THE MARGINAL ACCURACY OF LITHIUM DISILICATE SINGLE CROWNS IS COMPAREABLE WHEN MADE FROM CONVENTIONAL OR DIGITAL (DIRECT OR INDIRECT) WORKFLOWS.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Tabesh M, Nejatidanesh F, Savabi G, Davoudi A, Savabi O. Marginal accuracy of lithium disilicate full coverage crowns made by direct and indirect digital or conventional workflows: a systematic review and meta-analysis. J Prosthodont. 2022;31(9):744-753. doi:10.1111/jopr.13515. SOURCE OF FUNDING: Dental Research Center, Isfahan University of Medical Sciences Research Grant #298095. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.

Mechanical properties of a resin-modified glass-ionomer cement reinforced with short-glass fiber flowable resin composites.

PURPOSE: To evaluate the improvement of selected mechanical properties of a resin-modified glass-ionomer cement (RMGIC) with a discontinuous short E glass fiber flowable resin composites (GFRRC) to be used in load-bearing areas of permanent teeth. METHODS: Experimental materials were prepared using two different weight proportions, 7 wt% (1.75% E glass fibers) and 25 wt% (6.25% E glass fibers) of a GFRRC into an RMGIC matrix. Flexural strength was evaluated in 0- and 24-hour hydration periods, and fracture toughness was assessed after 24 hours. The internal microstructure of fractured samples was evaluated using a scanning electron microscope. RESULTS: The addition of 25% of GFRRC was more effective in strengthening RMGIC than the introduction of only 7% GFRRC. Hydration periods did not show any significant statistical difference (P> 0.05). SEM micrographs of experimental materials' fractured surfaces revealed pull-out and fractured fibers; the presence of the matrix attached to fibers indicates great fiber-matrix adhesion. Within the limitations of the study, the results revealed that reinforcing RMGIC with discontinuous short E glass fiber flowable resin composites (GFRRC) improved significantly the flexural strength and modestly enhanced fracture toughness. CLINICAL SIGNIFICANCE: The current study results are promising for the future of resin-modified glass-ionomer as a viable permanent restorative material in stress-bearing areas for permanent teeth after the reinforcement with short E glass fiber flowable resin composites as a source of discontinuous short glass fibers.

Mechanical and Biocompatibility Properties of 3D-Printed Dental Resin Reinforced with Glass Silica and Zirconia Nanoparticles: In Vitro Study.

This study aimed to assess the mechanical and biocompatibility properties of dental resin reinforced with different nanoparticle additives. Temporary crown specimens were 3D-printed and grouped based on nanoparticle type and amount, including zirconia and glass silica. Flexural strength testing evaluated the material's ability to withstand mechanical stress using a three-point bending test. Biocompatibility was tested using MTT and dead/live cell assays to assess effects on cell viability and tissue integration. Fractured specimens were analysed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) for fracture surface examination and elemental composition determination. Results show that adding 5% glass fillers and 10-20% zirconia nanoparticles significantly improves the flexural strength and biocompatibility of the resin material. Specifically, the addition of 10%, 20% zirconia, and 5% glass silica by weight significantly increases the flexural strength of the 3D-printed resins. Biocompatibility testing reveals cell viabilities greater than 80% in all tested groups. Reinforced 3D-printed resin holds clinical potential for restorative dentistry, as zirconia and glass fillers have been shown to enhance mechanical and biocompatibility properties of dental resin, making it a promising option for dental restorations. The findings of this study may contribute to the development of more effective and durable dental materials.

The Clinical Potential of 3D-Printed Crowns Reinforced with Zirconia and Glass Silica Microfillers.

