Fractography of clinically fractured, implant-supported dental computer-aided design and computer-aided manufacturing crowns

Today, a substantial part of the dental crown production uses computer-aided design and computer-aided manufacturing (CAD/CAM) technology. A recent step in restorative dentistry is the replacement of natural tooth structure with pre-polymerized and machined resin-based methacrylic polymers. Recently, a new CAD/CAM composite was launched for the crown indication in the load-bearing area, but the clinical reality forced the manufacturer to withdraw this specific indication. In parallel, a randomized clinical trial of CAD/CAM composite crowns luted on zirconia implant abutments revealed a high incidence of failure within the first year of service. Fractured crowns of this clinical trial were retrieved and submitted to a fractographic examination. The aim of the case series presented in this article was to identify failure reasons for a new type of CAD/CAM composite crown material (Lava Ultimate; 3M Oral Care, St. Paul, Minnesota, USA) via fractographic examinations and analytical assessment of luting surfaces and water absorption behavior. As a result, the debonding of the composite crowns from the zirconia implant abutments was identified as the central reason for failure. The adhesive interface was found the weakest link. A lack of silica at the zirconia surface certainly has compromised the bonding potential of the adhesive system from the beginning. Additionally, the hydrolytic stress released from swelling of the resin-based crown (water absorption) and transfer to the luting interface further added to the interfacial stress and most probably contributed to a great extend to the debonding failure

Cerâmica dentária: uma revisão de novos materiais e métodos de processamento.

The evolution of computerized systems for the production of dental restorations associated with the development of new microstructures for ceramic materials has caused an important change in the clinical workflow of dentists and technicians, as well as in the treatment options offered to patients. New microstructures have also been developed by the industry to offer ceramic and composite materials with optimized properties, that is, good mechanical properties, appropriate wear behavior and acceptable aesthetic characteristics. The purpose of this literature review is to discuss the main advantages and disadvantages of the new ceramic systems and processing methods. The manuscript is divided into five parts: I) monolithic zirconia restorations; II) multilayer dental prostheses; III) new glass-ceramics; IV) ceramic infiltrated by polymer; and V) new processing technologies. Dental ceramics and processing technologies have evolved significantly in the past ten years, with most of the evolution related to new microstructures and CAD-CAM methods. In addition, a trend towards the use of monolithic restorations has changed the way physicians produce all-ceramic dental prostheses, since more aesthetic restorations in several layers, unfortunately, are more prone to chipping or delamination. Composite materials processed via CAD-CAM have become an interesting option, as they have intermediate properties between ceramics and polymers and are more easily milled and polished.A evolução dos sistemas informatizados para a produção de restaurações dentárias associadas ao desenvolvimento de novas microestruturas para materiais cerâmicos causou uma mudança importante no fluxo de trabalho clínico de dentistas e técnicos, bem como nas opções de tratamento oferecidas aos pacientes. Novas microestruturas também foram desenvolvidas pela indústria para oferecer materiais cerâmicos e compósitos com propriedades otimizadas, ou seja, boas propriedades mecânicas, comportamento adequado ao desgaste e características estéticas aceitáveis. O objetivo desta revisão de literatura é discutir as principais vantagens e desvantagens dos novos sistemas cerâmicos e métodos de processamento. O manuscrito está dividido em cinco partes: I) restaurações monolíticas de zircônia; II) próteses dentárias multicamadas; III) novas vitrocerâmicas; IV) cerâmica infiltrada por polímero; e V) novas tecnologias de processamento. As cerâmicas dentárias e as tecnologias de processamento evoluíram significativamente nos últimos dez anos, com a maior parte da evolução relacionada a novas microestruturas e métodos CAD-CAM. Além disso, uma tendência ao uso de restaurações monolíticas mudou a maneira como os médicos produzem próteses dentárias totalmente em cerâmica, uma vez que as restaurações mais estéticas em várias camadas, infelizmente, são mais propensas a lascar ou delaminar. Os materiais compósitos processados ​​via CAD-CAM tornaram-se uma opção interessante, pois possuem propriedades intermediárias entre cerâmica e polímeros e são mais facilmente fresados ​​e polidos

