Is It Necessary to Photoactivate the Adhesive System Inside Ceramic Laminate Veneers in a Luting Procedure?

PURPOSE: To investigate the need for photoactivation of the adhesive system inside ceramic laminates before the luting procedure and to evaluate the color stability, nanohardness, and elastic modulus of the adhesive interface activated with singlewave and polywave light-curing units. MATERIALS AND METHODS: A total of 44 lithium disilicate ceramic veneers (7.0 mm × 8.0 mm × 0.6 mm) were fabricated, bonded to enamel, and sorted into four experimental groups (n = 11 each) according to the type of light-curing unit (Radii-Cal [singlewave] or Valo [polywave]) and mode of adhesive system activation (with or without previous photoactivation). Two luting agents were used: the Tetric N-Bond adhesive system and Variolink Veneer resin cement. A visible ultraviolet spectrophotometer was used to evaluate the color stability before and after UVB artificial accelerated aging for 252, 504, and 756 hours (n = 8 samples from each group). A nanohardness tester under a load of 1,000 µN was used to evaluate the nanohardness and elastic modulus (n = 3 samples from each group). Data regarding the color stability and the mechanical properties (nanohardness and elastic modulus) were subjected to analysis of variance and Tukey protected least significant difference test (α = .05). RESULTS: Prior activation of the adhesive system, the distinct light-curing units, and different aging periods exerted no significant difference on the color stability or mechanical properties of the resin cement (P > .05), except for in the group activated with Radii-Cal after 756 hours, in which the nonprevious activation showed lower color alteration compared to the previous photoactivation (P = .0285). Without prior activation of the adhesive with Valo, the polywave unit promoted higher nanohardness and elastic modulus values in the adhesive system (P < .05). CONCLUSION: In general, singlewave and polywave light-curing units promoted no difference in color stability or the mechanical properties of the adhesive interface. The prior curing of an adhesive system inside ceramic laminate is not necessary.

Effect of previous photoactivation of the adhesive system on the color stability and mechanical properties of resin components in ceramic laminate veneer luting.

STATEMENT OF PROBLEM: The color stability and mechanical properties of luting agents influence the esthetics and longevity of ceramic restorations. However, studies evaluating the color changes and mechanical properties of luting agents under ceramic laminates activated by using different methods are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the effects of different modes of photoactivation on the nanohardness and elastic modulus of resin cements and dental adhesives and on the color stability of ceramic laminate veneers. MATERIAL AND METHODS: Forty-four lithium disilicate blocks (7×8×0.6 mm) were cemented onto bovine enamel and divided into 4 groups according to the polymerization light (Radii-Cal or Valo) used and the mode of activation of the dental adhesive (no previous photoactivation or previous photoactivation). Single Bond Universal dental adhesive and RelyX Veneer resin cement were used in all experimental groups. Color stability was measured using a UV-2450 ultraviolet-visible spectrophotometer before and after ultraviolet-B artificial accelerated aging (n=8). The nanohardness and the elastic modulus of the adhesive and resin cement were measured using a nanohardness tester (n=3). The color stability and mechanical properties were measured and analyzed using ANOVA and the Tukey least significant difference test (α=.05). RESULTS: No difference in color stability or mechanical properties of the resin cement among the polymerization lights was detected (P>.05). Specimens that underwent previous photoactivation of the adhesive using the Valo polywave unit exhibited higher elastic modulus values than those that did not undergo previous photoactivation (P<.001). CONCLUSIONS: The Valo polywave polymerization light improved mechanical properties and color stability more than the Radii-Cal unit. Previous activation of the dental adhesive in the dental enamel with the Valo polywave polymerization light yielded more satisfactory results.

Effect of fiber addition on slow crack growth of a dental porcelain.

