Wear Behavior of Ceramic CAD/CAM Crowns and Natural Antagonists.
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ABSTRACT:
SUBMITTER: Naumova EA
PROVIDER: S-EPMC5503368 | biostudies-other | 2017 Feb
REPOSITORIES: biostudies-other
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Project description:To demonstrate the fatigue behavior of CAD/CAM resin composite molar crowns using a mouth-motion step-stress fatigue test. Monolithic leucite-reinforced glass-ceramic crowns were used as a reference.Fully anatomically shaped monolithic resin composite molar crowns (Lava Ultimate, n=24) and leucite reinforced glass-ceramic crowns (IPS Empress CAD, n=24) were fabricated using CAD/CAM systems. Crowns were cemented on aged dentin-like resin composite tooth replicas (Filtek Z100) with resin-based cements (RelyX Ultimate for Lava Ultimate or Multilink Automix for IPS Empress). Three step-stress profiles (aggressive, moderate and mild) were employed for the accelerated sliding-contact mouth-motion fatigue test. Twenty one crowns from each group were randomly distributed among these three profiles (1:2:4). Failure was designated as chip-off or bulk fracture. Optical and electron microscopes were used to examine the occlusal surface and subsurface damages, as well as the material microstructures.The resin composite crowns showed only minor occlusal damage during mouth-motion step-stress fatigue loading up to 1700N. Cross-sectional views revealed contact-induced cone cracks in all specimens, and flexural radial cracks in 2 crowns. Both cone and radial cracks were relatively small compared to the crown thickness. Extending these cracks to the threshold for catastrophic failure would require much higher indentation loads or more loading cycles. In contrast, all of the glass-ceramic crowns fractured, starting at loads of approximately 450N.Monolithic CAD/CAM resin composite crowns endure, with only superficial damage, fatigue loads 3-4 times higher than those causing catastrophic failure in glass-ceramic CAD crowns.
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Project description:In vitro studies investigating the mechanical properties of dental reconstructions use various materials to replicate prepared teeth. However, no uniform recommendation exists as to which material is most suitable for standardized testing. The purpose of this study was to identify a material that resembles human dentin in fracture load tests. Sixteen human teeth were scanned with an intraoral scanner to obtain copies of the original crown morphology and were then prepared for crowns. Replica dies of the prepared teeth including the root morphology were fabricated with a Computer-aided design and computer-aided manufacturing (CAD/CAM) system and divided into four groups: (A) reinforced composite (RC); (B) human dentin (HD); (C) polymethyl methacrylate (PM); and (D) hybrid ceramic (HC). Sixty-four feldspar ceramic crowns were designed with the biocopy mode, fabricated with a CAD/CAM system, luted on the dies, and then with the roots embedded in polymethyl methacrylate. Care was taken to position all specimens of the same morphology identically. Thermo-mechanical load cycling was performed in a chewing simulator followed by fractural loading of the crowns. A mixed effect linear model was fitted to the data, and pairwise contrasts were estimated on the marginal means and corrected for multiple testing according to Tukey (? = 0.05). The means for fracture load (N) were 2435 N (95% CI (2162, 2709)) for hybrid ceramic, 1838 N (95% CI (1565, 2112)) for reinforced composite, 1670 N (95% CI (1396, 1943)) for human tooth and 1142 N (95% CI (868, 1415)) for polymethyl methacrylate abutment materials. Post-hoc pairwise contrasts revealed a statistically significant (p < 0.05) difference among all groups except for reinforced composite and human dentin (p = 0.76). The results indicate that the mechanical properties of abutment dies play a significant role for a possible substitution of natural teeth in in vitro studies.
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Project description:BackgroundThe aim of this study was to evaluate the protective effects of fluoride mouthwash on the surface micro-hardness of two types of CAD/CAM ceramics after exposure to acidic solutions.Methods40 samples (5 × 5 × 3 mm3) were prepared from two different ceramics: Vitabloc Mark II CAD, and IPS e.max CAD. The samples were randomly divided into 5 groups in each ceramic (n = 8) immersed in different solutions: Gs: saliva: GGA: gastric acid, GAA: acetic acid, GFGA: sodium fluoride + gastric acid, GFAA: sodium fluoride + acetic acid. The microhardness of samples was measured before and after immersion in different solutions by Vickers microhardness tester. By subtracting the microhardness values after and before immersion, the microhardness changes of the samples were obtained. Data were analyzed by Two-way analysis of variance, one-way analysis of variance, and Tukey test (α = 0.05).ResultsImmersion in different solutions reduced the microhardness. Microhardness loss was significantly affected in G FAA and G FGA groups in both types of ceramics (P < 0.05). For Vitabloc Mark II groups, the microhardness loss was significantly higher in GFAA and GFGA compared to IPS e.max CAD P < 0.001).ConclusionFluoride mouthwash in conjunction with acidic solutions may adversely affect microhardness of Vitabloc Mark II CAD, and IPS e.max CAD that may consequently compromise the clinical service. Vitabloc Mark II CAD was significantly more affected than IPS e.max CAD.