The development of 3D-printed crown resin materials with improved mechanical and physical properties is an area of growing interest in dentistry. This study aimed to develop a 3D-printed crown resin material modified with zirconia glass (ZG) and glass silica (GS) microfillers to enhance overall mechanical and physical properties. A total of 125 specimens were created and divided into five groups: control unmodified resin, 5% either ZG or GS reinforced 3D-printed resin, and 10% either ZG or GS reinforced 3D-printed resin. The fracture resistance, surface roughness, and translucency parameter were measured, and fractured crowns were studied under a scanning electron microscope. The results showed that 3D-printed parts that were strengthened with ZG and GS microfillers demonstrated comparable mechanical performance to unmodified crown resin but resulted in greater surface roughness, and only the group that contained 5% ZG showed an increase in translucency. However, it should be noted that increased surface roughness may impact the aesthetics of the crowns, and further optimisation of microfillers concentrations may be necessary. These findings suggest that the newly developed dental-based resins that incorporate microfillers could be suitable for clinical applications, but further studies are necessary to optimise the nanoparticle concentrations and investigate their long-term clinical outcomes.

Effect of Printing Layer Thickness and Postprinting Conditions on the Flexural Strength and Hardness of a 3D-Printed Resin.

BACKGROUND: Recently, dentists can utilize three-dimensional printing technology in fabricating dental restoration. However, to date, there is a lack of evidence regarding the effect of printing layer thicknesses and postprinting on the mechanical properties of the 3D-printed temporary restorations with the additive manufacturing technique. So, this study evaluated the mechanical properties of a 3D-printed dental resin material with different printing layer thicknesses and postprinting methods. METHODS: 210 specimens of a temporary crown material (A2 EVERES TEMPORARY, SISMA, Italy) were 3D-printed with different printing layer thicknesses (25, 50, and 100 µm). Then, specimens were 3D-printed using DLP technology (EVERES ZERO, DLP 3D printer, SISMA, Italy) which received seven different treatment conditions after printing: water storage for 24 h or 1 month, light curing or heat curing for 5 or 15 minutes, and control. Flexural properties were evaluated using a three-point bending test on a universal testing machine (ISO standard 4049). The Vickers hardness test was used to evaluate the microhardness of the material system. The degree of conversion was measured using an FT-IR ATR spectrophotometer. Statistical analysis was performed using two-way analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) test (p ≤ 0.05). RESULTS: The 100 µm printing layer thickness had the highest flexural strength among the other thickness groups. As a combined effect printing thickness and postprinting conditions, the 100 µm with the dry storage group has the highest flexural strength among the tested groups (94.60 MPa). Thus, the group with 100 µm thickness that was heat cured for 5 minutes (HC 5 min 100 µm) has the highest VHN value (VHN = 17.95). Also, the highest mean DC% was reported by 50 µm layer thickness (42.84%). CONCLUSIONS: The thickness of the 100 µm printing layer had the highest flexural strength compared to the 25 µm and 50 µm groups. Also, the postprinting treatment conditions influenced the flexural strength and hardness of the 3D-printed resin material.

Evaluation of rheological behaviour of flowable dental composites reinforced with low aspect ratio micro-sized glass fibres.

OBJECTIVE: Experimental investigation is carried out to determine the flowability and stickiness of the developed composite material for dental restoration containing low aspect ratio (AR ≤ 100) surface treated micro-sized glass fibres. METHODS: Specimens are manufactured by mixing low AR (50/70/100) micro-sized glass fibres with two different weight fractions (5%/10%) into UDMA/TEGDMA based resin. Particulate filler composite (PFC) containing 55% glass fillers is used as the control group. Dynamic oscillatory strain sweep tests are conducted to analyse the linear viscoelastic behaviour. Solid-to fluidic transition behaviour of dental composites is also calculated in terms of flow and yield stresses. Furthermore, the oscillatory frequency sweep tests are conducted at three different strains (0.5%, 5% and 50%) resembling the positioning of unset paste onto restorations for different real-life clinical situations. Additionally, stickiness of dental composites with handling instrument (steel) and dentine covered with bonding agent is also evaluated. RESULTS: The results suggested the all the FRC groups exhibited non-Newtonian, shear-thinning behaviour. It is further established that inclusion of 5% of 50/70AR fibres into dental composites does not affect the flowability. Simultaneously, stickiness with dentine covered with bonding agent is more for these two compositions as compared to that of handling instrument (steel). SIGNIFICANCE: This study suggest that visco-elastic properties of dental composites are greatly affected by the type of filler (spherical shaped particulate fillers or rod-shaped fibres) as well as fibre weight fraction/fibre AR. This phenomenon can be attributed to the varying interactions between micro-sized fibres of different AR/weight fraction, particulate fillers and monomers.

