Effect of the Combination of Restorative Material and the Etching Protocol in Enamel Microleakage in Class II Cavities after Thermocycling.

This study is aimed at evaluating the marginal microleakage of bulk-fill class II restorations after thermocycling. Thirty-two human third molars received class II cavities prepared on mesial and distal faces. The cavities were bonded according to the adhesive protocol (total or self-etching). The cavities were then restored with composite and divided into 8 groups based on the composite combination: layering technique with Filtek Z350XT (G1 and G5), first layer with Filtek Z350 XT Flowable Restorative and then Filtek Z350XT (G2 and G6), bulk-fill technique with Filtek One Bulk Fill (G3 and G7), and first layer with Filtek One Bulk Fill Flow and Filtek Z350 XT (G4 and G8). The restorations were then subjected to thermocycling (2000 cycles, 5°C and 55°C, dwell time of 30 s). After aging, the restored teeth were immersed in methylene blue for 48 hours. The restorations (n = 32) were sectioned in the middle (two sections). The microleakage results were analyzed by two-way ANOVA followed by Tukey's post hoc test (α = 0.05). The groups did not differ statistically from each other in terms of marginal microleakage (p = 0.295). It can be concluded that there is no difference in the percentage of microleakage between conventional and bulk-fill resins on both consistencies, as well as there is also no statistically significant difference when the adhesive system is used in a conventional or self-etching mode.

Effect of different fabrication methods of occlusal devices on periradicular stress distribution: A photoelastic analysis.

STATEMENT OF PROBLEM: Investigations on the effectiveness of new methods for optimizing the fabrication of oral devices are lacking. PURPOSE: The purpose of this in vitro study was to evaluate stress distribution with photoelastic analysis in the periradicular area of teeth supporting occlusal devices fabricated by 5 different processes. MATERIAL AND METHODS: The occlusal devices were fabricated by vacuum thermoforming, heat-polymerized acrylic resin, chemical polymerized acrylic resin, 3-dimensional printing, and milling (computer-aided manufacturing). The devices were evaluated regarding initial fit, number of adjustments for passive fit, and stress distribution under 100-N and 400-N loads in the periradicular locations of posterior teeth. RESULTS: The 3-dimensional printing device did not require any adjustment for initial adaptation to the photoelastic model and presented a little friction with the model. The heat-polymerized acrylic resin device did not seat initially, requiring more sites of adjustment until passive adaptation. At 100-N and 400-N loads, the use of the computer-aided manufacturing occlusal device resulted in the lowest stresses in periradicular areas (0.744 and 1.583, respectively), and the 3-dimensional printing occlusal device produced the highest stresses with a 400-N load application (2.427). The lowest mean of fringe pattern was observed for the computer-aided manufacturing device, and the highest mean of fringe pattern was observed for the vacuum thermoforming device. CONCLUSIONS: The computer-aided design and computer-aided manufacturing milled occlusal device presented the best initial adaptation and transferred lower stresses to the periradicular areas than the other evaluated devices.

Linear dimensional change of edentulous models made of high-density laboratory silicones at different storage times / Alteração dimensional linear de modelos edêntulos fabricados com silicones laboratoriais de alta densidade em diferentes tempos de armazenagem

ABSTRACT Objective: To evaluate the dimensional change of edentulous models made of high density laboratory silicones at different storagetimes. Methods: A metallic master model simulating an edentulous maxilla was used. The model had projections of 1.8 cm located in the regions of canines (A and B) and molars (C and D) allowing the linear measurement of distances AB, BC, CD, DA, AC and BD. A laboratory silicone mold was made for duplication of master model in the following materials (n = 10): G1: Zetalabor 85, G2: Titanium 95, G3: Platinum 95 and G4: Gypsum type III (control). The samples were photographed and measured using a software (Image J) at times T1 (baseline) and T2 (after one week of models fabrication). The data were statistically analyzed using Kruskal- Wallis and Dun non-parametric tests (α = 0.05). Results: The storage time influenced the behavior of the materials evaluated. All groups presented dimensional changes in both times and the group Tit95 presented the best results. Only Zet85 group showed a different behavior related to the region of the model. Conclusions: The high density laboratory silicones showed satisfactory results when compared to the gypsum group. Tit95 was the most stable material and it can be recommended as an edentulous model for total protheses.

