Marginal accuracy of computer-aided design- and computer-aided manufacturing-fabricated full-arch zirconia restoration

Niwut Juntavee,1 Issarawas Sirisathit2 1Department of Prosthodontics, 2Division of Biomaterials and Prosthodontics Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand Objective: This study evaluated marginal accuracy of full-arch zirconia restoration fabricated from two digital computer-aided design and computer-aided manufacturing (CAD-CAM) systems (Trios-3 and CS3500) in comparison to conventional cast metal restoration. Materials and methods: A stainless steel model comprising two canine and two molar abutments was used as a master model for full-arch reconstruction. The canine and molar abutments were machined in a cylindrical shape with 5° taper and chamfer margin. The CAD-CAM systems based on the digital approach were used to construct the full-arch zirconia restoration. The conventional cast metal restoration was fabricated according to a conventional lost-wax technique using nickel–chromium alloys. Ten restorations were fabricated from each system. The marginal accuracy of each restoration was determined at four locations for each abutment. An analysis of variance (ANOVA) and Tukey’s honest significant difference (HSD) multiple comparisons were used to determine statistically significant difference at 95% confidence interval. Results: The mean values of marginal accuracy of restorations fabricated from conventional casting, Trios-3, and CS3500 were 48.59±4.16 μm, 53.50±5.66 μm, and 56.47±5.52 μm, respectively. ANOVA indicated significant difference in marginal fit of restorations among various systems. The marginal discrepancy of zirconia restoration fabricated from the CS3500 system demonstrated significantly larger gap than that fabricated from the 3Shape system (p<0.05). Tukey’s HSD multiple comparisons indicated that the zirconia restoration fabricated from either CS3500 or Trios-3 demonstrated a significantly larger marginal gap than the conventional cast metal restoration (p<0.05). Conclusion: Full-arch zirconia restoration fabricated from the Trios-3 illustrated better marginal fits than that from the CS3500, although, both were slightly less accurate than the conventional cast restoration. However, the marginal discrepancies of restoration produced by both CAD-CAM systems were within the clinically acceptable range and satisfactorily precise to be suggested for construction full-arch zirconia restoration. Keywords: digital dentistry, extensive reconstruction, zirconia, marginal fi

Flexural strength of various types of computerized machinable ceramic veneered to yttria stabilized tetragonal zirconia polycrystalline ceramic upon different hybridized techniques

Siripim Tangsatchatham,1 Niwut Juntavee21Division of Biomaterial and Prosthodontic Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand; 2Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, ThailandObjective: This study determined biaxial flexural strength (BFS) of computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic veneered yttria-stabilized tetragonal zirconia poly-crystalline (Y-TZP) related with hybridization techniques and veneering materials.Material and methods: One hundred and twenty zirconia Y-TZP (0.8 mm thick and 12 mm in diameter) were prepared and randomly divided into eight groups, to be conjugated with different veneering ceramics: Vitabloc (Vm), e.max-CAD (Em), Vita-Suprinity (Vs) and Celtra-Duo (Cd), using different hybridized techniques, CAD-bonded (Cb) versus CAD-fused (Cf). BFS was determined using piston on three balls and analyzed for Weilbull reliability. An analysis of variance (ANOVA) and Bonferroni’s multiple comparisons were determined for significant differences. Microscopic structures were examined with scanning electron microscope (SEM), along with X-ray diffraction (XRD).Results: BFS (mean±sd; MPa), Weibull modulus (m), and characteristic strength (σo) of each group were 630.46±65.08, 10.72, and 659.47 for VmCb, 709.03±102.88, 7.67, and 753.03 for VmCf, 651.83±69.48, 9.47, and 685.82 for EmCb, 721.17±121.28, 5.99, and 777.04 for EmCf, 692.83±89.10, 8.56, and 731.87 for VsCb, 888.61±164.26, 5.80, and 959.08 for VsCf, 687.17±59.39, 12.85, and 713.95 for CdCb, and 953.12±134.30, 7.97, and 1010.65 for CdCf. The BFS of ceramic veneered zirconia were significantly affected by different veneering ceramics, hybridized techniques, and their interactions (p<0.05). Cd showed highest BFS, followed by Vs, Em and Vm respectively. Both Cd and Vs showed significant higher BFS than Em and VM (p<0.05). No significant difference of BFS between Cd and Vs and between Em and Vm were indicated (p>0.05). Cf technique showed significantly higher impact on BFS than Cb (p<0.05). Veneering zirconia with either Cd or Vs using Cf technique revealed significantly higher flexural strength than others combinations (p<0.05).Conclusions: Type of veneering ceramics and hybridization techniques affected BFS of ceramic veneered Y-TZP. Veneering zirconia with either Cd or Vs using Cf-process produced superior BFS.Keywords: CAD-bonded, CAD-fused, ceramic veneered zirconia, flexural strengt

Clinical factors affecting the translucency of monolithic Y-TZP ceramics

The use of monolithic yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics in aesthetically critical regions is questionable because of the insufficient translucency and opacity of the restorations. Intrinsic (manufacturing process) and extrinsic factors (laboratory procedures and clinical factors) can affect the translucency of monolithic zirconia. In this narrative review, the clinical factors (thickness, cementation type, colour of the monolithic zirconia, surface finishing methods and wear, dental background, cement colour, low temperature degradation) affecting the translucency of monolithic Y-TZP ceramics were reported