AIMS: To evaluate the effect of the processing method (conventional sintering, S, and heat-pressing, HP) and addition of potassium titanate fibers, PTF, on the microstructure, mechanical properties (flexural strength, σf, and Weibull parameters, m and σ5%), slow crack growth parameters n (stress corrosion susceptibility coefficient), and optical properties (translucency parameter, TP, and opalescence index, OI) of a feldsphatic dental porcelain. METHODS: Disks (n = 240, Ø12 × 1 mm) of porcelain (Vintage-Halo, Shofu) were produced using S and HP methods with and without addition of 10 wt% (conventional sintering) or 5 wt% (heat-pressing) of PTF. For the S method, porcelain was sintered in a conventional furnace. In the HP technique, refractory molds were produced by lost wax technique. The porcelain slurry was dry-pressed (3t/30s) to form a cylinder with 12 mm (diameter) and 20mm (height), which was heat-pressed for 5 min/3.5 bar into the mold. Specimens were tested for biaxial flexural strength in artificial saliva at 37°C. Weibull analysis was used to determine m and σ5%. Slow crack growth (SCG) parameters were determined by the dynamic fatigue test, and specimens were tested in biaxial flexure at five stress rates: 10(-2), 10(-1), 10(0), 10(1) and 10(2)MPa/s (n=10), immersed in artificial saliva at 37°C. Parameter n was calculated and statistically analyzed according to ASTM F394-78. Optical properties were determined in a spectrophotometer in the diffuse reflectance mode. RESULTS: The highest n value was obtained by the combination of heat-pressing with fiber addition (37.1) and this value was significantly higher than those obtained by both sintered groups (26.2 for control group and 27.7 for sintered with fiber). Although heat-pressing alone also resulted in higher n values compared to the sintered groups, there were no significant differences among them. Fiber addition had no effect on mechanical strength, but it resulted in decreased TP values and increased OI values for both processing methods. Heat-pressing alone was able to reduce the porosity level of the porcelain. CONCLUSIONS: Addition of PTF combined with heat-pressing can reduce strength degradation of a dental porcelain compared to sintered materials with or without fibers. Heat-pressing (HP) alone should be considered as a good alternative for clinical cases where high translucency is required.

Determination of the slow crack growth susceptibility coefficient of dental ceramics using different methods.

This study compared three methods for the determination of the slow crack growth susceptibility coefficient (n) of two veneering ceramics (VM7 and d.Sign), two glass-ceramics (Empress and Empress 2) and a glass-infiltrated alumina composite (In-Ceram Alumina). Discs (n = 10) were prepared according to manufacturers' recommendations and polished. The constant stress-rate test was performed at five constant stress rates to calculate n(d) . For the indentation fracture test to determine n(IF) , Vickers indentations were performed and the crack lengths were measured under an optical microscope. For the constant stress test (performed only for d.Sign for the determination of n(s) ) four constant stresses were applied and held constant until the specimens' fracture and the time to failure was recorded. All tests were performed in artificial saliva at 37°C. The n(d) values were 17.2 for Empress 2, followed by d.Sign (20.5), VM7 (26.5), Empress (30.2), and In-Ceram Alumina (31.1). In-Ceram Alumina and Empress 2 showed the highest n(IF) values, 66.0 and 40.2, respectively. The n(IF) values determined for Empress (25.2), d.Sign (25.6), and VM7 (20.1) were similar. The n(s) value determined for d.Sign was 31.4. It can be concluded that the n values determined for the dental ceramics evaluated were significantly influenced by the test method used.

Slow crack growth and reliability of dental ceramics.

OBJECTIVE: To determine the slow crack growth (SCG) and Weibull parameters of five dental ceramics: a vitreous porcelain (V), a leucite-based porcelain (D), a leucite-based glass-ceramic (E1), a lithium disilicate glass-ceramic (E2) and a glass-infiltrated alumina composite (IC). METHODS: Eighty disks (Ø 12 mm × 1.1mm thick) of each material were constructed according to manufacturers' recommendations and polished. The stress corrosion susceptibility coefficient (n) was obtained by dynamic fatigue test, and specimens were tested in biaxial flexure at five stress rates immersed in artificial saliva at 37 °C. Weibull parameters were calculated for the 30 specimens tested at 1 MPa/s in artificial saliva at 37 °C. The 80 specimens were distributed as follows: 10 for each stress rate (10(-2), 10(-1), 10(1), 10(2)MPa/s), 10 for inert strength (10(2)MPa/s, silicon oil) and 30 for 10(0)MPa/s. Fractographic analysis was also performed to investigate the fracture origin. RESULTS: E2 showed the lowest slow crack growth susceptibility coefficient (17.2), followed by D (20.4) and V (26.3). E1 and IC presented the highest n values (30.1 and 31.1, respectively). Porcelain V presented the lowest Weibull modulus (5.2). All other materials showed similar Weibull modulus values, ranging from 9.4 to 11.7. Fractographic analysis indicated that for porcelain D, glass-ceramics E1 and E2, and composite IC crack deflection was the main toughening mechanism. SIGNIFICANCE: This study provides a detailed microstructural and slow crack growth characterization of widely used dental ceramics. This is important from a clinical standpoint to assist the clinician in choosing the best ceramic material for each situation as well as predicting its clinical longevity. It also can be helpful in developing new materials for dental prostheses.