RESUMO Objetivo: Avaliar a alteração dimensional de modelos edêntulos fabricados em silicone laboratorial de alta densidade em diferentes tempos de armazenagem. Métodos: Um modelo mestre metálico simulando uma maxila edêntula foi utilizado. O modelo possuía projeções oclusais de 1,8 cm localizadas nas regiões de caninos (A e B) e molares (C e D), permitindo a mensuração das distâncias lineares AB, BC, CD, DA, AC e BD. Um molde foi fabricado em silicone laboratorial para duplicação do modelo mestre com os seguintes materiais (n = 10): G1: Zetalabor 85, G2: Titanium 95, G3: Platinum 95 e G4: Gesso tipo III (controle). As amostras foram fotografadas e mensuradas com auxílio de um software (Image J) nos tempos T1 (baseline) e T2 (após uma semana de confecção). Os dados obtidos foram avaliados estatisticamente utilizando os testes não paramétricos de Kruskal- Wallis e Dunn (α = 0.05). Resultados: O tempo de armazenagem influenciou o comportamento dos materiais avaliados. Todos os grupos apresentaram alterações dimensionais em ambos os temos de avaliação e o G2 apresentou os melhores resultados. Apenas o grupo G1 mostrou alteração dimensional dependente da região mensurada. Conclusão: Silicones laboratoriais de alta densidade mostraram resultados satisfatórias de alteração dimensional quando comparados ao gesso tipo III. O material Titanium 95foi o mais estável e pode ser recomendado como alternativa para a confecção de modelos edêntulos.

Effect of Different Ceramic Materials on Fatigue Resistance and Stress Distribution in Upper Canines with Palatal Veneers.

OBJECTIVE: The aim of this study was to evaluate, by means of a fatigue life test, different ceramic materials used in palatal veneers to restore the canine guidance. MATERIALS AND METHODS: Forty-five standardized anatomical preparations were made in extracted healthy human canines with 1.2 uniform thickness. Samples were scanned, restorations were designed and milled in polymer-infiltrated ceramic network (PICN, Vita Enamic), zirconia-reinforced lithium silicate (ZLS, Vita Suprinity), and high translucent yttrium oxide-stabilized tetragonal zirconia (YZHT, Vita YZHT). Dental preparations were etched, restorations were processed according to the manufacturers' recommendations, and adhesively cemented. Then, three samples of each group were tested with load-to-fracture to determine the fatigue parameters. In addition, the palatal veneers stresses were evaluated using numerical models through finite element analysis. RESULTS: The mean of the monotonic test for PICN, ZLS, and YZHT was 674.18 N, 560.5 N, and 918.98 N, respectively. The StepWise test was performed until specimen fracture or until suspension of the test after 1.2 × 106 cycles. Regarding survival, using the Kaplan-Meier method, PICN presented results for the mean and median of 245.21 N and 225 N, respectively; ZLS had an average of 175.76 N and a median of 168 N, and YZHT with an average of 383.30 N and a median of 366 N. Regarding the Weibull method, PICN showed results of 5.43 ß and 264 η for form and scale, respectively; ZLS had 36.14 ß for form and 380.67 η for scale; and YZHT presented 4.95 ß for form and 417.38 η for scale. The highest stress value was calculated for YZHT, ZLS, and PICN, respectively. CONCLUSIONS: It was possible to conclude that all tested materials have the possibility of being used for rehabilitation of upper canines' palatal surface.

Mechanical Response of PEKK and PEEK As Frameworks for Implant-Supported Full-Arch Fixed Dental Prosthesis: 3D Finite Element Analysis.

