Brittleness index of machinable dental materials and its relation to the marginal chipping factor

OBJECTIVES: The machinability of a material can be measured with the calculation of its brittleness index (BI). It is possible that different materials with different BI could produce restorations with varied marginal integrity. The degree of marginal chipping of a milled restoration can be estimated by the calculation of the marginal chipping factor (CF). The aim of this study is to investigate any possible correlation between the BI of machinable dental materials and the CF of the final restorations. METHODS: The CERECTM system was used to mill a wide range of materials used with that system; namely the Paradigm MZ100TM (3M/ESPE), Vita Mark II (VITA), ProCAD (Ivoclar-Vivadent) and IPS e.max CAD (Ivoclar-Vivadent). A Vickers hardness Tester was used for the calculation of BI, while for the calculation of CF the percentage of marginal chipping of crowns prepared with bevelled marginal angulations was estimated. RESULTS: The results of this study showed that Paradigm MZ100 had the lowest BI and CF, while IPS e.max CAD demonstrated the highest BI and CF. Vita Mark II and ProCAD had similar BI and CF and were lying between the above materials. Statistical analysis of the results showed that there is a perfect positive correlation between BI and CF for all the materials. CONCLUSIONS: The BI and CF could be both regarded as indicators of a material’s machinability. Within the limitations of this study it was shown that as the BI increases so does the potential for marginal chipping, indicating that the BI of a material can be used as a predictor of the CF

Unified Approach to the Biomechanics of Dental Implantology

The human need for safe and effective dental implants is well-recognized. Although many implant designs have been tested and are in use today, a large number have resulted in clinical failure. These failures appear to be due to biomechanical effects, as well as biocompatibility and surgical factors. A unified approach is proposed using multidisciplinary systems technology, for the study of the biomechanical interactions between dental implants and host tissues. The approach progresses from biomechanical modeling and analysis, supported by experimental investigations, through implant design development, clinical verification, and education of the dental practitioner. The result of the biomechanical modeling, analysis, and experimental phases would be the development of scientific design criteria for implants. Implant designs meeting these criteria would be generated, fabricated, and tested in animals. After design acceptance, these implants would be tested in humans, using efficient and safe surgical and restorative procedures. Finally, educational media and instructional courses would be developed for training dental practitioners in the use of the resulting implants

Digital image correlation in dental materials and related research: A review

OBJECTIVE: Digital image correlation (DIC) is a non-contact image processing technique for full-field strain measurement. Although DIC has been widely used in engineering and biomechanical fields, it is in the spotlight only recently in dental materials. Therefore, the purpose of this review paper is introducing the working principle of the DIC technique with some modifications and providing further potential applications in various dental materials and related fields. METHODS: The accuracy of the algorithm depending on the environmental characteristics of the DIC technique, as well as the advantages and disadvantages of strain measurement using optical measurements, have been elaborated in dental materials and related fields. Applications to those researches have been classified into the following categories: shrinkage behavior of light-cured resin composite, resin-tooth interface, mechanical properties of tooth structure, crack extension and elastic properties of dental materials, and deformation of dental restoration and prosthesis. This classification and discussion were performed using literature survey and review based on numerous papers in the international journals published over the past 20 years. The future directions for predicting the precise deformation of dental materials under various environments, as well as limitations of the DIC technique, was presented in this review. RESULTS: The DIC technique was demonstrated as a more effective tool to measure full-field polymerization shrinkage of composite resin, even in a simulated clinical condition over the existing methods. Moreover, the DIC combined with other technologies can be useful to evaluate the mechanical behavior of material-tooth interface, dentine structure and restorative and prosthetic materials with high accuracy. Three-dimensional DIC using two cameras extended the measurement range in-plane to out-of-plane, enabling measure of the strain directly on the surface of dental restorations or prosthesis. SIGNIFICANCE: DIC technique is a potential tool for measuring and predicting the full-field deformation/strain of dental materials and actual prostheses in diverse clinical conditions. The versatility of DIC can replace the existing complex sensor devices in those studies

Influence of the CAD-CAM Systems on the Marginal Accuracy and Mechanical Properties of Dental Restorations