Fiber reinforcement of a resin modified glass ionomer cement.

OBJECTIVES: Understand how discontinuous short glass fibers and braided long fibers can be effectively used to reinforce a resin modified glass ionomer cement (RMGIC) for carious lesion restorations. METHODS: Two control groups (powder/liquid kit and capsule) were prepared from a light cured RMGIC. Either discontinuous short glass fibers or braided polyethylene fiber ribbons were used as a reinforcement both with and without pre-impregnation with resin. For the former case, the matrix was the powder/liquid kit RMGIC, and for the latter case the matrix was the capsule form. Flexural strength was evaluated by three-point beam bending and fracture toughness was evaluated by the single-edge V-notch beam method. Compressive strength tests were performed on cylindrical samples. Results were compared by analysis of variances and Tukey's post-hoc test. Flexural strength data were analyzed using Weibull statistical analysis. RESULTS: The short fiber reinforced RMGIC both with and without pre-impregnation showed a significant increase of ∼50% in the mean flexural strength and 160-220% higher fracture toughness compared with the powder/liquid RMGIC control. Reinforcement with continuous braided fibers gave more than a 150% increase in flexural strength, and pre-impregnation of the braided fibers with resin resulted in a significant flexural strength increase of more than 300% relative to the capsule control. However, for the short fiber reinforced RMGIC there was no significant benefit of resin pre-impregnation of the fibers. The Weibull modulus for the flexural strength approximately doubled for the fiber reinforced groups compared to the control groups. Finally, compressive strength was similar for all the groups tested. SIGNIFICANCE: By using a RMGIC as a matrix, higher flexural strength was achieved compared to reported values for short fiber reinforced GICs. Additionally, the short fibers provided effective toughening of the RMGIC matrix by a fiber bridging mechanism. Finally, continuous braided polyethylene fibers gave much higher flexural strength than discontinuous glass fibers, and their effectiveness was enhanced by pre-impregnation of the fibers with resin.

Acoustic emission and finite element study on the influence of cusp angles on zirconia dental crowns.

OBJECTIVE: The effect of cusp angle on the load-carrying capacity and failure behaviour of BionZ Diamond zirconia crowns is carried out using experimental and numerical investigations. METHODS: The experimental program using monolithic crowns were divided into three groups (n = 14) for three cusp angles, 60, 80 and 120 degrees and were tested to failure under the static load. A 2-channel acoustic emission (AE) system was used to monitor the failure process while the piezo sensors were attached to the rigid stainless-steel jig for recoding the AE events. Load-displacement and AE response were simultaneously monitored until failure of specimens. Parametric AE analysis was conducted for the factors such as amplitude, energy released, signal duration and cumulative counts, for each AE signal. Fast Fourier transform (FFT) was conducted to assess the frequency at failure. Linear finite element analysis (FEA) was carried out using commercial software Ansys Workbench 19.1 to present the stress distribution and failure modes. Post-failure surface morphology study was carried out using scanning electron microscopy (SEM) and statistical analysis was performed using Weibull analysis. RESULTS: All the samples in three different groups have failed at the mid-line, splitting the zirconia crowns into two equal pieces. The load to failure was directly proportional to the cusp angle in crowns; 120° group had the highest load-carrying capacity of 2.93 ± 0.26 kN while 60 and 80° groups had a failure load of 2.46 ± 0.53 and 2.52 ± 0.16 kN, respectively. Parametric AE analysis revealed that the failure was instantaneous and 60-degree samples had higher AE signature. FE analysis showed the crack initiation at the occlusal surface of the crown which is in agreement with the SEM images. A close agreement of results for the load and stress distribution from FEA complemented with the experimental study. SIGNIFICANCE: Optimisation of cusp-angle could help clinicians to accurately design the monolithic zirconia crown focussing on maximum load-carrying capacity, increasing the restoration life.

Effect of cooling protocol on mechanical properties and microstructure of dental veneering ceramics.