Abutments de cerâmica de Y-TZP e compósito Al2O3-ZrO2 / Mechanical performance of Y-TZP/Al2O3 ceramic abutments

Abutment, também denominado pilar de fixação, é um material metálico ou cerâmico, instalado acima de um implante que provê suporte para próteses dentais. O sucesso significativo destas aumentou a demanda por melhores resultados estéticos e consequentemente resulta em pesquisas para o desenvolvimento de novos componentes, materiais e conceitos de tratamento. Atualmente, os implantes mais utilizados são aqueles a base de titânio e os abutments, que também eram fabricados com materiais metálicos, estão sendo substituídos por materiais cerâmicos como alumina e zircônia estabilizada com ítria. O presente estudo propôs-se avaliar as propriedades mecânicas de pilares cerâmicos estéticos a base de compósitos alumina-zircônia (Al2O3-ZrO2) e zircônia estabilizada (ZrO2 Y-TZP), através de ensaios mecânicos, a fim de verificar sua viabilidade de produção e comercialização para utilização em procedimentos odontológicos em reabilitação oral. Para tanto, obteve-se pilares cerâmicos a base de compósitos de ZrO2 e Al2O3-ZrO2 e submeteu-os a ensaios mecânicos de fadiga cíclica úmida e carregamento por compressão tangencial. Os resultados foram avaliados por meio de avaliações macroscópicas dos corpos de prova, sobrevida de ciclos e valores de resistência à fratura. Dentro das condições experimentais, os resultados obtidos demonstraram que há possibilidade de se obter pilares de ZrO2 e Al2O3-ZrO2, usinados industrialmente, com elevada resistência mecânica e durabilidade clínica quando corretamente instalados baseado em um planejamento minucioso. Apesar da realização dos ensaios em associação, cuja finalidade foi de se aproximar das condições in vivo, os ensaios laboratoriais apresentam limitações, como os vários tipos de forças intraorais.

An abutment is a metallic or ceramic material installed onto the implant providing support for fixed dental prosthesis. The significant success these dental restorations increased patient demand for better esthetic results, which resulted in research to develop new components, materials and treatment concepts. Currently, the most widely used implants are those based on titanium; the abutments, which were also made of metallic materials, are being replaced by ceramic materials such as alumina and yttrium-stabilized zirconia (ZrO2 Y-TZP). The purpose of this study is to evaluate the mechanical properties of ceramic abutments on the aesthetic composite alumina-zirconia (Al2O3-ZrO2) and stabilized zirconia (ZrO2 Y-TZP) by mechanical tests to verify its feasibility and production marketing for use in dental procedures. The abutments ceramic composites of ZrO2 and Al2O3-ZrO2 were submitted to mechanical tests of wet cyclic fatigue and loading by tangential compression. The results were evaluated by macroscopic evaluations of the specimens, survival after cycling and values of fracture resistance. Within the experimental conditions, the results showed that is possible to produce industrially abutments of ZrO2 and Al2O3-ZrO2 with high mechanical strength and clinic success when properly installed, based on careful planning. Although tests were applied to approach in vivo conditions, there are limitations such as several intra-oral forces.

Subcritical crack growth in porcelains, glass-ceramics, and glass-infiltrated alumina composite for dental restorations.

The objective was to compare fracture toughness (K(Ic)), stress corrosion susceptibility coefficient (n), and stress intensity factor threshold for crack propagation (K(I0)) of two porcelains [VM7/Vita (V) and d.Sign/Ivoclar (D)], two glass-ceramics [Empress/Ivolcar (E1) and Empress2/Ivlocar (E2)] and a glass-infiltrated alumina composite [In-Ceram Alumina/Vita (IC)]. Disks were constructed according to each manufacturer's processing method, and polished before induction of cracks by a Vickers indenter. Crack lengths were measured under optical microscopy at times between 0.1 and 100 h. Specimens were stored in artificial saliva at 37 degrees C during the whole experiment. K(Ic) and n were determined using indentation fracture method. K(I0) was determined by plotting log crack velocity versus log K(I). Microstructure characterization was carried out under SEM, EDS, X-ray diffraction and X-ray fluorescence. IC and E2 presented higher K(Ic) and K(I0) compared to E1, V, and D. IC presented the highest n value, followed by E2, D, E1, and V in a decreasing order. V and D presented similar K(Ic), but porcelain V showed higher K(I0) and lower n compared to D. Microstructure features (volume fraction, size, aspect ratio of crystalline phases and chemical composition of glassy matrix) determined K(Ic). The increase of K(Ic) value favored the increases of n and K(I0).

Stress intensity factor threshold in dental porcelains.

The stress intensity factor threshold (KI0) is related to the stress level at which cracks start to grow stably, causing the weakening of porcelain prostheses during their use. The values of KI0 of seven dental porcelains (with and without reinforcing leucite crystal, KAlSi2O6) stored in air (22 degrees C, 60% relative humidity) and artificial saliva (37 degrees C) were determined by measuring the crack growth velocity of radial cracks generated at the corner of Vickers indentations. The results of KI0 were correlated with the leucite content, fracture toughness (KIc), and chemical composition of the porcelains. It was observed that KI0 increased with the increase of leucite content (only for the leucite-based porcelains) and with the increase of KIc. The increase in Al2O3 content or the decrease in the alkali oxide (K2O and Na2O) content of the material's glassy matrix tended to increase the KI0 values. Storage media (air and saliva) did not significantly affect the KI0 of porcelains tested, indicating that the control parameter of KI0 value was not the water content of the storage media.