The aim of this study was to compare the quality of different computer-assisted-design and computer assisted manufacturing systems (CAD-CAM) generated by only one scanner, focusing on vertical fit discrepancies and the mechanical properties. A master model was obtained from a real clinical situation: the replacement of an absent (pontic) tooth, with the construction of a fixed partial denture on natural abutments with three elements. Nine scans were performed by each tested and 36 copies were designed using a dental CAD-CAM software (Exocad). The frameworks were manufactured using three-axis and five-axis, with the same batch of the chrome-cobalt (CrCo) alloy. The frameworks were not cemented. A focus ion beam-high resolution scanning electron microscope (FIB-HRSEM) allowed us to obtain the vertical gap measurements in five points for each specimen. Roughness parameters were measured using white light interferometry (WLI). The samples were mechanically characterized by means of flexural tests. A servo-hydraulic testing machine was used with a cross-head rate of 1 mm/min. One-way ANOVA statistical analysis was performed to determine whether the vertical discrepancies and mechanical properties were significantly different between each group (significance level p < 0.05). The overall mean marginal gap values ranged: from 92.38 ± 19.24 µm to 19.46 ± 10.20 µm, for the samples produced by three-axis and five-axis machines, respectively. Roughness was lower in the five-axis machine than the three-axis one, and as a consequence, the surface quality was better when the five-axis machine was used. These results revealed a statistically significant difference (p < 0.005) in the mean marginal gap between the CAD-CAM systems studied. The flexural strength for these restorations range from 6500 to 7000 N, and does not present any statistical differences’ significance between two CAD-CAM systems studied. This contribution suggests that the number of axes improves vertical fit and surface quality due to the lower roughness. These claims show some discrepancies with other studies

Edge Chipping Resistance and Flexural Strength of Polymer Infiltrated Ceramic Network and Resin Nanoceramic Restorative Materials

Statement of problem Two novel restorative materials, a polymer infiltrated ceramic network (PICN) and a resin nanoceramic (RNC), for computer-assisted design and computer-assisted manufacturing (CAD-CAM) applications have recently become commercially available. Little independent evidence regarding their mechanical properties exists to facilitate material selection. Purpose The purpose of this in vitro study was to measure the edge chipping resistance and flexural strength of the PICN and RNC materials and compare them with 2 commonly used feldspathic ceramic (FC) and leucite reinforced glass-ceramic (LRGC) CAD-CAM materials that share the same clinical indications. Material and methods PICN, RNC, FC, and LRGC material specimens were obtained by sectioning commercially available CAD-CAM blocks. Edge chipping test specimens (n=20/material) were adhesively attached to a resin substrate before testing. Edge chips were produced using a 120-degree, sharp, conical diamond indenter mounted on a universal testing machine and positioned 0.1 to 0.7 mm horizontally from the specimen’s edge. The chipping force was plotted against distance to the edge, and the data were fitted to linear and quadratic equations. One-way ANOVA determined intergroup differences (α=.05) in edge chipping toughness. Beam specimens (n=22/material) were tested for determining flexural strength using a 3-point bend test. Weibull statistics determined intergroup differences (α=.05). Flexural modulus and work of fracture were also calculated, and 1-way ANOVA determined intergroup differences (α=.05) Results Significant (PLRGC=FC\u3ePICN; flexural strength: RNC=LRGC\u3ePICN\u3eFC; flexural modulus: RNCLRGC=PICN\u3eFC. Conclusions The RNC material demonstrated superior performance for the mechanical properties tested compared with the other 3 materials

Mechanical Behavior and Failure Analysis of Prosthetic Retaining Screws after Long‐term Use In Vivo. Part 1: Characterization of Adhesive Wear and Structure of Retaining Screws

Purpose: The general aim of this study and those presented in Parts 2–4 of this series was to characterize the structure, properties, wear, and fracture of prosthetic retaining screws in fixed detachable hybrid prostheses after long‐term use in vivo. This part of the overall investigation addresses whether there are differences in thread wear between the screws closest to the fulcrum and those that are farthest from the fulcrum in fixed detachable hybrid prostheses. Materials and Methods: The total number of prosthetic retaining screws used in this study was 100 (10 new and 90 used). New screws (controls) from Nobel Biocare (NB) were divided into Group 1 (slotted) and Group 2 (hexed). Ninety used screws (in service 18–120 months) were retrieved from fixed detachable hybrid prostheses in 18 patients (5 screws from each patient, 60 from NB and 30 from Sterngold). The used screws were divided into 18 groups. Additionally, each group was subdivided into A and B categories. Category A contained the middle three prosthetic screws, which were considered the farthest screws from the fulcrum line. Category B contained the most posterior two screws, which were considered the screws closest to the fulcrum line. All 100 screws were subjected to thorough, nondestructive testing. Results: Light and scanning electron microscopic examination of all used screws for each group revealed surface deterioration of the active profile of the screw threads consistent with adhesive wear. The observed thread profile deterioration ranged from mild to severe. The wear was aggressive enough to cause galling, which led to thinning of the threads and, in severe cases, to knife‐edges at thread crests. In ten groups, the most anterior three screws exhibited more wear than the most posterior two screws. In addition to thread wear, severe plastic deformation was detected on the bottom part of each screw for three groups, and a long external longitudinal crack was detected in one screw of Group 2. Conclusions: The findings of this study and those presented in Parts 2–4 demonstrate that different retaining screws from the same manufacturer and/or from different manufacturers have different geometrical design, microstructures, major alloy constituents, and microhardness, and that these differences influence their preload and fractured load values. In this part of the overall investigation, the occurrence of galling as a result of wear involving prosthetic retaining screws appears to be an inevitable and unavoidable consequence of long‐term use in vivo in fixed detachable hybrid prostheses regardless of the intended/original preload value. The galling rate is greater on the middle three screws compared to the most posterior two screws in fixed detachable hybrid prostheses. The wear pattern is consistent with an adhesive wear mechanism; however, this study does not provide enough data to support a definitive analysis

