Effect of low-temperature degradation and sintering protocols on the color of monolithic zirconia crowns with different yttria contents.

This study investigated the effects of low-temperature degradation (LTD) on the L*, a*, and b* values of highly translucent zirconia crowns. Four types of zirconia disks with different yttria contents (IPS e.max ZirCAD LT, IPS e.max ZirCAD MT, IPS e.max ZirCAD MT Multi, IPS e.max ZirCAD Prime, Ivoclar) and two shades (A2 and BL) were used. A crown was manufactured using four types of zirconia and LTD treated. Color measurements were performed, and the color difference (ΔE00) before and after LTD was calculated. The microstructure was determined through X-ray fluorescence and X-ray diffractometry. Highly translucent zirconia crowns showed greater changes in the a* and b* values than in the L* value after LTD, regardless of the shade. The Multi2 crowns exhibited a discernible color change due to the LTD treatment. The X-ray fluorescence results did not reveal any apparent change in the microstructure between sintering programs for all zirconia specimens.

Reliability of mixed dentition space analysis using a digital model obtained from an optical impression: a preliminary study.

OBJECTIVE: While mixed dentition space analysis is a common practice in pediatric dentistry, digital models created using an intraoral scanner are not as widely used in clinical settings. This preliminary study used a very small sample size with one reference model and aimed to (1) compare the accuracy of mixed dentition space analysis using a digital model obtained from an optical impression with that of conventional plaster model-based analysis and (2) assess inter-examiner differences. RESULTS: The space required for the mandibular permanent canine and premolars and arch length discrepancy were calculated using each model. The largest significant difference between plaster- and digital model-based analyses was identified when the right arch length discrepancy was considered (-0.49 mm; 95% confidence interval: -0.95-0.03); however, the value was considered clinically insignificant. Significant inter-examiner differences were observed for six items of the plaster model; however, no such differences were observed when using the digital model. In conclusion, digital model space analysis may have the same level of accuracy as conventional plaster model analysis and likely results in smaller inter-examiner differences than plaster model analysis.

The effect of low-temperature degradation and building directions on the mechanical properties of additive-manufactured zirconia.

This study aimed to investigate the effect of low-temperature degradation (LTD) on the mechanical properties of additive-manufactured zirconia. In addition, the mechanical properties of additive-manufactured were compared with those before aging under similar experimental conditions. This study prepared stereolithography apparatus fabricated zirconia specimens with flexural strength, modulus of elasticity, Vickers hardness, and fracture toughness. The specimen position data were set as parallel (0°), diagonal (45°), and perpendicular (90°) to the direction of the building. The LTD condition was 5 h under 134ºC and 0.2 MPa in an autoclave. It was found that the 0° direction differed significantly from all other conditions before and after aging, and the highest flexural strength was obtained when the additive specimen was manufactured perpendicular to the building direction. However, the results indicate that there is a negligible effect of aging on the mechanical properties of additive-manufactured zirconia.

Effect of 3D printing system and post-curing atmosphere on micro- and nano-wear of additive-manufactured occlusal splint materials.