OBJECTIVES: Understand how cooling protocols control the microstructure and mechanical properties of veneering porcelains. METHODS: Two porcelain powders were selected, one used to veneer metallic frameworks (VM13) and one for zirconia frameworks (VM9). After the last firing cycle, the monolithic specimens were subjected to two cooling protocols: slow and fast. Flexural strength (FS) was evaluated by three-point beam bending and fracture toughness (KIC) was evaluated by the single-edge V-notch beam (SEVNB) method. Scanning electron microscopy (SEM) was performed to determine the leucite crystal volume fraction (%), particle size, and matrix microcrack density. The results were compared by analysis of variances (ANOVA) and Tukey's multiple comparison test. RESULTS: The mechanical properties were significantly (p<0.05) higher for the VM13 porcelain (FS=111.0MPa, KIC=1.01MPa.√m) compared to VM9 (FS=79.6MPa, KIC =0.87MPa.√m) regardless of cooling protocol due to ∼250% higher volume fraction of leucite crystals. The slow cooled VM13 and fast cooled VM9 resulted in the highest and lowest mechanical properties, respectively, while the VM9 slow cooled properties were similar to the VM13 fast cooled. The SEM revealed that the slow cooling significantly increased the volume fraction of leucite crystals by 33-41 %. Across both porcelains, a significant linear correlation between both mechanical properties (strength and toughness) and leucite crystal content was found. Slow cooling was also associated with increased crystal growth resulting in more matrix microcracking. SIGNIFICANCE: Controlled crystallization using slow cooling can be applied as a means of strengthening dental porcelains. However, the benefits of slow cooling may be partially offset by increasing the microcrack density in the glass matrix. To achieve the maximum benefit of slow cooling, it is recommending to develop heat treatments to produce porcelain with fine-grained and homogenously dispersed leucite crystals to achieve minimal glass matrix microcracking.

Microstructural and Mechanical Characterization of CAD/CAM Materials for Monolithic Dental Restorations.

PURPOSE: To determine and compare the microstructure, flexural strength, flexural modulus, fracture strength, and microhardness of four types of computer-aided design/computer-aided manufacturing (CAD/CAM) materials for monolithic dental restorations. MATERIALS AND METHODS: A lithium disilicate (LD; IPS e.max CAD), a zirconia-reinforced lithium silicate (ZLS; VITA Suprinity), a hybrid high-performance polymer (HPP) composite resin (GC Cerasmart), and a hybrid polymer-infiltrated ceramic network (PICN) material (VITA Enamic) were used to manufacture monolithic ceramic posterior crowns (n = 10) that were adhesively cemented on resin-based composite dies and loaded until fracture. In addition, 40 rectangular bars (n = 10) were milled and polished for three-point flexural strength testing. Microhardness (Vickers indentation), as well as quantitative (energy dispersive spectroscopy) and qualitative (scanning electron microscopy) structural analysis were conducted on fracture surfaces. Data were analyzed by one-way ANOVA and Tukey HSD post-hoc test (p = 0.05). RESULTS: Mechanical testing results showed that the material type has a significant effect on the fracture strength (p < 0.0001) of the monolithic crowns with ZLS and LD presenting significantly higher fracture strength than the PICN and HPP hybrid materials. LD showed the highest flexural strength (p < 0.0001) followed by ZLS, HPP, and PICN, respectively. The lowest flexural modulus and hardness were presented by HPP whereas ZLS had the highest flexural modulus and hardness. The LD presented the highest modulus of resilience and the PICN the lowest. CONCLUSIONS: All CAD/CAM crown materials exhibited high values of fracture and flexural resistance, making them suitable materials for posterior full-crown restorations. Glass-ceramics suffered more from catastrophic and nonreparable fracture patterns, whereas minimal chipping and type II fracture patterns were more common in hybrid materials. The combination of more flexibility, less stiffness, and increased softness with satisfactory flexural and fracture strength values observed in PICN and HPP makes these two hybrid materials suitable choices for chairside monolithic crown fabrication.

Effect of short glass fibers on the polymerization shrinkage stress of dental composite.