OBJECTIVE: Polymeric framework represent an innovative approach for implant-supported dental prostheses. However, the mechanical response of ultra-high performance polymers as frameworks for full-arch prostheses under the "all-on-four concept" remains unclear. The present study applied finite element analysis to examine the behavior of polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) prosthetic frameworks. MATERIALS AND METHODS: A three-dimensional maxillary model received four axially positioned morse-taper implants, over which a polymeric bar was simulated. The full-arch prosthesis was created from a previously reported database model, and the imported geometries were divided into a mesh composed of nodes and tetrahedral elements in the analysis software. The materials were assumed as isotropic, elastic, and homogeneous, and all contacts were considered bonded. A normal load (500 N magnitude) was applied at the occlusal surface of the first left molar after the model was fixed at the base of the cortical bone. The microstrain and von-Mises stress were selected as criteria for analysis. RESULTS: Similarities in the mechanical response were observed in both framework for the peri-implant tissue, as well as for stress generated in the implants (263-264 MPa) and abutments (274-273 MPa). The prosthetic screw and prosthetic base concentrated more stress with PEEK (211 and 58 MPa, respectively) than with PEKK (192 and 49 MPa), while the prosthetic framework showed the opposite behavior (59 MPa for PEEK and 67 MPa for PEKK). CONCLUSION: The main differences related to the mechanical behavior of PEKK and PEEK frameworks for full-arch prostheses under the "all-on-four concept" were reflected in the prosthetic screw and the acrylic base. The superior shock absorbance of PEKK resulted in a lower stress concentration on the prosthetic screw and prosthetic base. This would clinically represent a lower fracture risk on the acrylic base and screw loosening. Conversely, lower stress concentration was observed on PEEK frameworks.

Adhesive systems applied to dentin substrate under electric current: systematic review.

OBJECTIVES: The purpose of this systematic review was to collect and discuss the technique of adhesive systems application on dentin substrate under electric current. MATERIALS AND METHODS: The first search strategy was based on data available at PubMed, LILACS, Scielo, Scopus, and Cochrane Library, using a combination of descriptors such as "dentin bond agents OR adhesive system AND electric current OR electrobond" or "dentin bonding agents OR dentin bonding agent application OR adhesive system AND electric current OR electrobond", with no limit regarding the publication year. The second search strategy was based on the articles' references found previously. An additional search strategy was applied that concerned the proposed theme in the SBU-UNICAMP (Unicamp's Library System Institutional Repository). RESULTS: Twelve studies published between 2006 and 2020 were found. The analyses of the selected studies showed that the use of electric current during adhesive systems application on dentin, whether conventional or self-conditioning, increases resinous monomer infiltration in the dentin substrate, which improves the hybridization processes and the bond strength of the restorative material to dentin. CONCLUSIONS: Despite the favorable results related to the use of this technique, there is still no specific protocol for the application of adhesive systems under electric current.

Effect of active application of self-etching ceramic primer on the long-term bond strength of different dental CAD/CAM materials.

BACKGROUND: The objective of this in vitro study was to evaluate the effect of the active application of self-etching ceramic primer (ME&P) on the bond strength of different dental CAD/CAM materials (Lithium Disilicate ceramic (LD), Leucite ceramic (LE), Zirconia reinforced lithium silicate ceramic (ZLS), and Hybrid ceramic (HC)) with thermocycling aging. MATERIAL AND METHODS: The samples were randomly divided into 16 groups (n = 20). Dual resin cement cylinders were made and light cured for 10 s (1.200 mW/cm2) for the shear bond strength test. 3-way ANOVA revealed that the factors were statistically significant (P< 0.05). RESULTS: The aging process had a negative impact on the bond strength for all groups except for Lithium Disilicate, with active application. ZLS and LE showed promising results with high bond strength values for the ME&P active application; however, after aging the bond strength value was significantly reduced. HC showed reduced bond strength values regardless the ME&P application. CONCLUSIONS: In order to obtain a durable bond strength, the recommended protocol of 20 s of active application followed by 40 s of sitting time in the self-etching ceramic primer should be followed when using reinforced-glass ceramics as restorative materials. Key words:Dentistry, dental materials, silane, shear strength, computer-aided design.

Effect of Cement Layer Thickness on the Immediate and Long-Term Bond Strength and Residual Stress between Lithium Disilicate Glass-Ceramic and Human Dentin.