Although additive manufacturing has been widely applied for occlusal splint (OS) fabrication, it is still unclear whether 3D printing system and post-curing atmosphere would play a role in the wear resistance of additive-manufactured OS. Therefore, the aim of this study was to evaluate the effect of 3D printing system (liquid crystal display (LCD) and digital light processing (DLP)) and post-curing atmosphere (air and nitrogen gas (N2)) on the wear resistance of hard and soft OS materials for additive-manufactured OSs (KeySplint® Hard and Soft). The evaluated properties were microwear (by two-body wear test) and nano-wear resistances (by nanoindentation wear test) as well as flexural strength and flexural modulus (by three-point bending test), surface microhardness (by Vickers hardness test), and nanoscale elastic modulus (reduced elastic modulus) and nano surface hardness (by nanoindentation test). For the hard material, the surface microhardness, microwear resistance, reduced elastic modulus, nano surface hardness, and nano-wear resistance were significantly affected by the printing system (p < 0.05), while all the evaluated properties except flexural modulus were significantly affected by the post-curing atmosphere (p < 0.05). Meanwhile, both the printing system and post-curing atmosphere significantly affected all the evaluated properties (p < 0.05). The specimens additive-manufactured by DLP printer tended to show higher wear resistance in the hard material groups and lower wear resistance in the soft material groups when compared to those by LCD printer. The post-curing at N2 atmosphere significantly enhanced the microwear resistance of hard material groups additive-manufactured by the DLP printer (p < 0.05) and soft material groups additive-manufactured by the LCD printer (p < 0.01), while it significantly enhanced the nano-wear resistance of both hard and soft material groups regardless of the printing system (p < 0.01). It can be concluded that 3D printing system and post-curing atmosphere affect the micro- and nano-wear resistance of tested additively manufactured OS materials. In addition, it can be also concluded that the optical printing system providing higher wear resistance depends on the material type, and using nitrogen gas as a protection gas during post-curing enhances the wear resistance of tested materials.

The Effects of Different Molding Orientations, Highly Accelerated Aging, and Water Absorption on the Flexural Strength of Polyether Ether Ketone (PEEK) Fabricated by Fused Deposition Modeling.

Rising prices are currently a problem in the world. In particular, the abnormal increases in the price of metals, which are often used in dental prosthetics, have increased the burden of dental costs on the public. There is therefore an urgent need to develop prosthetic devices made from materials that are not affected by the global situation and that have excellent biocompatibility and mechanical properties comparable to those of metals. Polyether ether ketone (PEEK) is a promising alternative to metal in dentistry. This study compared the effects of different molding orientations, highly accelerated aging, and water absorption on the flexural strength of PEEK fabricated by fused deposition modeling (FDM) and examined its potential for dental applications. The flexural strength of PEEK stacked at 0° to the molding stage (0° PF), with and without highly accelerated aging, was significantly greater than for the other molding orientations. As with PD, the maximum test load for 0° PF was measured without fracture. PEEK stacked at 45° (45° PF) and 90° (90° PF) to the molding stage easily fractured, as the applied load pulled the stacked layers. No statistically significant difference was found between the flexural strength of 45° PF and 90° PF. The flexural strength decreased under all conditions due to defects in the crystal structure of PEEK caused by highly accelerated aging.

Effect of resin composite shade on digital fiber-optic transillumination imaging in vitro.

Digital imaging fiber-optic transillumination (DIFOTI) devices have been used to detect caries, a technique without using X-rays. However, the effects of resin composites (RCs) shades on the images acquired with DIFOTI devices have not been investigated. Thus, this study aimed to elucidate the influence of RC shade on the images obtained with DIFOTI technique. Three shades (A1, A3, and Opaque) for each of four flowable RCs were filled on a cavity prepared in a left mandibular first premolar obtained from a donated body. Then, transmission images with a DIFOTI device (DIAGNOcam; KaVo, Biberach, Germany) were acquired, and the average lightness values of the images in the RC and enamel were used to calculate differences between those areas. To clarify the influence of the optical translucency and color on DIFOTI images, the color parameters (L*, a* and b*) of each RC were obtained with black and white backgrounds. The color differences between the backgrounds were calculated as transparency parameter (TP) values. The number of repetitions was set to 10. Differences in the lightness value of the shades varied in each RC. The difference in lightness was significantly associated with the TP value and color parameters of L* (p < 0.01), with negative (R = - 0.81) and positive (R = 0.84) correlations, respectively. In conclusion, DIFOTI images of RCs with high optical translucency resembled those of the natural tooth structure.

Mechanical and surface properties of additive manufactured zirconia under the different building directions.

