Evaluation of surface characterization and mechanical features of resin-matrix ceramics before and after different surface treatments.

STATEMENT OF PROBLEM: Surface treatments (STs) required for micromechanical interlocking can lead to alterations in the surface characterization and mechanical features of the resin-matrix ceramics (RMCs), which may jeopardize the long-term outcome of an indirect restoration. However, evidence on this issue is lacking. PURPOSE: The purpose of this in vitro study was to assess the influence of different STs on the surface roughness (SR), water contact angle (WCA), and flexural strength (FS) of RMCs. MATERIAL AND METHODS: Two hundred rectangular plates (12×14×1 mm) were prepared from 5 different RMC ingots, including a polymer-infiltrated ceramic network (Vita Enamic [VE]), 2 resin nanoceramics (Lava Ultimate [LU], Grandio Blocks [GB]), a flexible nanoparticle-filled resin (GC Cerasmart [GC]), and a reinforced composite resin (Brilliant Crios [BC]). Plates of each RMC group were further divided into 4 subgroups according to the ST applied: Control, no treatment (C); airborne-particle abrasion with aluminum oxide particles (APA); 2W- and 3W-Er,Cr:YSGG laser irradiations (LI2W, LI3W) (n=10 per ST). The SR (Ra) of each plate was recorded with a contact profilometer. WCAs (θ) of distilled water on the plates were determined by using the sessile-drop method. The FS (MPa) of each plate was measured with a universal testing machine. Data acquired for SR, WCA, and FS were statistically analyzed (α=.05). Weibull statistics were also conducted to determine the reliability of each material. RESULTS: The 2-way ANOVA showed that SR, WCA, and FS values were significantly influenced not only by all tested variables but also by their interaction terms (P<.001). All STs significantly increased the SR values (P<.05). Maximum and minimum SR values were recorded in GC-LI3W (7.06 ±0.16) and GC-C (0.07 ±0.02) groups. After STs, WCA values significantly diminished (P<.05). Maximum and minimum WCA values were recorded in LU-C (61.74 ±2.45) and VE-APA (40.38 ±1.56) groups. All STs significantly reduced the FS values (P<.05). The upper and lower FS bounds were 140.7 ±17.07 and 60.66 ±6.31, respectively, set by VG-C and GC-APA. Weibull distribution indicated that the untreated groups presented the highest m values. Among the treated groups, BC-LI3W demonstrated superior reliability (m=14.04). CONCLUSIONS: APA for LU, LI2W for VG and BC, and LI3W for GC and VE can be preferred. Although APA increased the SR and provided more wettable surfaces, it caused considerable loss of FS. Therefore, LI can be recommended as a safer ST for RMCs.

Evaluation of shade correspondence between current monolithic CAD/CAM blocks and target shade tab by considering the influence of cement shade and restorative material thickness.

It was aimed to evaluate shade matching between novel CAD/CAM blocks and the A2 target shade tab by considering the influence of cement shade and restorative material thickness on the chromatic background. A total number of 120 rectangular-shaped specimens were subtracted from four different prefabricated CAD/CAM blocks [Vita Enamic (VE), Lava Ultimate (LU), GC Cerasmart (GC), and Vita Mark II (VMII)]. These specimens had thicknesses of 0.5 mm and 1.0 mm. Three different shades (A2, opaque, and translucent) of dual-polymerized resin cement were chosen. The dentin shade (A3.5) restorative composite foundation was incrementally fabricated in a silicon mold. For control group, the A2 shade tab of the Vitapan classical shade guide was used. Different restorative material-cement-foundation assemblies were generated with optic gel. Color readings were performed by using a clinical spectrophotometer, and CIEDE2000 (ΔE00) formula was used to assess color differences. Data were statistically analyzed (α = 0.05). With increasing thickness, color difference values decreased. Higher mean ΔE00 units were observed in all restorative material sub-groups for 0.5 mm thickness. In TR shade, no statistically significant difference was detected among the mean ΔE00 values of 0.5 mm-thick restorative materials. Color differences in groups 1.0 mm-opaque-LU and 1.0 mm-opaque-GC indicated perceptible but clinically acceptable values (0.8˂ΔE00 ≤ 1.8). The highest and lowest ΔE00 units were observed in the 0.5 mm-A2-VE group (ΔE00 = 7.07) and 1 mm-opaque-GC group (ΔE00 = 1.46), respectively. Luting cement shade, restorative material type, and thickness significantly influenced the resultant color of restoration. Opaque cement on dentin foundation exhibited lower color differences.

How will surface conditioning methods influence the translucency and color properties of CAD-CAM resin-matrix ceramics with different thicknesses?

