CAD/CAM materials and resin composite. METHODOLOGY: 150 blocks (6 × 5 × 2.5 mm) were made out of each restorative material (CAD/CAM resin composite -RC), polymer-infiltrated ceramic - PIC and glass ceramic (VS), totaling 450 blocks. Fifty blocks of each material were submitted to a 60-day in situ aging by fixing the blocks into cavities prepared in the posterior region of the base of complete dentures. The aged and non-aged blocks were randomly divided into 30 groups of 10 (N = 300) according to the following factors: "Restorative material", "Surface Treatment", and "Aging". Z350 resin composite cylinders were made on the surface of the blocks, and the specimens were submitted to thermocycling, shear test, failure mode analysis, and complementary analyses of roughness, fungal and bacterial CFUs, SEM, and EDS. The SBS (MPa) and CFU/mL data were statistically analyzed by ANOVA and Tukey's test (5%). The other variables were analyzed by qualitative analyzes. RESULTS: The "aging" factor was significant for RC and VS and the "surface treatment" factor was significant for the three restorative materials. Hydrofluoric (HF) acid etching followed by silanization was the best protocol for PIC and VS and diamond bur + SBU was the best protocol for RC. CFU/mL was similar among the restorative materials. CONCLUSION: In situ aging reduced the bond strength between the resin composite repair and RC and VS materials. CLINICAL SIGNIFICANCE: The repair protocol for each restorative material is different and may be influenced by the time of clinical use.

Mechanical Behavior of Different Micro Conical Abutments in Fixed Prosthesis.

PURPOSE: To evaluate the biomechanical behavior between two different micro conical abutments: two-piece and one-piece abutments. MATERIALS AND METHODS: Four groups were divided according to the prosthetic connection (internal or external hexagon) and abutment type. The vertical misfit between the abutment and implant was evaluated under stereomicroscope. Next, the implants were divided into pairs and embedded in polyurethane to receive two-element prostheses. The initial removal torque was measured for abutments and for prosthesis fixation. The samples were mechanically cycled (200 N, 2 Hz, 2 × 106 cycles) before measuring the torque loss in the same regions. For stress verification, a finite element analysis was used. RESULTS: For vertical misfit, one-piece (4.70 ± 0.26 µm) < two-piece (16.8 ± 0.32 µm). For preload in abutment screw, two-piece = one-piece. For prosthetic screw, a higher percentage of preload was found for two-piece, but no statistical difference was observed after fatigue cycling between the groups. For stress analysis, no difference (10%) was observed for abutments, retention screw, or for the bone. CONCLUSION: The one-piece abutment maintained even amounts of preload after cyclic loading and presented less vertical misfit in comparison with the two-piece abutment for both implant connections. The use of one-piece abutments did not increase the stress and strain concentration, suggesting acceptable biomechanical behavior.

Carbon film coating of abutment surfaces: effect on the abutment screw removal torque.

PURPOSE: To evaluate the effect of diamond-like carbon (DLC) coating of prefabricated implant abutment on screw removal torque (RT) before and after mechanical cycling (MC). MATERIALS AND METHODS: Fifty-four abutments for external-hex implants were divided among 6 groups (n = 9): S, straight abutment (control); SC, straight coated abutment; SCy, straight abutment and MC; SCCy, straight coated abutment and MC; ACy, angled abutment and MC; and ACCy, angled coated abutment and MC. The abutments were attached to the implants by a titanium screw. RT values were measured and registered. Data (in Newton centimeter) were analyzed with analysis of variance and Dunnet test (α = 0.05). RESULTS: RT values were significantly affected by MC (P = 0.001) and the interaction between DLC coating and MC (P = 0.038). SCy and ACy showed the lowest RT values, statistically different from the control. The abutment coated groups had no statistical difference compared with the control. Scanning electron microscopy analysis showed DLC film with a thickness of 3 µm uniformly coating the hexagonal abutment. CONCLUSION: DLC film deposited on the abutment can be used as an alternative procedure to reduce abutment screw loosening.