PURPOSE: This study investigates the mechanical and surface properties of zirconia manufactured using additive manufacturing (AM) technology and the effect of the building direction on the mechanical and surface properties. METHODS: Specimens were prepared using ZrO2 paste (3DMix ZrO2; 3DCeram) and a three-dimensional printing system (CeraMaker 900; 3DCeram) based on the principles of stereolithography (SLA). The mechanical properties (flexural strength, Vickers hardness, fracture toughness, elastic modulus, and Poisson's ratio) and surface properties (chemical composition and surface observation) were evaluated for three building directions (parallel, diagonal, and perpendicular) to investigate the relationship between the building directions and the anisotropy of the mechanical and surface properties of SLA-manufactured zirconia. Statistical analysis was performed using a one-way analysis of variance and Tukey's honestly significant difference test. RESULTS: The highest flexural strength was obtained for a perpendicular building direction. The flexural strength was significantly higher in the perpendicular direction than in the parallel and diagonal directions; it was also significantly higher in the diagonal direction than in the parallel direction (P<0.05). The Vickers hardness, fracture toughness, elastic modulus, Poisson's ratio, and chemical composition did not differ significantly. Microstructural observations revealed that the layers, large crystals, and pores were more prominent in the parallel direction. CONCLUSIONS: The flexural strength and surface structure of the tested SLA-manufactured zirconia were influenced by the building direction; however, other mechanical properties remained unaffected. The layer boundaries affected the anisotropic behavior of the builds to a certain extent, owing to the layer-by-layer production method.

Influence of toothbrush abrasion on the surface characteristics of CAD/CAM composite resin blocks with shade gradations.

Crown restorations in anterior region are recommended highly color-reproductivity because of aesthetic reason. Composite resin block with several shade gradations is especially produced for anterior restorations. To clarify the durability of an aesthetic, the effect of toothbrush abrasion on surface properties was performed. Composite-resin blocks without shade gradation and a ceramic block were used as controls. All specimens were prepared using #2000 SiC paper and polished using an aluminum oxide polishing paste. Toothbrush abrasion tests were carried out for 20,000 cycles at a frequency of 2 Hz with 2.0 N load. Gloss and surface roughness were measured before and after toothbrush abrasion. The number of repetitions was set to five. It was clarified that tooth brushing caused to decrease in the gloss and to increase in the surface roughness with significant negative correlations between these results not only in composite-resin blocks without shade gradation but also in those with gradation.

Effect of speed sintering of monolithic zirconia with different yttria contents on color and crystal phase.

This study evaluated the color and microstructure of monolithic zirconia crowns with different yttrium oxide (Y2 O3 ) contents treated by conventional or speed sintering. Four types of zirconia ceramics were assessed: two monolayer zirconia, and two multilayer zirconia. The monolithic zirconia crowns were fabricated using a dental computer-aided design/computer-aided manufacturing (CAD/CAM) system and in two shades (A2 and BL). After milling, the zirconia crowns were sintered using either speed sintering or conventional sintering. For each combination of zirconia (4), shade (2), and sintering condition (2), the color parameters were determined at three positions of each of nine crowns using a non-contact dental spectrophotometer. In addition, the zirconia phases in the specimens were quantified using X-ray diffractometry. Significant differences in the ΔE00 values at different measurement positions were observed for the Multi2 crown of the BL shade group. The color difference resulting from conventional and speed sintering programs was not affected by the difference in yttria content of Mono1, Mono2, and Multi1. However, in Multi2, containing 3Y-TZP and 5Y-PSZ, a color change was caused by the use of speed sintering. Therefore, when performing speed sintering with Multi2, it is necessary to select the color in consideration of these results or take measures for staining.

Application of fused deposition modeling technology for fabrication jigs of three-point bending test for dental composite resins.