This study tested whether three different cement layer thicknesses (60, 120 and 180 µm) would provide the same bonding capacity between adhesively luted lithium disilicate and human dentin. Ceramic blocks were cut to 20 blocks with a low-speed diamond saw under cooling water and were then cemented to human flat dentin with an adhesive protocol. The assembly was sectioned into 1 mm2 cross-section beams composed of ceramic/cement/dentin. Cement layer thickness was measured, and three groups were formed. Half of the samples were immediately tested to evaluate the short-term bond strength and the other half were submitted to an aging simulation. The microtensile test was performed in a universal testing machine, and the bond strength (MPa) was calculated. The fractured specimens were examined under stereomicroscopy. Applying the finite element method, the residual stress of polymerization shrinkage according to cement layer thickness was also calculated using first principal stress as analysis criteria. Kruskal-Wallis tests showed that the ''cement layer thickness'' factor significantly influenced the bond strength results for the aged samples (p = 0.028); however, no statistically significant difference was found between the immediately tested groups (p = 0.569). The higher the cement layer thickness, the higher the residual stress generated at the adhesive interface due to cement polymerization shrinkage. In conclusion, the cement layer thickness does not affect the immediate bond strength in lithium disilicate restorations; however, thinner cement layers are most stable in the short term, showing constant bond strength and lower residual stress.

Dimensional Accuracy Comparison of Physical Models Generated by Digital Impression/3D-Printing or Analog Impression/Plaster Methods

ABSTRACT: This study aimed to compare the trueness and precision of physical models manufactured chairside (intraoral scanner and 3D printed) or by plaster models obtained using impression with alginate or addition silicone. A full- arch stainless steel die was impressed to obtain ten physical models for each group. The models were measured in a stereomicroscope, considering four linear distances. To assess the precision accuracy, an analysis of the measurement variability was carried out, identified by the coefficients of variation and by the Levene's test to compare the groups. To analyze trueness, the data average was subtracted from the database and compared considering alpha as 5 %. Considering precision, the higher dispersion of data occurred in the models obtained with silicone impression. And for trueness, Kruskal Wallis and Dunn tests results did not indicate differences between the groups in the anteroposterior linear distances (p> 0.05). Only in anterior transverse distance obtained through TRIOS (0.31 mm), it presented lower accuracy compared to the models from silicone impression (0.13 mm); however, at transverse posterior distance, the models from silicone impression showed the lowest accuracy (p 0.05). The physical dental models obtained by digital and analog workflows showed acceptable dimensional accuracy expressed by high precision and trueness. There is no difference between the evaluated intraoral scanner systems and the impression materials for the full-arch impression.

RESUMEN: Este estudio tuvo como objetivo comparar la veracidad y precisión de modelos físicos fabricados en la clínica dental (escáner intraoral e impreso en 3D) o por modelos de yeso obtenidos mediante impresión con alginato o silicona de adición. Una matriz de acero inoxidable de arco completo fue impresa para obtener diez modelos físicos para cada grupo. Los modelos se midieron en un estereomicroscopio, considerando cuatro distancias lineales. Se realizó un análisis de la variabilidad de la medida para evaluar la precisión, identificada por los coeficientes de variación y por la prueba de Levene para comparar los grupos. Para analizar la veracidad, el promedio de los datos se restó de la base de datos y se comparó considerando alfa como 5 %. Considerando la precisión, la mayor dispersión de datos ocurrió en los modelos obtenidos con impresión de silicona. Y para la veracidad, los resultados de las pruebas de Kruskal Wallis y Dunn no indicaron diferencias entre los grupos en las distancias lineales anteroposteriores (p> 0,05). Solo en la distancia transversal anterior obtenida mediante TRIOS (0,31 mm) presentó menor precisión en comparación con los modelos de impresión de silicona (0,13 mm); sin embargo, la distancia transversal posterior, los modelos de impresión de silicona mostraron la menor precisión (p 0,05). Los modelos dentales físicos obtenidos mediante flujos de trabajo digitales y analógicos mostraron una precisión dimensional aceptable expresada por alta precisión y veracidad. No se observó diferencia entre los sistemas de escáner intraoral evaluados y los materiales de impresión para la impresión de arco completa.

Stress Concentration of Endodontically Treated Molars Restored with Transfixed Glass Fiber Post: 3D-Finite Element Analysis.