FEM and Von Mises analysis on prosthetic crowns structural elements: evaluation of different applied materials

The aim of this paper is to underline the mechanical properties of dental single crown prosthodontics materials in order to differentiate the possibility of using each material for typical clinical condition and masticatory load. Objective of the investigation is to highlight the stress distribution over different common dental crowns by using computer-aided design software and a three-dimensional virtual model. By using engineering systems of analyses like FEM and Von Mises investigations it has been highlighted the strength over simulated lower first premolar crowns made by chrome cobalt alloy, golden alloy, dental resin, and zirconia. The prosthodontics crown models have been created and put on simulated chewing stresses. The three-dimensional models were subjected to axial and oblique forces and both guaranteed expected results over simulated masticatory cycle. Dental resin presented the low value of fracture while high values have been recorded for the metal alloy and zirconia. Clinicians should choose the better prosthetic solution for the teeth they want to restore and replace. Both prosthetic dental crowns offer long-term success if applied following the manufacture guide limitations and suggestions

Mechanical properties of CoCr dental-prosthesis restorations made by three manufacturing processes. Influence of the microstructure and topography

The aim of this study is to compare the mechanical properties of three different dental restorations’ manufacturing processes (CADCAM milling, casting and laser sintering) generated by only one laboratory scanner focusing on marginal fit analysis and their mechanical properties. A chrome-cobalt (Cr-Co) alloy from the same batch was used for three different methods to make an implant abutment. This simulates a maxillary right first molar that was fixed in a hemi-maxillary stone model. Five scans were performed by each tested framework. Nine frameworks were manufactured for each manufacture procedure. Field-Emission Scanning Electron Microscope (FE-SEM) direct vision was used to marginal gap measurement in five critical points for each specimen. In order to fix the samples in the microscope chamber, the restorations were submitted at a compression load of 50 N. The samples always have the same orientation and conditions. The resolution of the microscope is 4 nm and it is equipped by J image software. The microstructure of the samples was also determined with the FE-SEM equipped with EDS-microanalysis. Roughness parameters were measured using White Light Interferometry (WLI). The arithmetical mean for the Ra and Rq of each sample was calculated. The samples were mechanically characterized by means of microhardness and flexural testing. Servo-hydraulic testing machine was used with cross-head rate of 1 mm/min. Two-way ANOVA statistical analysis was performed to determine whether the marginal discrepancies and mechanical properties were significantly different between each group (significance level p < 0.05). The overall mean marginal gap values were: from 50.53 ± 10.30 µm for the samples produced by CADCAM to 85.76 ± 22.56 µm for the samples produced by the casting method. Laser sintering presents a marginal gap of 60.95 ± 20.66 µm. The results revealed a statistically significant difference (p-value < 0.005) in the mean marginal gap between the CADCAM systems studied. The higher flexure load to fracture for these restorations were for CADCAM restoration and the lower was for the casting samples. For these restorations, CADCAM Restoration yielded a higher flexure load to fracture and Casting ones yielded the lower. Porosity and microstructure play a very important role in the mechanical properties.Peer ReviewedPostprint (published version

Comparison of Different Temperatures on Bending Properties of Six Niti Endodontic File Systems