This study aimed to clarify the application possibility of the fused deposition modeling (FDM) technology on the fabrication of jigs for a flexural test of dental composite resins (CRs). Three types of jigs were prepared to carry out three-point bending tests; 3D printed jig including support rollers, 3D printed jig with stainless-steel support rollers, and stainless-steel jig and stainless-steel support rollers. An FDM 3D printer with polylactic acid filament was used to produce 3D printed jigs. For evaluation of flexural strength, two types, packable and flowable, of composite resins were selected to prepare specimens. Three-point bending tests were performed using a universal testing machine. Then flexural strength and flexural elastic modulus were calculated. Specimen preparation and three-point bending test were conducted according to the ISO 4049:2019. All experiments were repeated 20 times. Flexural strength and flexural elastic modulus of packable CR were significantly larger than those of flowable. However, there were no significant differences among the jigs in both results. Consequently, FDM technology could be applied to fabricate jigs for the flexural test of CRs, and the mechanical properties could be evaluated as accurately as a stainless-steel jig.

The Effect of Implant Length and Diameter on Stress Distribution around Single Implant Placement in 3D Posterior Mandibular FE Model Directly Constructed Form In Vivo CT.

A three-dimensional (3D) finite element (FE) model of the mandibular bone was created from 3D X-ray CT scan images of a live human subject. Simulating the clinical situation of implant therapy at the mandibular first molar, virtual extraction of the tooth was performed at the 3D FE mandibular model, and 12 different implant diameters and lengths were virtually inserted in order to carry out a mechanical analysis. (1) High stress concentration was found at the surfaces of the buccal and lingual peri-implant bone adjacent to the sides of the neck in all the implants. (2) The greatest stress value was approximately 6.0 MPa with implant diameter of 3.8 mm, approx. 4.5 MPa with implant diameter of 4.3 mm, and approx. 3.2 MPa with implant diameter of 6.0 mm. (3) The stress on the peri-implant bone was found to decrease with increasing length and mainly in diameter of the implant.

Effects of Removal Conditions on Mercury Amount Remaining in the Oral Cavity and inside Drainage System after Removing Dental Amalgams.

Mercury is produced and drained into the environment by removing dental amalgams, which may cause mercury pollution. This study aimed to clarify the mercury amount remaining in the oral cavity and inside the drain system after removal. The effects of the removal conditions and differences in drainage systems were also investigated. Dental amalgams filled in the tooth and placed in a phantom head were removed using an air turbine under several conditions (two removal methods, absence of cooling water, and intraoral suction). Then, the oral cavity was rinsed with 100 mL of water (oral rinse water), and 500 mL of water was suctioned to wash the inside of the drainage system (system rinse water). Both water samples were collected in two ways (amalgam separator and gas-liquid separator), and their mercury amounts were measured. It was found that the amount of mercury left in the oral cavity and drainage system after dental amalgams removal could be reduced when the amalgams were removed by being cut into fragments as well as using cooling water and intraoral suction. In addition, using amalgam separators can significantly reduce the amount of mercury in the discharge water and prevent the draining of mercury into the environment.

Polymerization Shrinkage of Short Fiber Reinforced Dental Composite Using a Confocal Laser Analysis.

The purpose of this study was to investigate the polymerization shrinkage of short fiber reinforced composite (SFRC) using a multicolor confocal displacement laser that can measure the polymerization shrinkage with high accuracy. The three types of SFRCs used in this study were XD (Ever X Flow Dentin), XB (Ever X Flow Bulk), and XP (EverX Posterior). In addition, CF (Clearfil majesty ES Flow) with hybrid type filler was used as a control. The measured values of the final polymerization shrinkage rate and amount of polymerization shrinkage rate when the polymerization shrinkage rate became constant (less than 0.1 µm/s) were approximated for all SFRCs. XP had a large aspect ratio of glass fiber filler and showed a significant difference from XD with a small aspect ratio (p < 0.05). There was no significant difference in the measured value of time when the polymerization contraction reached a constant speed (0.1 µm/s or less) for all SFRCs (p > 0.05). There was no significant difference in the measured values of polymerization shrinkage rate after the polymerization shrinkage reached a constant rate for all SFRCs (p > 0.05). These results show that glass fiber with large aspect ratio can alleviate polymerization shrinkage stress. The polymerization behavior of SFRC was found to be dependent on the amount of glass fiber filler, aspect ratio, and orientation.