The loss of dental structure caused by endodontic treatment is responsible for a decrease in tooth resistance, which increases susceptibility to fracture. Therefore, it is important that minimally invasive treatments be performed to preserve the dental structure and increase the resistance to fracture of endodontically treated posterior teeth. To evaluate under axial loads, using the finite element method, the stress distribution in endodontically treated molars restored with both transfixed or vertical glass fiber posts (GFP) and resin composite. An endodontically treated molar 3D-model was analyzed using finite element analyses under four different conditions, class II resin composite (G1, control model), vertical glass fiber post (G2), transfixed glass fiber posts (G3) and vertical and transfixed glass fiber posts (G4). Ideal contacts were considered between restoration/resin composite and resin composite/tooth. An axial load (300 N) was applied to the occlusal surface. The resulting tensile stresses were calculated for the enamel and dentin tissue from five different viewports (occlusal, buccal, palatal, mesial and distal views). According to the stress maps, similar stress trends were observed, regardless of the glass fiber post treatment. In addition, for the G1 model (without GFP), a high-stress magnitude can be noticed in the proximal faces of enamel (7.7 to 14 MPa) and dentin (2.1 to 3.3 MPa) tissue. The use of transfixed glass fiber post is not indicated to reduce the stresses, under axial loads, in both enamel and dentin tissue in endodontically treated molar with a class II cavity.

Lithium Disilicate Ceramic Endocrown Biomechanical Response According to Different Pulp Chamber Extension Angles and Filling Materials.

The purpose of this study is to evaluate the effect of pulp chamber extension angles and filling material mechanical properties on the biomechanical response of a ceramic endocrown. A 3D model of maxillary molar that underwent endodontically treatment was exported to computer aided design software to conduct finite element analysis (FEA). The endocrown model was modified considering different pulp chamber extension angles (right angle; 6°, 12° and 18° of axial divergence). The solids were imported into the computer aided engineering software in Standard for the Exchange of Product Data (STEP) format. Nine different filling materials were simulated to seal the orifice of the root canal system under each endocrown restoration (resin composite, bulk-fill resin composite, alkasite, flowable resin composite, glass ionomer cement, autocured resin-reinforced glass ionomer cement, resin cement, bulk-fill flowable resin composite, zinc oxide cement), totaling 36 models. An axial load (300 N) was applied at the occlusal surface. Results were determined by colorimetric graphs of von-Misses stress (VMS) and Maximum Principal Stress (MPS) on tooth, cement layer, and endocrown restorations. VMS distribution showed a similar pattern between the models, with more stress at the load region for the right-angled endocrowns. The MPS showed that the endocrown intaglio surface and cement layer showed different mechanical responses with different filing materials and pulp chamber angles. The stress peaks plotted in the dispersion plot showed that the filling material stiffness is proportional to the stress magnitude in the endocrown, cement layer and tooth adhesive surface. In addition, the higher the pulp chamber preparation angle, the higher the stress peak in the restoration and tooth, and the lower the stress in the cement layer. Therefore, 6° and 12° pulp chamber angles showed more promising balance between the stresses of the adhesive interface structures. Under the conditions of this study, rigid filling materials were avoided to seal the orifice of root canal system when an endocrown restoration was planned as rehabilitation. In addition, the pulp chamber axial walls were prepared between 6° and 12° of divergence to balance the stress magnitude in the adhesive interface for this treatment modality.

Failure load and shear bond strength of indirect materials bonded to enamel after aging.

This study evaluated the failure load and the shear bond strength of 4 block materials indicated for computer-aided design/computer-aided manufacturing (CAD/CAM) of dental veneers: lithium disilicate, feldspathic ceramic, polymer-infiltrated ceramic, and nanohybrid composite. The tested hypothesis was that the material that combined an elastic modulus similar to that of enamel with the highest bond strength values would present the highest failure load. From prefabricated CAD/CAM blocks, disc-shaped specimens (6.0 × 0.7 mm; n = 10) and cylinders (2.4 × 2.5 mm; n = 10) were fabricated for load-to-failure and shear bond strength tests, respectively. Materials were adhesively bonded to flattened bovine enamel surfaces, stored in distilled water at 37°C for 90 days, and subjected to thermocycling (2000 cycles of 5°C to 55°C). Discs of restorative material were bonded to enamel and subjected to an increasing load that was applied perpendicular to the bonding interface until catastrophic failure occurred. A chisel was used to apply an increasing load parallel to the adhesive interface between the enamel and a cylinder of restorative material to measure shear bond strength. Data were subjected to a Weibull analysis and 1-way analysis of variance followed by a Tukey post hoc test (α = 0.05). The type of restorative material significantly affected the (mean [SD]) failure load when bonded to enamel (P = 0.006): polymer-infiltrated ceramic (1167.9 [310.2] N) = feldspathic ceramic (1115.0 [382.0] N) = nanohybrid composite (1067.3 [251.0] N) > lithium disilicate (786.2 [304.5] N). The type of restorative material also significantly affected the (mean [SD]) bond strength to enamel (P < 0.001): lithium disilicate (32.81 [11.19] MPa) = polymer-infiltrated ceramic (27.04 [7.65] MPa) > feldspathic ceramic (21.11 [9.16] MPa) > nanohybrid composite (9.08 [3.66] MPa). The polymer-infiltrated ceramic presented the best performance when bonded to enamel.