OBJECTIVE: It was aimed to evaluate the effect of various surface-conditioning methods on the translucency and color properties of resin-matrix ceramics (RMCs) with different types and thicknesses. MATERIALS AND METHODS: Rectangle-shaped RMCs were prepared from Voco Grandio, Brilliant Crios, Lava Ultimate, GC Cerasmart, and Vita Enamic blocks at 0.5 and 1.0 mm thicknesses. Specimens were divided into four groups: control, airborne-particle abrasion (APA), 2 and 3 W Er, Cr:YSGG laser irradiations (L2W , L3W ) (n = 15). The color values of specimens were recorded before and after surface-conditioning using a spectrophotometer. The translucency parameter (RTP00 ) and color difference (ΔE00 ) values were calculated. Data were statistically analyzed using three-way ANOVA and Tukey post hoc tests. RESULTS: The translucencies of RMCs decreased after all surface-conditioning procedures. L caused more decline in translucency of materials than APA. All ΔE00 values were under the acceptability threshold except for APA-applied Voco Grandio at 0.5 mm. Differences in ΔE00 values between APA and L3W groups were significant (P˂0.05); while differences between L2W and L3W groups were insignificant (P > .05). In all experimental groups, ΔE00 values decreased with increasing thickness of RMCs. CONCLUSIONS: L and APA significantly affected the translucency and color properties of RMCs. APA was found more favorable than L. CLINICAL SIGNIFICANCE: Clinicians should carefully use surface conditioning methods, considering their impact on the optical characteristics of RMCs, especially when the restoration is thin.

Effect of color of the cement and the composite resin foundation on the resultant color of resin-matrix ceramics.

STATEMENT OF PROBLEM: An improper restoration color match to the adjacent natural teeth can jeopardize esthetic success. The type of resin-matrix ceramic (RMC), the shade of the underlying foundation, and the shade of cement may affect the optical behavior of RMC materials, but studies on this issue are lacking. PURPOSE: The purpose of this in vitro study was to assess the cumulative effect of different shades of composite resin foundation (CRF) and cement on the optical behaviors of 3 different RMCs. MATERIAL AND METHODS: Forty-five rectangular RMC specimens (14×12×1 mm, shade A2) were prepared from 3 different blocks, including a polymer-infiltrated ceramic network (Vita Enamic [VE]), a resin nanoceramic (Lava Ultimate [LU]), and a flexible nanoparticle-filled resin (GC Cerasmart [GC]) (n=15 per RMC block). CRFs (14×12×4 mm) were fabricated in white and dentin shades (n=1 per composite resin shade). Cement specimens (G-CEM LinkForce) were prepared from 3 shades (A2, opaque [OP], and translucent [TR]) (n=15 per shade). For control groups, 3 rectangular RMC foundations (14×12×4 mm) were also milled from RMC blocks (n=1 per block). Color coordinates were recorded by using a digital spectrophotometer. The coordinates of 4-mm-thick RMC foundations served as the control groups. The coordinates of RMC specimens on each combination of CRF and cement served as test groups. The CIEDE2000 (ΔE00) formula was used to assess color differences. Data were subjected to 3-way ANOVA and Tukey honestly significant difference (HSD) tests (α=.05). RESULTS: ΔE00 values of specimens were influenced by the CRF shade, cement shade, RMC type, as well as the interaction terms of the 3 variables (P<.001). Color differences in groups VE-A2-dentin, VE-OP-dentin, LU-OP-dentin, and GC-OP-dentin showed perceptible but clinically acceptable values (0.8<ΔE00≤1.8). The highest and lowest ΔE00 values were observed in the white-OP-LU (5.32 ±0.34) and dentin-OP-VE (0.94 ±0.31) groups. CONCLUSIONS: Opaque cement on the white foundation led to the highest ΔE00 values in the resultant colors of all RMC groups. When used with the same shade on the dentin foundation, this cement produced clinically acceptable results.

The Effect of Surface Treatments on the Mechanical and Optical Behaviors of CAD/CAM Restorative Materials.

PURPOSE: To evaluate the effect of different surface treatments on mechanical and optical properties of lithium disilicate ceramic (IPS e.max CAD), 2 resin nanoceramics (Lava Ultimate, GC Cerasmart), and polymer-infiltrated ceramic network material (Vita Enamic). MATERIALS AND METHODS: CAD/CAM blocks were sectioned into 4 × 1 × 14 mm3 bars for three-point bending test and 1 × 8 × 8 mm3 square specimens were obtained for color and translucency measurements. Bar-shaped and square specimens were divided into five groups according to the surface treatment method as: control (no treatment), hydrofluoric acid etching, airborne-particle abrasion, 2 W and 3 W Er,Cr:YSGG laser irradiation (n = 10). Three-point bending test was carried out on a universal test machine with a 1 mm/min crosshead speed. Color and translucency measurements were performed with a spectrophotometer and repeated after surface treatments. Flexural strength, translucency parameter, and ΔE values were calculated and data were statistically analyzed using one-way ANOVA and Bonferroni post hoc tests. ΔE values >1.2 and >2.7 were considered as perceptible and unacceptable, respectively. RESULTS: All surface treatment methods decreased the flexural strength of all tested materials (P < 0.05) except for 2 W laser-irradiated and airborne-particle abraded Vita Enamic and 2 W laser irradiated Lava Ultimate (P > 0.05). Color changes of lithium disilicate specimens were not perceptible except for airborne-particle abraded specimens. All ΔE values of resin-based materials were above the perceptibility threshold. Acid-etched and 3 W laser-irradiated GC Vita Enamic specimens revealed unacceptable color changes. The translucencies of resin-based materials significantly decreased after all surface treatment applications. CONCLUSIONS: Surface treatments affected the flexural strength and optical properties of CAD/CAM restorative materials. Er,Cr:YSGG laser irradiation with 2 W energy level may be an alternative surface treatment method for CAD/CAM materials.