This study examines contraction stresses of seven short fiber reinforced composites (sFRC) exhibiting different volume loads and aspect ratios (AR)* of fibres. The shift towards a greater utilization of posterior resin composites in dentistry has seen increased interest in the use of randomly oriented short glass fibers in these restorative materials. While the effect of these fibers on modulus, strength, and toughness has been studied, very little information exists on their effect on polymerization shrinkage and even less on shrinkage stress. S2-glass fibers with an average AR of 68 were used to form three experimental groups with 5%, 10%, and 20% volume loads. Commercial sFRC with ARs of 20 and 100 were also tested. A tensilometer set up was used with moderate compliance, 5.4 J/cm2 irradiance, and a C-factor of 2.75. Data was statistically analyzed using ANOVA followed by post hoc Tukey's test. The addition of 5% of the experimental fiber did not significantly increase stress while the 10% and 20% groups resulted in 36.3% and 39.1% higher stress values, respectively, compared to the non-fiber control group (p < 0.05). Of all the sFRC groups, the very low AR material exhibited the lowest stress [0.682 MPa (p = 0.001)] while another commercial material with higher AR fibers exhibited the highest overall value [1.822 MPa (p < 0.001)] when compared to the control group. The results indicate that both short fiber volume and AR are important variables to consider with regards to setting stresses of sFRC. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1930-1937, 2017.

Evaluation of the physical properties of dental resin composites using optical fiber sensing technology.

OBJECTIVES: The characterization of the physical properties of dental resin composites is fraught with difficulties relating to significant intra and inter test parameter variabilities and is relatively time consuming and expensive. The main aim of this study was to evaluate whether optical fiber Bragg grating (FBG) sensing system may become a viable tool to study dental material characteristics. Of particular focus was the potential for the system to demonstrate a multi parameter all-in-one feature. METHODS: A miniature FBG was embedded in six different dental resin composites and employed as a sensor to evaluate linear polymerization shrinkage, thermal expansion and water sorption. Six commercially available dental composites with different filler types and volume are evaluated. The tests are repeated with three sets of samples. The curing characteristics and residual strain gradient exhibited by the cured dental composites were also observed and commented. RESULTS: Among the studied samples, SDR shows lowest polymerization shrinkage, while Beautifil FO3 shows the highest. The results also show clear distinction between particle filler type and fiber reinforcement based composites in their polymerization shrinkage properties. The agreement of the results with existing literatures show that FBG based system provides accurate results. Polymerization shrinkage rate of the samples are also obtained. Thermal expansion of the composites are measured using the FBG sensing method for the first time and is correlated with resin type, volume, filler type and glass transition temperature. The water sorption characteristics of the dental composite are also successfully measured using the FBG sensing method. The high level of repeatability and the low standard deviations shown in the results indicate good reliability with the use of FBG sensors. SIGNIFICANCE: This study demonstrates how optical fiber technology can provide simple and reliable methods of measuring the critical physical properties of dental composites. In addition due to the embedding and preservation of the sensor within the samples multiple parameters can be tested for with the same sample. These features are expected to greatly assist material science researchers in dentistry as well as other biomedical fields. Of some interest the phenomenon of stress relaxation of dental composite at higher temperature was observed.

Enhancing Fluoride Mediated Dentine Sensitivity Relief through Functionalised Tricalcium Phosphate Activity.

Background. To assess the clinical efficacy of a dentifrice containing fluoride and functionalised tricalcium phosphate (fTCP) in reducing dentine sensitivity. Methods. A 10-week parallel blind randomised control trial was conducted. Subjects were assigned to one of four groups and instructed to brush twice daily: A: Colgate Cavity Protection (1000 ppmF-MFP); B: Sensodyne Total Care (1000 ppmF-NaF + 19300 ppmK(+)-KNO3); C: Clinpro Tooth Crème (950 ppmF-NaF + fTCP); and D: Clinpro Tooth Crème (brushing + additional topical application). Seventy-one patients were assessed at baseline, 6 weeks, and 10 weeks for cold, tactile, and hypertonic sensitivity using the NRS-11 pain rating scale. A combined modalities sensitivity score (CMS) was calculated. Results. At 6 weeks, patients reported the following reduction in CMS: A (20%); B (30%); C (42%); D (52%). At 10 weeks, patients reported the following reduction in CMS: A (18%), B (40%), C (24%), and D (54%). The only CMS comparisons to show a significant difference (P < 0.05) were between Groups A and D (6 and 10 weeks). Conclusions. Addition of fTCP to a dentifrice enhances the ability of dentifrice fluoride in reducing dentine sensitivity. Using Clinpro Tooth Crème twice daily for brushing can be as effective to reduce dentine sensitivity as twice daily brushing using Sensodyne Total Care. However, additional nightly topical application of fTCP, in addition to twice daily brushing, showed an enhanced reduction in dentine sensitivity.