Effect of Interpenetrating Polymer Network (IPN) Thermoplastic Resin on Flexural Strength of Fibre-Reinforced Composite and the Penetration of Bonding Resin into Semi-IPN FRC Post.

The purpose of this study was to evaluate the effects of interpenetrating polymer network (IPN) thermoplastic resin on the flexural strength of fibre-reinforced composite (FRC) with different IPN polymer compositions. The penetration of bonding resin into semi-IPN FRC posts was also evaluated. The IPN thermoplastic resin used was UDMA-MMA monomer with either PMMA (0.5%, 2%, 5%) or PMMA-copolymer (0.5%, 2%). A no added IPN polymer resin was also made. Mixed resin was impregnated to S- and E-glass fibre rovings. These resins and resin impregnated fibres were used for flexural strength (FS) test. To evaluate the penetration of bonding resin into semi-IPN post, SEM observation was done with various impregnation time and polymerization mehods (hand-light- and oven-cure). The result of FS was recorded from 111.7 MPa (no-IPN polymer/no-fibre-reinforcement) to 543.0 MPa (5% PMMA/S-glass FRC). ANOVA showed that there were significant differences between fibre-reinforcement and no-fibre-reinforcement (p < 0.01) both in S- and E-glass fibre groups, and between 0.5% PMMA and 5% PMMA in the S-glass FRC group. SEM micrographs showed that the penetration layers of bonding resin into hand-light cured semi-IPN posts were different according to impregnation time. Fibre reinforcement is effective to improve flexural strength. The depth of penetration layer of bonding resin into semi-IPN matrix resin was improved when a hand-light cure was used.

Long-term color stability of light-polymerized resin luting agents in different beverages.

Purpose The purpose of this study was to evaluate the long-term color stability of light-polymerized resin luting agents stored in different beverages.Methods Eleven shades of two light-polymerized resin luting agents, Choice2 (A1, A2, B1, TRANSLUCENT, MILKY OPAQUE, and MILKY BRIGHT) and BeautiCem Veneer (H-Value, M-Value, L-Value, Ivory-D, Ivory-L) were selected in this study. Disk-shaped specimens were fabricated with 1.3 mm thickness and 15.0 mm diameter. A total of 198 specimens, 18 for each shade, were prepared and randomly divided into six storage conditions (purified water, coffee, cola, tea, red wine, and air). All shades of specimens were three times measured at three random locations (n = 9) at 24 h storage in air after specimen preparation and then measured after immersion at 1, 3, 6, 9, and 12 mos. using a colorimeter. Then, the color difference (ΔE) between the specimens at 24 h after preparation and after storage in each liquid for 12 mos. was calculated. Statistical analysis was performed using Steele-Dwass multiple comparison test of the ΔE values or one-way ANOVA and Tukey's honest significant difference test.Results For all immersion conditions, ΔE was significantly higher than air (control). The ΔE of the shades in the various storage conditions showed no significant difference between Purified Water-Cola and Coffee-Tea. Comparisons of the color components L*, a*, and b* for each shade showed different behaviors among the shades.Conclusions The results suggest that the color stability of light-polymerized resin luting agents may differ between different shades and beverages.

Development of a Weight-Drop Impact Testing Method for Dental Applications.

For evaluating the impact strength of dental materials, the Izod test or Charpy test has been used, but specimen preparation for these tests is difficult due to the adjustment of a notch on them. By contrast, a weight-drop impact test does not require notched specimens. Therefore, it might be possible to measure the impact strength more accurately than conventional methods. This study aimed to establish appropriate conditions for applying the weight-drop impact test on small specimens of acrylic resin. To determine the most reliable impact fracture energy of acrylic resins, different diameters and thicknesses of PMMA resin specimens, diameters and weights of the striker, and diameters of the supporting jig were compared. For all specimen thicknesses, when the striker diameter was 6-10 mm, the impact fracture energy was constant when the inner diameter of the specimen-supporting jig was 8-10 mm. In addition, the measured E50% value was mostly equal to the median value of the impact fracture energy. Thus, for the weight-drop impact test, this method was effective for material testing of small specimens, by clearly specifying the test conditions, such as the thickness of disc-shaped specimens, the diameter of the striker, and the inner diameter of the specimen-supporting jig.