Introduction: Manufacturers claim that modern NiTi files with proprietary heat treatment transform at higher temperatures, thus staying more martensite and being more resistant to cyclic fatigue and more flexible. There are some studies comparing the effect of body temperature and room temperature on cyclic fatigue of these newer NiTi files. However, there is not yet a study published for evaluating the relationship between bending properties of NiTi instruments and temperature following the ISO 3630-1 guideline. The objective of this study was to evaluate how temperature affects the bending properties of six different brands of NiTi rotary instruments with different transformation temperature ranges. Methods: Six commercially available NiTi files were selected for this experiment. The tested files included K3 40/.04 (Sybron Endo, Orange, CA), ProFile Series 29 Green Size 6 (Dentsply Tulsa Dental Specialties), K3XF 40/.04 (Sybron Endo, Orange, CA), Vortex Blue 40/.04 (Dentsply Tulsa Dental Specialties), ProFile Vortex 40/.04 (Dentsply Tulsa Dental Specialties), and HyFlex CM™ 40/.04 (Coltène/Whaledent Inc., Cuyahoga Falls, OH). The Austenite finish temperatures of the files were 9.6 ± 0.5, 17.6 ± 0.6, 24.9 ± 1.1, 35.4 ± 1.2, 45.7 ± 0.9, and 60.3 ± 3.1, respectively. The bending properties of the files were measured using a torsiometer (Sa bri Dental Enterprises, Inc. Downers Grove IL) following ISO 3630-1 guidelines. Twelve of each file type were grouped into 3 groups based on temperatures. Each temperature group had a total of 72 files. Group 1 measured the bending moment (g.cm) at 9±2°C, group 2 at 23±2°C, and group 3 at 35±2°C. The data was statistically analyzed by ANOVA and post hoc HSD (P\u3c0.05) Results: For all tested files, the bending moment of the files increased as the temperature rose from 9to 23 to 35°C. At all temperatures, HyFlex CM was significantly more flexible than other files. ProFile Vortex, K3XF, and Vortex Blue showed similar flexibility with each other. They were significantly more flexible than ProFile Series 29, which was significantly more flexible than K3. Conclusion: Testing temperature and brand of the files were significant independent variables affecting the flexibility of the files

Effect of Increased Implant Crown Height on Fracture Strength of IPS-e.max CAD Hybrid Abutment Crown: An In-vitro Study

Introduction: The use of a secondary titanium insert has a beneficial influence on the stability of ceramic abutments and appears to be clinically useful for premolar and molar single-tooth replacements. Available titanium inserts in the market produced by Sirona, have a single height of 4.6mm with various platform diameters for different implant systems. The aim of this in-vitro study was to determine the fracture strength of IPS-e.max CAD hybrid abutment crowns with various crowns heights by simulating cyclic masticatory loads in vitro. Materials and Methods: Forty conical AstraTech EV dental implants, 4.2 mm in diameter and 9.0 mm in length were embedded 30 degree off-axis in acrylic resin blocks. Five groups (n=8/group) were designed to simulate the following treatment modalities for an implant crown #3i; Group 1 (control): Atlantis abutment and milled cemented zirconia crown with the dimensions of 11mm height, 10mm mesiodistal, 11mm buccolingual. Group 2: Atlantis CustomBase solution with milled cemented zirconia crown with the exact same dimensions as group 1. Groups 3, 4, 5: CAD/CAM hybrid abutment crown (TiBase) with the same mesiodistal and buccolingual dimensions as group 1 and different heights of the crown which were 11mm for group 3, 13mm for group 4, and 15mm for group 5. Implant position and wax-up crown were scanned with the Omnicam intraoral scanner. Lithium disilicate glass ceramic blocks (IPS e.max) were used to mill the full contour crowns in a milling machine. 100N mechanical cyclic loading at 30 degree off-axis was applied to the palatal cusps of each specimen for 250,000 cycles. Then, all survived specimens were loaded at the same angle in the universal testing machine with dislocation speed of 0.5 mm/min which increased from 0 to1000N or when fracture or deformation occurred. Removal torque value was measured after mechanical cyclic loading as well as compressive loading. A mixed-effects general linear model was employed for comparison among five groups. R-Studio and R 3.2.2 were used for all statistical analysis, and significance was accepted at p \u3c 0.05. Results: All TiBase groups did not demonstrate any significant difference in the amount of reduction in removal torque values before and after compressive loading, compared to control group (CBS). Furthermore, in the two-by-two comparison, the difference between TiBase 11mm and 15 mm was statistically significant (p value: 0.048). The fracture resistance ranged from 673.24-759.77 N for group 5, and 809.1-994.28 N for group 4. Different pattern of failure occurred for TiBase groups after compressive load test including plastic deformation of TiBase, screw bending, screw fracture, and ceramic fracture. Conclusion: Under the limitations of this study, Lithium disilicate hybrid implant supported restorations (IPS e.max CAD hybrid-abutment-crowns) with various crown heights including 11,13,15 mm did not fail during the estimate of 1-year chewing simulation. Under 1000N compressive load, all of the 15mm and most of the 13mm crowns failed, demonstrating the significant effect of the TiBase height on final fracture strength and survival of the crowns. Additional laboratory and clinical studies are needed to study the effect of the various titanium base design and abutment characteristics on the fracture strength of the complete structure