The effect of fiber aspect ratio and volume loading on the flexural properties of flowable dental composite.

OBJECTIVE: To evaluate the efficacy on flexural properties of flowable dental resin composite reinforced with short glass fiber of different aspect ratios (ARs) and volume percent loadings. It is hypothesized that with the addition of randomly oriented fibers it is possible to significantly improve flexural strength and modulus while maintaining flowability. METHODS: Ten groups of samples with varying glass fiber volume loads (0, 5%, 10%, 20%, 40% and 60%) and three different ARs (5.2, 68 and 640) were tested in three point bending to fracture according to ISO 4049. A flowable resin composite was used as the control and also as the filled resin composite that was subsequently reinforced with fibers. Load deflection results were used to calculate flexural strength and flexural modulus. SEM images were used to determine the mode(s) of failure, to describe surface features of reinforcement and were correlated with force displacement graphs. All results were statistically analysed using ANOVA followed by post hoc Tukey's test. Level of significance was set at 0.05. RESULTS: When compared to the "sculptable" control (68.6 vol% filler loaded) results for flexural strength varied from a mean reduction of 42% (p>0.05) for the low AR group to an increase of 77% (p<0.001) for the high AR samples. Flexural modulus results varied from a low of 6.6 [0.67] GPa for the non reinforced spatulated control to 20.3 [1.31] GPa (p<0.001) for the 60% loaded low AR group. The low fiber loaded mid AR group was still flowable with 49% total loading (5% fiber/44% filler) but gave strength values (181.2 [33.5] MPa) 30% higher than the "sculptable" control (p>0.05) and comparable modulus. SIGNIFICANCE: This study shows that short and very short glass fibers can significantly reinforce flowable dental composite. The fiber's aspect ratio was shown to be more important than volume loading for flexural strength. It appears possible to produce a light cured short glass fiber reinforced flowable material with superior flexural properties compared to conventional universal composites.

Long-term fluoride exchanges at restoration surfaces and effects on surface mechanical properties.

Aim. The aim of the study was to determine whether three fluoride containing resin composites could maintain fluoride release, fluoride recharge, and mechanical stability over long-term (18-month) aging. Materials and Methods. Fluoride containing composites Beautifil II, Gradia Direct X, Tetric EvoCeram, and glass ionomer Fuji IX Extra were analyzed. Specimens of each material were fabricated for two test groups: Group 1: bimonthly fluoride release/recharge analysis (n = 5); Group 2: hardness and elastic modulus analysis (n = 6). Nanoindentation was employed at 24 hours and at 1, 3, 6, 12, and 18 months. After 18 months, each specimen was immersed (recharged) in 5000 ppm NaF gel, and fluoride rerelease, hardness, and elastic modulus were measured. Results. Beautifil II and Gradia Direct X maintained fluoride release and recharge capability throughout 18-month aging (Beautifil II > Gradia Direct X > Tetric EvoCeram). The fluoride rerelease from Beautifil II following a 10-minute NaF recharge (at 18 months) was comparable to the long-term fluoride release from Fuji IX Extra. Elastic modulus and hardness did not change significantly (P > 0.05) with fluoride release, recharge, and water aging over 18 months for all three analyzed composites. Conclusions. The long-term fluoride release, fluoride recharge, and mechanical property stability of Beautifil II and Gradia Direct X render these composites suitable for load bearing restorations in high caries risk patients. Clinical Relevance. The ability for Beautifil II and Gradia Direct X to maintain fluoride release and fluoride recharge capability, despite long-term aging, raises the potential for unrestored tooth surfaces in contact with Beautifil II or Gradia Direct X restorations to demonstrate a reduced rate of caries incidence compared to unrestored surfaces adjacent to conventional nonfluoride containing composites.