Dental Glass Ionomer Cements as Permanent Filling Materials? – Properties, Limitations and Future Trends

Glass ionomer cements (GICs) are clinically attractive dental materials that have certain unique properties that make them useful as restorative and luting materials. This includes adhesion to moist tooth structures and base metals, anticariogenic properties due to release of fluoride, thermal compatibility with tooth enamel, biocompatibility and low toxicity. The use of GICs in a mechanically loaded situation, however, has been hampered by their low mechanical performance. Poor mechanical properties, such as low fracture strength, toughness and wear, limit their extensive use in dentistry as a filling material in stress-bearing applications. In the posterior dental region, glass ionomer cements are mostly used as a temporary filling material. The requirement to strengthen those cements has lead to an ever increasing research effort into reinforcement or strengthening concepts

Characterization of Heat-Polymerized Monomer Formulations for Dental Infiltrated Ceramic Networks

(1) Objectives: This work examined properties of dental monomer formulations of an aromatic dimethacylate (BisGMA), aliphatic urethane dimethacrylate (UDMA), and triethylene glycol dimethacrylate (TEGDMA). The monomers were combined in different ratio formulations and heat-polymerized containing the initiator benzoyl peroxide (BPO) specifically for the purpose of infiltration into polymer-infiltrated composite structures. (2) Methods: The monomers were combined in different weight ratios and underwent rheological analysis (viscosity and temperature dependence), degree of conversion, and mechanical properties (elastic modulus, hardness, fracture toughness). (3) Results: Rheological properties showed Newtonian behavior for monomers with a large dependence on temperature. The addition of BPO allowed for gelation in the range of 72.0–75.9 °C. Degree of conversion was found between 74% and 87% DC, unaffected by an increase of TEGDMA (up to 70 wt%). Elastic modulus, hardness, and fracture toughness were inversely proportional to an increase in TEGDMA. Elastic modulus and hardness were found slightly increased for UDMA versus BisGMA formulations, while fracture toughness ranged between 0.26 and 0.93 MPa·m0.5 for UDMA- and 0.18 and 0.68 MPa·m0.5 for BisGMA-based formulations. (4) Significance: Heat-polymerization allows for greater range of monomer formulations based on viscosity and degree of conversion when selecting for infiltrated composite structures. Therefore, selection should be based on mechanical properties. The measured data for fracture toughness combined with the reduced viscosity at higher UDMA:TEGDMA ratios favor such formulations over BisGMA:TEGDMA mixtures

A step toward bio-inspired dental composites

AbstractThis feasibility study aimed to develop a new composite material of aligned glass flakes in a polymer resin matrix inspired by the biological composite nacre. The experimental composite was processed by an adapted method of pressing a glass flake and resin monomer system. By pressing and allowing the excess monomer to flow out, the long axis of the flakes was aligned. The resultant anisotropic composite with silanized and non-silanized glass flakes were subjected to fracture toughness tests. We observed increasing fracture toughness with increasing crack extension (Δa) known as resistance curve (R-curve) behavior. Silanized specimens had higher stress intensity KR-Δa over non-silanized specimens, whereas non-silanized specimens had a much lower Young’s modulus, and higher nonlinear plastic-elastic JR-Δa R-curve. In comparison with conventional composites, flake-reinforced composites can sustain continued crack growth for more significant extensions. The primary toughening mechanism seen in flake-reinforced composites was crack deviation and crack branching. We produced an anisotropic model of glass flake-reinforced composite showing elevated toughening potential and a prominent R-curve effect. The feasibility of flake reinforcement of dental composites has been shown using a relatively efficient method. The use of a biomimetic, nacre-inspired reinforcement concept might guide further research toward improvement of dental restorative materials