Reliability of Different Bending Test Methods for Dental Press Ceramics.

OBJECTIVE: This study investigates the reliability of different flexural tests such as three-point-bending, four-point bending, and biaxial tests, in strengthening the dental pressed ceramics (DPCs) frequently used in clinical applications. METHODS: The correlations between the three types of bending tests for DPCs were investigated. Plate-shaped specimens for the three-point and four-point bending tests and a disc-shaped specimen for the biaxial bending test were prepared. Each bending test was conducted using a universal testing machine. RESULTS: The results for six DPCs showed that the flexural strength in descending order were the three-point flexural strength, biaxial flexural strength, and four-point flexural strength, respectively. Then, a regression analysis showed a strong correlation between each of the three test methods, with the combination of four-point and biaxial flexural strength showing the highest values. The biaxial flexural strength was not significantly different in the Weibull coefficient (m) compared to the other tests, with the narrowest range considering the 95% interval. The biaxial bending test was found to be suitable for materials with small plastic deformation from the yield point to the breaking point, such as DPCs.

Mechanical Properties of Selective Laser Sintering Pure Titanium and Ti-6Al-4V, and Its Anisotropy.

Selective laser sintering (SLS) is being developed for dental applications. This study aimed to investigate the properties of Ti-6Al-4V and pure titanium specimens fabricated using the SLS process and compare them with casting specimens. Besides, the effect of the building direction on the properties of the SLS specimens was also investigated. Specimens were prepared by SLS using Ti-6Al-4V powder or pure titanium powder. Casting specimens were also prepared using Ti-6Al-4V alloys and pure titanium. The mechanical properties (tensile strength and elongation), physical properties (surface roughness, contact angle, and Vickers hardness); corrosion resistors (color difference and corrosion), and surface properties (chemical composition and surface observation) were examined. Both Ti-6Al-4V and pure titanium specimens produced using the SLS process had comparable or superior properties compared with casting specimens. In comparing the building directions, specimens fabricated horizontally to the printing platform showed the greatest tensile strength, and the surface roughness scanned in the horizontal direction to the platform showed the smallest. However, there was no significant effect on other properties. Thus, the SLS process with Ti-6Al-4V powder and pure titanium powder has great performance for the fabrication of dental prosthesis, and there is a possibility for it to take the place of conventional methods.

Dimensional Accuracy of Dental Casting Patterns Fabricated Using Consumer 3D Printers.

Consumer 3D printers have improved considerably due to the evolution of additive manufacturing. This study aimed to examine the accuracy of consumer printers in dental restoration. Cylindrical patterns mimicking a full crown were created and enlarged from 100% to 105% of the original size. Two types of consumer 3D printers, including a fused deposition modeling (FDM) device and a stereolithography (SLA) device, and two types of dental 3D printers, including a multi-jet device and an SLA device, were used to fabricate the patterns. Then, the outer and inner diameters and depths, and surface roughness of the patterns were measured. The changing rates of the outer diameter of models created using dental printers were significantly smaller than those of the models created using consumer printers (p < 0.05). Significantly greater surface roughness was obtained in the tooth axis of the model fabricated using the consumer FDM device (p < 0.05). However, no significant differences were observed on the surface roughness of both axes between the consumer SLA device and the dental devices (p > 0.05). However, FDM showed larger surface roughness than dental devices in both axes (p < 0.05). Thus, the SLA consumer printer can be applied to fabricate resin patterns with enlargement editing of 1-3% along the horizontal axis.