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Project description:An investigation is made of wear mechanisms in a suite of dental materials with a ceramic component and tooth enamel using a laboratory test that simulates clinically observable wear facets. A ball-on-3-specimen wear tester in a tetrahedral configuration with a rotating hard antagonist zirconia sphere is used to produce circular wear scars on polished surfaces of dental materials in artificial saliva. Images of the wear scars enable interpretation of wear mechanisms, and measurements of scar dimensions quantify wear rates. Rates are lowest for zirconia ceramics, highest for lithium disilicate, with feldspathic ceramic and ceramic-polymer composite intermediate. Examination of wear scars reveals surface debris, indicative of a mechanism of material removal at the microstructural level. Microplasticity and microcracking models account for mild and severe wear regions. Wear models are used to evaluate potential longevity for each dental material. It is demonstrated that controlled laboratory testing can identify and quantify wear susceptibility under conditions that reflect the essence of basic occlusal contact. In addition to causing severe material loss, wear damage can lead to premature tooth or prosthetic failure.
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Project description:Acid resistance of CAD/CAM resin composites. Erosion-related tooth surface loss is closely related to acid exposure, such as contact with acidic beverages or disease-related reflux. As a result, dental restorations in affected patients are also exposed to acids, which indicates that the performance and longevity of a dental restoration is impacted by the acid resistance of the individually employed restorative materials. However, unlike for ceramic materials, the acid resistance of CAD/CAM resin composites is not commonly evaluated by the manufacturers, and no standardised test methods have yet been established. Against this background, the present in vitro study aimed to examine the long-term resistance of CAD/CAM resin composites (Brilliant Crios, Cerasmart, Grandio blocs, Lava Ultimate, Shofu Block HC) against three acidic media (tonic water, acetic acid, hydrochloric acid) as well as demineralized water and to investigate potential damage mechanisms. Changes in surface roughness (Sa) were detected by confocal laser scanning microscopy (CLSM), and changes in surface hardness were measured using Vickers hardness (HV). The damage mechanisms were analysed by scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy (EDS) and micro X-ray computer tomography (µXCT). For each material, few changes in either Sa or HV were identified for at least one of the different media; for Cerasmart, the sharpest deterioration in surface properties was observed. SEM-EDS revealed leaching of barium, aluminium, and titanium from fillers in a 2 µm zone on the rough but not on the polished surface of the specimen. Within the limitations of the current study, it can be concluded that polished CAD/CAM resin composites can be recommended for clinical use in patients with erosive conditions.
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Project description:Ceramic-on-ceramic (CoC) hip bearings were tested in short-term wear tests with a systematically varied contact force. Continuous vibration and intermittent surface roughness measurements were obtained to elucidate potential causes of in vivo hip joint squeaking. The three-phase test comprised alternating cycles of edge loading (EL) and concentric articulation (CA), always using ample serum lubricant. A 50,000-cycle wear trial in which the contact force during CA was distant from the head's wear patch yielded no squeaking and practically no liner roughening. In 10-cycle trials of an edge-worn head coupled with a pristine liner, the contact force was varied in magnitude and point of application; immediate, recurrent squeaking occurred only when the contact force exceeded a critical threshold value and was centered upon the head's wear patch. In a 27,000-cycle wear trial with the contact force applied near the margin of the head's wear patch, recurrent squeaking emerged progressively as the liner's inner surface was roughened via its articulation with the worn portion of the head. The results reveal key conditions that yield recurrent squeaking in vitro in various scenarios without resorting to implausible dry conditions. A fundamental theory explains that hip squeaking is induced by myriad stress waves emanating from asperity collisions; yet, the root cause is edge loading.