Effect of Restorative Material on Mechanical Response of Provisional Endocrowns: A 3D-FEA Study.

The goal of this study was to evaluate the stress distribution in an endocrown restoration according to different provisional restorative materials. An endodontically treated maxillary molar model was selected for conducting the finite element analysis (FEA), with a determined amount of dental remnant of 1.5 mm. The model was imported to the analysis software (ANSYS 19.2, ANSYS Inc., Houston, TX, USA) in STEP format. All contacts were considered perfectly bonded. The mechanical properties of each structure were considered isotropic, linear, elastic, and homogeneous. Three different provisional restorative materials were simulated (acrylic resin, bis-acrylic resin, and resin composite). An axial load (300 N) was applied at the occlusal surface in the center of the restoration. Results were determined by colorimetric stress maps of maximum principal stress, maximum shear stress, and total deformation. The different materials influenced the stress distribution for all structures; the higher the material's elastic modulus, the lower the stress magnitude on the cement layer. In the present study, all provisional restorative materials showed similar stress patterns in the endocrown and on the cement layer however, with different magnitude. Based on this study limitation, the use of resin composite to manufacture provisional endocrowns is suggested as a promising material to reduce the stresses in the cement layer and in the dental tissue surfaces.

Resin composite adhesion to dentin using different curing lights and adhesive systems applied under electric current.

OBJECTIVES: To evaluate the effect of electric current application on the resin composite-tooth bond strength and hybrid layer of three adhesive systems light-cured by two light-curing units (LCUs). MATERIALS AND METHODS: Human molar teeth were distributed into 12 groups (n=6). Three adhesive systems were used: two-step etch-and-rinse (SB2; Adper Single Bond 2, 3M ESPE); two-step self-etch (CSE; Clearfil SE Bond, Kuraray); and one-step self-etch (SBU; Single Bond Universal, 3M ESPE) applied with (50µA) and without (control; conventional application) electric current, and light-cured with different LCUs. Resin composite blocks (Filtek Z350XT, 3M ESPE) were produced and cut into sticks (~1mm2) for microtensile bond strength (µTBS). Fracture patterns were analyzed on stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive, or mixed. Specimens were prepared for scanning electron microscope observation. The hybrid layer analysis was carried out using a confocal laser scanning microscopy (n=2). Data were submitted to three-way ANOVA followed by Tukey's post hoc test (α=0.05). RESULTS: The electric current increased the µTBS for all adhesive systems light-cured with single-emission peak and multiple-emission peak LCUs. Both LCUs presented similar µTBS values. CSE applied under electric current showed the highest µTBS mean values. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems. CONCLUSIONS: The adhesive systems applied under electric current increased the bond strength using single-emission peak and multiple-emission peak LCUs. CLINICAL RELEVANCE: Electric current at 50µA applied throughout the dentin is a safe mode and results in better impregnation of the adhesive systems.

Biomechanical evaluation of anterior implants associated with titanium and zirconia abutments and monotype zirconia implants.