Effect of ion exchange on hardness and fracture toughness of dental porcelains.

The objective of this study was to evaluate the effect of ion exchange, IE, on fracture toughness K(Ic) and hardness H of five dental porcelains with different microstructures: B, Ceramco II/Dentstply; C, Finesse/Dentsply; Cb, Cerabien/Noritake; D, d.Sign/Ivoclar; V, Vitadur Alpha/Vita. Specimens were sintered according to manufacturers' instructions, n = 10. Vickers indentations were made on specimens' surfaces before and after IE to calculate H and K(Ic). IE treatment consisted in coating the surface of the specimen with slurry of KNO(3) and distilled water, with subsequent drying for 20 min at 150 degrees C and heating for 30 min at 450 degrees C. Microstructural analysis was also performed. The measured leucite contents were 22, 15, 6, 0, and 0% for porcelains B, D, C, Cb, and V, respectively. Porcelains C, Cb, D, and V showed a significant increase in hardness after IE. Hardness of porcelain B was not affected by IE. Materials with lower leucite content tended to present higher increases in hardness after ion exchange. Ion exchange significantly increased K(Ic) between 64 and 156% of 4 out of 5 porcelains studied. Porcelain B was the only one to present a decrease in fracture toughness after ion exchange.

Influence of the finishing technique on surface roughness of dental porcelains with different microstructures.

UNLABELLED: This study compared the surface roughness of 4 dental porcelains with different microstructures (d.Sign-D, Finesse-F, Noritake-N and Symbio-S) using varied surface treatments. The porcelain surfaces were submitted to the following surface treatments: 1) g (glazing only); 2) rg (polishing with a rubber wheel before glazing); 3) 2g (reglazing); 4) r (rubber wheels); 5) rp (rubber wheels + diamond paste); 6) d (sandpaper discs) and 7) dp (sandpaper discs + diamond paste). Treatments 3 through 7 were performed after breaking the glaze layer with a diamond bur. Surface roughness (Ra, in m) was determined using a profilometer (n=10). Visual inspection was made using the scanning electron microscope. Microstructural characterization was also performed (hardness, leucite content and particle size). Reglazed specimens presented significantly rougher surfaces compared to glazed specimens. The use of a polishing paste after the sandpaper discs or after the rubber wheel resulted in a reduction of the Ra value for all materials (except for the dp group of porcelain S). Rubber or discs followed by diamond paste were the best surface treatments for porcelains D (D-rp: 0.21 +/- 0.06 microm and D-dp: 0.22 +/- 0.05 microm) and F (F-rp and F-dp: 0.17 +/- 0.03 microm). For porcelains N and S, both reglazing (2g) and the use of rubber or sandpa- per discs followed by diamond paste (groups rp and dp) resulted in similar roughness (N-2g: 0.22 +/- 0.03 microm; N-rp: 0.22 +/- 0.04 microm; N-dp: 0.20 +/- 0.04 microm, S-2g: 0.22 +/- 0.04 microm; S-rp: 0.19 +/- 0.04 microm; S-dp: 0.23 +/- 0.04 microm). CONCLUSION: The best choice of surface treatment for leucite-based porcelains depended on the material considered. Porcelains with lower leucite content (F and S) tended to present lower roughness compared to those with higher leucite content after being polished with rubbers or discs followed by diamond pastes.

Relationship between fracture toughness and flexural strength in dental porcelains.

The aim of this study was to investigate the correlation between fracture toughness (K(Ic)) and flexural strength (FS) in dental porcelains. Porcelains with different leucite contents and clinical indications were used (A, B, C, D, and E). K(Ic) was determined by surface crack in flexure method (SCF) and FS was determined by four-point-bending test. Microstructural characterization was also carried out. The leucite contents of porcelains A, B, C, D, and E were, respectively, 22, 22, 6, 15, and 0%. Materials with higher leucite content (A and B) presented significantly higher K(Ic) values compared to materials with lower leucite content (C and E). The Weibull moduli (m) of porcelains A and B were statistically higher than those of the other three materials. Regarding characteristic strength (sigma(0)), porcelains D and E showed similar values and statistically higher than those of the other materials which were statistically different from each other. According to the regression analysis, sigma(0) increased with the increase of K(Ic) until approximately 0.75 MPa m(1/2). After that, the increase in K(Ic) was accompanied by a decrease in sigma(0). However, the Weibull modulus increased with the increase in K(Ic), especially for values greater than 0.80 MPa m(1/2).