Influence of implant abutment angulations and two types of fibers on the fracture resistance of ceramage single crowns.

PURPOSE: To assess the effect of three implant abutment angulations and two types of fibers on the fracture resistance of overlaying Ceramage single crowns. MATERIALS AND METHODS: Three groups, coded A to C, with different implant abutment angulations (group A/0°, group B/15°, and group C/30° angulation) were restored with 45 overlay composite restorations; 15 Ceramage crowns for each angulation. Groups A, B, and C were further subdivided into three subgroups (n = 5) coded: 1, crowns without fiber reinforcement; 2, crowns with Connect polyethylene reinforcement; and 3, crowns with Interlig glass reinforcement. All crowns were constructed by one technician using the Ceramage System. The definitive restorations (before cementation) were stored in distilled water at mouth temperature (37°C) for 24 hours prior to testing. Before testing, the crowns were cemented using Temp Bond. The compressive load required to break each crown and the mode of failure were recorded. The speed of testing was 1 mm/min. The results were statistically analyzed by two-way ANOVA (p < 0.05). The tested crowns were examined using a stereomicroscope at 40×, and selected crowns (five randomly selected from each group) were further examined by scanning electron microscopy (SEM) to reveal the composite-fiber interface. RESULTS: Fracture resistance of single crowns was not affected (p > 0.05) by the different abutment angulations chosen (0°, 15°, 30°) or fiber reinforcement (Connect and Interlig fibers). Crowns in group A exhibited average loads to fracture (N) of A1 = 843.57 ± 168.20, A2 = 1389.20 ± 193.40, and A3 = 968.00 ± 387.53, which were not significantly different (p > 0.05) from those of groups B (B1 = 993.20 ± 327.19, B2 = 1471.00 ± 311.68, B3 = 1408.40 ± 295.07), or group C (C1 = 1326.80 ± 785.30, C2 = 1322.20 ± 285.33, C3 = 1348.40 ± 527.21). SEM images of the fractured crowns showed that the origin of the fracture appeared to be located at the occlusal surfaces of the crowns, and the crack propagation tended to extend from the occlusal surface towards the gingival margin. CONCLUSIONS: Implant abutment angulations of 0°, 15°, and 30° did not significantly (p > 0.05) influence the fracture resistance of overlaying Ceramage single crowns constructed with or without reinforcing fibers. The two types of fibers used for reinforcement (Connect and Interlig) had no effect (p > 0.05) on the fracture resistance of overlaying Ceramage single crowns.

Influence of immediate dentin sealing on the shear bond strength of pressed ceramic luted to dentin with self-etch resin cement.

Objectives. To examine the effect of immediate dentin sealing (IDS), with dentin bonding agents (DBAs) applied to freshly cut dentin, on the shear bond strength of etched pressed ceramic luted to dentin with RelyX Unicem (RXU) cement. Method. Eighty extracted noncarious third molars were ground flat to expose the occlusal dentin surfaces. The teeth were randomly allocated to five groups (A to E) of sixteen teeth each. Groups A to D were allocated a dentin bonding agent (Optibond FL, One Coat Bond, Single Bond, or Go!) that was applied to the dentin surface to mimic the clinical procedure of IDS. These specimen groups then had etched glass ceramic discs (Authentic) luted to the sealed dentin surface using RXU. Group E (control) had etched glass ceramic discs luted to the dentin surface (without a dentin bonding agent) using RXU following the manufacturer's instructions. All specimens were stored for one week in distilled water at room temperature and then shear stressed at a constant cross-head speed of 1 mm per minute until failure. Statistical analysis was performed by ANOVA followed by post hoc Tukey HSD method (P < 0.05) applied for multiple paired comparisons. Results. The shear bond strength results for group A to E ranged from 6.94 ± 1.53 to 10.03 ± 3.50 MPa. One-way ANOVA demonstrated a difference (P < 0.05) between the groups tested and the Tukey HSD demonstrated a significant (P < 0.05) difference between the shear bond strength (SBS) of Optibond FL (Group A) and Go! (Group D). There was no statistical difference (P > 0.05) in the SBS between the test groups (A-D) or the control (group E). Conclusion. IDS using the dentin bonding agents tested does not statistically (P > 0.05) affect the shear bond strength of etched pressed ceramic luted to dentin with RXU when compared to the control.