PURPOSE: The present in silico study evaluated the behavior of titanium dental implants associated with abutments in zirconia and monotype zirconia implant using finite element analysis (FEA). METHODS: A partial image of the anterior region of the maxilla was obtained by computed tomography. Three models of finite element were made using 3D modeling software (SolidWorks): Ti-Ti (control): implant morse cone (3.75 x 11mm; NobelActive) and titanium abutment (Esthetic Abutment); Ti-Zr: cone morse implant in titanium (3.75 x 11mm; NobelActive) and zirconia abutment (Procera Esthetic Abutment #9); Zr: monotype zirconia implant (4.1 x 12mm; Straumann Pure Ceramic). Computerized crowns of element 11 in lithium disilicate (IPS e.max Press, Ivoclar Vivadent) cemented in all groups were created. A load of 100N (45º) was applied simulating the excursion movement of the incisal guide. The von Mises, modified von Mises, maximum (tensile) and minimum (compression) principal stresses were obtained, compared and used for the quantitative and qualitative evaluation of the groups. RESULTS: The Zr presented the lowest values of maximum, minimum, and von Mises tensions than the two pieces systems (Ti-Ti and Ti-Zr). Ti-Zr group had the highest values of tensions evaluated in this study. CONCLUSIONS: The type of material as well as the geometry of implant influenc ed the tension values evaluated.

The effect of repeated surface treatment of zirconia on its bond strength to resin cement.

PURPOSE: The aim of this study is to evaluate the influence of repeated surface treatments on wettability and surface roughness for zirconia surface and bond strength of zirconia-based ceramics to resin cement. MATERIALS AND METHODS: Seventy blocks (10 × 10 × 3 mm) of zirconia-based ceramics were fabricated and divided into two groups according to the surface treatments: (A) 110 µm Al2O3 airborne-particle abrasion and (R) 110 µm silica modified Al2O3 airborne-particle abrasion. At stage 2, each group was subdivided into 5 groups according to the surface retreatments: (a) 110 µm Al2O3 airborne-particle abrasion, (r) 110 µm silica modified Al2O3 airborne-particle abrasion, (D) diamond bur, (Da) diamond bur + 110 µm Al2O3 airborne-particle abrasion, and (Dr) diamond bur + 110 µm silica modified Al2O3 airborne-particle abrasion. Cylinders of self-adhesive resin cement were cemented onto each treated ceramic surface and subjected to micro-shear bond strength test. Additional specimens were prepared for roughness and wettability analyses. The data were subjected to t-test and One-way ANOVA followed by Tukey's post hoc test (α=.05). RESULTS: At stage 1, group R presented higher bond strength values than group A (P=.000). There was a statistically significant increase of bond strength at stage 2 for group A (P=.003). The diamond bur influenced the surface roughness, increasing the values (P=.023). Group R provided better wettability. Regardless of the applied surface treatment, most of failures were adhesive. CONCLUSION: The combination of application and reapplication of Rocatec Plus showed the best results of bond strength. Surface retreatment and recementation might be an indicated clinical strategy.

Effect of Implant Platform Connection and Abutment Material on Removal Torque and Implant Hexagon Plastic Deformation.

OBJECTIVES: The aim of this study was to evaluate the plastic deformation of the hexagonal connection, and the removal torque of the implant-abutment joint of two dental implants combined with internal or external hexagonal connection implants after mechanical cycling. MATERIALS AND METHODS: Twenty-four dental implants were used in the study. Half of the implants had internal hexagonal connections (IH; Titamax II Plus) and the other half had external hexagonal connections (EH; Titamax Ti Ex). Four groups of two types of dental implant abutments (titanium: Ti, UCLA II Plus and zirconia: Zr, fabricated by CAD/CAM; n = 6) were investigated. The abutments received a metallic crown and the settings were submitted to mechanical cycling (MC; 106 cycles, axial load, 120N). The connection surface area was measured by scanning electron microscope (SEM) images. The removal torque was evaluated and the plastic deformation of the hexagonal surface of the implant was measured by comparing the images before and after MC. STATISTICAL ANALYSIS: Paired-t test was used to analyze the data statistically at a significance level of α = 0.05. RESULTS: The torque values decreased for all groups after MC, and the hexagonal surface area decreased due to plastic deformation for IH and EH associated with Zr abutments. CONCLUSIONS: Zirconia abutments showed the worst plastic deformation of the implant connection surface and torque loosening when associated with IH implant.