In-Vitro Investigation of Marginal Adaptation and Fracture Resistance of Resin Matrix Ceramic Endo-Crown Restorations.

The aim of this study was to evaluate the fracture resistance and marginal adaptation of endo-crown restorations produced from different resin-matrix ceramics (RMS) and the effects of these materials on marginal adaptation and fracture resistance. Three frasaco models were used by preparing (first) premolar teeth in three different margin preparations: butt-joint, heavy chamfer and shoulder. Each group was further divided into four subgroups according to the type of restorative material used: Ambarino High Class (AHC), Voco Grandio (VG), Brilliant Crios (BC) and Shofu (S) (n = 30). Master models were obtained using an extraoral scanner and fabricated with a milling machine. Marginal gap evaluation was performed with a silicon replica technique using a stereomicroscope. Replicas of the models (n = 120) were produced with epoxy resin. The fracture resistance of the restorations was recorded using a universal testing machine. The data were statistically analyzed using two-way ANOVA, and a t-test was applied for each group. Tukey's post-hoc test was performed to compare significant differences (p ≤ 0.05). The highest marginal gap was observed in VG, and the best marginal adaptation and the highest fracture resistance were found in BC. The lowest fracture resistance in Butt-joint preparation design was found in S. In addition, the lowest fracture resistance value in the heavy chamfer preparation design was found in AHC. The heavy shoulder preparation design displayed the highest fracture resistance values for all materials.

Micro-shear bond strengths of resin-matrix ceramics subjected to different surface conditioning strategies with or without coupling agent application.

PURPOSE: This study aimed to assess the influence of various micromechanical surface conditioning (MSC) strategies with or without coupling agent (silane) application on the micro-shear bond strength (µSBS) of resin- matrix ceramics (RMCs). MATERIALS AND METHODS: GC Cerasmart (GC), Lava Ultimate (LU), Vita Enamic (VE), Voco Grandio (VG), and Brilliant Crios (BC) were cut into 1.0-mm-thick slices (n = 32 per RMC) and separated into four groups according to the MSC strategy applied: control-no conditioning (C), air-borne particle abrasion with aluminum oxide particles (APA), 2W- and 3W-Er,Cr:YSGG group coding is missing. The specimens in each group were further separated into silane-applied and silane-free subgroups. Each specimen received two resin cement microtubules (n = 8 per subgroup). A shear force was applied to the adhesive interface through a universal test machine and µSBS values were measured. Data were statistically analyzed by using 3-way ANOVA and Tukey HSD test. Failure patterns were scrutinized under stereomicroscope. RESULTS: RMC material type, MSC strategy, and silanization influenced the µSBS values (P<.05). In comparison to the control group, µSBS values increased after all other MSC strategies (P<.05) while the differences among these strategies were insignificant (P>.05). For control and APA, there were insignificant differences between RMCs (P>.05). The silanization decreased µSBS values of RMCs except for VE. Considerable declines were observed in GC and BC (P<.05). CONCLUSION: MSC strategies can enhance bond strength values at the RMC - cement interface. However, the choice of MSC strategy is dependent on RMC material type and each RMC can require a dedicated way of conditioning.

A Comparative Study on the Mechanical Properties of a Polymer-Infiltrated Ceramic-Network Material Used for the Fabrication of Hybrid Abutment.

Polymer-infiltrated ceramic-network (PICN) material is a new type of material used for the hybrid abutments of dental implants. This study aimed to compare flexural strength, bond strengths, and fracture-resistance values of PICN with lithium disilicate ceramic (LDS) and to evaluate the effect of thermocycling on the tested parameters. Twenty specimens were fabricated using computer-aided design and manufacturing (CAD-CAM) technology for each material according to three-point bending (n = 10), microshear bond strength (µSBS), and a fracture-resistance test (hybrid abutment, n = 10). All specimens of each test group were divided into two subgroups, thermocycled or nonthermocycled. Hybrid abutments were cemented on titanium insert bases and then fixed on implants to compare fracture resistance. Failure loads were recorded for each test and data were statistically analyzed. Thermocycling decreased bond strength to the resin luting agent and the fracture-resistance values of both materials (p < 0.001), whereas flexural-strength values were not affected. LDS ceramic showed significantly higher flexural strength, bond strength, and fracture-resistance values than PICN material (p < 0.001). Within the limitations of this study, LDS may be a preferable hybrid-abutment material to PICN in terms of mechanical and bonding properties.