Polymerization profile analysis of resin composite dental restorative materials in real time.

OBJECTIVES: In this study, the hypothesis that the polymerization shrinkage profile of "low shrinkage" non-methacrylate based composite; Silorane and "low shrinkage" high molecular mass methacrylate based composite; Kalore is not different from that of three conventional methacrylate based composites (Gradia Direct X, Filtek Supreme XT and Beautifil II) was tested. METHODS: Five commercially available composites were analysed: one "low shrinkage" non-methacrylate based composite (Silorane); one "low shrinkage" high molecular mass methacrylate based composite (Kalore) and three conventional methacrylate based composites (Gradia Direct X, Filtek Supreme XT and Beautifil II). Polymerization shrinkage was measured using an electromagnetic balance which recorded changes in composite buoyancy occurring due to volumetric changes during polymerization. This instrument allowed real time volumetric shrinkage measurements to be made at 40 ms intervals. RESULTS: All five resin composites demonstrated a similar volumetric shrinkage profile during polymerization. The rate of shrinkage of all five composites decreased from t=0 at a rate approximating x=t. After 170 s the rate of shrinkage of all five composites was at or below 0.01%/s. During the initial 5s of light exposure Silorane and Kalore exhibited a significantly lower (p<0.05) rate of contraction relative to the three conventional methacrylate composites. After 640 s of analysis, Silorane exhibited a significantly lower (p<0.05) percentage volumetric contraction compared to the other four analysed materials. CONCLUSIONS: The newly developed "low shrinkage" composites (Silorane, Kalore) in the present study demonstrated significantly lower (p<0.05) shrinkage rates and shrinkage volumes compared to the three conventional methacrylate composites. Investigation to identify whether polymerization shrinkage profile analysis is a good predictor of relative polymerization contraction stress levels generated by different composites, is warranted. CLINICAL SIGNIFICANCE: Clinicians making a resin composite selection with the view to minimizing the clinical effects of polymerization shrinkage must consider the rate of polymerization as well as the total volumetric shrinkage of a composite. Silorane (non methacrylate composite) and Kalore (high molecular mass methacrylate composite) have the ability to exhibit lower shrinkage rates and lower shrinkage volumes compared to conventional methacrylate composites.

Occlusal geometrical considerations in all-ceramic pre-molar crown failure testing.

OBJECTIVES: To evaluate the influence of occlusal geometry of all-ceramic pre-molars, namely cusp angle and associated notch radius, on the scatter of load to failure tests. METHODS: Forty-five all-ceramic upper pre-molar crowns with three zirconia core thicknesses (0.4, 0.6 and 0.8 mm) were broken on dental implant abutments oriented in three angulations (0°, 15°, and 30°). The crowns were loaded using a 4 mm diameter steel cylindrical bar placed along the midline fissure at a crosshead speed of 1 mm min(-1). The scatter of the failure load was evaluated using Weibull analysis. The cusp angle of each crown was critically evaluated to determine the cusp angle and effective radius of the fissure notch root. The relationship between failure load and cusp angle was compared with that between failure load and effective radius as well as notch induced stress concentration by considering R(2) values of fitted trend lines with these relationships. RESULTS: The fracture load differences either between abutment angulations or zirconia thicknesses were not clearly revealed in this study. Except for the group of 30° abutment angulation, the crowns present high scatter of failure loads with low Weibull modulus. However, a simple dependence between fracture load and effective cusp angle was observed. SIGNIFICANCE: Occlusal geometry is an important issue that affects the degree of stress concentration and should be understood by both technician and clinician for appropriate design and material selection of all-ceramic crowns.