Stress distribution in the peri-implant area of pure titanium and titanium-zirconium small implants

Aim: In dental implant treatment, there is a demand for mechanically stronger implants. Despite the existence of several studies showing the clinical success of narrow diameter implants, most of them are based on pure titanium (cpTi) alloys. There is a few clinical evidences of the success rate of titanium-zirconium (TiZr) narrow diameter implants. The aim of this study was to evaluate the stress distribution in the peri-implant area of narrow diameter cpTi and TiZr implants under axial and oblique loads. Methods: Photoelastic models were produced using epoxy resin (PL2, Vishay Precision Group) from a master model. The implants (cpTi and TiZr; Straumann AG) had 3.3 mm in diameter and 12 mm in height. Loads of 100 N and 200 N were applied to the abutment at angles of 0° (axial), 10°, 20°, and 30° (oblique). A circular polariscope (Eikonal) was used under dark field white-light configuration. The isochromatic fringes were analyzed in the peri-implant region in 5 areas, using ASTM table with isochromatic fringes; cervical-mesial, cervical-distal, mid-mesial, mid-distal and apical. Results: In general, under axial and oblique loads, the stress in the TiZr implant was lower than in the cpTi implant. The load of 200 N produced the highest stress values in cpTi and TiZr implants. In both implants and loads, the fringes were located more in apical area at all angles evaluated. Conclusion: It can be concluded that for small implants, the load inclination and intensity change the pattern of stress distribution and the cpTi implant exhibited the highest peri-implant stress

Effect of polymerization method and fabrication method on occlusal vertical dimension and occlusal contacts of complete-arch prosthesis.

PURPOSE: This study evaluated the dimensional stability of a complete-arch prosthesis processed by conventional method in water bath or microwave energy and polymerized by two different curing cycles. MATERIALS AND METHODS: Forty maxillary complete-arch prostheses were randomly divided into four groups (n = 10): MW1 - acrylic resin cured by one microwave cycle; MW2 - acrylic resin cured by two microwave cycles: WB1 - conventional acrylic resin polymerized using one curing cycle in a water bath; WB2 - conventional acrylic resin polymerized using two curing cycles in a water bath. For evaluation of dimensional stability, occlusal vertical dimension (OVD) and area of contact points were measured in two different measurement times: before and after the polymerization method. A digital caliper was used for OVD measurement. Occlusal contact registration strips were used between maxillary and mandibular dentures to measure the contact points. The images were measured using the software IpWin32, and the differences before and after the polymerization methods were calculated. The data were statistically analyzed using the one-way ANOVA and Tukey test (α = .05). RESULTS: he results demonstrated significant statistical differences for OVD between different measurement times for all groups. MW1 presented the highest OVD values, while WB2 had the lowest OVD values (P<.05). No statistical differences were found for area of contact points among the groups (P=.7150). CONCLUSION: The conventional acrylic resin polymerized using two curing cycles in a water bath led to less difference in OVD of complete-arch prosthesis.

Influence of plasma-based dry etching on the bond strength of Y-TZP ceramic.

The aim of this study was to evaluate the bond strength between an yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic and a luting agent when submitted to plasma etching surface treatment before and after thermocycling (TC) with 3000 cycles of 5°C-55°C. The null hypothesis was that the surface treatments and thermocycling would not influence the bond strength. A total of 160 Y-TZP ceramic blocks in 2 sizes (10 size 1 and 10 size 2 blocks in each group) were distributed into 8 groups: group C (control), no surface treatment; group C-TC, TC without prior surface treatment; group SAO, sandblasting with aluminum oxide (Al2O3); group SAO-TC, sandblasting with Al2O3 followed by TC; group SAOS, sandblasting with silica-coated Al2O3; group SAOS-TC, sandblasting with silica-coated Al2O3 followed by TC; group PE, plasma etching; and group PE-TC, plasma etching followed by TC. In each group, size 1 blocks were cemented to size 2 blocks to fabricate specimens for microshear bond strength testing (n = 10 per group). Cementation followed surface treatments (except in control groups) and preceded any TC. All specimens were cemented using a luting agent that contained 10-meth-acryloyloxydecyl dihydrogen phosphate (MDP). The specimens were submitted to a microshear bond strength test and the means were analyzed with a 2-factor analysis of variance and Tukey test. Group PE showed the highest bond strength value before thermocycling (17.31 MPa). After thermocycling, the highest value was observed in the SAO-TC group (9.73 MPa), and statistically significant differences were observed between SAOS-TC and SAO-TC (P < 0.05) and PE-TC and SAO-TC (P < 0.05). Plasma etching improved the bond strength values between the Y-TZP ceramic and MDP-containing luting agent before thermocycling. After thermocycling, all groups showed lower bond strength values.