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Project description:This review focuses on the wear mechanisms of natural and restorative dental materials, presenting a comprehensive description and analysis of the works published in the last two decades on the wear at the interface of occlusal surfaces. Different groups of tribological pairs were considered: tooth-tooth, tooth-restorative material (tooth-ceramic, tooth-resin-based-materials, and tooth-metal), and restorative-restorative materials. The lack of standardization of the wear tests impairs the direct comparison of the obtained results. However, it was possible to infer about the main wear mechanisms observed on the different classes of dental materials. Concerning ceramics, their toughness and surface finishing determines the wear of antagonist tooth. Abrasion revealed to be the main wear mechanisms at occlusal interface. In the case of resin-based composites, the cohesion of the organic matrix and the nature, shape, and amount of filler particles greatly influences the dental wear. The protruding and detachment of the filler particles are the main causes of abrasion of antagonist enamel. Metallic materials induce lower wear on antagonist enamel than the other classes of materials, because of their low hardness and high ductility. Most of the studies revealed plastic deformation and adhesive wear as the main wear mechanisms. Overall, more research in this area is needed for a better understanding of the mechanisms involved at the occlusal surfaces wear. This would be essential for the development of more suitable restoration materials.
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Project description:A total of 20 lithium disilicate glass-ceramics (IPS e.max CAD, Ivoclar Vivadent) and 20 resin nano-ceramic (Voco Grandio Blocks) onlay restorations were performed in 20 patients using a split-mouth design to compare the two-year clinical performance of lithium disilicate and resin nano-ceramic onlay restorations. Both restorations were evaluated at baseline, one-year, and two-year clinical follow-ups based on the modified United States Public Health Service (USPHS) criteria. Chi-square and Fisher's exact tests showed no statistically significant difference between Voco Grandio and IPS e.max ceramic restorations for all evaluated parameters during the different follow-up periods (p > 0.05). Cochrane's and MC-Nemar's tests indicated statistically significant differences regarding color match within the Voco Grandio group. They also indicated statistically significant differences in marginal discoloration, marginal adaptation, surface texture, and postoperative hypersensitivity within both ceramic material groups (p < 0.05). Kaplan-Meier curve indicated that the survival rate of both ceramic materials was 90%. After two years of clinical service, IPS e.max CAD and Voco Grandio onlay restorations exhibited similar clinical performance.
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Project description:Background: This randomized clinical trial was conducted to assess whether sleep bruxism (SB) is associated with an increased rate of technical complications (ceramic defects) in lithium disilicate (LiDi) or zirconia (Z) molar single crowns (SCs). Methods: Adult patients were classified as affected or unaffected by SB based on structured questionnaires, clinical signs, and overnight portable electromyography (BruxOff) and block randomized into four groups according to SB status and crown material (LiDi or Z): LiDi-SB (n = 29), LiDi-no SB (n = 24), Z-SB (n = 23), and Z-no SB (n = 27). Differences in technical complications (main outcome) and survival and success rates (secondary outcomes) one year after crown cementation were assessed using Fisher’s exact test with significance level α = 0.05. Results: No technical complications occurred. Restoration survival rates were 100% in the LiDi-SB and LiDi-no SB groups, 95.7% in the Z-SB group, and 96.3% in the Z-no SB group (p > 0.999). Success rates were 96.6% in the LiDi-SB group, 95.8% in the LiDi-no SB group (p > 0.999), 91.3% in the Z-SB group, and 96.3% in the Z-no SB group (p ≥ 0.588). Conclusions: With a limited observation time and sample size, no effect of SB on technical complication, survival, and success rates of molar LiDi and Z SCs was detected.
| S-EPMC9821737 | biostudies-literature
Project description:ObjectivesThe purpose of this randomized clinical trial was to compare the required time of potential clinical adjustments of posterior screw-retained monolithic zirconia implant retained crowns based on intraoral optical scanning (IOS) or conventional impressions.Materials and methodsPatients with posterior tissue level implants (Straumann RN) replacing solitary teeth were recruited. Of all patients, impressions were taken with both an IOS (3M™ TDS) and a conventional (polyether) pick-up impression. Randomization was performed after impression taking and patients were to receive either a crown based on the digital or the conventional impression. The time required for adjustments at placement was recorded. Additionally, restoration survival and mechanical complications with a follow-up of one year were documented.ResultsThirty two patients with 45 implants were included: 23 restorations in the test (IOS) and 22 in the control (conventional) group. The average adjustment time was 3.35 min (SD ± 3.38, range: 0-11 min) for the digital versus 6.09 min (SD ± 4.63, range: 0-18 min) for the conventional impressions (p = .039). A proper fit (no adjustments required) was achieved 39,1% in the digital and 18,2% conventional group respectively. All 45 restorations could be placed within the two planned appointments and only two minor mechanical complications occurred during the first year of function.ConclusionsThe use of IOS resulted in shorter adjustment times at try-in than conventional impressions for solitary CAD/CAM implant restorations. Screw-retained solitary monolithic zirconia restorations on ti-base abutments show low complication- and survival rates in the short term.
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